Abstract
Purpose :
To compare the demographics, best corrected visual acuity (BCVA), severity of disease, and rate of follow up between populations seen at a free homeless eye clinic with a tertiary eye care center.
Methods :
A retrospective review was conducted on one or both eyes of 171 patients seen from November 2008 to February 2013 at a free homeless clinic in Salt Lake City, Utah. Data on one or both eyes from 181 patients seen from January 2012 to December 2013 were collected from the Moran Eye Center, at a tertiary referral center in Salt Lake City, UT. Patients that presented to the comprehensive clinic for the first time were randomly selected via the electronic medical record.
Results :
The homeless population was more likely to be male (65.5%) compared to those seen at the tertiary eye center (45.9%) and had a higher prevalence of medical comorbidities (4.17 vs 1.83, p<0.0001). 58.8 % eyes examined at the tertiary eye center compared to 35.7% of the eyes examined at the free clinic had a BCVA of 20/20 or better (p<0.0001). In eyes diagnosed with a cataract, none the eyes at the tertiary eye center had a 4+ cataract, while 19% of the homeless street clinic did (p=0.003). In those presenting to the tertiary eye center for a diabetic eye exam none had diabetic retinopathy (DR) while 45% of those at the free clinic presented with some form of DR and 25% of those had severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy. 3.87% of patients seen at the tertiary eye center were either glaucoma suspects or diagnosed with glaucoma while 12.9% of patients at the free clinic were (p=0.002). 8.3% of patients seen at the tertiary eye center and 18.0% of the free clinic patients were recommended to have a surgical procedure. 100% the patients in the tertiary eye care group completed their surgery while only 59% of the free clinic patients did (p=0.004).
Conclusions :
The homeless eye clinic patients were more likely to be male and had twice as many comorbidities as their tertiary eye care counterparts. Homeless patients on average presented with worse BCVA, higher rates of vision-threatening pathologies, and more severe cases of diabetic retinopathy, glaucoma, and cataracts. Patients seen at the free eye clinic were twice as likely to be given the recommendation to have surgery or subspecialty follow-up compared to their non-homeless counterparts, however they were less likely to receive the recommended care.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.