Outcomes of a Novel Full-Service, Free Ophthalmology Clinic-Within-A-Clinic: A Four-Year Longitudinal Study

We evaluate the Clínica Esperanza Ophthalmology Service, a free service for uninsured patients in southern New England.

The service operates monthly under a novel clinic-within-a-clinic model, existing as a subsidiary of a local free clinic. A mixed-methods program evaluation and a retrospective chart review from December 2021 to January 2025 were analyzed using descriptive statistics.

One hundred and forty-three (143) patients were scheduled during the study period, of whom 106 (74%) were seen. Median age was 51 years and 52/106 (49%) were female. Most patients (97%) identified Spanish as their primary language. There were no significant demographic differences between those seen and no-shows. Diabetic retinopathy was the most common diagnosis (37/106, 35%), followed by dry eye (35/106, 33%), and cataracts (29/106, 27%). Half of the patients (51/106, 48%) received a referral, most commonly for refraction (23/51, 45%). Ophthalmic medication was prescribed for 53/106 (50%) patients, most commonly for artificial tears (43/53, 81%). Qualitative strengths included education and low operational overhead. Qualitative challenges included long length of encounters and consequently, low patient volumes.

Our novel ophthalmology service supplements existing operations and helps meet an unmet public health need among its region's most vulnerable patients. Opportunities for improvement include improving clinic volumes and mitigating no-show rates.