What is the Guerilla Eye Service?

Evan “Jake” Waxman, MD, PhD

Living up to their motto of “travel light and save sight,” Dr. Evan Waxman, along with ophthalmology residents and medical school students, take their “mobile eye clinic” to underserved communities around Pittsburgh three times a month.

Vision loss is a debilitating condition that affects millions of people around the world. Exasperating this problem is the fact that in many communities, vision care often takes a backseat to other necessities and responsibilities. While many eye diseases cannot be cured, in some patients, vision loss can be saved if the condition is diagnosed and treated early enough. Fortunately, physicians, residents, and students from the Department of Ophthalmology at the University of Pittsburgh School of Medicine continue to advance their efforts to provide free vision care for residents in underserved communities around the Pittsburgh area.

Travel Light and Save Sight

The Guerilla Eye Service, or GES, was established in 2005 by Evan “Jake” Waxman, MD, PhD to help provide vision care to individuals who may not have access to vision screenings due to a myriad of reasons. “Likely barriers to care for this population include issues related to finances, transportation, time off from work for themselves or a family member, mobility, a misunderstanding of the importance of the findings, and difficulty with navigating an increasingly complex healthcare system,” states Dr. Waxman, Associate Professor of Ophthalmology and Vice Chair of Medical and Resident Education at the University of Pittsburgh, as well as the Director of Comprehensive Ophthalmology Division.

Living up to their motto of “travel light and save sight,” Dr. Waxman, along with ophthalmology residents and medical school students, take their “mobile eye clinic” to underserved communities around Pittsburgh three times a month. Here they provide free vision screenings, including retinal screening, for patients throughout the day. Depending on their diagnosis, patients can receive prescriptions for medicine, vouchers for glasses, and referrals for those conditions requiring more specialized follow-up care. Following this model, the GES team is able to see more than 300 patients annually.

Addition of GES Recon

After a decade of running GES and seeing its impact on the community, it became apparent that even more screening was needed. In 2012, Dr. Waxman and his team launched GES Recon, a program designed to reach a larger number of people and to target the patients at the highest risk of vision loss and blindness.  The program provides service for patients at sites that GES Mobile does not reach and for patients who are unlikely to make it to the eye doctor.

A web-connected retinal camera, which requires minimal operator skill, is permanently placed at a primary care site, such as a community health clinic. Onsite staff is trained to use the camera and to identify those patients who are at the highest risk for vision loss. Once retinal images of these patients are taken, the images are sent to be interpreted by physicians at the UPMC Eye Center. Follow-up reports and treatment recommendations are sent back to the community health providers to discuss with the patients.

“GES Recon targets patients at risk of losing vision from diabetes and glaucoma. These are two conditions that do not cause symptoms until the disease is very advanced and are over-represented in underserved populations,” states Dr. Waxman. Our work to date shows that remote screening is effective at detecting patients at greatest risk for vision loss.”

Currently, there are roughly 50 retinal cameras placed around the Pittsburgh area at any given time, producing over 7,000 images annually.

Looking Towards the Future

“I think the GES service activities help to remind all of us who participate why we became doctors in the first place – to help people, to provide the best and much-needed care for the underserved populations,” explains Dr. Waxman. “We have seen ophthalmology departments at other academic health centers create similar programs after asking for our advice and we’d like to continue to see the GES model spread nationally.”

Programs like GES, made possible through the generosity of Eye & Ear Foundation supporters, is helping to lay the groundwork for increasing access to care and saving vision for thousands of at-risk patients. If you would like to be a part of this crucial work, please consider making a gift to The Eye & Ear Foundation to support our research.

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