Lisa A Hark1,2, Jennifer Adeghate3, L Jay Katz1,4, Mikdat Ulas4, Michael Waisbourd5, Alisha Maity4, Tingting Zhan6, Sarah Hegarty6, Benjamin E Leiby6, Louis R Pasquale7, Stela Leite1, Jinan B Saaddine8, Julia A Haller4,9, Jonathan S Myers1,4. 1. Wills Eye Hospital, Glaucoma Research Center, Philadelphia, Pennsylvania, USA. 2. Columbia University Vagelos College of Physicians and Surgeons, Edward S. Harkness Eye Institute, New York, New York, USA. 3. University of Pittsburgh, Department of Ophthalmology, Pittsburgh, Pennsylvania, USA. 4. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. 5. Division of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv University Sackler Faculty of Medicine, Tel-Aviv, Israel. 6. Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA. 7. Icahn School of Medicine at Mount Sinai, Department of Ophthalmology, New York, New York, USA. 8. Centers for Disease Control and Prevention, Division of Diabetes and Translational Research, Vision Health Initiative, Atlanta, Georgia, USA. 9. Wills Eye Hospital, Ophthalmologist-in-Chief, Philadelphia, Pennsylvania, USA.
Abstract
Background: Cataracts are a major cause of visual impairment and blindness in the United States and worldwide. Introduction: Risk factors for cataracts include age over 40 years, smoking, diabetes, low socioeconomic status, female sex, steroid use, ocular trauma, genetic factors, and exposure to ultraviolet-B light. Community-based telemedicine vision screenings can be an efficient method for detecting cataracts in underserved populations. The Philadelphia Telemedicine Glaucoma Detection and Follow-Up Study reports the prevalence and risk factors for cataracts in individuals screened and examined for glaucoma and other eye diseases. Materials and Methods: A total of 906 high-risk individuals were screened for glaucoma using telemedicine in seven primary care practices and four Federally Qualified Health Centers in Philadelphia. Participants with suspicious nerves or other abnormalities on fundus photographs, unreadable images, and ocular hypertension returned for an eye examination with an ophthalmologist at the same community location. Results: Of the participants screened through telemedicine, 347 (38.3%) completed a follow-up eye examination by an ophthalmologist. Of these, 267 (76.9%) were diagnosed with cataracts, of which 38 (14.2%) had visually significant cataracts. Participants who were diagnosed with visually significant cataract were more likely to be older (p < 0.001), have diabetes (p = 0.003), and worse visual acuity (p < 0.001). Discussion: Our study successfully detected and confirmed cataracts in a targeted, underserved urban population at high risk for eye disease. Conclusions: Telemedicine programs offer an opportunity to identify and refer individuals who would benefit from continuous follow-up eye care and treatment to improve visual function and quality of life.
Background: Cataracts are a major cause of visual impairment and blindness in the United States and worldwide. Introduction: Risk factors for cataracts include age over 40 years, smoking, diabetes, low socioeconomic status, female sex, steroid use, ocular trauma, genetic factors, and exposure to ultraviolet-B light. Community-based telemedicine vision screenings can be an efficient method for detecting cataracts in underserved populations. The Philadelphia Telemedicine Glaucoma Detection and Follow-Up Study reports the prevalence and risk factors for cataracts in individuals screened and examined for glaucoma and other eye diseases. Materials and Methods: A total of 906 high-risk individuals were screened for glaucoma using telemedicine in seven primary care practices and four Federally Qualified Health Centers in Philadelphia. Participants with suspicious nerves or other abnormalities on fundus photographs, unreadable images, and ocular hypertension returned for an eye examination with an ophthalmologist at the same community location. Results: Of the participants screened through telemedicine, 347 (38.3%) completed a follow-up eye examination by an ophthalmologist. Of these, 267 (76.9%) were diagnosed with cataracts, of which 38 (14.2%) had visually significant cataracts. Participants who were diagnosed with visually significant cataract were more likely to be older (p < 0.001), have diabetes (p = 0.003), and worse visual acuity (p < 0.001). Discussion: Our study successfully detected and confirmed cataracts in a targeted, underserved urban population at high risk for eye disease. Conclusions: Telemedicine programs offer an opportunity to identify and refer individuals who would benefit from continuous follow-up eye care and treatment to improve visual function and quality of life.