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

• Published in: American journal of ophthalmology Vol. 251; pp. 12 - 23
• Main Authors: 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., Carrion, Jailine, Muhire, Remy S. Manzi, Kresch, Yocheved S., Pizzi, Laura T., Jutkowitz, Eric, Sapru, Saloni, Sharma, Tarun, De Moraes, C. Gustavo, Friedman, David S., Liebmann, Jeffrey M., Cioffi, George A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2023
• Subjects: Aged; Aged, 80 and over; Female; Follow-Up Studies; Glaucoma - diagnosis; Humans; Intraocular Pressure; Middle Aged; Prospective Studies; Vision Screening
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2023.01.019

•Targeted recruitment considered social determinants of health.•Study participants were 51.8% African American and 42% Hispanic.•In all, 78.4% failed the screening and 66.1% were referred to ophthalmology.•A total of 70% did not have an eye doctor.•A total of 50% had not had a dilated eye examination in the past 2 years.•Costs of $180.88 per participant and $273.64 per case of eye disease were detected. 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. Five-year prospective, cluster-randomized controlled trial. 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. 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. 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.