Methods to Develop a Sustainable Free Eye Clinic at a Homeless Shelter

Homelessness is a major public health problem in the United States.[1] [2] According to the 2018 Annual Homeless Assessment Report to Congress, on a single night in 2018, more than 550,000 people were experiencing homelessness in the United States.[3] A recent study showed that 4.2% of individuals in the United States experienced homelessness for at least 1 month at some point in their lives and 1.5% experienced homelessness in the past year.[2] Eye health among the homeless community is of paramount importance, as poor vision makes this population particularly vulnerable and adds, significantly, to the social and health burdens.

The homeless population has been found to have high rates of uncorrected refractive error,[4] [5] [6] [7] cataract,[6] [7] [8] retinal disease,[6] and glaucoma.[7] [8] Visual impairment has also been associated with unemployment.[9] [10] Further, it has been suggested that screening for visual problems and providing free spectacles may improve the quality of life and earning potential of homeless individuals.[5] Despite this, there is a paucity of literature on the eye care needs of the homeless population; little is known about how homeless patients access eye care[4] or if/how their eye care needs are met.

In 2017, we created a free eye clinic in San Francisco at a homeless shelter to help bridge these gaps. The primary goal of our eye clinic is to meet the eye health needs of its residents in an effective and sustainable manner. Secondary goals of the clinic include teaching medical students basic principles about the eye examination and ophthalmologic decision making, and increasing medical student exposure to ophthalmology and community service as potential career choices.

As there are no papers to date on methods to develop a sustainable free eye clinic for homeless patients, our purpose is to outline the methodology and strategies that we employed to develop our free eye clinic. Our hope is that these strategies may serve as a template that will catalyze further efforts elsewhere.

Note

Supported in part by NIH-NEI EY002162–Core Grant for Vision Research and by an unrestricted grant from Research to Prevent Blindness, the United States.

• References

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