2013 HEHP Projects
Saving Sight – Pilot Project for Latino Community in Los Angeles Area
Tina Mac Donald, O.D.
The project’s goal is to increase public awareness among the Latino community about the sight-threatening effects of diabetes. Additionally, Saving Sight wants to boost accessibility to comprehensive eye care. Two, one-hour classes in self-management and ocular effects of diabetes are offered to the uninsured or underinsured Latinos in the community. Topics include the role of comprehensive eye examinations in preventing the complications of diabetes, the risk factors for diabetic retinopathy, and the importance of management to preserve vision and general health. Patients also receive free educational material. Attendees are administered the National Eye Institute (NEI) Diabetic Eye Disease: How much do you know? test before and after the classes to measure the effectiveness in raising awareness. Class participants also are offered free exams, with a goal of performing 15 comprehensive dilated eye exams each month in the first year. Arrangements are made for patients requiring more service or continuing exams. The project receives support from the Southern California College of Optometry, with participation from fourth-year optometry externs. These students learn appropriate treatment and management of diabetes, as well as referral procedures. The American Diabetes Association in Los Angeles provides educational support and promotes the project through its community outreach.
Connecticut Optometry and Children with IEP
Elizabeth McMunn, O.D.
It’s been documented that children with IEPs (Individualized Education Programs) have a high rate of vision problems that are often missed during typical school vision screenings. This project addresses the situation by educating teachers, parents and school administrators about the importance of comprehensive eye examinations for children with IEPs. Reaching ages from 1 to 17, the project offers education, resources and support to the following professional associations: ASNC (Connecticut Association of School Nurses); Connota (Connecticut Association of Occupational Therapists); and CEA (Connecticut Educators Association). Precision Optical Co. collaborates with educational brochures and supportive materials. Continuing education for teachers, school nurses and occupational therapists is critical in stressing the importance of comprehensive eye examinations and the relationship between uncorrected vision problems and school performance particulary as it relates to those students with IEPs.
Coeur d’Alene School District Educational Project
Robert Sorensen, O.D.
The project has three goals: Determine the percentage of students who are falling behind grade level – particularly in the 2-4 grade range – with learning-related vision issues; Discover the most prevalent vision conditions in this group; And train the specialists in the school district (RNs, OTs and vision specialists) on how to detect the vision conditions and, in some of cases, how to remediate them. Current vision screenings provided in the kindergarten and first grade poplulations may be inadequate since many children fall through the cracks. Consequently, the project may lead to a new project to revamp the districtwide school vision screening programs. The local school district employs RNs at every school, and there is a district occupational therapist and a district vision specialist. These profesionals requested this project. Activities include isolating the group of children districtwide who are falling behind grade level, with a particular focus on grades 2-5; testing this group for hyperopia, amblyopia, convergence disorders, accommodative disorders and dyslexia; remediating the group via software VT or referral to an optometrist; and reporting the prevalence of vision problems in this group. Presentations are scheduled at the Idaho RN association conference and the Idaho Optometric Physican’s association conference.
Vision of Hope Health Alliance (VOHHA)
Janis Winters, O.D.
