Telemedicine Screening for Eye Disorders in Federally Qualified Health Centers: Relationship to Vision-Targeted Health-Related Quality of Life

Telemed J E Health. 2024 Jun;30(7):e2080-e2086. doi: 10.1089/tmj.2023.0695. Epub 2024 Apr 25.

Abstract

Introduction: Federally Qualified Health Centers (FQHCs) play a crucial role as safety-net primary health care clinics in the United States, serving medically underserved areas and populations. However, eye services are rarely offered at FQHCs. We examined how telemedicine-generated ocular diagnoses impacted vision-targeted health-related quality of life at FQHCs in rural Alabama. Methods: We focused on patients who are at risk for glaucoma. Both visual function and retinal imaging were assessed. The telemedicine vision screening protocol performed by a remote ophthalmologist evaluated eyes for glaucoma, diabetic retinopathy, cataract, age-related macular degeneration, and a measurement of habitual visual acuity. The National Eye Institute Visual Function Questionnaire-9 (VFQ-9) was administered. Results: Using stepwise regression, the best-fitting model for predicting VFQ-9 scores incorporated visual acuity 20/40 or worse, a diabetic retinopathy diagnosis, and sociodemographic variables (gender, transportation, insurance type/status, and employment status). Conclusion: Vision-targeted, health-related quality of life in our FQHC settings was related to the visual acuity impairment and the diagnosis of diabetic retinopathy but was also influenced by a variety of sociodemographic factors.

Keywords: Federally Qualified Health Center; Visual Function Questionnaire-9; eye screening; glaucoma; quality of life; telemedicine.

MeSH terms

  • Adult
  • Aged
  • Alabama
  • Diabetic Retinopathy / diagnosis
  • Eye Diseases / diagnosis
  • Female
  • Glaucoma / diagnosis
  • Humans
  • Male
  • Middle Aged
  • Quality of Life*
  • Safety-net Providers
  • Sociodemographic Factors
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Telemedicine*
  • Vision Disorders / diagnosis
  • Vision Disorders / epidemiology
  • Vision Screening / methods
  • Visual Acuity