title: Improving Access to Eye Care among Persons at High-Risk of Glaucoma in Philadelphia--Design and Methodology: The Philadelphia Glaucoma Detection and Treatment Project.
abstract: OBJECTIVE
  The Wills Eye Glaucoma Research Center initiated a 2-year demonstration project to develop and implement a community-based intervention to improve detection and management of glaucoma in Philadelphia.
  
  
  METHODS
  The glaucoma detection examination consisted of: ocular, medical, and family history; visual acuity testing; corneal pachymetry; biomicroscopy of the anterior segment; intraocular pressure (IOP) measurement; gonioscopy; funduscopy; automated visual field testing; and fundus-color photography. Treatment included laser surgery and/or IOP-lowering medication. A cost analysis was conducted to understand resource requirements. Outcome measures included; prevalence of glaucoma-related pathology and other eye diseases among high-risk populations; the impact of educational workshops on level of knowledge about glaucoma (assessed by pre- and post-test evaluation); and patient satisfaction of the glaucoma detection examinations in the community (assessed by satisfaction survey). Treatment outcome measures were change in IOP at 4-6 weeks and 4-6 months following selective laser trabeculoplasty treatment, deepening of the anterior chamber angle following laser-peripheral iridotomy treatment, and rate of adherence to recommended follow-up examinations. Cost outcomes included total program costs, cost per case of glaucoma detected, and cost per case of ocular disease detected.
  
  
  RESULTS
  This project enrolled 1649 participants (African Americans aged 50+ years, adults 60+ years and individuals with a family history of glaucoma). A total of 1074 individuals attended a glaucoma educational workshop and 1508 scheduled glaucoma detection examination appointments in the community setting.
  
  
  CONCLUSIONS
  The Philadelphia Glaucoma Detection and Treatment Project aimed to improve access and use of eye care and to provide a model for a targeted community-based glaucoma program.
authors.affiliation: Wills Eye Hospital, Glaucoma Research Center, Philadelphia, PA, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Hark
authors.affiliation: Wills Eye Hospital, Glaucoma Research Center, Philadelphia, PA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Waisbourd
authors.affiliation: Wills Eye Hospital, Glaucoma Research Center, Philadelphia, PA, USA.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Myers
authors.affiliation: Temple University School of Medicine, Department of Ophthalmology, Philadelphia, PA, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Henderer
authors.affiliation: Vision Health Initiative, Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Crews
authors.affiliation: Vision Health Initiative, Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Jinan B
authors.initials: JB
authors.lastname: Saaddine
authors.affiliation: Wills Eye Hospital, Glaucoma Research Center, Philadelphia, PA, USA.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Molineaux
authors.affiliation: Wills Eye Hospital, Glaucoma Research Center, Philadelphia, PA, USA.
authors.forename: Deiana
authors.initials: D
authors.lastname: Johnson
authors.affiliation: Wills Eye Hospital, Glaucoma Research Center, Philadelphia, PA, USA.
authors.forename: Harjeet
authors.initials: H
authors.lastname: Sembhi
authors.affiliation: Wills Eye Hospital, Glaucoma Research Center, Philadelphia, PA, USA.
authors.forename: Shayla
authors.initials: S
authors.lastname: Stratford
authors.affiliation: Wills Eye Hospital, Glaucoma Research Center, Philadelphia, PA, USA.
authors.forename: Ayman
authors.initials: A
authors.lastname: Suleiman
authors.affiliation: Thomas Jefferson University School of Pharmacy, Philadelphia, PA, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Pizzi
authors.affiliation: Wills Eye Hospital, Glaucoma Research Center, Philadelphia, PA, USA.
authors.forename: George L
authors.initials: GL
authors.lastname: Spaeth
authors.affiliation: Wills Eye Hospital, Glaucoma Research Center, Philadelphia, PA, USA.
authors.forename: L Jay
authors.initials: LJ
authors.lastname: Katz
mesh_terms: D003153:Community Health Services / Q000458:organization & administration*; D003266:Continuity of Patient Care; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000191:economics / Q000601:surgery; D006068:Gonioscopy; D015438:Health Behavior; D017048:Health Care Costs; D006297:Health Services Accessibility / Q000458:organization & administration*; D006782:Hospitals, Special; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000458:organization & administration; D015143:Philadelphia; D012107:Research Design; D012307:Risk Factors; D014065:Tonometry, Ocular; D014130:Trabeculectomy / Q000379:methods; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D035862:Vulnerable Populations
keywords: Access to eye care; community-based; glaucoma detection; glaucoma treatment; underserved population