VOHHA’s primary goal is to provide free primary vision and advanced medical eye care to 1,000 (700 new and 300 returning patients) uninsured adults. In Illinois, access to vision care for the uninsured and underinsured is devastatingly low. Federally qualified health centers (FQHCs) cannot bill for optometry services, even at a recognized provider rate, resulting in fewer opportunities for the uninsured to find a place for care. Furthermore, in Chicago, it is estimated that less than 5% of eye care providers accept Medicaid recipients because reimbursement rates cover less than 30% of professional costs.VOHHA patients receive, at no charge, eye examinations that include dilation, advanced diagnostic testing, eye wear and other related services, such as information on health issues and links to primary care providers. The referral network includes Illinois Eye Institute optometrists with a broad range of specialties and links to ophthalmologists for surgical care. Additionally, referrals are made to primary care providers for advanced care and to community hospitals for those requiring immediate care such as cataracts, detached retinas and other serious issues. Advanced diagnostic exams and individual case histories allow ocular and systemic diseases to be identified and health treatment plans addressed. Referrals are made to an FQHC coalition member to assist patients without access to primary care. The program projects several outcomes: Eyeglasses and/or other vision correction devices will be dispensed to approximately 85% (850) of the patients; upwards of 30% (300) will require follow-up services, including treatment for diabetic retinopathy, glaucoma, cataracts and other eye conditions; approximately 5% (50) will require surgical care; and approximately 20% (200) will be without primary care homes and connected to community partners. Approximately 60% of all referrals made to the VOHHA program come from alliance members, including local FQHC partners (Heartland Health Outreach, Alivio, Erie and Access Community Network), and 30% from social service agencies (Chinese American Service League, Lawson House YMCA, Salvation Army, Renaissance Collaborative, Inner Voice and many more).
U & Eye
The project seeks to decrease disparities and increase access to professional eye care in Central Louisiana through the largest employer in Avoyelles parish, Paragon Casino & Resort. This hinges on educating its employees about the need to see an optometrist regularly. The project emphasizes annual eye exams for people with diabetes and those at risk for diabetes, with nearly nine in 10 (88%) of these employees either overweight or obese and therefore at high risk to develop diabetes. The secondary goal spills over into the rural community by educating its diverse population on how optometrists can manage, improve and save vision. Led by the Optometry Association of Louisiana, professionals provide the support, coordination and expertise to educate the employees of the Tunica-Biloxi Tribe of Louisiana, which operates Paragon Casino & Resort, about the need for an annual eye exam. The outreach effort receives assitance from the Louisiana Business Group on Health (LBGH) and tribal members and the casino’s senior management. Paragon has purchased the on-line employee wellness services of Keas and is a participant in MyCardioLife, both designed to help its employees improve their health status. Paragon has contracted with Keas, an on-line employee wellness program that acts like a social network with game mechanics. Keas runs a web site where Paragons’ employees can form online teams of up to six players and compete to earn points by eating better, working out more and managing stress. Keas leverages the power of the team dynamic by rewarding succes through incentives provided by Paragon. As part of this, the project team works with Paragon to incorporate an annual eye exam into the Keas wellness mix and incentives. OAL publishes a list of optometrists that work in the area along with information about glaucoma and diabetic retinopathy. QR Codes (quick response codes) move the employees from their e-mail, web site or newsletter to the OAL web site. The OAL site then provides information on diabetes and eye diseases, along with a locator for optometrists. Louisiana Business Group on Health is going to include U & Eye information, brochures, QR Codes and flyers in its bimonthly educational seminars held at Paragon and other Central Louisiana businesses.
Nina Doyle, O.D. & Jennifer Levy
Launched last year by the Maryland Optometric Association, Mission 20/20 is a public health campaign that complements AOA’s goal “to provide public health services as an integral part of the health care system.” In 2013, it focuses activities on improving general health and reducing eye and vision health disparities in Maryland’s most economically disadvantaged racial and ethnic minority communities. Major events are scheduled for the year in Prince George’s County. At the end of June, the first event collarborates with Vision Service Plan (VSP) for a week of eye and vision health outreach at the grand opening of a new Maryland Federally Qualified Health Center (FQHC) operated by Community Coalition Inc. (CCI) by providing eye examinations and glasses for local residents. A second grand opening event is tentatively planned for the fall. This fall, the project also partners with the Essilor Vision Foundation (EVF) and the “Adopt a School” program. Spring Lake Elementary School, an underserved and need-based school, has been chosen since many of its students face disabilities and live in an economically challenged area with little resources. Vision Service Plan provides its mobile eye clinic and Eye on Diabetes program to provide comprehensive eye examinations and materials to residents who qualify under their program rules. Additionally, VSP also allows the use of portable equipment for residents that may not qualify under their program rules, likely undocumented residents, so MOA doctors can still provide eye examinations and the donation of frames (but not lenses) should spectacles be required. Spring Lake Elementary School has been chosen in conjunction with the Essilor Vision Foundation as the recipient of the “Adopt a School” program, which brings comprehensive vision care (screenings, eye examinations and materials) to an underserved, Title 1 elementary school on a recurring annual basis. Walman Optical has agreed to provide lenses at significantly reduced cost in VSP donated-frames for residents and patients that do not qualify under VSP’s program rules.
