Abstract
Purpose:
To evaluate the detection rates of non-glaucomatous ocular pathology requiring follow-up care and to identify the barriers to this follow-up care in a Centers for Disease Control and Prevention (CDC)-sponsored community glaucoma detection program.
Methods:
Subjects 18 or older participated in a CDC-sponsored community-based exam to detect glaucoma throughout Philadelphia, Pennsylvania. An ophthalmologist conducted a slit lamp examination, gonioscopy, and an undilated fundus exam. Octopus® perimetry and optic nerve head photography were also performed. Subjects who were recommended for follow-up ophthalmic care at their own eye care provider for non-glaucomatous ocular pathology were also recorded. These subjects were given a telephone survey to assess rates of follow-up and to evaluate potential barriers to follow-up. Survey results were correlated with attendance of a follow-up exam using the Wilcoxon nonparametric test and Fisher’s exact test.
Results:
Eight hundred and ninety-nine (899) subjects were examined from January 2013 to August 2013. One hundred three (103) subjects (11%) diagnosed with non-glaucomatous ocular pathology were recommended follow-up ophthalmic care for visually significant cataracts (6.9%), diabetic retinopathy (1.0%), macular degeneration (1.7%) and other ocular pathology (2.2%). Fifty-eight of the 103 subjects (56%) responded to the telephone survey. The average age of respondents was 58 years and females (64%) and African-Americans (69%) predominated. Of the respondents, 29% attended a follow-up appointment. Subjects who did not remember their results and recommendations were less likely to attend their follow-up appointment (p=0.036 and 0.039, respectively). Subjects’ primary language (p=0.73), education level (p=0.68), type of transportation (p=1.0), type of health insurance (p=0.18), and interval of time between their last visit to an eye specialist and the glaucoma exam (p=0.053) were not significantly associated with attending their follow-up appointment.
Conclusions:
A community-based glaucoma exam is able to detect a significant amount of non-glaucomatous ocular pathology requiring further ophthalmic follow-up. However, actual follow-up rates at participants’ own eye care provider are poor and warrant the need to continue follow-up eye care at these community sites.
Keywords: 466 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials •
463 clinical (human) or epidemiologic studies: prevalence/incidence •
460 clinical (human) or epidemiologic studies: health care delivery/economics/manpower