title: Eye care services for the populations of remote districts in eastern Taiwan: a practical framework using a Mobile Vision Van Unit.
abstract: BACKGROUND
  To put a blindness prevention program into practice in remote districts of Eastern Taiwan, a Mobile Vision Van Unit (MVVU) was established to work as a community eyecare station. The aim of this study was to describe the operation and challenges encountered with this unit and its efficacy in expanding eyecare services.
  
  
  METHODS
  A population-based primary eyecare model was applied to a population in remote regions of eastern Taiwan. An MVVU, equipped with an autorefractometer, a non-contact tonometer, a slit-lamp biomicroscope, a retinoscope, an ophthalmoscope and a mini optician workshop was taken into remote areas of eastern Taiwan to provide comprehensive eyecare services. An integrated vertical referral system for further diagnosis and treatment was also employed. Data including the services provided, spectacles dispensed, health promotion activities conducted and the effectiveness of the model were collected and analysed. The main outcome measures were practicability of a primary eyecare model, prevalence of visual impairment and the major causes in middle-aged and elderly patients.
  
  
  RESULTS
  Between 2002 and 2008, a total of 600 primary eyecare services were delivered to 28 indigenous villages and remote townships in eastern Taiwan. The MVVU screened a total of 35 275 inhabitants. The ages of those screened ranged from preschool children to the elderly, and 2073 patients were referred to secondary or tertiary centres in the middle-aged and elderly blindness prevention program. On-site dispensing of low-cost spectacles and the rapid delivery of more complex prescriptions were provided without charge to 1816 participants who could not afford glasses. In addition, 118 eye health educational programs and training courses for paramedical personnel and volunteers were conducted.
  
  
  CONCLUSIONS
  An MVVU model for blindness prevention is highly feasible in its efficiency and cost-effectiveness in communities with deficient medical resources.
authors.affiliation: Department of Ophthalmology, Tzu Chi General Hospital, Hualien, Taiwan. oph.nancy.chen@gmail.com.
authors.forename: Nancy
authors.initials: N
authors.lastname: Chen
authors.affiliation: Department of Special Education, National Dong Hwa University, Shoufeng, Hualien, Taiwan. cacabao@gmail.com.
authors.forename: His-Pao
authors.initials: HP
authors.lastname: Hsieh
authors.affiliation: Institute of Eye Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan. tsai.rk@gmail.com.
authors.forename: Rong-Kung
authors.initials: RK
authors.lastname: Tsai
authors.affiliation: Department of Ophthalmology, Mennonite Christian Hospital, Hualien, Taiwan. minmuhsu@gmail.com.
authors.forename: Min-Muh
authors.initials: MM
authors.lastname: Sheu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001766:Blindness / Q000517:prevention & control*; D002648:Child; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D008952:Mobile Health Units / Q000458:organization & administration*; D020380:Needs Assessment; D011634:Public Health; D019035:Rural Health Services / Q000458:organization & administration*; D012424:Rural Population; D013624:Taiwan; D014786:Vision Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D035862:Vulnerable Populations; D055815:Young Adult
keywords: Aged Care; Asia; Community Participation; Community-Controlled Health Services; Diabetes; Epidemiology; Health Promotion; Indigenous Health Worker; Ophthalmology; Practice Tips; Procedures; Public Health