Community screening for eye disease by laypersons: the Hoffberger program☆
Section snippets
Methods
The Hoffberger Program for the Prevention of Blindness is a community-based vision screening program begun in Baltimore, Maryland, in 1996 and is funded by three charitable foundations. In this report, a retrospective review of cross-sectional data are presented to evaluate specific program outcomes. In particular, the outcomes of greatest interest were the proportion of screened persons (screenees) who came for definitive examination and what eye diseases they exhibited. Among nearly 13,000
Results
From 1996 to 2000, data for 5352 screenees in the East Baltimore program were available for analysis, representing 97.7% of the total of 5473 screenees. Of these, 3155 met one or more of the referral criteria. Our staff found that 2000 of these were not receiving regular eye care and were offered an examination within the program. A total of 1331 persons agreed to be scheduled for a definitive examination at the Wilmer Institute (25% of all screenees, 42% of those who met one or more screening
Discussion
In the United States, higher rates of visual impairment and blindness are associated with lower socioeconomic status, minority ethnic status, and older age.7, 8, 9 While genetic makeup may explain some differences in disease prevalence,10, 11 the higher rates of eye disease among economically disadvantaged persons may be related to barriers to eye care access. Black Americans have lower rates of eye care visits and surgery for glaucoma than would be estimated from the age-specific prevalence of
Acknowledgements
The authors thank Adrian Mosley, Lane Cameron, Laura McKiernan, Ondra Walker, Patrice Tucker, Yvonne Blake, Yana Rachinskaya, Felicia Keel, Eve Higginbotham, MD, Nancy Ellish, PhD, and the other members of the Hoffberger Program staff, Irvin Fuss, OD, the clergy of East Baltimore, the Maryland Society for Sight, and our many volunteers for their hard work and devotion to their community and to this program.
References (21)
- et al.
Eye care for elderly Americans with diabetes mellitus. Failure to meet current guidelines
Ophthalmology
(1996) - et al.
Prevent Blindness America visual field screening study. The Prevent Blindness America Glaucoma Advisory Committee
Am J Ophthalmol
(1995) - et al.
The cause-specific prevalence of visual impairment in an urban population. The Baltimore Eye Survey
Ophthalmology
(1996) - et al.
Risk factors for non-compliance with glaucoma follow-up visits
Ophthalmology
(1998) The number of persons with glaucoma worldwide
Br J Ophthalmol
(1996)- et al.
Barriers to compliance with screening guidelines for diabetic retinopathy
Ophthalmic Epidemiol
(1999) - et al.
A hand held OKP chart for screening of glaucoma
Eye
(1990) Identification of glaucomatous visual field abnormality with the screening protocol of frequency doubling technology
Am J Ophthalmol
(1998)- et al.
The Baltimore Eye Survey Research Group. Blindness and visual impairment in an American urban populationthe Baltimore Eye Survey
Arch Ophthalmol
(1990) - et al.
Causes of blindness and visual impairment in a population of older Americansthe SEE study
Arch Ophthalmol
(2000)
Cited by (97)
Alabama Screening and Intervention for Glaucoma and Eye Health through Telemedicine (AL-SIGHT): Baseline Results
2024, American Journal of OphthalmologyImproving Access to Eye Care: A Systematic Review of the Literature
2022, OphthalmologyCitation Excerpt :According to a cross-sectional survey of 540 patients using the Primary Care Assessment Tool, a positive association was observed between medical-home performance and improvements in diabetic care process measures as reported by patients, even those in low socioeconomic settings. Nevertheless, some investigators maintain that despite removal of existing barriers to care, inducing individuals to follow up with vision examination and treatment is still challenging, disrupting continuity of care and rendering community programs inefficient and suboptimal.157 For example, Hamilton Health Center, a federally qualified community health center, implemented a Diabetes Healthy Outcomes Program for uninsured patients in 2008, using case managers, patient educators, physical activity coaches, and clinical pharmacies to deliver coordinated services ranging from diabetes counseling to ophthalmology examinations during 4 office visits per year.
An Initiative to Improve Follow-up of Patients with Glaucoma
2021, Ophthalmology ScienceFollow-up Adherence and Barriers to Care for Pediatric Glaucomas at a Tertiary Care Center
2021, American Journal of Ophthalmology
- ☆
Supported in part by grants from the Aaron Straus and Lillie Straus Foundation, Baltimore, MD, the Hoffberger Foundation, Baltimore, MD, and the Local Initiatives Program of the Robert Wood Johnson Foundation, Princeton, NJ.