<p>Delivering mobile eye care to underserved communities while providing training in ophthalmology to medical students: experience of the Guerrilla Eye Service</p>

Abstract

The objective of the study was to characterize the population served by the student-led Guerrilla Eye Service (GES), a mobile outreach program that delivers comprehensive ophthalmic care to underserved communities in the greater Pittsburgh area. Patients and methods: Patients attending GES missions at a single urban free clinic from 2012 through 2017 were included in this retrospective case series. All patients underwent a comprehensive eye examination at no cost, with referral to a university eye clinic if necessary. Demographic characteristics, past ocular history, reasons for attendance, and ophthalmic diagnoses were recorded. Attendance rates and treatment outcomes of patients referred to the university eye clinic were also reviewed. Results: We reviewed records of 360 GES patients (mean age 43 years, age range 1-79 years; 56% [200] male; 37% [133] non-English speakers). The most common reasons for attending were blurry vision (28% [101]), need for new glasses (22% [80]), and referral for a diabetic eye exam (18% [63]). The most common diagnosis made was refractive error (59% [214]), and vouchers for free spectacles were provided. One-third of diabetic patients had retinopathy (32% [38]). Glaucoma suspect (11% [40]), narrow angles (4% [13]), treatment-requiring diabetic eye disease (4% [14]), and visually-significant cataract (3% [11]) were diagnoses that most often prompted referral to the university clinic. In all, 114 patients were referred (32%), of whom 82 (72%) attended the follow-up visit. Other patients continued to receive longitudinal care through GES. Conclusion: Medical student-led outreach programs under the supervision of an attending ophthalmologist can deliver regular eye care to underserved communities while providing referrals to a university clinic for those with advanced disease.

Assessment of patient follow-up from student-run free eye clinic to county ophthalmology clinic

“…Similar follow-up barriers have been reported by other free ophthalmology clinics in underserved, socioeconomically vulnerable communities. For patients requiring specialized ophthalmic care, one student-run free clinic in Pittsburgh not only provided patients with the referral clinic contact information, but also provided the referral clinic coordinators with the patient contact information 11 . The coordinators then directly contacted the patients to schedule follow-up and assist with navigating programs such as Medicaid at no cost to the patient.…”

“…Under this system, medical student volunteers known as Patient Navigators (PN’s) contact patients requiring further care after their in-person free eye clinic visit to ensure they are able to schedule a follow-up appointment at the local county clinic. Thus, our PN’s serve a similar role as the referral clinic coordinators in Pittsburgh 11 . Previously, our free clinic would provide patients with instructions to call the county clinic to make an appointment.…”

A seven-year analysis of the role and impact of a free community eye clinic

“…The proportion of uninsured patients seen at our outreach clinic is also more than triple that of the total proportion of uninsured nonelderly individuals in the state of Indiana, reported to be 10.3% in 2019 [ 23 ]. However, it appears to compare similarly to other community eye clinics that have reported on the insurance status of the patient population they serve [ 24 , 25 ]. The large proportion of uninsured patients seen at the IUSOC Eye Clinic is especially notable considering the lack of insurance has been well-reported to result in decreased access to and utilization of eye care services, thereby increasing the risk of irreversible visual impairment [ 10 , 26 , 27 ].…”

The Ophthalmology Mini-Elective Gives Vision to Preclinical Medical Students

“…The Guerrilla Eye Service (GES) is a free, mobile eye clinic that provides ophthalmology care to underserved patients in Pittsburgh and the surrounding communities. 20 While GES draws volunteers from all levels of training, the majority of our volunteers are in their preclinical years. Medical students run the clinic, with the supervision and support of ophthalmology residents and attendings.…”

“…Lectures were given addressing the most frequently encountered pathologies at GES, including refractive error, diabetic retinopathy, glaucoma, narrow angles, and cataract. 20 Our current OME course is largely based on the previously offered GES Boot Camp.…”