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Heilenbach N, Ogunsola T, Elgin C, Fry D, Iskander M, Abazah Y, Aboseria A, Alshamah R, Alshamah J, Mooney SJ, Maestre G, Lovasi GS, Patel V, Al-Aswad LA. Novel Methods of Identifying Individual and Neighborhood Risk Factors for Loss to Follow-Up After Ophthalmic Screening. J Glaucoma 2024; 33:288-296. [PMID: 37974319 PMCID: PMC10954411 DOI: 10.1097/ijg.0000000000002328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 10/09/2023] [Indexed: 11/19/2023]
Abstract
PRCIS Residence in a middle-class neighborhood correlated with lower follow-up compared with residence in more affluent neighborhoods. The most common explanations for not following up were the process of making an appointment and lack of symptoms. PURPOSE To explore which individual-level and neighborhood-level factors influence follow-up as recommended after positive ophthalmic and primary care screening in a vulnerable population using novel methodologies. PARTICIPANTS AND METHODS From 2017 to 2018, 957 participants were screened for ophthalmic disease and cardiovascular risk factors as part of the Real-Time Mobile Teleophthalmology study. Individuals who screened positive for either ophthalmic or cardiovascular risk factors were contacted to determine whether or not they followed up with a health care provider. Data from the Social Vulnerability Index, a novel virtual auditing system, and personal demographics were collected for each participant. A multivariate logistic regression was performed to determine which factors significantly differed between participants who followed up and those who did not. RESULTS As a whole, the study population was more socioeconomically vulnerable than the national average (mean summary Social Vulnerability Index score=0.81). Participants whose neighborhoods fell in the middle of the national per capita income distribution had a lower likelihood of follow-up compared with those who resided in the most affluent neighborhoods (relative risk ratio=0.21, P -value<0.01). Participants cited the complicated process of making an eye care appointment and lack of symptoms as the most common reasons for not following up as instructed within 4 months. CONCLUSIONS Residence in a middle-class neighborhood, difficulty accessing eye care appointments, and low health literacy may influence follow-up among vulnerable populations.
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Affiliation(s)
- Noah Heilenbach
- New York University, Grossman School of Medicine, Department of Ophthalmology
| | | | | | - Dustin Fry
- Drexel University, Dornsife School of Public Health, Urban Health Collaborative
| | - Mina Iskander
- University of Miami, Miller School of Medicine, Department of Medicine
| | - Yara Abazah
- New York University, Grossman School of Medicine, Department of Ophthalmology
| | - Ahmed Aboseria
- State University of New York, Downstate Health Sciences University College of Medicine
| | - Rahm Alshamah
- New York University, Grossman School of Medicine, Department of Ophthalmology
| | - Jad Alshamah
- New York University, Grossman School of Medicine, Department of Ophthalmology
| | | | - Gladys Maestre
- University of Texas, Rio Grande Valley School of Medicine
| | - Gina S. Lovasi
- Drexel University, Dornsife School of Public Health, Urban Health Collaborative
| | - Vipul Patel
- New York University, Grossman School of Medicine, Department of Ophthalmology
| | - Lama A. Al-Aswad
- University of Pennsylvania, Scheie Eye Institute, Department of Ophthalmology
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Heilenbach N, Hu G, Lamrani R, Prasad J, Ogunsola T, Iskander M, Elgin CY, McGowan R, Vieira D, Al-Aswad LA. Environmental influences on ophthalmic conditions: A scoping review. Clin Exp Ophthalmol 2023; 51:516-545. [PMID: 37309709 DOI: 10.1111/ceo.14262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/05/2023] [Accepted: 05/18/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Environmental factors have been implicated in various eye pathologies. The purpose of this review is to synthesise the published research on environmental effects on eye disease. METHODS Four databases were searched for terms relating to environmental exposures and ophthalmic disease. Titles and abstracts were screened followed by full-text review. Data was extracted from 118 included studies. Quality assessment was conducted for each study. RESULTS Air pollutants, including nitrogen dioxide, nitrites, sulphur dioxide, particulate matter, carbon monoxide, ozone and hydrocarbons are associated with ocular conditions ranging from corneal damage to various retinopathies, including central retinal artery occlusion. Certain chemicals and metals, such as cadmium, are associated with increased risk of age-related macular degeneration. Climate factors, such as sun exposure, have been associated with the development of cataracts. Living in rural areas was associated with various age-related eye diseases whereas people living in urban settings had higher risk for dry eye disease and uveitis. CONCLUSION Environmental exposures in every domain are associated with various ophthalmic conditions. These findings underscore the importance of continued research on the interplay between the environment and eye health.
