Assessing Eye Care Needs and Service Accessibility in a Student-Run Free Clinic in an Underserved Urban Population

Introduction: Student-run free clinics offer valuable firsthand experience in providing care to uninsured and underserved communities. As efforts to enhance eye care expand over time, it is crucial to evaluate the accessibility and effectiveness of these services within the community. This study examines the demographics and needs of patients seeking eye care, as well as the availability of initial screenings at our clinic. Methods: A retrospective review of patient charts was conducted for individuals who attended the Sight Saver’s free healthcare clinic to receive an eye exam. Data collected includes patient demographics, comorbidities, family history of eye-related diseases, visual acuity and IOP measurements, as well as whether the patient was referred to an ophthalmologist or optometrist. Visual acuity was categorized into mild or no visual impairment (20/20-20/70), moderate visual impairment (20/70- 20/200), severe visual impairment (20/400-20/400) and blindness (20/400-20/1200) using the International Classification of Diseases, Tenth Revision (ICD-10) system. Results: The sample consisted of 241 patients with a mean age of 49.5 years (SD=19.6). The most common comorbidities were hypertension (35.7%), diabetes (18.3%), glaucoma (7.9%), cataracts (5.0%) and thyroid disease (3.3%). A family history of glaucoma was reported in 18.7% of patients, followed by diabetes (10.8%), cataracts (7.5%) and hypertension (5.0%). Visual acuity assessments revealed that the majority of patients had mild or no visual impairment (61% for right eye without correction (SCOD) and left eye without correction (SCOS)), while 16.2% (SCOD and SCOS) had moderate visual impairment, and 1.2% (SCOD) and 2.1% (SCOS) had severe visual impairment. The mean IOP was 18.7 mmHg (SD = 5.8) in the right eye (OD) and 18.2 mmHg (SD = 6.0) in the left eye (OS). In the patients that were assessed, 14.9% were referred to an ophthalmologist while 27% were referred to an optometrist. Conclusion: This retrospective review highlights the prevalence of eye disease in the underserved population in Detroit, Michigan. The results emphasize the vital role of delivering early eye care and enabling detection and treatment of ocular conditions. There was a significant need for referrals to optometrists and ophthalmologists, highlighting the importance of increasing efforts to connect patients with appropriate eye care services. Expanding similar initiatives could further bridge gaps in access to proper eye care and assist in addressing disparities in ocular health in vulnerable communities.