Evaluation of vision services delivered by a mobile eye clinic in Costa Rica.

A number of private voluntary organizations provide mobile eye services to underserved populations in the developing world. This paper seeks to determine what segment of the population makes use of mobile vision clinics and whether the clinics are identifying significant eye conditions previously undetected by local eye care providers. The population studied were those attending the 1989 vision screening project conducted in rural Costa Rica by members of Volunteer Optometric Services to Humanity (VOSH). Sources of data include patient records of clinic attendees (N = 1530), patient interviews, and Costa Rican census data. Most of the clinic attendees were female (56.9%), over 35 years of age, and literate (71.1%). The three most commonly stated occupation categories were (1) housewife; (2) agriculture, forestry, or fishery worker; and (3) student. Over one-half reported having had a previous eye examination. Presbyopia and low hyperopia were the predominant refractive conditions encountered. Over one-third of patients presented with visual acuities 6/15 (20/50) or worse, and one-third of this group had never had an eye examination. Three-quarters of the patients required prescription lenses and over 20% had cataract. The dispensing of presbyopic corrections to first time patients is clearly the most valuable service provided by the clinics. Teaming up with mobile cataract camps may improve the access to surgical care for patients with cataract. It is important that mobile vision projects target future efforts toward those likely to be missed by conventional screenings.