Community Eye Service Program: Factors Associated with Delayed Presentation to A Tertiary Centre Post Community Screening

Early detection and prompt treatment of eye diseases can prevent visual disability. To our knowledge, there is no published data on factors associated with delayed presentation of eye diseases in Malaysia. Our objective is to determine the proportion of patients with eye disease who had a delayed presentation to an ophthalmologist after an initial screening, as well as the factors associated with delay in seeking treatment. This was a retrospective cohort study of patients with eye diseases detected during a Community Eye Survey (CES) program from September 2004 to December 2012 who were referred to the ophthalmologist in Hospital Universiti Sains Malaysia (USM). Delayed presentation of eye disease was defined as patients who came to the eye clinic more than six months after eye screening. Multiple logistic regression was used for analyses. A total of 434 patients who were referred to Hospital USM, Kubang Kerian were included in the study. Their mean (standard deviation) age was 55.65 (21.62) years. The majority of patients (76%) had delayed presentation of eye disease post screening. Type of ocular diseases was not associated with delayed presentation. The factors associated with delayed presentation were unemployment (adjusted odds ratio (OR): 2.51, 95% CI (1.36, 4.64), p<0.05) and non-hypertensive status (adjusted OR: 2.31, 95% CI (1.39, 3.84) p<0.05). As a conclusion, delayed presentation to an ophthalmologist is common among patients post community eye screening in Kelantan. Unemployment and absence of systemic diseases increased the risk of delayed presentation to a tertiary centre. Increasing public awareness might shorten the time of presentation to the eye clinic.