Pop-up community-based vision screening in New Zealand

ABSTRACT

Purpose: Visual impairment has a significant negative impact on quality of life, independence and ability to work. This study quantifies the prevalence of undiagnosed visual impairment detected at pop-up community screening clinics in the Waikato region of New Zealand. Locations were selected to target vulnerable populations including elderly Māori that may not otherwise attend vision assessments elsewhere. Methods: Pop-up screening clinics were completed at two locations regional marae performing COVID-19 vaccinations and at a local retirement home. Best corrected visual acuity (BCVA) and autorefraction was measured. Individuals were flagged for community follow-up if BCVA was better than 6/12 or hospital follow-up if BCVA was worse than 6/12 bilaterally or 6/15 in either eye. All individuals 40 years or older were invited to participate in the vision screening. Results: In total 64 individuals were screened with 59% females. Ethnicities included Māori (44%), New Zealand-European (34%) and undeclared (22%). Average age was 69.74 years. Based on BCVA, 59% were flagged for community follow-up and 41% for hospital follow-up. Of the 26 referred for hospital follow-up, 69% have been reviewed. Diagnosed pathology included cataract (55%), age-related macular degeneration (17%), other (17%), and refractive error (11%). Conclusion: This pilot study reports high rates of undiagnosed ocular pathology. Obtaining accurate prevalence data on visual impairment in vulnerable populations is important for developing service delivery models to provide timely treatment for these populations. This pilot highlights barriers to access public funded ophthalmic care for vulnerable populations using the existing models of healthcare delivery.