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Glaucoma exams, treatment at community-based sites improve access to care
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Researchers targeted individuals at risk for glaucoma in underserved Philadelphia communities, resulting in a detection rate of 39.1% for glaucoma-related diagnoses, according to recent research in Ophthalmology.
Black patients 50 years old or older, along with other races at least 60 years old or those with a family history of glaucoma were examined and treated in 43 community centers across underserved communities in Philadelphia.
After attending an information glaucoma workshop, 1,649 patients underwent a targeted glaucoma examination including ocular, medical and family history; visual acuity testing; IOP measurement; corneal pachymetry; slit-lamp and optic nerve examination; automated visual field testing; and fundus color photography.
A total of 39.1%, or 645 patients, received a glaucoma-related diagnosis; 20% were identified as open-angle glaucoma (OAG) suspects, 9.2% were identified as having narrow angles and 10% were diagnosed with glaucoma, including 9% with OAG and 1% with open-closure glaucoma.
Overall, 39% of those diagnosed with glaucoma were unaware of their diagnosis, according to researchers.
A total of 196 patients underwent glaucoma-related treatment: 84 patients received laser peripheral iridotomy, 13 had selective laser trabeculoplasty, and 103 were prescribed IOP-lowering medication.
“The innovation of this project lies in its successful community outreach and its linking of examination and treatment. Previously identified barriers to eye care were effectively minimized by the project’s design,” the researchers wrote.
The researchers worked to lessen the barriers to care with the use of workshops to increase glaucoma awareness, exams with same-day treatment options (offered at community-based sites), decreasing follow-ups, free examinations and on-site translators, they said. – by Abigail Sutton
Disclosure: Waisbourd received research grants from Iridex Corp., Diopsys Inc., Heidelberg Engineering, Allergan, OrCam and Merck. Please see the full study for all remaining authors’ financial disclosures.
Perspective
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Scott Anthony, OD, FAAO
Although glaucoma goes undiagnosed in a large percentage of those affected, significant barriers to care persist even after the patient is diagnosed. Much as glaucoma is considered to be a multifactorial disease, the reasons for delayed diagnosis and poor treatment compliance are multifactorial as well, with social, medical, mental health and financial issues all capable of diminishing glaucoma care.
This study highlights the benefit of glaucoma outreach programs that seek to diagnose glaucoma in an at-risk population and jump-start glaucoma care by offering same-day treatments and medication prescriptions. To improve the health literacy of the at-risk population studied, the researchers conducted a glaucoma awareness workshop prior to the screenings.
If such programs can bring awareness and sustained glaucoma care and support to at-risk populations, other communities can use this same model to help tackle this very treatable disease. Glaucoma continues to be a global public health problem, and greater efforts to reach more people are essential for eliminating it as the leading cause of irreversible blindness in the world.
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