Purpose
Vision loss due to common ocular disease such as cataract and glaucoma is largely preventable with timely diagnosis and treatment. However, at-risk individuals may lack access to vision care. Community-based screening aims to address these issues through direct outreach to at-risk populations. In this project, we seek to evaluate a community-based ophthalmic screening program.<br /> Hypothesis: Community-based screening will aid in the timely identification of preventable cases of blindness or visual disability.
Methods
Kress Vision is a non-profit that provides free eye exams, prescription glasses, and ophthalmologic referral care to community groups. We reviewed screening data from Jan-Feb 2013. Exam results (visual acuity, tonometry, visual fields and fundoscopic exam) and demographic factors were recorded. For referrals, the reason for referral was recorded, and medical records were reviewed to determine a final diagnosis. Descriptive and correlational statistics were performed.
Results
From Jan-Feb 2013, 197 adults were screened. 113 (57.4%) were female and mean age was 43.4 (SD= 18.9). A majority of screening clients were uninsured (n=116; 58.9%) and had not received an eye exam in the past two years (n= 130; 66.0%). Uninsured clients were more likely to report never having an exam in the past (OR 4.17, 95% CI: 1.89, 9.20, p= 0.0001).<br /> Refractive errors were common: 95 (48.2%) had initial VA worse than 20/40, and 173 (87.8%) required new prescription glasses. 47 (23.9%) clients were referred for ophthalmologic care. Common reasons for referral were: glaucoma suspect (22), need for dilated exam (15), cataract (5), and pterygium (5). Ultimately, 28 clients (59.6% of referrals) had vision-threatening disease, and 12 (25.5%) received timely treatment for vision-threatening conditions, including cataract extraction (3), pterygium excision (2), glaucoma treatment (2), PRP for diabetic retinopathy (1) and others (4). Complete results are depicted in figure 1.
Conclusions
Kress Vision is a community-based screening program that is effective in the timely detection and management of vision-threatening conditions. Kress serves a largely uninsured population with a high burden of disease. The majority of persons referred from screening were found to have vision-threatening disease and a significant portion required surgical management.