Ocular Screening Study

Abstract

Purpose : Community glaucoma screening programs identify glaucoma patients with the goal of early diagnosis and intervention, but the effectiveness of these programs has not been adequately studied. We retrospectively utilized a cohort of glaucoma suspect subjects identified at local community health fairs and prospectively conducted phone interviews 2.5 years later to determine the rate of eye care follow-up and factors associated with failure to follow-up.

Methods : We reviewed available records of persons who received glaucoma screening from our institution community outreach at 6 different health fair locations, all in low socioeconomic areas in South Florida from October 2012 to March 2013. During the screening, visual acuity using current refractive correction, FDT visual field (if VA<20/40), intraocular eye pressure (IOP), and cup-to-disc ratio were obtained. Glaucoma suspects were defined as having either an IOP of > 24 mm Hg or cup-to-disc ratio of 0.6 > in either eye. Missed sectors on FDT VF was used to corroborate other findings. Using internet search services for current phone numbers, a standardized scripted telephone survey was prospectively administered to the identified glaucoma suspects in June to July 2015 to determine eye care follow-up and any factors that may have influenced lack of follow-up.

Results : Of the 144 glaucoma suspect identified, 72 (50%) responded to the follow-up phone survey; of the 72 respondents, 69% were African American and 51% were Haitian. Subjects with health insurance were significantly more likely to follow up than those who were uninsured (73% vs 39%, p=0.005). Other reasons for lack of follow up included “Not Worried” (14%) and “No Time” (4%). No other differences between patients who did and did not follow up were found, including: education (p=0.15), gender (p=0.48), race, or ethnicity.

Conclusions : Our data show the lack of insurance is the greatest barrier to obtaining follow-up among glaucoma suspects identified in the community glaucoma screenings. The results suggest the effectiveness of community glaucoma screening may be limited unless sustainable health insurance is available.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.