Moumneh Khaled, Centeno Gavica Jenifer, Centeno Gavica Mishelle S, Terrell Mark, Lomiguen Christine M
Primary Care, Touro College of Osteopathic Medicine, New York, USA.
Medical Education, Lake Erie College of Osteopathic Medicine, Erie, USA.
Cureus. 2020 Oct 10;12(10):e10875. doi: 10.7759/cureus.10875.
Background The American Optometric Association (AOA) recommends adults between the ages of 18 to 65 have an eye exam every two years while older individuals or those who utilize vision correction should have yearly exams. Previous vision screenings throughout New York City's Harlem community determined that 60% warranted referral to an ophthalmologist. Objective As delayed vision screening could potentially leave a sight-threatening condition undiagnosed for many years, the objective of this study was to identify barriers to regular eye examinations. Methods A voluntary anonymous survey was verbally administered and recorded at free medical student-run vision screenings throughout multiple Harlem community health fairs. Data gathered included demographics, insurance coverage, comfort with an eye exam, and knowledge associated with an ophthalmologist eye exam. As a strategy to curtail the frequency of non-compliance to regular eye examinations, all participants were then educated about knowledge of ocular examinations and assured about uncertainties. Comfort levels were remeasured after education to determine the effectiveness and impact of community-based education. Results One hundred surveys fit the inclusion criteria. Of the participants with suboptimal knowledge of an eye exam (n=41), 32% were more comfortable after education and assurance versus 3% of the optimal knowledge participants (n=59). Of the participants with non-compliance to regular eye exams (n=39), 41% had suboptimal knowledge and 23% were more comfortable after education versus 33% and 10% of the compliant participants (n=61), respectively. Participants with suboptimal knowledge were 20.9% more likely to be noncompliant with regular eye examinations and at the same time, 18.1% more likely to have increased comfort after education and assurance than those with optimal knowledge. Of the participants without medical insurance (n=15), 67% were noncompliant with regular eye examinations and 60% had suboptimal knowledge versus 34% and 38% of the insured participants (n=85), respectively. Participants with medical insurance were 23.8% more likely to be compliant with regular eye examinations than those without medical insurance. Conclusion Measured perceptions of ophthalmology in New York City's Harlem community solidifies a lack of education as a clear barrier against proper vision care. Lack of health insurance coverage also contributed to decreased participation in regular eye examinations but to a lesser extent than education. These results suggest that empowering people through education can significantly improve compliance with regularly scheduled eye exams, thus improving the overall visual health of this minority-rich community.
美国验光协会（AOA）建议18至65岁的成年人每两年进行一次眼部检查，而年龄较大的人或使用视力矫正的人应每年进行检查。此前在纽约市哈莱姆社区进行的视力筛查确定，60%的人需要转诊至眼科医生处。
由于视力筛查延迟可能会使威胁视力的疾病多年未被诊断出来，本研究的目的是确定定期眼部检查的障碍。
在多个哈莱姆社区健康集市上，由医学生免费进行的视力筛查中，以口头方式进行了一项自愿匿名调查并记录。收集的数据包括人口统计学信息、保险覆盖情况、对眼部检查的舒适度以及与眼科医生眼部检查相关的知识。作为减少不遵守定期眼部检查频率的一项策略，随后向所有参与者传授眼部检查知识并消除他们的疑虑。教育后重新测量舒适度，以确定基于社区的教育的有效性和影响。
100份调查问卷符合纳入标准。在对眼部检查知识掌握欠佳的参与者（n = 41）中，32%的人在接受教育和得到保证后感觉更舒适，而知识掌握良好的参与者（n = 59）中这一比例为3%。在不遵守定期眼部检查的参与者（n = 39）中，41%的人知识掌握欠佳，23%的人在接受教育后感觉更舒适，而遵守检查的参与者（n = 61）中这两个比例分别为33%和10%。知识掌握欠佳的参与者不遵守定期眼部检查的可能性比知识掌握良好的参与者高20.9%，同时，在接受教育和得到保证后感觉更舒适的可能性比后者高18.1%。在没有医疗保险的参与者（n = 15）中，67%的人不遵守定期眼部检查，60%的人知识掌握欠佳，而有保险的参与者（n = 85）中这两个比例分别为34%和38%。有医疗保险的参与者遵守定期眼部检查的可能性比没有医疗保险的参与者高23.8%。
在纽约市哈莱姆社区对眼科的认知调查结果表明，缺乏教育是获得适当视力保健的明显障碍。缺乏医疗保险覆盖也导致定期眼部检查的参与率下降，但程度低于教育因素。这些结果表明，通过教育增强人们的能力可以显著提高对定期眼部检查的依从性，从而改善这个少数民族聚居社区的整体视觉健康。
