From the Guidelines
Community health fair ophthalmic screenings are a crucial preventive measure for detecting common eye conditions, and they should include visual acuity testing, intraocular pressure measurement, and basic external eye examinations, with a clear referral system for follow-up care, as recommended by the comprehensive adult medical eye evaluation preferred practice pattern guidelines 1.
Key Components of Ophthalmic Screenings
- Visual acuity testing using Snellen charts to detect refractive errors and other vision problems
- Intraocular pressure measurement for glaucoma detection, although it is noted that this method has limitations in terms of sensitivity and specificity 1
- Basic external eye examinations to identify signs of eye diseases such as cataracts, diabetic retinopathy, and macular degeneration
- Educational materials about eye health to promote awareness and encourage regular comprehensive eye examinations
Importance of Targeted Screening
- Screening for glaucoma in the general population is not cost-effective, but targeted screening in high-risk populations such as older adults, those with a family history of glaucoma, and African Americans and Hispanics can be beneficial 1
- Early detection and treatment of eye diseases can prevent vision loss and improve quality of life, as highlighted in the comprehensive adult medical eye evaluation preferred practice pattern guidelines 1
Recommendations for Screening
- Comprehensive eye examinations are recommended every 1-2 years for adults over 40 and those with risk factors like diabetes, hypertension, or family history of eye disease 1
- Community health fair ophthalmic screenings should be conducted by volunteer ophthalmologists, optometrists, or trained technicians, with a clear referral system for participants who need follow-up care
- The screening area should be well-lit, private, and accessible to all community members, including those with disabilities
From the Research
Community Health Fair Ophthalmic Screening
- The effectiveness of community-based ophthalmic screening programs has been evaluated in several studies 2, 3.
- A study conducted in 2002 found that community screening for eye disease by laypersons can be effective, but efforts to provide definitive ophthalmic examination were only modestly effective, with 41% of screenees completing the visit 2.
- Another study published in 2018 found that incorporating an on-site ophthalmologist during screening events and leveraging community partner resources can improve the effectiveness of vision screening programs, with 97% of participants completing definitive exams and 78.8% receiving care for all of their immediate vision health needs 3.
Ophthalmic Screening Methods
- Non-mydriatic retinography has been used as a screening tool for diabetic retinopathy, with a study finding that it can detect a high percentage of diabetic patients with suspicion of diabetic retinopathy, but may not detect other eye diseases such as glaucoma or cataracts 4.
- Optical coherence tomography angiography (OCTA) has been used to assess retinal microvascular changes in diabetic patients, with studies finding that it can detect early retinal microvascular and functional changes in diabetic patients without clinical evidence of diabetic retinopathy 5, 6.
Screening Outcomes
- A study published in 2013 found that suspicion of diabetic retinopathy was detected in 9.3% of patients, while suspicion of glaucoma was detected in 8.1% of patients with complete examination and 3.4% of patients with partial examination 4.
- Another study published in 2020 found that OCTA parameters such as the foveal avascular zone area and vessel density were correlated with visual acuity in patients with diabetic retinopathy 5.