Diabetes and Your Eyes
Beth Coleman, ED
The project’s overall goal is to broaden awareness, especially among underserved populations, of the importance of preventative and therapeutic eye care for all diabetics, whether type 1 or 2. This includes an eye exam every year or more often if indicated. A secondary goal is to promote volunteerism by Minnesota Optometric Association members and to expand outreach in members’ communities. The Open Cities Health Center in St. Paul serves a large low-income, diverse population that includes the immigrant groups, Somalis and Hmong. As one of the few community health centers in the metro area and the state that offers full-time eye health services, Open Cities reaches its patient base through health fairs and interpreters. Working with Open Cities, a major event ties into national Diabetic Awareness month in November. Volunteers from the Minnesota Optometric Association staff the event, offering education and eye exams. Local MOA members receive referrals as necessary. Additionally, MOA members statewide receive an overview and are offered formatting for similar events and key messaging materials.
Nebraska See To Learn Program
The project’s goal is to increase the number of 3-year-olds across the state who have had a See To Learn assessment, which detects vision disorders that would have otherwise gone unnoticed and reduces visual impairment due to uncorrected refractive error. Membrs of the Nebraska Optometric Association provide the preschool vision assessments free through the See To Learn program, and doctors throughout the state are encouraged to participate to maximize patient access. The NOA works with the Nebraska Foundation for Children’s Vision (NFCV) to promote the program to various groups, including parents, teachers, daycare providers and more. The See To Learn project is administered by the Eye Care Council, with the NOA covering the licensing fee to the Eye Care Council for participating Nebraska optometrists. Promotional activities include a presentation at the Week of the Young Child Conference in Omaha and the Early Chidhood Professional Development Conference, both which target early childhood professionals. NOA staff and the NFCV also make a presentation and offer resources at the NOA Spring Conference. The NFCV makes personal phone calls to all new NOA OD members. The NOA staff provides mailings and e-mails to members. The Eye Care Council distributes promotional materials to all participating doctors. Additionally, the program is promoted through See To Learn month across Nebraska in October. Advertisements run in 170 Nebraska newspapers, and press releases are sent to media outlets. Promotional materials are sent to daycares, Head Start and the Nebraska Association for the Education of Early Childhood.
Stephanie Lee, O.D.
The project is aimed at providing eyecare to the uninsured, underserved population. It involves multiple disciplines in healthcare, including the network with the Volunteers in Medicine in Southern Nevada(VMSN), the Lions Eye Foundation, Lion’s Sight First of Southern Nevada, Opticians program at the College of Southern Nevada and the Southern Nevada Optometric Association. This widespread participation allows the project to provide a wealth of services, including comprehensive exams, co-management of ocular and systemic diseases, and surgery. As an ongoing project, visits vary according to each patient’s diagnois and need for monitoring. The project provides full co-management of glaucoma, macular degeneration, cataracts, retinal detachments, diabetic retinopathy and more. The data collection has been coordinated at the Volunteers in Medicine where comprehensive patient charts are housed. Patients are seen in the practices of the optometrists and their medical testing and exams are provided at the VMSN clinic. As a team effort, the project co-manages care with the doctors at the Volunteers in Medicine and several local ophthalmologists. The Lions clubs serve as the screening organization. The Lions Eye foundation provides surgical services as well. The Opticians program at the College of Southern Nevadav have jumped on board to help provide some eyewear. And the OD’s of the SNOA provide volunteer services to the patients. This team effort offers medical care not just eyecare.
Diabetic Eye Exam Initiative
Sarah E Jagatic, O.D.
