title: Undetected eye disease in a primary care clinic population.
abstract: BACKGROUND
  Population-based data have indicated that a significant proportion of persons with undiagnosed ocular disease in the community are regular users of general medical services. This, combined with the high prevalence of chronic medical disorders known to be risk factors for ocular disease in such clinics, makes them an attractive site for screening.
  
  
  METHODS
  The prevalence of ocular disease was estimated in a sample of 405 general medicine patients attending an adult primary care clinic in an urban teaching hospital.
  
  
  RESULTS
  Overall, 205 (50.6%) of 405 patients were found to have clinically important ocular pathology. One third of those affected (n = 68) were unaware of their eye disease, and 26% (n = 18) of these 68 patients required immediate medical or surgical intervention. Patients 65 years or older (odds ratio [OR], 1.76), in fair or poor general health (OR, 1.78), with diabetes mellitus (OR, 2.07), or with self-reported fair or poor vision (OR, 3.03), were at increased risk for the presence of ocular disease. Among patients with eye disease, those who had no insurance coverage for eye care (OR, 3.45), those who had not had an eye examination during the previous 2 years (OR, 4.03), and those whose last eye examination was performed by an optometrist (OR, 7.25, reference ophthalmologist) were more likely to not be aware of their eye disease.
  
  
  CONCLUSIONS
  Our results underscore the importance of screening for ocular disease in primary health care settings, especially for patients who are older than 65 years, are in poor health, report poor vision, have had infrequent eye examinations, or have inadequate insurance coverage for eye care.
authors.affiliation: Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, School of Hygiene and Public Health, Baltimore, MD.
authors.forename: F
authors.initials: F
authors.lastname: Wang
authors.forename: D
authors.initials: D
authors.lastname: Ford
authors.forename: J M
authors.initials: JM
authors.lastname: Tielsch
authors.forename: H A
authors.initials: HA
authors.lastname: Quigley
authors.forename: P K
authors.initials: PK
authors.lastname: Whelton
mesh_terms: D000328:Adult; D000368:Aged; D015142:Baltimore / Q000453:epidemiology; D005128:Eye Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D015995:Prevalence; D011320:Primary Health Care; D012307:Risk Factors