Abstract
Purpose :
Community vision screening initiatives provide an opportunity to identify unmet vision needs among underserved populations. The purpose of this study is to determine the proportion of patients referred for in-person follow-up from our no-cost event, reasons for referral, attendance rate of clinic appointments, and patient characteristics associated with successful clinic follow-up.
Methods :
A retrospective chart review was conducted for all participants at the 2-day Mission of Mercy (MoM) event held in Pittsburgh in 2022. Patients received visual acuity assessment and manifest refraction, and those with diabetes or concerning symptoms were offered a dilated fundus examination. Demographic information and reasons for clinic referral were documented, when applicable. Patients were referred to the university-based clinic at the discretion of the volunteer ophthalmologists. Clinic attendance and associated diagnoses were obtained from review of the university clinic’s electronic health record. Associations between patients’ clinical and demographic characteristics and appointment attendance were assessed by chi-square test and univariate binary logistical regression.
Results :
A total of 662 patients underwent vision screening at the MoM event of whom 78 (12%) were referred for clinic follow-up. The mean ± standard deviation age of patients referred was 54 ± 17 years, half (42, 54%) were women, almost all self-identified as Black (30, 46%) or White race (30, 46%), and most were English-speaking (62, 83%). Half of referred patients were unemployed (24, 45%) or uninsured (39, 51%). The most common reasons for referral were cataract (10, 13%), diabetic retinopathy (9, 12%), and glaucoma (5, 6%). All referred patients scheduled a follow-up visit, but only 35 (45%) attended the clinic appointment. Lack of health insurance was associated with less likelihood of clinic follow up (34.2% vs 61.1%,p=0.021),but other demographic factors were not, including age, race, gender, and employment status(p>0.05 for all).
Conclusions :
Despite scheduling follow-up appointments on-site and offering care at no cost, only half of patients referred from a vision screening event attended their scheduled clinic visit. Lack of health insurance was associated with less successful follow up despite offering clinic-based care at no cost. Further engagement with vulnerable populations is warranted to understand pervasive barriers to care.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.