Abstract
Purpose :
The Wills Eye Glaucoma Research Center, with funding from the CDC, initiated a 5-year community-based telemedicine intervention to improve detection and management of glaucoma and other eye diseases in high-risk patients in Philadelphia.
Methods :
Subjects (African Americans, Hispanic, or Asian individuals age >45; Caucasian individuals age >65; and anyone age >40 with diabetes or a family history of glaucoma) were offered eye screenings (Visit 1) in primary care physician offices and Federally Qualified Health Centers. Visit 1 consisted of an ocular, medical, and family history; fundus photographs using a non-mydriatic, auto-focus, hand-held fundus camera (Volk, Ohio, USA); intraocular pressure (IOP) measurements (iCare, Helsinki, Finland); and visual acuity testing. Subjects with abnormal images and unreadable photos were invited for a complete eye exam in the same community location (Visit 2). Satisfaction surveys were administered to all subjects at Visit 1 and analyzed independently by Westat, Inc.
Results :
From April 1, 2015 to December 1, 2015, 414 subjects consented and attended Visit 1. The mean age was 58.4 years. Subjects were predominately female (59.3%); 58% African American, 21% Caucasian, 4.1% Asian, 19.8% Hispanic/Latino and 0.8% other/mixed race. A total of 156 subjects had abnormal images (37.7%) and 62 subjects had unreadable images (15%). Fifty-three subjects (17%) had abnormal cup-to-disc ratio, 16 subjects (5.1%) had rim width <0.2 and 39 subjects (12.5%) had cup-to-disc asymmetry >0.2. Sixteen subjects (3.9%) had ocular hypertension with normal images. The majority of subjects (94%), stated they would return to this community location for a complete eye exam if a problem was found. At least 82% reported they would recommend the screening to a friend or family member and 80% said it was very convenient to have the screening in their doctor’s office.
Conclusions :
This project clearly demonstrates how community-based telemedicine screening can improve access, detection, and follow-up eye care of individuals at high-risk for glaucoma and other eye diseases. Conducting eye screenings and complete eye examinations in primary care offices and federally qualified health centers holds promise in improving follow-up eye care and delaying vision loss in high-risk populations.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.