Community screening for eye disease by laypersons: the Hoffberger program.
OBJECTIVE
To describe the results of a community-based eye screening program in Baltimore.


METHODS
Cross-sectional study.


METHODS
This was a retrospective study of the results of screening both eyes of 5352 persons who presented at multiple community sites. The screening examination had eight risk factor questions, visual acuity measurement, and a screening field test and was carried out by technicians and lay volunteers. Screened persons (screenees) received a definitive eye examination at no out-of-pocket cost, transportation was offered, and inexpensive eyeglasses were provided if needed. The main outcome measures were the rate of appointment keeping and the eye diseases identified. Telephone interviews were used to assess reasons for missing appointments and satisfaction with visits.


RESULTS
Screenees had a median age of 45 years, were 71% black, 59% female, and had estimated median annual family income of 24,000 dollars. Among 1331 screenees who scheduled a definitive examination appointment, 552 (41%) completed the visit. Data on definitive diagnosis was available in 480 out of 552 persons (87%). Reasons given for failing to come for definitive examination were: no appointment given (26%), forgot (20%), lack of transportation (9%), and lack of insurance coverage (6%). Of those who accepted a second visit date after defaulting, only 25% (41/167) appeared. Of 17 persons identified with glaucoma at screening, 4 had previously been diagnosed, but had ceased active care.


CONCLUSIONS
After community screening for eye disease, efforts to provide definitive ophthalmic examination were only modestly effective. Failure of screenees to come for examination and loss to follow up were identified as serious problems.
Quigley
Harry A
HA
Glaucoma Service and the Dana Center for Preventive Ophthalmology and the Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. hquigley@jhmi.edu
Park
Chan Kee
CK
Tracey
Patricia A
PA
Pollack
Irvin P
IP
D000368:Aged; D015142:Baltimore / Q000453:epidemiology; D003153:Community Health Services; D003430:Cross-Sectional Studies; D005128:Eye Diseases / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006282:Health Personnel; D006293:Health Promotion; D006302:Health Services Research; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010352:Patient Dropouts; D012189:Retrospective Studies; D012307:Risk Factors; D012923:Social Class; D011795:Surveys and Questionnaires; D015351:Vision Screening / Q000379:methods*; D014792:Visual Acuity; D014838:Volunteers