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Bringing eye care closer to home: OHSU trains community health workers for statewide network

Portland-based OHSU Casey Eye Institute team collaborates with community health clinics across Oregon to prevent blindness
A woman uses an eye pressure testing device close to the eye of Gerry Vasquez, who keeps his right eye open as the device is very close, he has dark hair and wearing a mask.
Gerry Vasquez, a community health worker from Hood River's One Community Health, gets his eye pressure tested during a basic eye health training session in Hood River on Fri., Nov. 12, 2021. (OHSU/Christine Torres Hicks)

It wasn’t until Gisela Ayala Echeverria started kindergarten about two decades ago that her family realized she needed glasses.

Gisela Ayala, a woman smiling wearing glasses, she has long dark hair.
Gisela Ayala Echeverria (OHSU)

Her parents are farmworkers and didn’t know where they could receive eye care. While they were eventually referred to a local doctor’s office, the provider didn’t speak Spanish. Despite her young age, she had to provide unofficial interpretation services between her parents and the provider as she had her vision checked.

Today, Ayala Echeverria is determined to ensure others have better and more culturally appropriate access to eye care so other families don’t have to go through what hers did.

She is among nine community health workers from Hood River’s One Community Health who were the first to receive training on the basics of eye health on Nov. 12, 2021, as part of a statewide effort to improve eye care access for the state’s underserved and underinsured residents.

Called the Oregon Vision Health Network, the effort involves OHSU’s Casey Community Outreach Program growing partnerships with community clinics across the state. OHSU will train local community health workers and clinical staff as vision health navigators who will help local residents determine if they need glasses or if they might have common sight-threatening diseases such as glaucoma, macular degeneration and diabetic retinopathy. In addition, OHSU will provide its partner community clinics and their navigators ongoing support and resources, with the ultimate goal of addressing Oregon’s vision health inequities.

Mitchell Brinks, M.D. (OHSU) A man with light brown hair smiling.
Mitchell Brinks, M.D. (OHSU)

“This statewide network provides local health leaders with the knowledge they need to prevent eye issues and preserve vision in their community,” said Mitchel Brinks, M.D., M.P.H., medical director of the OHSU outreach program and associate professor of ophthalmology in the OHSU School of Medicine. “We’re honored to work alongside community health clinics to better meet underserved Oregonians’ eye health needs right in their own backyards.”

Ayala Echeverria is part of One Community Health’s preventive health team, which offers education and support for patients living with chronic illness. At least 500 of the clinic’s patients have diabetes, which can lead to vision-threatening issues if it isn’t controlled. She plans to use the information she learned at the training to help her fellow community members better understand their eye health risks and prevent conditions such as diabetic retinopathy.

In addition to training local clinic staff, the Oregon Vision Health Network will bring advanced eye imaging equipment that uses a technology called Optical Coherence Tomography, or OCT, to up to eight partner clinics. OCT, which takes a quick cross-dimensional scan of the eye’s interior, provides a noninvasive way to diagnose and inform the treatment of eye diseases such as macular degeneration.

Community clinic staff will operate the OCT equipment locally and send the resulting images to OHSU Casey Eye Institute ophthalmologists in Portland, who will then review and provide recommendations for the clinics’ patients. In December, One Community Health in Hood River is expected to become the first partner clinic to receive this equipment.

Being a network partner allows One Community Health to expand the services it offers its 18,000 patients, about 64% of whom are on Medicaid or uninsured and about 40% of whom speak Spanish. The federally qualified health center currently offers behavioral health, primary medical care and dental services. Soon, it will also offer some basic eye health services at its Hood River clinic as well as at its mobile health clinics. Although they won’t provide advanced eye care in house, they will help connect their patients with local eye providers if needed. One Community Health aims to help its patients understand their risks and take preventive steps now, so specialized care isn’t needed later.

An image of Gladys Rivera, One Community Health's director of preventive health. A woman with dark wavy hair smiling.
Gladys Rivera (OHSU)

“This creates a new level of access for our community,” said Gladys Rivera, One Community Health’s director of preventive health. “When you screen a patient ahead of time, you can treat eye issues early and prevent blindness.”

Throughout the Oregon Vision Health Network’s first five years, patients will receive care for free. The equipment and infrastructure needed to make this possible is supported by two generous gifts, totaling $3.25 million, that were jointly given to the OHSU Casey Community Outreach Program by philanthropist Heather Killough and the Roundhouse Foundation in early 2021.

The Oregon Vision Health Network expands the OHSU Casey Eye Institute’s efforts to end preventable blindness. The OHSU Casey Community Outreach Program’s mobile eye clinic has provided free eye exams to more than 10,000 Oregonians in every corner of the state since 2010. But while the OHSU mobile clinic can only visit each community about every 1.5-2 years, trained community health workers and clinical staff can screen local residents for eye diseases year-round.

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