Ophthalmic Care at an Academic Medical Centre for Patients who were Incarcerated or in Immigration Detention

Ophthalmic care for patients who are incarcerated or in immigration detention presents complex challenges for patients and providers. There remains a paucity of literature investigating ophthalmic care for these marginalised populations. We investigated delivery of ophthalmic care in an academic health system to patients who were incarcerated or in immigration detention.

We conducted a retrospective observational study and secondary analysis of electronic health record data for inpatient, outpatient, and surgical visits between 1 November 2018 and 30 September 2023 in an ophthalmology department at an academic medical centre in the United States for patients who were incarcerated or in immigration detention. Attendance at outpatient clinic visits and follow-up based on ophthalmic subspecialty, loss to follow-up, delays in follow-up, rates of ancillary testing were analysed.

1628 visits were extracted for 401 patients, for which 1084 were attended [2.7 ± 3.6 per patient] and 544 were canceled or no-showed [1.4 ± 1.8 per patient]. Patients attended 100 [68.5%] of cornea, 116 [64.4%] of glaucoma, 2 [28.6%] of neuro-ophthalmology, 139 [58.2%] oculoplastics, 9 [36.0%] of paediatrics/strabismus, and 109 [54.5%] of retina visits. Using a 2-week grace period for follow-up, 72 patients (40.9% with complete follow-up data) completed follow-up within 2 weeks. 229 patients (57.1%) were lost to follow-up at the end of the study period.

Delays in care and visit attrition were substantial for patients who were incarcerated or in immigration detention. More work is needed to quantify outcomes and address disparities in care for these marginalised communities.