Up Close and Personal With a Community Eye Clinic

In October 2014, Seattle Center and its Seattle Center Foundation partnered with Remote Area Medical (RAM) to host its first community clinic, where 1,500 volunteers provided nearly $2.4 million in free dental, vision, and medical care to roughly 3,400 individuals.¹ The clinic typically takes place once a year, for 4 consecutive days (Thursday through Sunday), with setup and teardown taking place a few days before and after. Many of the patients served have health insurance, but do not have vision or dental coverage. They may otherwise have poor coverage and difficulty accessing quality care otherwise (see Understanding Those Served by Community Health Clinics).

The Seattle/King County Clinic doesn’t require identification or proof of citizenship, but it does have many interpreters and interpretation technology to serve non-English speakers. All are welcome, regardless of age, race, ethnicity, income level, or housing situation. The clinic also partners with a local organization called Project Access Northwest, which helps facilitate referrals for additional care to treat conditions such as cataract, glaucoma, and retina disease using relationships we have set up with Kaiser Permanente and the University of Washington Medical Center.

The main leadership of the Seattle/King County Clinic consists of about five non–health care providers who work for the Seattle Center Foundation. Over the years, they have connected with many volunteer health professionals and other general support volunteers to fill the ranks of clinic leadership. A free health clinic is a huge logistical effort, requiring many different groups of people. We have an entire volunteer IT department; equipment technicians; interpreters; volunteers in every specialty (providers, techs, nurses, and more); and many general volunteers to help with tasks such as setup and escorting patients. There are thousands of volunteers each year.

The clinic has an excellent registration and informational website for volunteers with consistent messaging and branding (Figure 1). This is all due to the incredible brain and organizational talent of its Director, Julia Colson, who works for Seattle Center, and her team. The volunteers self-market a good deal of the clinic using social media and flyers. However, the event is also often written up in local newspapers, mentioned in newscasts, and advertised on its social media accounts (@seattlekingcountyclinic).

DEALING WITH CHANGE

The 2020 Seattle/King County Clinic took place in February, just 1 month before the World Health Organization declared a global pandemic, and the 2021 clinic was cancelled because the COVID-19 pandemic was ongoing. Last year, because a facility large enough to accommodate the full clinic (medical, dental, and vision) was not available, it was decided to host a vision-only clinic. The full medical, dental, and vision clinic returned this spring.

In October 2022, 2.5 years after the last clinic was held, 1,058 volunteers and therapy dogs (Figure 2) provided $613,210 in vision care to 1,039 individuals and 45 organizations contributed to the project. A total of 53 ophthalmologists, 50 optometrists, 53 opticians, and 74 technicians/assistants donated their time to the clinic to perform 983 eye examinations and dispense 515 bifocals, 54 readers, and 531 single-vision glasses.

THE VISION CLINIC IN A NUTSHELL

In the vision clinic, we provide comprehensive eye examinations, including intake, visual acuity assessment, confrontation testing, IOP measurement via Tono-Pen (Reichert) or Goldmann applanation tonometry, refraction, and ocular health examination, including dilation and OCT, if needed. We write prescriptions for medication, if warranted, and we have a full optical from which we can order one pair of single-vision or bifocal glasses (or two, if necessary for someone with prism or a high prescription, etc.). These prescriptions are sent to our lab and are dispensed at a separate event about 1 month later. We give patients a copy of their eyeglass prescriptions so they can take them elsewhere, and all medical records are retained and accessible to patients at any time. We have many patients who return each year for their annual eye examinations. We do not fit or dispense contact lenses or perform any surgical procedures, but we refer patients to other providers in the community who can provide these services through Project Access Northwest.

Patients are incredibly grateful, and volunteers love working at the clinic because we can simply take care of patients without having to worry about many of the frustrations of typical practice, such as dealing with insurance, billing, or costs. Many say they wish the American health system wasn’t so bad that it was necessary to put on clinics like this, but until it improves, we will continue to return as volunteers for as long as we are needed. It is not unusual for patients to cry at the dispensing event when they put on their new glasses. We are also incredibly lucky to have excellent, quality, donated frames (Figure 3), allowing patients to pick from great, fashionable options, rather than being left sorting through a box of the cheap, out-of-style frames typical of many low-income clinics.

A LIFE-CHANGING EXPERIENCE

I have moved from being an OD volunteer at my first event in 2017 to a leadership role as an assistant vision director in 2022, to now being one of seven vision directors this year, working alongside three certified technicians, two opticians, and one ophthalmologist. I believe it is in clinics like ours where the skills we have as ODs can shine. We help people with their eye problems every day in our normal clinics, but we can help thousands more who truly need it by participating in volunteer clinics.

I have refracted kids who were -6.00 D who didn’t have any usable glasses for the previous year. We have also seen patients with -20.00 D prescriptions and those with serious vision issues, such as retinal detachments, which we have been able to refer to a retina specialist the next day. Because of the pandemic, we had even more patients who have delayed or denied themselves medical or eye care for years.

Many people who visited our 2022 clinic were in desperate need of new glasses. By volunteering in this capacity, you can see a real, tangible improvement in the patient’s quality of life by performing eye exams and dispensing glasses. I also like not having to deal with the annoyance of insurance billing and determining the cost of frames, lenses, exams, copays, etc. I can see just one patient at a time, listen to their story, and take care of them with no strings attached. It’s very fulfilling.

Once they volunteer for 1 year, most people come back again and again because it’s such a great experience. Being able to work with so many other like-minded volunteers is also fun, and many of them have become my friends over the years. It is a joy to be surrounded by people with the same mindset to get things done and help as many people as possible. One patient mentioned they like coming to our clinic because they “know the volunteers here are here because they want to be, not because they have to be. When you come here, they treat you like you are a person.”

GIVE A LITTLE ANd GET SOME YOURSELF

I would encourage all ODs to volunteer their eye care skills in some capacity. I bet everyone put down some version of “wanting to help people see” on their optometry school application essays. This is a way for you to do that. We have special knowledge and skills. Not everyone can refract or diagnose eye conditions. We can do these things and provide care that people don’t currently have access to.

It’s hard to live your life, work, and do anything if you can’t see, and this is a way for us to help the people in our community and improve the quality of life for everyone. It’s a win-win situation, honestly. Volunteers feel good about helping people, and patients get great quality care from knowledgeable providers and other volunteers. It’s also a nice reminder for those more medically focused ODs that refraction is still important and that glasses with a proper prescription can be truly life-changing for patients.

Our most recent clinic took place April 27–30. Next year’s clinic will be held in early 2024. We can always use more volunteers! Contact me at the email below if you’re interested in getting involved with Seattle/King County Clinic or Uplift Northwest—another weekly volunteer clinic I co-coordinate in the Belltown neighborhood of Seattle. If you are looking for other optometric volunteer work around the country, consider Special Olympics and Volunteer Optometric Services to Humanity.