Am J OphthalmolJanuary 202311 citations

Manhattan Vision Screening and Follow-up Study (NYC-SIGHT): Baseline Results and Costs of a Cluster-Randomized Trial.

Hark Lisa A, Horowitz Jason D, Gorroochurn Prakash, Park Lisa, Wang Qing, Diamond Daniel F, Harizman Noga, Auran James D, Maruri Stefania C, Henriquez Desiree R

View on PubMed DOI: 10.1016/j.ajo.2023.01.019

AI Summary

This study screened high-risk public housing residents for eye diseases. It found high rates of undetected disease requiring referral (66.1%), demonstrating community screening can improve early detection and access to care for $273.64 per detected case.

Abstract

Purpose

To describe the 15-month baseline results and costs of the Manhattan Vision Screening and Follow-up Study, which aims to investigate whether innovative community-based eye health screening can improve early detection and management of glaucoma and other eye diseases among high-risk populations.

Design

Five-year prospective, cluster-randomized controlled trial.

Methods

Individuals aged 40+ years were recruited from public housing buildings in New York City for an eye health screening (visual acuity (VA) with correction, intraocular pressure measurements (IOP), and fundus photography). Participants with VA 20/40 or worse, IOP 23-29 mm Hg, or an unreadable fundus image failed the screening and were scheduled for an optometric examination at the same location; those with an abnormal image were referred to ophthalmology. A cost analysis was conducted alongside the study.

Results

A total of 708 participants were screened; mean age 68.6±11.9 years, female (65.1%), African American (51.8%) and Hispanic (42%). 78.4% (n = 555) failed the eye health screening; 35% (n= 250) had an abnormal image and were also referred to ophthalmology. 308 participants attended the optometric exam; 218 were referred to ophthalmology. Overall, 66.1% were referred to ophthalmology. The cost per participant to deliver the eye health screening and optometric examination was $180.88. The cost per case of eye disease detected was $273.64.

Conclusions

This innovative study in public housing developments targeted high-risk populations, provided access to eye-care, and improved early detection of ocular diseases in New York City. The study has identified strategies to overcoming barriers to eye care to reduce eye health disparities.

MeSH Terms

HumansFemaleMiddle AgedAgedAged, 80 and overVision ScreeningIntraocular PressureFollow-Up StudiesProspective StudiesGlaucoma

Shields Classification

Ch. 2Intraocular Pressure and Tonometry

Ch. 9Clinical Epidemiology of Glaucoma

Ch. 27Management of the Glaucoma Patient

Key Concepts5

In the Manhattan Vision Screening and Follow-up Study (NYC-SIGHT), 78.4% (n=555) of participants failed the eye health screening, which included visual acuity (VA) with correction, intraocular pressure measurements (IOP), and fundus photography.

DiagnosisCohortProspective, Cluster-Randomized Controlled Trialn=708 participantsCh10Ch28

In the Manhattan Vision Screening and Follow-up Study (NYC-SIGHT), 35% (n=250) of participants had an abnormal fundus image and were referred to ophthalmology.

DiagnosisCohortProspective, Cluster-Randomized Controlled Trialn=708 participantsCh5Ch10Ch28

In the Manhattan Vision Screening and Follow-up Study (NYC-SIGHT), a total of 708 participants were screened, with a mean age of 68.6±11.9 years, 65.1% female, 51.8% African American, and 42% Hispanic.

EpidemiologyCohortProspective, Cluster-Randomized Controlled Trialn=708 participantsCh10

In the Manhattan Vision Screening and Follow-up Study (NYC-SIGHT), the cost per participant to deliver the eye health screening and optometric examination was $180.88.

MethodologyCohortProspective, Cluster-Randomized Controlled Trialn=708 participantsCh10Ch28

In the Manhattan Vision Screening and Follow-up Study (NYC-SIGHT), the cost per case of eye disease detected was $273.64.