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Eye Care Needs Identified Through Community-Based Vision Screening in an Underserved Urban Population in Cleveland,
Joyce W Kuo1, Charles W Guo1, Thomas L Steinemann1,2
1Department of Ophthalmology and Visual Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Purpose:
To characterize vision screening findings, eye care utilization, referral need, and referral outcomes among underserved adults at community-based vision screening events in Cleveland, Ohio.
Methods:
This cross-sectional study analysed de-identified screening forms from 150 adults participating in community vision screenings in Cleveland. Screenings included visual acuity, confrontation visual fields, and self-reported medical and ocular histories. Participant characteristics were summarized descriptively overall and by referral status. Household income was estimated from ZIP codes using 2020-2024 American Community Survey data.
Results:
Median age was 48.5 years (IQR, 33-61); 54.7% were Black/African American and 44.0% were uninsured. Overall, 58.7% had not undergone an eye examination within 2 years or were uncertain when their last examination occurred. Distance visual acuity worse than 20/40 in the better-seeing eye was present in 16.0% of participants, near visual acuity worse than 20/40 in the better-seeing eye was present in 28.0%, and 13.7% had reduced peripheral visual fields. 119 participants (79.3%) were referred for follow-up eye care. Of 33 referred to Vision Care Outreach, 20 (60.6%) completed an appointment, 5 (15.2%) were directed to their insurance provider, and 8 (24.2%) could not be contacted.
Conclusion:
Community-based vision screening identified a high frequency of referral needs among this convenience sample of underserved adults. High rates of uninsurance, delayed eye care, and incomplete follow-up support integrating screening with accessible comprehensive eye care pathways. Limitations include the relatively small, single-city convenience sample and unavailable follow-up data for participants referred to MetroHealth Ophthalmology, limiting assessment of overall referral completion and generalizability.
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