Delivering Eye Care to Homeless and Marginally Housed Populations during the Coronavirus-19 Pandemic: A Pilot Study

Slomovic, Jacqueline; Hanna, Verina; Chaban, Yuri; Rafael, Josha; Popovic, Marko M.; Arjmand, Parnian; Wylson-Sher, Victoria; Lichter, Myrna

Background Homeless and marginally housed populations experience a higher prevalence of visual impairment relative to the general population. The aim of this pilot study is to present a novel model for conducting ocular screening clinics for homeless individuals during a pandemic, and to describe the status of ocular health in this population during this time. Study Design Cross-sectional study. Methods Three outdoor, tent-based ocular screening clinics were held in a park in Toronto, Canada. Most participants were recruited from local shelters, however additional spots were allocated for homeless individuals on a drop-in basis. Prior to enrollment, each participant underwent COVID-19 screening via a questionnaire and temperature measurement. Those who screened negative received a comprehensive eye exam including vision testing, dilated fundus examination, and auto-refraction. Results Eleven individuals completed all assessments. The mean age of participants was 54.5 years, and 11 of the participants were men. Visual impairment was found in 5 individuals. Refractive error via pinhole testing was found in 1 patient. Ocular pathology in this sample was found in 4 participants. Two patients required a referral to an ophthalmologist. From a psychosocial perspective, 4 participants reported significant difficulties. Conclusions This novel, tent-based ocular screening program provides a viable option for screening in a pandemic.