Table 2.

Barriers to eye care addressed by the patient navigator

Barrier to eye care	Approach to overcome barrier
Reaching high-risk populations	Community-based, targeted intervention performed near or at the residency of individuals at risk or glaucoma.
Lack of knowledge regarding risk	Educational programs/workshops prior to glaucoma examinations.
Lack of trust	Collaborating with trusted local community partners; establishing relationship with community partners and patients.
Lack of access to eye care provider	Facilitating access by providing the examination at the community sites and providing names of local ophthalmologists for follow-up.
Need for multiple follow-up visits once glaucoma treatment is initiated	Reducing the number of visits by offering laser treatment at the community site and treating both eyes on the same day.
Low rate of follow-up	Reminding patients of follow-up appointments by letters and phone-calls; providing follow-up appointments in the community setting.
Lack of single test to diagnose glaucoma	Establishing detection system that includes intraocular pressure, corneal pachymetry, visual field, gonioscopy, and slit-lamp examination in one visit.
Poor adherence with using glaucoma medication	Offering selective laser trabeculoplasty as a first-line treatment as an alternative for eye drops for primary open-angle glaucoma.
Language	Translated educational material; medical interpreters on site.
Transportation	Transporting the intervention team and equipment to the community; community and senior center managed transportation.
Lack of medical insurance	Assistance with application to charity care and referral to city health centers that provide eye care for uninsured residents of Philadelphia.
Cost of eye care for office visits and treatments	Provided comprehensive eye examination and laser treatment at no cost to the patient as part of the demonstrational project.

Note: Wills Eye Hospital Glaucoma Research Center. 2016. Used with permission.