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Affiliation(s)
- Noah Heilenbach
- Grossman School of Medicine, Department of Ophthalmology, New York University, New York, New York, USA
| | - Galen Hu
- Grossman School of Medicine, Department of Ophthalmology, New York University, New York, New York, USA
| | - Ryan Lamrani
- Department of Ophthalmology, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Jaideep Prasad
- Grossman School of Medicine, Department of Ophthalmology, New York University, New York, New York, USA
| | - Titilola Ogunsola
- Department of Ophthalmology, Howard University College of Medicine, Washington, District of Columbia, USA
| | - Mina Iskander
- Miller School of Medicine, Department of Medicine, University of Miami, Miami, Florida, USA
| | - Cansu Yuksel Elgin
- Department of Ophthalmology, Istanbul Universitesi-Cerrahpaşa, Istanbul, Turkey
| | - Richard McGowan
- Health Sciences Library, New York University, New York, New York, USA
| | - Dorice Vieira
- Health Sciences Library, New York University, New York, New York, USA
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Iskander M, Hu G, Sood S, Heilenbach N, Sanchez V, Ogunsola T, Chen D, Elgin C, Patel V, Wronka A, Al-Aswad LA. Validation of the New York University Langone Eye Test Application, a Smartphone-Based Visual Acuity Test. Ophthalmol Sci 2022; 2:100182. [PMID: 36245756 PMCID: PMC9560635 DOI: 10.1016/j.xops.2022.100182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE To validate and assess user satisfaction and usability of the New York University (NYU) Langone Eye Test application, a smartphone-based visual acuity (VA) test. DESIGN Mixed-methods cross-sectional cohort study. PARTICIPANTS Two hundred forty-four eyes of 125 participants were included. All participants were adults 18 years of age or older. Participants' eyes with a VA of 20/400 (1.3 logarithm of the minimum angle of resolution [logMAR]) or worse were excluded. METHODS Patients were tested using the clinical standard Rosenbaum near card and the NYU Langone Eye Test application on an iPhone and Android device. Each test was performed twice to measure reliability. Ten patients were selected randomly for subsequent semistructured qualitative interviews with thematic analysis. MAIN OUTCOME MEASURES Visual acuity was the parameter measured. Bland-Altman analysis was used to measure agreement between the results of the NYU Langone Eye Test application and Rosenbaum card, as well as test-retest reliability of each VA. The correlation between results was calculated using the intraclass correlation coefficient. Satisfaction survey and semistructured interview questions were developed to measure usability and acceptability. RESULTS Bland-Altman analysis revealed an agreement between the application and the Rosenbaum near card of 0.017 ± 0.28 logMAR (iPhone) and 0.009 ± 0.29 logMAR (Android). The correlation between the application and the Rosenbaum near card was 0.74 for both the iPhone and Android. Test-retest reliability was 0.003 ± 0.22 logMAR (iPhone), 0.01 ± 0.25 logMAR (Android), and 0.01 ± 0.23 logMAR (Rosenbaum card). Of the 125 participants, 97.6% found the application easy to use, and 94.3% were overall satisfied with the application. Thematic analysis yielded 6 key themes: (1) weaknesses of application, (2) benefits of the application, (3) tips for application improvement, (4) difficulties faced while using the application, (5) ideal patient for application, and (6) comparing application with traditional VA testing. CONCLUSIONS The NYU Langone Eye Test application is a user-friendly, accurate, and reliable measure of near VA. The application's integration with the electronic health record, accessibility, and easy interpretation of results, among other features, make it ideal for telemedicine use.
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Affiliation(s)
- Mina Iskander
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
- New York Medical College, New York, New York
| | - Galen Hu
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
| | - Shefali Sood
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
| | - Noah Heilenbach
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
| | - Victor Sanchez
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
| | - Titilola Ogunsola
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
- New York Medical College, New York, New York
| | - Dinah Chen
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
| | - Ceyhun Elgin
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
- Bogazici University, Istanbul, Turkey
| | - Vipul Patel
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
| | - Andrew Wronka
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
| | - Lama A. Al-Aswad
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
- Department of Population Health, Grossman School of Medicine, New York University, New York, New York
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Laroche D, Sakkari S, Ogunsola T. Combination Cataract Extraction, Goniotomy, Ahmed Valve and Retrobulbar tube in a patient with bilateral Uveitic Glaucoma and Cogan's Syndrome. J Natl Med Assoc 2021; 113:661-665. [PMID: 34325883 DOI: 10.1016/j.jnma.2021.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/28/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Daniel Laroche
- Advanced Eye care of New York, New York, NY, United States; Department of Ophthalmology, New York Eye and Ear Infirmary, Icahn School of Medicine of Mount Sinai, New York, NY, United States.
| | - Sohail Sakkari
- Advanced Eye care of New York, New York, NY, United States
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Abstract
PURPOSE Most published systematic reviews have focused on the use of virtual reality (VR)/augmented reality (AR) technology in ophthalmology as it relates to surgical training. To date, this is the first review that investigates the current state of VR/AR technology applied more broadly to the entire field of ophthalmology. METHODS PubMed, Embase, and CINAHL databases were searched systematically from January 2014 through December 1, 2020. Studies that discussed VR and/or AR as it relates to the field of ophthalmology and provided information on the technology used were considered. Abstracts, non-peer-reviewed literature, review articles, studies that reported only qualitative data, and studies without English translations were excluded. RESULTS A total of 77 studies were included in this review. Of these, 28 evaluated the use of VR/AR in ophthalmic surgical training/assessment and guidance, 7 in clinical training, 23 in diagnosis/screening, and 19 in treatment/therapy. 15 studies used AR, 61 used VR, and 1 used both. Most studies focused on the validity and usability of novel technologies. CONCLUSIONS Ophthalmology is a field of medicine that is well suited for the use of VR/AR. However, further longitudinal studies examining the practical feasibility, efficacy, and safety of such novel technologies, the cost-effectiveness, and medical/legal considerations are still needed. We believe that time will indeed foster further technological advances and lead to widespread use of VR/AR in routine ophthalmic practice.
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Affiliation(s)
- Mina Iskander
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, US
| | - Titilola Ogunsola
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, US
| | - Rithambara Ramachandran
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, US
| | - Richard McGowan
- Department of Epidemiology and Health Promotion, NYU College of Dentistry, New York, New York, US
| | - Lama A. Al-Aswad
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, US
- Department of Population Health, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, US
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