NHOA optometrists and local New Hampshire community health centers are working together to reduce the frequency of vision-threatening retinopathy through annual dilated eye examinations. The NHOA currently collaborates quarterly with local community health centers: Manchester Community Health Center, Goodwin-Avis Health Center and Families First Health Center. NHOA members provide free dilated eye examinations and education for the uninsured and underinsured. The goal is to ensure that all of the community health centers’ diabetic population have annual diabetic eye examinations to help prevent visual impairment due to preventable diabetic retinopathy. Two successful events were held last October, and three were planned in March and April 2013. In April, the first lunch and learn event was held at Avis Goodwin, with a local optometrist educating the staff and physicians on diabetes and effects on the eye. Project activities include dilated eye examinations scheduled on Saturdays every three months at two or three locations. These comprehensive exams capture a wealth of information: medical and ocular history; visual acuity; pupils, EOMS and confrontational visual fields; Goldman tonometry; anterior segment exam with slit lamp; and dilated fundus examination both direct and indirect. Results are shared with the patient’s primary care physician.
Jane Compton, O.D.
The project’s goal is to reduce visual impairment in children and adolescents. Taos Lions KidSight has screened more than 8,300 pre-K through 3rd grade children and adolescents since the program’s inception in 2008. Approximating 14% of those screened have been referred to NMOA members for treatment. The Lions provide financial support for needy, uninsured families. KidSight has already increased screening among the pre K to 3rd grade school population from 70% to 85%. To sustain this and increase screening, the project extends KidSight to infants (ages 2-5) and home schooled students at scheduled in-school screenings. Additionally, it targets adults and seniors to enhance earlier detection of diabetes eye disease through experimenting with new screening technology while supporting NMOA members in regional hospital health fairs and diabetes clinics. Taos and Colfax County (public and private schools) cooperate on scheduling screening and referral follow up. Holy Cross Hospital reaches adults and seniors as the primary hospital serving the Northern New Mexico region. The Taos Lions supports the local NMOA optometrists in arranging for and participating in hospital health fairs and hospital diabetic clinics where adults and seniors are screened for eye diseases. Lion volunteers conduct mass in-school free vision screenings of children and adolescents using a Pediavision digital screening instrument which identifies eye disorders (amblyopia, myopia, hyperopia, anisocoria, strabismus, astigmatism and anisometropia). Approximately 1,700 children and adolescents are screened annually with a referral rate of 14%. The effort is extended through newspaper and radio announcements inviting family attendance at scheduled school screenings at health fairs.
Eye Exams in Putnam City Schools
Ruthie Ruan, O.D.
The project’s goal is two fold. First, reinforce public awareness of the importance of timely comprehensive eye exams for school-aged children to reduce visual impairment due to uncorrected refractive error and other undiagnosed vision disorders. Second, continue to educate students, parents and educators on the difference between vision screenings and comprehensive eye exams and encourage access to professional vision care to ensure healthy vision. Last year’s project educated nearly 10,000 pre-K to 5th grade students and their families on the importance of comprehensive eye exams. This led to significant increase the number of students who received an eye exam in 2012. The rate almost doubled compared to 2011.There are still a large number of students who have never received an eye exam. Dr. Ruthie Ruan, O.D., project director, and her staff worked with pre-K to 5th grade students, their parents and educators in the Putnam City Schools to promote comprehensive eye exams and collect data through questionnaires. This effort continues with support from the Putnam City schools in distributing materials, arranging health fairs to educate parents and staff, providing the training facility and opportunities for school nurses, nursing aids and other staff to learn to identify potential vision problems, and collecting questionnaires and following up on the results of referrals/recommendations.
Rebecca R. Chown, O.D.
