Abstract
In the U.S., the prevalence of blindness is expected to double by 2050 and as many half of those with blinding eye disease are unaware of their diagnosis. Screening for vision health in the community setting may offer a key strategy to address the rising trend avoidable vision loss. However, problems with excessive referrals and low compliance with these referrals (often <50%) undermine the effectiveness of vision screening programs. We investigated the outcomes of a modified vision screening program design. Key modifications were 1) incorporating an on-site ophthalmologist during screening events; and 2) leveraging community partner resources to maximizing benefit to participants. A review of screening outcomes of 4349 particpant examinations from the Casey Eye Institute Outreach Program (CEIO program) from 01/04/2012 to 10/3½016 were analyzed for demographics and disease findings. The burden on participants to comply with referrals was lessened as 97% of participants completed definitive exams. Clinical care was recommended for 924 (21.2%) participants. Nearly four out of five participants (78.8%) were provided care for all of their immediate vision health needs (full exams, refractions, and spectacle ordering). Modifications to vision screening program design may improve their effectiveness.
Highlights
In the U.S, the prevalence of blindness and visual impairment is projected to double by 2050 (Prevention, 2006; Varma et al, 2016)
Vision health screening in the community setting can identify the major causes of vision loss in the U.S, including glaucoma, diabetic retinopathy, and macular degeneration (Mansberger, Edmunds, Johnson, Kent, & Cioffi, 2007; National Academies of Sciences et al, 2016; Quigley, Park, Tracey, & Pollack, 2002; Zhao et al, 2017)
Vision screening programs frequently report difficulties delivering efficient and cost-effective programs, which undermines support for their broader implementation. Both the U.S Preventive Services Task Force (USPSTF) and the National Academy of Science Engineering Medicine (NASEM) noted the insufficient evidence to demonstrate the benefits from vision screening or to guide screening strategies (Force, 2014; National Academies of Sciences et al, 2016)
Summary
In the U.S, the prevalence of blindness and visual impairment is projected to double by 2050 (Prevention, 2006; Varma et al, 2016). Blindness and visual impairment weigh heavily on society generally with a toll estimated at $139 annually for the U.S economy (America, 2012; Wittenborn et al, 2013). Vision screening programs frequently report difficulties delivering efficient and cost-effective programs, which undermines support for their broader implementation. In recent years, both the U.S Preventive Services Task Force (USPSTF) and the National Academy of Science Engineering Medicine (NASEM) noted the insufficient evidence to demonstrate the benefits from vision screening or to guide screening strategies (Force, 2014; National Academies of Sciences et al, 2016). These limitations will need to be addressed if community-based vision screening is to fulfil its potential as a key strategy to improve vision health in the U.S (National Academies of Sciences et al, 2016; Services, 2013)
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