Visual Impairment From Uncorrected Refractive Error among Participants in a Novel Program to Improve Eye Care Access Among Low-income Adults in Michigan

Details

• Alternative Title:
  Ophthalmology
• Personal Author:
  Killeen, Olivia J. ; Niziol, Leslie M. ; Elam, Angela R. ; Bicket, Amanda K. ; John, Denise ; Wood, Sarah Dougherty ; Musch, David C. ; Zhang, Jason ; Johnson, Leroy ; Kershaw, Martha ; Woodward, Maria A. ; Newman-Casey, Paula Anne
• Description:
  Purpose:
  
  Assess rate of visual impairment (VI) from uncorrected refractive error (URE) and associations with demographic and socioeconomic factors among low-income patients presenting to the Michigan Screening and Intervention for Glaucoma and eye Health through Telemedicine (MI-SIGHT) program.
  
  Design:
  
  Cross-sectional study.
  
  Participants:
  
  Adults ≥ 18 years without acute ocular symptoms.
  
  Methods:
  
  MI-SIGHT Program participants received a telemedicine-based eye disease screening and ordered glasses through an online optical shop. Participants were categorized based on refractive error (RE) status: VI from URE (presenting visual acuity [PVA] ≤20/50, best corrected visual acuity [BCVA] ≥20/40), URE without VI (PVA ≥20/40, had ≥2 lines of improvement to BCVA), and no or adequately corrected RE (PVA ≥20/40, <2 line improvement to BCVA). Patient demographics, self-reported visual function, and satisfaction with glasses obtained through the program were compared between groups using analysis of variance (ANOVA), Kruskal-Wallis (KW), Chi-square, and Fisher exact testing.
  
  Main Outcome Measures:
  
  PVA, BCVA, and presence of VI (defined as PVA ≤20/50)
  
  Results:
  
  Of 1171 participants enrolled in the MI-SIGHT program during the first year, average age was 55.1 years old (SD=14.5), 37.7% were male, 54.1% identified as Black, and 1166 (99.6%) had both PVA and BCVA measured. VI was observed in 120 (10.3%); 96 had VI from URE (8.2%), 168 (14.4%) had URE without VI, and 878 (75.3%) had no or adequately corrected RE. A smaller percentage of participants with VI from URE reported having a college degree and a larger percentage reported income <$10,000 compared to participants with no or adequately corrected RE (3.2% versus 14.2%, p=0.02; 45.5% versus 21.6%, respectively, p<0.0001. Visual function was lowest among participants with VI from URE, followed by those with URE without VI, and then those with no or adequately corrected RE (VFQ9 composite score 67.3±19.6 versus 77.0±14.4 versus 82.2±13.3, respectively; p<0.0001). 71.2% (n=830) ordered glasses for an average cost of $36.80±$32.60; 97.7% were satisfied with their glasses.
  
  Conclusions:
  
  URE was the main cause of VI at two clinics serving low-income communities and was associated with reduced vision related quality of life. An online optical shop with lower prices made eyeglasses accessible to low-income patients.
  
  
• Subjects:
  Adult Cross-Sectional Studies Female Humans Male Michigan Middle Aged Prevalence Quality Of Life Refractive Errors Vision, Low

  More +
• Source:
  Ophthalmology. 131(3):349-359
• Pubmed ID:
  37758028
• Pubmed Central ID:
  PMC10922592
• Document Type:
  Journal Article
• Funding:
  U01 DP006442/DP/NCCDPHP CDC HHSUnited States/
• Volume:
  131
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:2756d860630ef1ec7f54fa080c5342b1b2efc869da6549344f372d698c5bbe9a6563eb96ec1d21f16b55be3e8b5d1f275e430ca1b63895cae004b3d5f126877d
• Download URL:
  https://stacks.cdc.gov/view/cdc/151639/cdc_151639_DS1.pdf
• File Type:
  [PDF - 376.49 KB ]