Prevalence of visual impairment, ocular pathology, and ability to achieve a thorough examination in an eye clinic for patients with disabilities

PURPOSE To report the demographics, types of visual/ocular pathology, and ability to achieve a comprehensive examination at a university-based outpatient clinic for individuals of all ages with disabilities. METHODS The medical records for all patients with disabilities examined from January 2014 through December 2016 at our monthly clinic staffed by a pediatric ophthalmologist were reviewed retrospectively. Descriptive statistics were calculated for demographics, visual acuity, ocular diagnoses, nonocular diagnoses, refractive error, and achievable examination data. Ocular diagnoses were categorized as treatable or nontreatable and noted if newly diagnosed. RESULTS A total of 178 patients with disabilities were examined at 281 visits; 119 patients (66.9%) were nonverbal. Of the 178, 140 patients (78.7%) had pathology or refractive error requiring glasses; 126 had pathology and 14 had no pathology. Of the 126 patients with pathology, 113 had treatable ocular diagnoses and 13 had only nontreatable diagnoses. Of the 113 with treatable conditions, 56 (49.6%) were newly diagnosed. Cycloplegic refraction was attained in 168 patients (94.4%); 85 had a significant refractive error, 66 of whom had another treatable ocular diagnosis. Lack of cooperation precluded slit-lamp examination in 1 patient, cycloplegic refraction in 3 (1.7%), dilated fundus examination in 4 (2.2%), and iCare or Goldmann intraocular pressure measurement in 28 (15.7%). CONCLUSIONS Patients with disabilities in our cohort had a high prevalence of ocular pathology, which was often treatable and previously unrecognized. Refractive errors were common and frequently accompanied by other treatable conditions. A thorough ophthalmic examination was achievable in most individuals with disabilities.