OPHTHALMIC REFERRAL RATES FOR PATIENTS WITH DIABETES IN PRIMARY-CARE CLINICS LOCATED IN DISADVANTAGED URBAN COMMUNITIES

The level of adherence with recommended standards for ophthalmic exami nations was assessed in a purposive sample of diabetic patient charts (n = 350) from four clinics in medically underserved areas. All of the clinics referred patients with diabetes to off-site services for comp rehensive eye examinations (dilation, visual acuity, and intraocular p ressure); adherence with the standard of care was defined as a chart n ote indicating a referral for an ophthalmic examination. Overall, 86% of the patients were from high-risk minority groups (black or Hispanic ) for diabetes and its complications. Mean age and duration of diabete s were 57.7 and 8.8 years, respectively. Referrals for ophthalmic exam s were noted in 18% of the charts during the year preceding the review and in 28.6% of the charts during the 2 preceding years. Annual refer rals in the preceding 2 years were noted in 3.1% of the charts. Eye di sease was noted as a diagnosis in 22%, Patients who had a diagnosis of eye disease noted in their charts had a 7.5-fold increase in the odds of having a referral noted. The increased likelihood of being referre d in patients with known eye disease may be due to follow-up of curren t eye problems.