PURPOSE. Beginning February 2001, The Primary Care Service of the Illinois Eye Institute (IEI) began providing comprehensive care to the indigent population of Chicago. The objective of this public and private funded project is to prevent vision loss through early intervention and appropriate treatment. The VISION OF HOPE (VOH) program targeted patients 40 years of age and older who are uninsured or underinsured and at risk of visual impairment through lack of care. Patients are referred by community agencies that have partnership agreements with IEI METHOD. VOH patients are given comprehensive eye examinations. Addition diagnostic testing and treatment is initiated as needed. 200 patient files were reviewed and prevalence rates for ocular pathology were determined, as were prevalence rates for systemic diseases associated with ocular pathology.
RESULTS. Of the first 200 patients seen 140 (70%) presented with ocular pathology and 144 (72%) with systemic conditions associated with ocular pathology. Glaucoma represented a significant portion of ocular pathology with 43 patients effected (21.5%). This represents 7-fold increase in disease prevalence from the general population and a 3-fold increase in the African American community. Other ocular pathology included cataracts 80 (40%), corneal disease 54 (27%), non-diabetic retinal pathology 36 (18%), traumatic injury 18 (9%), macular degeneration 10 (5%), lid disease 10 (5%), diabetic retinopathy 6 (3%), and uveal disease 4 (2%). The prevalence of systemic disease was significant as 22 patients (11%) had diabetes (one diagnosed with workup after noted refractive changes), and 50 (25%) had systemic hypertension. 72 (36%) patients presented with other systemic conditions often associated with ocular pathology.
CONCLUSIONS. The increased prevalence of ocular and systemic disease among indigent and uninsured adults clearly demonstrates the need for preventative eyecare for these individuals.