Manhattan Vision Screening and Follow-up Study: Epidemiologic characteristics of individuals referred to ophthalmology

Abstract

Purpose : Higher rates of undetected eye disease have previously been identified in older individuals, minority populations, and those with low income and education level. Community-based vision screening may target at-risk populations in urban environments such as Manhattan. This study evaluates the social determinants of health of individuals who failed vision screening and received a referral to ophthalmology in the Manhattan Vision Screening and Follow-up Study.

Methods : We performed a retrospective analysis of preliminary data collected from the Manhattan Vision Screening and Follow-up Study. A total of 382 individuals aged 40 and older and living in affordable housing developments in upper Manhattan were enrolled and screened. Visual acuity, intraocular pressure, and fundus photography are measured. Participants with visual acuity equal to or worse than 20/40, or IOP 23 to 29 mmHg, or unreadable fundus images fail the screening and are scheduled with the on-site optometrist who also refers to ophthalmology. Those with an abnormal image or IOP greater than or equal to 30 mmHg are referred directly to ophthalmology.

Results : Of the 382 individuals enrolled and screened, 256 participants were ultimately referred to ophthalmology, among them 109 after optometry evaluation (Figure 1). Of this population, average age was 70.6 years old, 70.1% female, 50.7% Black/African American, 42.3% Hispanic/Latino, 79.6% unmarried, 67.1% completed less than college education, 39.8% did not speak English as a primary language, 66.3% had Medicare or Medicaid insurance, 87.5% were unemployed, 17.4% were active smokers, and 77.6% had not had an eye exam within the previous year. The most common reasons for referral to ophthalmology were glaucoma suspect (49.2%), retinal abnormality (42.2%), and cataract (14.8%).

Conclusions : This study identified African American and Hispanic race, single marital status, low education level, federal insurance, and unemployment as common epidemiologic characteristics of individuals who needed referral to ophthalmology. Identifying social determinants of health that prevent detection of eye disease may help providers target at-risk populations, and improve access to and utilization of eye care services.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

Figure 1