A U-M Kellogg Eye Center team, led by Maria Woodward, M.D., M.S., the Alan Sugar, M.D., Research Professor of Ophthalmology and Visual Sciences; Associate Professor of Ophthalmology and Visual Sciences; and Section Leader of Cornea, Cataract, and Refractive Surgery, is working with a national task force from the American Academy of Ophthalmology to improve access to eye care at Federally Qualified Health Centers (FQHCs) across the United States. FQHCs are community-based primary care clinics that serve medically underserved areas by providing a wide range of services to both insured and uninsured patients, regardless of their ability to pay. Dr. Woodward is joined by Paula Anne Newman-Casey, M.D., M.S., the Jerome Jacobson Professor of Ophthalmology & Visual Sciences; Associate Professor of Ophthalmology and Visual Sciences; and Associate Chair for Clinical Research, in work focused on the state of Michigan.

“Millions of Americans are at risk of losing their vision, but only about half of them ever see an eye doctor. This is a bigger problem for those living outside of large cities,” says Dr. Woodward. “We are especially interested in improving access to eye care for people in rural areas and with lower incomes.” The most common eye health issue for these patients is the need for eyeglasses, which many people can’t afford or obtain. Other common problems include cataracts, glaucoma, eye disease due to diabetes, and macular degeneration. Barriers to care include cost, difficulty accessing clinics, and a lower priority for eye health compared to other needs. “Federally Qualified Health Centers are a great place to offer eye care because they have gained the trust of communities for their health needs,” she says. “There is this huge infrastructure that effectively delivers care to patients every day.” Dr. Woodward’s team seeks to highlight the practical solutions developed by eye clinicians and researchers throughout the country. Their group works with policymakers to pilot and implement new ways of delivering eye care. “When people have competing health demands, they often prioritize systemic health conditions over their eye needs,” she says. “We need to lower the barriers to seeking and receiving eye care.” The Kellogg team has examined national data on eye care in Federally Qualified Health Centers. “We found that, even though about a third of the Federally Qualified Health Centers offer some form of eye care, less than three percent of patients receive any form of eye care services,” says Dr. Woodward. “Centers providing eye care are concentrated in a few states, and eye care is mainly available in cities. Patients in rural areas have less access to eye care services.” The goal over the next five years is to help more Federally Qualified Health Centers offer eye care, especially in Michigan, and to learn from the new demonstration programs for delivering eye care that have been funded by the Centers for Disease Control and Prevention (CDC) around the country. Expanding care will take teamwork among eye doctors, other health professionals, and organizations. “We do not envision that there will be a single solution; it really has to be a collective effort with personalized programs,” she says. “The Association of Clinicians for the Underserved and Research to Prevent Blindness are also active in this domain and are already making a difference in making sure people get the eye care that they need.”