Outcomes of an InnerCity Vision Outreach Program

Authors: Gad Dotan Billy Truong Melanie Snitzer Colleen McCauley Sarah MartinezHelfman Kathy Santa Maria Alex V Levin

Publish Date: 2015/05/01

Volume: 133, Issue: 5, Pages: 527-532

PDF Link

Abstract

Objective  To characterize the demographic characteristics and ophthalmic conditions in children attending Give Kids Sight Day GKSD an outreach ophthalmic care program held annually in Philadelphia Pennsylvania providing vision screening and immediate treatment when neededMain Outcomes and Measures  Demographic characteristics insurance status spoken languages reasons for attending prior failure of vision screening and attendance pattern of previous events were analyzed The ophthalmological findings of these children were examined including refractive errors need for optical correction and diagnoses for which continuous ophthalmic care was necessary For children who needed ophthalmic followup the rate of return to clinic and barriers for continuous care were analyzedResults  We studied 924 children mean age 9 years age range 018 years 51 female 25 speaking a nonEnglish language coming from 584 families who attended GKSD 2012 of whom 27 were uninsured and 10 were not aware of their insurance status Fortytwo percent of participants had public insurance which covered vision care and glasses but 35 did not know their benefits and did not realize vision care was covered Fortynine percent of children attended because they failed community vision screening Provision of free glasses and failure of previous vision screening were the most common reasons families elected to attend GKSD 64 and 49 respectively Eightyfive percent of children attended GKSD 2012 for the first time whereas 15 attended prior events Glasses were provided to 61 of attendees Ten percent of the attendees needed continuous ophthalmic care most commonly for amblyopia Ten children needed ocular surgery for cataract strabismus nystagmus ptosis or nasolacrimal duct obstruction With the assistance of a social worker 59 of children requiring continuous treatment returned to the clinic compared with 2 in prior years before social worker interventionConclusions and Relevance  Programs such as GKSD can bridge the gap between successful vision screening and ophthalmic treatment a gap that often occurs in lowsocioeconomic urban populations Those with public insurance coverage for vision services may not realize these services are covered Social worker intervention is useful in overcoming common barriers to followup careVision loss is a common pediatric problem1 Unless treatment is provided promptly and effectively longterm implications on quality of life for both child and family may occur2 The 2020 US government health objectives include reducing childhood visual impairment and blindness and increasing the proportion of children undergoing vision screening3 These goals are not necessarily linked increases in US vision screening have not been matched with declines in visual impairment35 One explanation may be that some children who fail vision screening do not receive proper followup ophthalmic care This problem is more pronounced in urban lowincome minorities267

Keywords: