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CC BY-NC-ND 4.0 · Journal of Academic Ophthalmology 2020; 12(02): e214-e220
DOI: 10.1055/s-0040-1718563
Research Article

Ophthalmology Clinic for the Homeless in San Francisco: Experiences and Findings

Ogonna N. Nnamani Silva 
1   School of Medicine, University of California San Francisco, San Francisco, California
,
Lauren Hennein
2   Department of Ophthalmology, University of California San Francisco, San Francisco, California
,
Saras Ramanathan
2   Department of Ophthalmology, University of California San Francisco, San Francisco, California
› Author Affiliations Funding This study was supported in part by an unrestricted grant from Research to Prevent Blindness, United States.
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Abstract

Background Homelessness is a growing area of concern for communities around the world and homeless individuals are often not connected to healthcare and, consequently, this population is often left out of crucial studies that influence the care provided at public hospitals. The main aim of this study is to examine the prevalence of eye disease, demographics, and common comorbidities of patients who utilized the student-run, institution-sponsored ophthalmology clinic for homeless individuals across a 2-year period. A secondary aim was to elucidate the role that student-run clinics can play in connecting the homeless population to healthcare and community services.

Methods A retrospective cohort study examined individuals who utilized a student-run, free ophthalmology clinic at two homeless shelters in an urban community for 2 years, from 2017 to 2019.

Results A volunteer sample consisting of 123 residents at two homeless shelters who signed up to receive an eye examination at the free eye clinic. The average age of participants was 51 years, with 74% identifying as male, and the largest number of patients identified as African-American/Black (33%) and White (27%). The most prevalent eye disease was refractive error at a prevalence rate of 70% with presbyopia and myopia accounting for 77% and 42% of the refractive error diagnoses, respectively. A visually significant cataract was the second most prevalent pathology, which was diagnosed in 13% of patients. Diabetic retinopathy had a prevalence rate of 11%. Glaucoma had a prevalence rate of 20%. When stratifying the prevalence of glaucoma by race/ethnicity, Black/African-Americans had a prevalence rate of 30% and Asians had a prevalence rate of 29%.

Conclusion This study demonstrated a high prevalence of eye disease among the homeless population highlighting the major role that social determinants of health play in patient outcomes. Student-run ophthalmology clinics provide rich educational experiences, and most importantly, connect homeless populations to essential ophthalmologic care.

Keywords

homelessness - ophthalmology - healthcare disparities - student-run clinics - ophthalmology education - medical education


Publication History

Received: 02 June 2020

Accepted: 31 August 2020

Article published online:
30 October 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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