Abstract
Purpose :
Limited data exists on the role of school-based eye clinics. An optometrist from the University of Michigan (UM) holds a biweekly clinic at Ypsilanti Community High School. We performed a retrospective analysis of clinical and demographic data to describe the population and design interventions to improve care.
Methods :
Students presenting to clinic received comprehensive eye exams. We collected demographic and ocular data from initial visits 2/2015-7/2019. Follow up visits were excluded. Statistical analysis was performed using SAS 9.4. The UM IRB approved the study.
Results :
429 patients visited during this period. Average age was 14.2±2.7 years. 55.7% were female, 59.7% Black, 17.9% White, and 10.9% Hispanic. 61.7% had Medicaid, 23.6% had private health insurance, and 14.8% were uninsured. 69.0% had a previous eye exam; there was no relationship between insurance and prior exam (P=0.41). Medical eye concerns included 4.2% with elevated intraocular pressure, 8.7% with amblyopia, and 0.23% with a cataract. For refractive error, 56.0% had myopia and 31.9% had hyperopia. 52.9% had presenting visual acuity (PVA) worse than 20/40 in both eyes and 15.0% had PVA 20/100 or worse in at least one eye. 58.4% had improvement in best corrected visual acuity (BCVA) of 2 or more lines; 62.7% of Black patients had 2 or more line improvement compared to 42.9% of White patients (P=0.013). There was no difference in BCVA improvement by insurance (P=0.22). 60.8% wore glasses previously; 24.1% were still wearing glasses. 56.9% of former glasses wearers reported glasses were lost or broken. There was no difference in glasses wear by insurance (P=0.078) or race (P=0.10). There was no difference in rates of myopia (P=0.28) or hyperopia (P=0.052) by race. 21 students were referred to UM for further care; 13 (61.9%) attended the appointment, 3 (14.3%) scheduled but did not attend, and 5 (23.8%) never scheduled.
Conclusions :
The school-based clinic identified important pathology. Over half wore glasses previously, but less than a quarter still wore glasses. Glasses wear was not correlated to race or insurance, suggesting barriers to glasses beyond access to care. Many students referred for further care did not attend; barriers to follow up must be addressed.
This is a 2021 ARVO Annual Meeting abstract.