The 130th Annual Meeting of APHA

Abstract #38753

Evelina DiFranco, Michael Tolentino, MD, Mary Brightwell-Arnold, Liliana Riva Clement, MPH, Anthony Shih, MD, and Maureen G. Maguire, PhD. Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, 3535 Market Street, Suite 701, Philadelphia, PA 19104, 215-615-1554, evelinad@mail.med.upenn.edu

The 4Sight Program is a community outreach program that facilitates dilated eye exams among diabetic patients residing in West Philadelphia by providing assistance with scheduling, payment, and transportation. In an effort to reach more diabetics at higher risk of blinding eye disease, and to test the feasibility of implementing a diabetic retinopathy screening program, 4Sight targeted diabetics in three area dialysis clinics and offered patients a fundus photography screening, provided at no cost and on-site. Trained laypersons conducted patient interviews, obtained consent and performed the photography. Photographs were taken with a Canon CR6-45NM Non-Mydriatic Retinal Camera after dilation of pupils. A retinal specialist graded photos for signs of diabetic eye disease. Letters were sent to patients indicating the results of the screening and advised when they should next obtain an eye exam. 121 patients were approached, of these, 11 were already 4Sight members, and 52 agreed to join. 41 of the 63 4Sight patients consented to photography and 29 were photographed. Three patients were referred based on photographic findings of possible treatable disease (who were not currently being treated); and an additional 9 were referred for overdue examinations. Despite considerable efforts to provide screening for diabetic retinopathy at no cost to the patient, only 52% of patients enrolled in the program and only 24% of the 121 patients had photography. Targeting dialysis clinics for an on site screening may not be cost effective since considerable effort must be expended to identify a few patients with disease that may be treatable.

Learning Objectives:

• At the conclusion of the presentation, the participant will be able to assess the feasibility of implenting a screening program for diabetic eye disease targeted to high risk diabetics in dialysis clinics, to assess whether the program provides a high yield of patients with possible treatable eye disease, and to examine the willingness of these individuals to participate in such a program.

Keywords: Vision Care, Diabetes

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Canon USA
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.