Columbia Begins Vision Screening Program for NYC Public Housing Residents

Free onsite vision screening and eye exams are now being offered to residents age 40 and older at some New York City Housing Authority (NYCHA) complexes in Washington Heights and East Harlem as part of a study by researchers in the Department of Ophthalmology at Columbia University's Vagelos College of Physicians and Surgeons.

The program aims to prevent vision loss among some of the city’s most vulnerable residents. Although early detection and treatment are critical for preventing vision loss and blindness, approximately 50% of people with glaucoma and 25% of people with diabetic retinopathy are undiagnosed and don’t know they have these eye conditions. 

“Getting annual eye exams often falls to the bottom of the list of priorities, and only half of American adults have regular eye exams,” says Lisa Hark, PhD, RD, professor of ophthalmic sciences at VP&S and principal investigator of the CDC-funded SIGHT STUDY at Columbia University. “We hope that bringing our vision screening and eye care team to people where they live will lead to earlier detection, follow-up eye care, and treatment of glaucoma, cataracts, and diabetic retinopathy in residents who may not be getting regular eye exams—especially during the pandemic, when many people have put off routine medical care.” 

Onsite vision screening

The program, which has already screened more than 80 people at Polo Grounds and Rangel Houses, will expand to include other NYCHA buildings in Washington Heights and East Harlem (Lincoln Houses, Drew Hamilton, and St. Nicholas) over the next year, offering vision screening to more than 6,000 NYCHA residents over age 40.  

A Columbia vision screening team—including community health workers, research coordinators, and an optometrist—visits the developments on Tuesdays and Wednesdays to examine participants for vision impairment, cataracts, glaucoma, diabetic retinopathy, and age-related macular degeneration. The screening will be repeated one year later. 

Those with vision impairment get an optometry exam onsite. They may receive a prescription for eyeglasses or free eyeglasses provided by New York-based eyewear brand, Warby Parker. The team will schedule a follow-up appointment for a comprehensive eye exam at either Columbia University’s or Harlem Hospital’s Department of Ophthalmology for those who are referred by the vision screening team. 

(Members of the screening team have been vaccinated against COVID-19 and wear personal protective equipment at every visit. Residents are asked about COVID-19 symptoms and given temperature checks, along with hand sanitizer, gloves, and a mask, before vision screening.)

Vision impairment more common among Blacks and Hispanics

The Columbia program is focused on improving eye health among NYC residents at greatest risk of vision impairment, glaucoma, cataracts, and diabetic retinopathy. Studies show that glaucoma and diabetic retinopathy—the two leading causes of blindness—disproportionately affect low-income and other vulnerable populations. One study found that, compared to whites, Black Americans have three to four times the risk of glaucoma and tend to develop it at an earlier age; another found that Hispanics are nearly twice as likely as whites to develop diabetic retinopathy. 

Vision screening and eye exams are available to any resident over age 40 living in the participating NYCHA buildings.  

Program’s success will be measured

The researchers will determine if onsite vision screening and eye exams where people live improve detection of vision impairment and eye diseases. They also will evaluate whether the use of patient navigators to assist with appointment reminders and follow-up eye care increases use of ophthalmology services and treatments. 

“The majority of residents we’ve screened have not had an eye exam in the past two years and at least half have required follow-up appointments with our onsite optometrist or have been referred directly to an ophthalmologist,” says Hark. “We know that detection of eye diseases and follow-up care results in better eye health, so our aim is to identify the best way to help more people get screened and the follow-up eye care they need so they can be treated to prevent blindness.” 

Hark adds, “If successful, the program could be expanded to other at-risk communities in New York City.”