Beijing Eye Public Health Care Project

Abstract

AbstractPurpose The Beijing Eye Public Health Care Project was designed to screen all elderly subjects (age 55‐85 years) of the rural region of Greater Beijing. It was developed as preparatory step for a telemedicine based public health care system in ophthalmology in China.Methods Project participants were visited, interviewed and examined by 2500 trained barefoot doctors. If visual acuity was <0.3, subjects were referred to primary health care centers where ocular photographs were taken. Using telemedicine, the photographs were transmitted to a reading center and causes for visual impairment were diagnosed.Results Out of 692,323 eligible inhabitants, 562,788 (81.3%) subjects participated. Visual impairment in at least one eye was detected in 54,155 (9.62%) subjects, and 30,164 (5.36%) subjects had bilateral visual impairment. Ocular fundus photographs were taken for 37,281 subjects. Cause for visual impairment was cataract in 19,163 (3.41%) of all screened subjects, glaucoma in 1,606 (0.29%) subjects, diabetic retinopathy in 905 (0.16%) subjects, other macular diseases in 2,700 (0.48%) subjects, pterygium in 1381 (0.25%) subjects, and corneal leukoma in 283 (0.05%) subjects. For 5,853 (1.04%) subjects, a diagnosis of urgent cataract surgery was made. After cataract surgery, visual acuity was ≥0.3 in 1464 (91.7%) of 1596 postoperatively re‐examined subjects.Conclusion Using a telemedicine approach, the Beijing Eye Public Health Care Project developed, applied and tested an infrastructure for ophthalmic mass screening of more than 500,000 elderly inhabitants with a response rate of >80%. Besides cataract, retinal diseases including diabetic retinopathy and glaucoma were major causes for visual impairment.