Implementation of a vision-screening program in rural northeastern United States

Implementation of a vision-screening program in rural northeastern United States

Edmund Tsui,1,2 Andrew N Siedlecki,3 Jie Deng,3 Margaret C Pollard,3 Sandolsam Cha,3 Susan M Pepin,4 Erin M Salcone4 1Department of Surgery, Dartmouth–Hitchcock Medical Center, Lebanon, NH, 2Department of Ophthalmology, New York University School of Medicine, New York, NY, 3Geisel School...

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Autores principales: Tsui E, Siedlecki AN, Deng J, Pollard MC, Cha S, Pepin SM, Salcone EM
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2015
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Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/edb21fac2cc24195ac515e9dcfd77b27
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spelling oai:doaj.org-article:edb21fac2cc24195ac515e9dcfd77b272021-12-02T02:39:53ZImplementation of a vision-screening program in rural northeastern United States1177-5483https://doaj.org/article/edb21fac2cc24195ac515e9dcfd77b272015-10-01T00:00:00Zhttps://www.dovepress.com/implementation-of-a-vision-screening-program-innbsprural-northeastern--peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Edmund Tsui,1,2 Andrew N Siedlecki,3 Jie Deng,3 Margaret C Pollard,3 Sandolsam Cha,3 Susan M Pepin,4 Erin M Salcone4 1Department of Surgery, Dartmouth–Hitchcock Medical Center, Lebanon, NH, 2Department of Ophthalmology, New York University School of Medicine, New York, NY, 3Geisel School of Medicine at Dartmouth, Hanover, NH, 4Section of Ophthalmology, Dartmouth–Hitchcock Medical Center, Lebanon, NH, USA Background: Rural populations comprise almost 20% of the US population and face unique barriers in receiving health care. We describe the implementation of a medical student-run free vision-screening clinic as a strategy to overcome barriers in accessing eye care in New Hampshire and Vermont.Methods: Medical students were trained by an ophthalmologist to administer screening eye examinations. Patients from New Hampshire and Vermont were enrolled through a free community clinic. Screening included a questionnaire, distance and near visual acuity, extraocular movements, confrontational visual fields, and Amsler grid. Patients who met predetermined screening criteria were referred to an ophthalmologist or optometrist for further evaluation. Data including patient demographics, appointment attendance, level of education, and diagnoses were recorded and analyzed.Results: Of 103 patients (mean age of 45.5±12.3 years, 63% female), 74/103 (72%) were referred for further evaluation, and 66/74 (89%) attended their referral appointments. Abnormal ophthalmologic examination findings were observed in 58/66 (88%) patients who attended their referral appointment. Uncorrected refractive error was the most common primary diagnosis in 38% of referred patients. Other diagnoses included glaucoma suspect (21%), retinal diseases (8%), amblyopia (8%), cataract (6%), others (6%), and normal examination (12%). Of the 8/74 (11%) referred patients who did not attend their appointments, reasons included patient cancellation of appointment, work conflicts, or forgetfulness. Patients traveled a mean distance of 16.6 miles (range: 0–50 miles) to attend screening examinations. Mean time for patients’ last effort to seek eye care was 7.1 years (range: 1–54 years).Conclusion: This study underscores the high prevalence of unmet eye care needs in a rural population. Furthermore, it demonstrates that using community health centers as a patient base for screening can yield a high referral attendance rate for this at-risk population and facilitate entrance into the eye care system in a rural setting. Keywords: vision screening, rural health, uninsuredTsui ESiedlecki ANDeng JPollard MCCha SPepin SMSalcone EMDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2015, Iss default, Pp 1883-1887 (2015)
institution DOAJ
collection DOAJ
language EN
topic Ophthalmology
RE1-994
spellingShingle Ophthalmology
RE1-994
Tsui E
Siedlecki AN
Deng J
Pollard MC
Cha S
Pepin SM
Salcone EM
Implementation of a vision-screening program in rural northeastern United States
description Edmund Tsui,1,2 Andrew N Siedlecki,3 Jie Deng,3 Margaret C Pollard,3 Sandolsam Cha,3 Susan M Pepin,4 Erin M Salcone4 1Department of Surgery, Dartmouth–Hitchcock Medical Center, Lebanon, NH, 2Department of Ophthalmology, New York University School of Medicine, New York, NY, 3Geisel School of Medicine at Dartmouth, Hanover, NH, 4Section of Ophthalmology, Dartmouth–Hitchcock Medical Center, Lebanon, NH, USA Background: Rural populations comprise almost 20% of the US population and face unique barriers in receiving health care. We describe the implementation of a medical student-run free vision-screening clinic as a strategy to overcome barriers in accessing eye care in New Hampshire and Vermont.Methods: Medical students were trained by an ophthalmologist to administer screening eye examinations. Patients from New Hampshire and Vermont were enrolled through a free community clinic. Screening included a questionnaire, distance and near visual acuity, extraocular movements, confrontational visual fields, and Amsler grid. Patients who met predetermined screening criteria were referred to an ophthalmologist or optometrist for further evaluation. Data including patient demographics, appointment attendance, level of education, and diagnoses were recorded and analyzed.Results: Of 103 patients (mean age of 45.5±12.3 years, 63% female), 74/103 (72%) were referred for further evaluation, and 66/74 (89%) attended their referral appointments. Abnormal ophthalmologic examination findings were observed in 58/66 (88%) patients who attended their referral appointment. Uncorrected refractive error was the most common primary diagnosis in 38% of referred patients. Other diagnoses included glaucoma suspect (21%), retinal diseases (8%), amblyopia (8%), cataract (6%), others (6%), and normal examination (12%). Of the 8/74 (11%) referred patients who did not attend their appointments, reasons included patient cancellation of appointment, work conflicts, or forgetfulness. Patients traveled a mean distance of 16.6 miles (range: 0–50 miles) to attend screening examinations. Mean time for patients’ last effort to seek eye care was 7.1 years (range: 1–54 years).Conclusion: This study underscores the high prevalence of unmet eye care needs in a rural population. Furthermore, it demonstrates that using community health centers as a patient base for screening can yield a high referral attendance rate for this at-risk population and facilitate entrance into the eye care system in a rural setting. Keywords: vision screening, rural health, uninsured
format article
author Tsui E
Siedlecki AN
Deng J
Pollard MC
Cha S
Pepin SM
Salcone EM
author_facet Tsui E
Siedlecki AN
Deng J
Pollard MC
Cha S
Pepin SM
Salcone EM
author_sort Tsui E
title Implementation of a vision-screening program in rural northeastern United States
title_short Implementation of a vision-screening program in rural northeastern United States
title_full Implementation of a vision-screening program in rural northeastern United States
title_fullStr Implementation of a vision-screening program in rural northeastern United States
title_full_unstemmed Implementation of a vision-screening program in rural northeastern United States
title_sort implementation of a vision-screening program in rural northeastern united states
publisher Dove Medical Press
publishDate 2015
url https://doaj.org/article/edb21fac2cc24195ac515e9dcfd77b27
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AT pepinsm implementationofavisionscreeningprograminnbspruralnortheasternunitedstates
AT salconeem implementationofavisionscreeningprograminnbspruralnortheasternunitedstates
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