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Glaucoma Screenings

 

The Past, the Future and the Economic Effect of the
Friends of the Congressional Glaucoma
Caucus Foundation

Glaucoma has been called the “silent thief of sight” because it attacks without symptoms. The condition causes no pain, nor does it leave visible physical traces. A person with glaucoma can still have 20/20 vision straight ahead even as the disease is robbing its victims of peripheral vision inexorably until eyesight has been completely lost. Yet it is well known that for the vast majority of individuals with glaucoma, the chances of preserving their sight are significantly improved if diagnosed and treated early enough.

This has been the rationale behind the work of the Friends of the Congressional Glaucoma Caucus Foundation and our motto, “Don't go untested!” From early 2001 to July, 2007, the Friends of the Congressional Glaucoma Caucus Foundation screened 162,941 individuals in 37 states, the District of Columbia , Puerto Rico , and the US Virgin Islands. FCGCF has held 7,669 screenings nationwide – or an average of 104 screenings a month. Of those screened, 30% were referred for further vision related medical treatment: 14% displayed signs consistent with glaucoma and 16% showed signs of other vision problems. (See Totals Column, Table 1.)

During the year 2006 alone, the Friends of the Congressional Glaucoma Caucus Foundation screened 47,332 men and women in 993 locations across the United States . Altogether, the Foundation set up and conducted 1,651 screenings, for an average of more than FOUR screenings a DAY, 365 days a year. Of those screened, 5,206 showed signs of early or established glaucoma. Another 8,993 evidenced eye diseases other than glaucoma. (See Column 06, Table 1).

TABLE 1: FCGCF Findings, 2001 to 2007

Results

01

02

03

04

05

06

07*

Totals

Number of Screenings

464

694

721

1,150

1,521

1,651

1,451

7,669

Number Screened

2,479

6,004

13,019

26,706

45,475

47,332

21,926

162,941

Glaucoma Referrals

822

1,310

2,323

4,906

5,175

5,206

2,068

21,810

Other Eye Diseases Found

343

971

1,361

4,073

6,821

8,993

2,163

24,725

* 2007 through June

Although glaucoma does attack everyone, it particularly strikes African Americans and Hispanics. People with diabetes and people with high blood pressure are also at increased risk for glaucoma. The Friends of the Congressional Glaucoma Caucus Foundation has paid particular attention to these high risk groups. Of the almost 163,000 people screened by the program, 76% belong to minorities. Another contributing factor is age; senior citizens of all races are another high-risk group. Again, the Foundation has taken particular care to reach this group. Three-quarters of all people screened are over the age of 40. Americans over the age of 65 comprise 21% of the Foundation's screening population.

Mobile Units of the Friends of the Congressional Glaucoma Caucus Foundation

The Foundation conducts many of its screening through the use of vans and medically equipped trucks in locations across the United States .

Mobile units are operated in:

  • Washington , DC (MESU1);
  • New York (MESU3, MESU4);
  • Austin , Texas (MESU2, currently traveling through Oklahoma , Arkansas , Mississippi , and Louisiana );
  • Boston , Massachusetts (the Harvard Family Van);
  • Miami , Florida (Bascom Palmer's Vision Van);
  • San Francisco , California (UCSF's Vision Unit);
  • Baltimore , Maryland ( Maryland Society for Sight Van);
  • San Antonio , Texas (The Lions Club Screening Unit); and
  • Los Angeles , California (UCLA's Jules Stein Institute Van).

Two kinds of units are used. The larger units are called Mobile Eye Screening Units (MESUs) and they range in size from 28 feet long to 40 feet long. Each is an “ophthalmologist's office on wheels,” containing at least two screening stations and a small private consulting office. These units have been used in at least 1,500 screenings thus far in 20 States. The Friends of the Congressional Glaucoma Caucus Foundation owns and operates four of these vehicles, based in Washington , DC and in New York State . Another MESU has been completed at the factory in Columbus , Ohio , and will be delivered to the Foundation in Mid-February, 2007. The Friends of the Congressional Glaucoma Caucus Foundation also partners with six other groups and helps support their own mobile units.

Being mobile, the vans have been able to reach potential glaucoma victims in isolated areas – such as the southwest, rural communities in Appalachia, the delta country of Mississippi , and the wide plains of Texas and Oklahoma ; in fact, anywhere.  Already in 2006, in fact, Friends of the Congressional Glaucoma Caucus Foundation vans have made swings through rural areas of southwest Texas , from San Antonio to the Rio Grande valley; New Mexico ; Arizona ; Oklahoma ; Arkansas ; and Alabama . Another mobile eye unit traveled south from New York to Florida , where it could be more effectively utilized during the winter months. A new screening venue has proven very successful – the Friends of the Congressional Glaucoma Caucus Foundation has participated in major health fairs at convention centers across the USA as part of the MSNBC health fair project. The Foundation's MESUs have been featured attractions at major health fairs in Los Angeles , Chicago , San Jose , New Jersey , Long Island , Washington , and Philadelphia .

