Improved access could boost glaucoma screening program

Increasing the number of ophthalmologists who conduct glaucoma screenings in low-access areas for the EyeCare America Glaucoma EyeCare Program (GEP) may improve the success of the program, said Steven L. Mansberger, MD, MPH.

The GEP is a public service program wherein people are encouraged via a mass marketing campaign to schedule a glaucoma screening by visiting a Web site or calling a toll-free telephone number. To be eligible, patients must not have had an eye exam within the past 12 months, must not have insurance through a health maintenance organization or veterans' program, and must have a risk factor for glaucoma (aged more than 40 years, family history of glaucoma, African-American race, etc.). Ophthalmologists conducting GEP eye exams are supposed to fill out outcome forms for all referred patients, indicating whether a referred patient finished an eye exam as well as the results of the exam.

Dr. Mansberger, of the Devers Eye Institute, Portland, OR, discussed a review of 790 outcomes forms (12.5%) submitted for 6,343 patients who had been referred to the GEP.

Investigators found no difference in gender, age, percent ethnicity, family history of glaucoma, history of diabetes, or insurance status between those patients for whom forms were completed and the others. Of those for whom forms existed, 54% had an eye exam. 42% did not make an appointment with a GEP ophthalmologist, and 4% made an appointment but did not show up.

Patients who lacked health insurance, had a history of diabetes, had a family history of glaucoma, were younger, or had to travel a shorter distance to their ophthalmologist's office were more likely to complete their exams. The only one of these factors that is modifiable, however, is the distance the patient has to travel for an appointment with an ophthalmologist, Dr. Mansberger said. Increasing the number of ophthalmologists participating in low-access areas, therefore, may improve the success of the GEP, he said.

The program serves an important function, Dr. Mansberger said, noting that about 70% of patients who kept their appointments had eye-care issues that needed to be followed up. He encouraged ophthalmologists to participate in the GEP program and to complete outcome forms for all referred patients.