This program is designed to identify potential vision problems in at-risk second grade students and provide access to comprehensive eye care and glasses in Hood River County. C2READ is a community-based collaboration between Indian Creek Family Eye Care, Beta Sigma Phi-Alpha Gamma chapter, 141 eyewear and the Hood River County School District. Hood River county school district officials identify the lower one-third of readers in the second grade. Beta Sigma Phi Alpha Gamma chapter trains volunteers to assist with screenings. Rebecca Chown, OD, performs indepth vision screenings. 141 Eyewear provides glasses to the children identified in need. Each child’s indepth screening result is compared to the basic vision screen performed at the beginning of the school year. Comparing these results then allows recommendations of best practices for future pediatric eye care in the state of Oregon. Additionally, OOPA will introduce legislation to support the need for early identification and treatment of eye health problems to minimize the risk of eye disease, and thus minimize the risk of vision related academic delay. C2READ utilizes the January 2011 clinical summary of the U.S. Preventive Services Task Force Recommendation to determine screening tests performed. Tests on selected students include Best corrected visual acuity distance and near, stereopsis, unilateral and alternating cover test, Hirschberg light reflex and autorefraction (Retinomax 3.0 handheld autorefractor). If amblyogenic risk factors are identified, students receive follow up at Indian Creek Family Eye Care and eye wear.
Project Homeless Connect: Focus on Vision Care
Zakiya Nicks, O.D.
The project’s goal is to increase access to comprehensive vision and eye health care and reduce visual impairment due to uncorrected refractive error, diabetic retinopathy, glaucoma, cataract and age-related macular degeneration in the homeless community. Formed in February 2010, the Community Alliance for the Homeless is a private, non-profit entity that provides planning, technical assistance, and service coordination to public and private agencies working to end homelessness in Memphis and Shelby County. The organization links planners, providers, data and resources to develop an effective and outcomes-driven system for ending homelessness. The alliance coordinates Project Homeless Connect, a massive, one-day service delivery event through which hundreds of community volunteers work hand-in-hand with the homeless to break down barriers to services needed to leave the streets of Shelby County. The first event held in September 2011 served more than 1,000 homeless guests. People struggling with homelessness often find it difficult to access comprehensive vision and eye health care. The Eye Center at Southern College of Optometry participated in Project Homeless Connect on Feb. 14, 2013. More than 75 volunteers – faculty, staff and students – conducted screenings and comprehensive eye exams on more than 200 homeless individuals. Clinic and industry partners also provided care at this pilot event, including spectacle correction to approximately 140 individuals and follow-up medical and refractive care to 28 people. Unfortunately, more than 30 individuals that failed the initial vision screening were unable to receive a comprehensive evaluation due to time constraints and some patients could not receive the appropriate eyewear due to limitations by industry partners. The project wants to improve on this performance at the next event in September 2013. As part of this, the event will eliminate the screening component and provide comprehensive eye care to all individuals at the September event. Additional industry partners at this event will support refractive and medical follow-up care. After the comprehensive eye exam, patients identified as having visual impairment secondary to uncorrected refractive error are fitted for prescription glasses or receive readers when appropriate. Patients diagnosed with diabetic retinopathy, cataracts, glaucoma, age-related macular degeneration and any other ocular conditions receive medical follow-up care from The Eye Center and its clinical partners.
Frank Haskell Lions Eye Clinic
Ken Henderson, O.D. and Brian Koning, O.D.
The primary goal of this project is to continue to provide no-cost eye care to the uninsured, low-income population in Whatcom County, WA. Data is collected to characterize the risk factors for vision impairment among the unique population seen at the Frank Haskell Lions Eye Clinic to improve patient care. Secondarily, the project wants to build community awareness of the clinic’s services. A tertiary goal is the development of clinic procedures and policies through collaboration of the volunteer optometrists, the clinic oversight committee and the undergraduate pre-optometry students. This is designed to better serve patients in the relatively new community eye clinic, which opened in February 2012. The Frank Haskell Eye Clinic provides eye health examinations, eyeglass frames and Rx lenses, as well as eye medications as available. During its first year of operation, the clinic served approximately 400 individuals. The clinic continues to function to provide eye health care and glasses for those who qualify. The clinic currently operates one afternoon per week, but this may increase as demand dictates and volunteers allow.