Friends of the Congressional Glaucoma Caucus Foundation and its Partners

The Friends of the Congressional Glaucoma Caucus Foundation has found that it can extend its reach to many more Americans by forming partnerships with medical schools, teaching hospitals at university health science centers, and federally funded health clinics. These partners enable the Foundation to establish a presence in many more areas. These partnerships are just as vital to our efforts as the Mobile Eye Screening Units. Oftentimes, too, our MESUs work together with these other partners.

Partnership I: Student Sight Saver Programs

In 2006, there are some 52 Student Sight Saver Programs on-going under the auspices of the Friends of the Congressional Glaucoma Caucus Foundation. These programs are run at medical schools and schools of optometry around the United States . In such programs, students, under the direction of licensed physicians or optometrists, conduct screenings in their local communities. Student Sight Saver Program participants screened 13,553 people last year. Of those, 1,898 were referred to eye care specialists for glaucoma follow-ups; 2,168 were referred for ophthalmic follow-ups for conditions other than glaucoma; and the remainder were considered routine. All participants were urged to return for screenings at least every two years.

Student Sight Saver Programs have accounted for 25% of all the people screened by the Foundation. Dr. Eve Higginbotham, now the Dean of the Morehouse School of Medicine, who first conceived of the Student Sight Saver Program, has said, “The Student Sight Saver Program gives medical students fertile ground to grow their knowledge and use it to make a difference in another person's life. The first time a medical student identifies an unsuspecting person's suspicious optic nerve or visual field, it will change his or her life. They will have discovered one of the first secrets of being a good doctor, the joy of serving.” The Friends of the Congressional Glaucoma Caucus Foundation now has Student Sight Savers Program at such top-notch institutions as the University of California at San Francisco , Columbia University , Georgetown University , Harvard University , Howard University , the University of Maryland , Morehouse School of Medicine, New York University, the University of Texas at San Antonio , and dozens of others. A listing of Student Sight Saver Programs now in place is available at our webpage, www.glaucomacongress.org. All in all, nearly 200 medical students are now involved as volunteers with the Student Sight Saver Programs of the Friends of the Congressional Glaucoma Caucus Foundation. At each school we also try to establish what we call an “Ophthalmology Preceptor,” who would be in charge of enriched ophthalmology education funded by the Foundations “Eve J. Higginbotham, M.D. Lecture Fund.”

Partnership II: University Health Science Centers

Oftentimes, a Student Sight Saver Program grows and evolves into a program based at a University Health Science Center , a major teaching hospital in the region. The Friends of the Congressional Glaucoma Caucus Foundation has now formed important lasting relationships with 14 such centers in strategic locations around the United States . These are:

  • University of Arizona , Tucson
  • University of California , Los Angeles
  • University of California , San Francisco
  • Columbia University , New York
  • Cornell University , New York
  • Creighton University , Omaha , Nebraska
  • Duke University , Durham , North Carolina
  • Howard University , Washington , DC
  • University of Illinois , Chicago
  • University of Miami
  • New York University
  • University of Texas , San Antonio
  • University of Utah , Salt Lake City
  • Yale University , New Haven , Connecticut

University Programs are vital to the FCGCF because they provide screenings, top-notch follow-up, and treatment plans. They are also equipped and willing to aid the under- or uninsured. At University Health Science Centers, patients get excellent care and medical students get superb training in treating glaucoma and other diseases of the eyes.

Partnership III: Federally Funded Health Clinics

Another important partner for the Friends of the Congressional Glaucoma Caucus Foundation can be a Federally funded health care clinic. Such clinics are often the “medical home” of indigent and economically disadvantaged people, oftentimes minorities. Not only do such people have harder times paying for health care or obtaining good medical insurance, but minorities have three to four times the incidence of glaucoma than Caucasians. For this reason the Friends of the Congressional Glaucoma Caucus Foundation has developed partnerships with eight major Federally funded health care clinics in four states (Arizona, California, Illinois, and Texas) and less structured alliances with such clinics in five other states (Connecticut, Florida, Massachusetts, Nebraska, and New York).

Whom Do We Serve? And How Do They Know About Us?

The screenings conducted by the Friends of the Congressional Glaucoma Caucus Foundation and its partners are all open to the public and depend upon “walk in” traffic. In order to generate as large a population as possible, each individual screening must be preceded by public education and advertising.

The mobile Friends of the Congressional Glaucoma Caucus Foundation screening program utilizes a three-step procedure originally devised for our screening program.  These steps are:

 

  1. A public awareness campaign to alert the local population of the dangers of glaucoma;
  2. Free public screenings for glaucoma and other potentially vision-destroying diseases;
  3. Consistent, timely follow-up to ensure, to the greatest extent possible, that anyone whose screening test indicated a problem sees an eye care professional to be thoroughly examined and treated.

