Diabetic Retinopathy Screening and Treatment Capacity in Student-Run Free Clinics: A National Assessment

Purpose: To characterize ophthalmic resources and evaluate diabetic retinopathy screening, treatment, and referral practices among student-run free clinics in the United States that provide ophthalmology services. Methods: A cross-sectional survey was distributed to 54 student-run free clinics identified through a national network. The 17-item survey assessed clinic demographics, funding sources, ophthalmic equipment availability, diabetic retinopathy screening and treatment practices, referral pathways, perceived barriers, and resource needs. Results: Of the 54 clinics contacted, 21 (39%) responded, representing 13 states. All clinics reported caring for patients with diabetic retinopathy (100%), glaucoma (81%), and cataracts (76%). Primary funding sources included grants (38%) and alternative funding mechanisms (29%). Commonly available equipment included slit lamps (67%) and indirect ophthalmoscopes (52%), while advanced imaging modalities such as optical coherence tomography were available in only 14% of clinics. Diabetic retinopathy screening was performed in 95% of clinics, primarily via dilated retinal examination (55%). Only 14% of clinics (3/21) reported access to diabetic retinopathy treatment via external referral pathways, and none provided treatment on site. Key barriers to comprehensive care included insufficient funding, lack of diagnostic equipment, and limited availability of trained clinical personnel. Conclusions: Student-run free clinics commonly provide diabetic retinopathy screening but lack the capacity to deliver definitive treatment, relying primarily on external referral pathways. Strengthening academic partnerships and expanding treatment access may improve equitable, vision-preserving care for underserved populations.