# Ophthalmic care at an academic medical centre for patients who were incarcerated or in immigration detention

## TL;DR

This study examines the challenges of providing ophthalmic care to incarcerated or detained patients at an academic medical center.

## Contribution

The paper provides one of the few empirical analyses of ophthalmic care delivery to incarcerated and detained populations in an academic health system.

## Key findings

- A significant proportion of scheduled visits were either cancelled or missed by patients.
- Follow-up rates varied across ophthalmic subspecialties, with many patients lost to follow-up.
- The study highlights substantial delays and attrition in care for this marginalized group.

## Abstract

Ophthalmic care for patients who are incarcerated or in immigration detention presents complex challenges for patients and providers. There remains a paucity of literature investigating ophthalmic care for these marginalised populations. We investigated the delivery of ophthalmic care in an academic health system to patients who were incarcerated or in immigration detention.

We conducted a retrospective observational study and secondary analysis of electronic health record data for inpatient, outpatient, and surgical visits between 1 November 2018 and 30 September 2023 in an ophthalmology department at an academic medical centre in the United States for patients who were incarcerated or in immigration detention. Attendance at outpatient clinic visits and follow-up based on ophthalmic subspecialty, loss to follow-up, delays in follow-up, and rates of ancillary testing were analysed.

1628 scheduled visits were extracted for 401 patients, of which 1084 were attended (2.7 ± 3.6 per patient) and 544 were cancelled or no-showed (1.4 ± 1.8 per patient). Patients attended 100 (68.5%) of cornea, 116 (64.4%) of glaucoma, 2 (28.6%) of neuro-ophthalmology, 139 (58.2%) oculoplastics, 9 (36.0%) of paediatrics/strabismus, and 109 (54.5%) of retina visits. Using a 2-week grace period for follow-up, 72 patients (40.9% with complete follow-up data) completed follow-up within 2 weeks. 229 patients (57.1%) were lost to follow-up at the end of the study period, which is consistent with data from previous reports on ophthalmic care at other centres for patients who were incarcerated.

Delays in care and visit attrition were substantial for patients who were incarcerated or in immigration detention. More work is needed to quantify outcomes and address disparities in care for these marginalised communities.