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Diamond DF, Hirji S, Xing SX, Gorroochurn P, Horowitz JD, Wang Q, Park L, Harizman N, Maruri SC, Henriquez DR, Liebmann JM, Cioffi GA, Hark LA. Manhattan Vision Screening and Follow-Up Study (NYC-SIGHT): optometric exam improves access and utilization of eye care services. Graefes Arch Clin Exp Ophthalmol 2024; 262:1619-1631. [PMID: 38189973 DOI: 10.1007/s00417-023-06344-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/22/2023] [Accepted: 12/12/2023] [Indexed: 01/09/2024] Open
Abstract
PURPOSE To describe the benefits of optometric evaluation for detection of vision-affecting conditions in the context of community-based eye health screenings and identify factors associated with having a recent dilated eye exam. METHODS Enrolled participants were age 40 and older, living independently in affordable housing developments in New York City. Eye health screening failure and criteria for seeing the on-site study optometrist were defined as visual acuity 20/40 or worse in either eye, intraocular pressure 23-29 mmHg, or an unreadable fundus image. The optometrist conducted a manifest refraction using loose lenses and used a portable slit lamp and ophthalmoscope to perform a non-dilated anterior and posterior segment ocular health evaluation. Demographics, social determinants of health, eye health screening results, and rates of suspected ophthalmic conditions were recorded. To determine factors associated with having a recent dilated eye exam, which was the main outcome for this statistical analysis, a stepwise multivariate logistic regression was performed. RESULTS A total of 708 participants were screened, 308 attended the optometric exam; mean age 70.7 ± 11.7 [standard deviation (SD)] years. Among this subgroup, 70.1% identified as female, 54.9% self-identified as African American, 39% as Hispanic/Latino, and 26.6% Dominican ethnicity; 78.2% (241/308) had not undergone a dilated eye exam within the last year, 71.4% reported they did not have an eye care provider. Stepwise multivariate logistic regression analysis indicated that participants who self-reported having cataracts (odds ratio (OR) 2.15; 95% confidence interval (CI) 1.03-4.47; p = 0.041), self-reported having glaucoma/glaucoma suspect (OR 5.60; 95% CI 2.02-15.43; p = 0.001), or spoke Spanish as their primary language (OR 3.25; 95% CI 1.48-7.11; p = 0.003) had higher odds of having a recent dilated eye exam. CONCLUSIONS This community-based screening initiative demonstrated the effectiveness of optometric exams in detecting vision-affecting conditions and identified factors associated with having a recent dilated eye exam. Optometrists play a vital role in increasing access to eye care for high-risk, underserved populations. TRIAL REGISTRATION ClinicalTrials.gov (NCT04271709).
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Affiliation(s)
- Daniel F Diamond
- Department of Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Sitara Hirji
- Department of Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Samantha X Xing
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Prakash Gorroochurn
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Jason D Horowitz
- Department of Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Qing Wang
- Department of Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Lisa Park
- Department of Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Noga Harizman
- Department of Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Stefania C Maruri
- Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Desiree R Henriquez
- Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Jeffrey M Liebmann
- Department of Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - George A Cioffi
- Department of Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Lisa A Hark
- Department of Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
- Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA.
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