Alabama Screening and Intervention for Glaucoma and Eye Health through Telemedicine (AL-SIGHT): Baseline Results

Abstract

To describe baseline results of the Alabama Screening and Intervention for Glaucoma and eye Health through Telemedicine (AL-SIGHT) for patients at federally qualified health centers (FQHC's). Candidates were persons at-risk for glaucoma associated diseases (GAD) based on age, race/ethnicity, current diagnosis of GAD, family history, and diabetes. Baseline screening visit followed by remote diagnosis and referral for follow-up examinations. Patients presenting to FQHCs ≥18 years old were enrolled and underwent screening for acuity, autorefraction, intraocular pressure, visual field testing, and fundus imaging. Results were transmitted to an ophthalmologist at UAB for diagnosis who made referrals for follow-up; follow-up attendance was noted. Questionnaires assessed participants' perspectives on screening. Primary outcomes were rates of disease detection, referral for follow-up, follow-up attendance, and participant satisfaction. Of 500 participants enrolled (mean age 58), 45.6% were African American and 51.6% White. Remote diagnostic evaluation of ocular screening by ophthalmologist revealed 30% GAD, 6.8% diabetic retinopathy, 37.6% cataract, 68.4% refractive error, 9.2% other eye conditions. 47.2% were referred for follow-up examination and for acuity 20/40 or worse or IOP ≥ 23mmHG in one or both eyes. Follow-up examination attendance was 76.7% for those referred. Participants reported being very satisfied with screening (85.8%) and the convenience of screening in their primary care clinic (92.2%). The high percentage of patients diagnosed with treatable eye conditions at telemedicine screening suggest these programs in FQHCs can be effective and scalable nationwide. Attendance when referred for follow-up examination was high. Participants welcomed screenings in their communities.