School of Medicine Publications and Presentations

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Residence in a middle-class neighborhood correlated with lower follow-up compared to residence in more affluent neighborhoods. The most common explanations for not following up were the process of making an appointment and lack of symptoms.


To explore which individual and neighborhood-level factors influence follow-up as recommended after positive ophthalmic and primary care screening in a vulnerable population using novel methodologies.


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 healthcare 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.


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 lower likelihood of follow-up compared to 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 four months.


Residence in a middle-class neighborhood, difficulty accessing eye care appointments, and low health literacy may influence follow up among vulnerable populations.


Original published version available at

Publication Title

Journal of glaucoma



Academic Level


Mentor/PI Department

Office of Human Genetics

Available for download on Sunday, October 20, 2024

Included in

Ophthalmology Commons