Because of the high incidence of glaucoma among persons with diabetes and hypertension, screenings are done in conjunction with testing for glucose and blood pressure when possible.

Future of the Friends of the Congressional Glaucoma Caucus Foundation

The FCGCF sees its future in three parallel paths: first, it plans to expand its geographical coverage by reaching out to more partners and by adding to its fleet of mobile units; second, it plans to promote greater interest in the fields of ophthalmology and optometry by increasing its contacts with medical schools and schools of optometry; and finally, the Foundation plans to offer more services at its screenings.

Specifically, the Foundation plans to:

  • Expand its formal partnerships with Federally funded health clinics from the current ten clinics in four states to a goal of 25 clinics in 10 states;
  • Increase the number of medical schools and optometry schools in which it has Student Sight Saver Programs operating from the current 52 to 75 (i.e., from one-third of all American medical schools to one-half of all U.S. medical schools);
  • Upgrade more of its current Student Sight Saver Programs to Health Science Center major programs from the current 14 to at least 25 carefully selected and geographically diverse programs, targeting especially the middle south (Alabama, Louisiana), the upper Midwest (Minnesota, Wisconsin), the Rocky Mountain region (Colorado), and the Pacific Northwest (Oregon, Washington);
  • Construct and purchase more vehicles, both full-size MESUs and the smaller SUV-types;
  • Foster fellowships in ophthalmology at major teaching hospitals whenever cost effective or possible; and
  • Begin a systematic attempt to gather data on diabetes, hypertension, and other contributing causes. The Foundation is now reaching out to screening partners who have the capacity to collect such data and will include its findings in future reports, so that we may offer comprehensive information on a spectrum of disease states.

 

Economic Impact of the FCGCF's work.

Dr. Paul Lee of Duke University has demonstrated that the cost of caring for a patient who has been diagnosed with early stage glaucoma is very low, on the order of $700 per year for medicines and physician office visits.

On the other hand, Department of Health and Human Services statistics show that on average the cost to society when an American goes blind at age 45 is upwards of $1,000,000 over the remainder of that person's lifetime (average 30 years). This cost represents lost wages, lost productivity, lost tax revenues, and the cost of disability care for that individual.

Thus it follows that for every individual with early glaucoma that the Friends of the Congressional Glaucoma Caucus Foundation saves from going blind in his or her mid-40s, the Foundation has saved not only that person's precious, irreplaceable sight, but also saved hundreds of thousands of dollars. In fact, since it costs about $700 per year to treat glaucoma, a person living to 75 would spend $21,000 on their condition, not $1,000,000; so the saving to society is approximately $979,000.

Since 2001, the Friends of the Congressional Glaucoma Caucus Foundation has referred 21,810 individuals for glaucoma work-ups. The most conservative figures we currently have are that one in ten of all glaucoma suspects actually have treatable glaucoma – or a total of 2,181 men and women whose sight has been saved by the Foundation's work. Approximately half of them (1,090) are in their mid-40s. How much, then, has the Friends of the Congressional Glaucoma Caucus Foundation saved the American society?

 

$979,000 X 1,090 = $1,067,110,000

 

This is more than a billion dollars. And it is an amount that would fund the Friends of the Congressional Glaucoma Caucus Foundation at $4 million per year for 266 years – or until the year 2273 AD. During that time, of course, the Foundation would identify tens of thousands of more glaucoma victims, and continue to save society billions of dollars.

 

Brief History of the Friends of the Congressional Glaucoma Caucus Foundation

Founded in late 1999, the Friends of the Congressional Glaucoma Caucus Foundation, Inc. (FCGCF) is dedicated to supporting the activities of the Congressional Glaucoma Caucus, a group of United States Congress members who are committed to helping all Americans fight the scourge of glaucoma and other eye diseases. Original members of the Congressional Glaucoma Caucus were Charles Rangel and Ed Towns of New York, John Porter of Illinois, John Boozman of Arkansas (a licensed optometrist), and Donna Christian-Christensen of the US Virgin Islands (a physician). The Caucus now has 77 members and a dozen former members, and many others who support the work of the Foundation. The FCGCF has provided diagnostic screening opportunities for high risk glaucoma population groups in more than 150 home districts across the nation at no cost to screening participants. FCGCF targets groups of people at high risk of developing glaucoma or other eye disease, such as African Americans and Hispanics over the age of 40. We also target geographic areas, where adequate eye care is unavailable.

The Friends of the Congressional Glaucoma Caucus Foundation is a 501(c)(3) entity having its main offices at 1983 Marcus Avenue, Suite 111 , Lake Success , New York , 11042 . Phone: 516/327-2236; Fax: 516/327-0260. Website: www.glaucomacongress.org.

 

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