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New Hampshire’s ‘Diabetic Eye Exam Initiative’ partners with CHCs to prevent visual impairment

October 29, 2013

Expansion of a New Hampshire Optometric Association (NHOA) program partnering optometrists and local community health centers is helping reduce the frequency of vision-threatening retinopathy by providing annual dilated eye examinations. The program’s expansion increased exams to more than 90 patients and resulted in a 20-percent pathology rate.

Events were previously based on the needs of patients with diabetes within a single community, but in 2012 the program expanded to three neighborhood health centers across New Hampshire.

The NHOA now collaborates with Manchester Community Health Center in Manchester, Goodwin Community Health in Somersworth and Families First Health Center in Portsmouth.

The three leading diagnoses are cataracts, glaucoma and diabetic retinopathy. Doctors also noted dry eye and anterior segment disease.

Further program expansion is planned, however, each health center has unique needs and challenges. What works in one center may not fit in another, so expansion will be done strategically to benefit all involved.

“NHOA members provide free dilated eye examinations and education for un-insured and under-insured diabetics,” said David Caban, O.D., NHOA immediate past president. “The goal is for community health center diabetic populations to have annual eye examinations to help prevent visual impairment due to preventable diabetic retinopathy.”

Dr. Caban is the program co-director along with Sarah Jagatic, O.D., and is a Healthy Eyes Healthy People® (HEHP) grant recipient.

The program held five successful events within the last year. In April, they held the first lunch-and-learn event at Goodwin Community Health, with a local optometrist educating the staff and physicians on diabetes and its effects on the eye. Project activities included dilated eye examinations scheduled on Saturdays every quarter.

“These comprehensive exams captured a wealth of information: medical and ocular history, visual acuity, pupils, EOMS and confrontational visual fields, Goldman tonometry, anterior segment exam with slit lamp, and dilated fundus examination both direct and indirect,” Dr. Caban said.

Diabetic testing strips were provided as an incentive for people to keep their exam appointments. Results were then shared with the patient’s primary care physician. Testing strips were purchased using funds from the HEHP grant.

“We promoted the program through partnering with community health centers using a targeted approach to their uninsured and under-insured diabetic patients,” said Dr. Caban. “The centers have tight budgets, and HEHP grant funding helped bridge the gap to potentially aid hundreds of diabetics in getting the comprehensive eye exams they needed.”

In addition to funding the purchasing of the testing strips, HEHP funding was used for brochures, postage and mailing costs and helped achieve program goals by maximizing health center partnerships.

“We are grateful to the NHOA for its collaborative effort to provide the necessary preventive dilated eye examinations to benefit diabetic patients,” said Kris McCracken, executive director of the Manchester Community Health Center. “By partnering with community health centers that already serve patients with barriers to care like financial constraints, language barriers and transportation limitations, the NHOA has found a way to partner effectively to get eye care services to the populations that need them most.”

Drs. Caban’s and Jagatic’s future plans include broadening the program within the state and continuing to provide quarterly eye exams for diabetics in need. NHOA doctors also periodically present at educational lunch and learns for diabetic patients, physicians and staff, and use pamphlets available through the AOA in mailings.

Beyond the scope of this program, Drs. Caban and Jagatic plan to partner with local businesses to increase eye care awareness and provide free eye exams for the homeless as part of a community health fair partnering with Lions International.

The following NHOA member ODs and Raymond Chew, O.D., of the Armed Forces Optometric Society, participated in the New Hampshire Diabetic Eye Exam Initiative:
James Belanger, O.D.
David Caban, O.D.
Shirlie Dowd, O.D.
David Eaton, O.D.
David Hartenstein, O.D.
Sarah Hudson, O.D.
Sarah Jagatic, O.D.
Brian Klinger, O.D.
Charles LaFreniere, O.D.
James Mancini, O.D.
Amy Pruszenski, O.D.

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