Manhattan Vision Screening and Follow-Up Study (NYC-SIGHT): optometric exam improves access and utilization of eye care services

Details

• Alternative Title:
  Graefes Arch Clin Exp Ophthalmol
• Personal Author:
  Diamond, Daniel F. ; Hirji, Sitara ; Xing, Samantha X. ; Gorroochurn, Prakash ; Horowitz, Jason D. ; Wang, Qing ; Park, Lisa ; Harizman, Noga ; Maruri, Stefania C. ; Henriquez, Desiree R. ; Liebmann, Jeffrey M. ; Cioffi, George A. ; Hark, Lisa A.
• Description:
  Purpose
  
  To describe the benefits of optometric evaluation for detection of vision-affecting conditions in the context of community-based eye health screenings and identify factors associated with having a recent dilated eye exam.
  
  Methods
  
  Enrolled participants were age 40 and older, living independently in affordable housing developments in New York City. Eye health screening failure and criteria for seeing the on-site study optometrist were defined as visual acuity 20/40 or worse in either eye, intraocular pressure 23–29 mmHg, or an unreadable fundus image. The optometrist conducted a manifest refraction using loose lenses and used a portable slit lamp and ophthalmoscope to perform a non-dilated anterior and posterior segment ocular health evaluation. Demographics, social determinants of health, eye health screening results, and rates of suspected ophthalmic conditions were recorded. To determine factors associated with having a recent dilated eye exam, which was the main outcome for this statistical analysis, a stepwise multivariate logistic regression was performed.
  
  Results
  
  A total of 708 participants were screened, 308 attended the optometric exam; mean age 70.7 ± 11.7 [standard deviation (SD)] years. Among this subgroup, 70.1% identified as female, 54.9% self-identified as African American, 39% as Hispanic/Latino, and 26.6% Dominican ethnicity; 78.2% (241/308) had not undergone a dilated eye exam within the last year, 71.4% reported they did not have an eye care provider. Stepwise multivariate logistic regression analysis indicated that participants who self-reported having cataracts (odds ratio (OR) 2.15; 95% confidence interval (CI) 1.03–4.47; p = 0.041), self-reported having glaucoma/glaucoma suspect (OR 5.60; 95% CI 2.02–15.43; p = 0.001), or spoke Spanish as their primary language (OR 3.25; 95% CI 1.48–7.11; p = 0.003) had higher odds of having a recent dilated eye exam.
  
  Conclusions
  
  This community-based screening initiative demonstrated the effectiveness of optometric exams in detecting vision-affecting conditions and identified factors associated with having a recent dilated eye exam. Optometrists play a vital role in increasing access to eye care for high-risk, underserved populations.
  
  Trial registration
  
  ClinicalTrials.gov (NCT04271709).
  
  
• Subjects:
  Adult Aged Aged, 80 And Over Cataract Female Follow-Up Studies Glaucoma Humans Middle Aged Ocular Hypertension Vision Disorders Vision Screening

  More +
• Keywords:
  Community-based Eye Health Screening Health-care Access Optometric Exam Optometrist Refraction Vision Impairment
• Source:
  Graefes Arch Clin Exp Ophthalmol. 262(5):1619-1631
• DOI:
  http://dx.doi.org/10.1007/s00417-023-06344-2
• Pubmed ID:
  38189973
• Pubmed Central ID:
  PMC11748831
• Document Type:
  Journal Article
• Funding:
  U01 DP006435/DP/NCCDPHP CDC HHSUnited States/ ; U01 DP006436/DP/NCCDPHP CDC HHSUnited States/ ; U01DP006436/DP/NCCDPHP CDC HHSUnited States/ ; U01DP006435/DP/NCCDPHP CDC HHSUnited States/
• Volume:
  262
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:b732923a99b177498a011c79fda7c166b5a5475dfea1db0cb0f355e85b3cef15f6f51e68bafeed0b2446843e34207788c8f5c0719439ee99e64f04593c2a983e
• Download URL:
  https://stacks.cdc.gov/view/cdc/175935/cdc_175935_DS1.pdf
• File Type:
  [PDF - 777.71 KB ]