Eye-Care Research Initiative Tested in Honduras
Proyecto Vision trains visual-health workers to perform vision screening and dispense over-the-counter reading glasses and eye drops.
A volunteer research initiative in the rural Honduran community of La Guacamaya could complement vision-care health "brigades" to Honduras and have implications for developing countries throughout the world.
Proyecto Vision was designed to determine whether basic eye-care services can be provided effectively by trained community healthcare workers, or "promotoras," when licensed physicians are not available.
The project is led by principal investigator Daniel Twelker, an optometrist and assistant clinical professor at the University of Arizona department of ophthalmology and vision science and the Mel and Enid Zuckerman College of Public Health.
Twelker is among a number of students and faculty members at the Arizona Health Sciences Center, Cornell University and the University of Washington in Seattle who have been volunteering their time and expertise in Honduras.
Under the umbrella of the not-for-profit Salud Juntos, the volunteers provide health-care services and consultation on public health infrastructure to communities in rural Honduras.
"At present," Twelker said, "vision-screening brigades are held once or twice a year for community members by members of our UA department of ophthalmology faculty. However, for the remainder of the year, eye and vision care are just not available."
To answer the need, he developed Proyecto Vision to train visual-health promotoras to perform vision screening and dispense over-the-counter reading glasses and eye drops.
Prior to a recent Honduras trip, Twelker trained Cornell University undergraduate Marion Robine, a co-investigator on the project, in vision screening, just as a promotora would be trained. Next, he and Dr. Dawn de Castro, a resident-physician at the UA department of ophthalmology, accompanied Robine to Honduras to test the program.
On that trip, community members were examined by both a licensed eye doctor and the trained visual-health promoter, Robine.
Outcome measures were collected (graded vision and recommendation for correction, at distance and near, and diagnosis of eye disease with referral) for analysis. If these measures prove to be equivalent, future promotoras will be trained to provide vision screening in remote areas.
In all, the group examined 320 patients, dispensing spectacles and eye drops. They also diagnosed and treated a 16-year-old female patient with angle closure glaucoma.
"This project has the potential to provide vision screening through promotoras who are widely distributed in the developing world. The potential implications of this are important for those who live without access to vision care throughout the world," Twelker said.
Proyecto Vision is in collaboration with project co-investigator Jane Mohler, associate director of research and global health at the UA's Arizona Center on Aging, and Salud Juntos.
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