appearance is not characteristic of RP. Other ocular signssuch as myopia and strabismus develop before the retinalchanges and can alert the clinician to the possible diagnosis.Visual acuity is usually reduced by age 6 and continues todecrease such that 65% of patients are legally blind by age20. Management of this condition includes genetic testing/counseling, vision rehabilitation, coordination of vision ser-vices with the school, and comanagement with the PCP forsystemic manifestations.Case Report: A 6-year-old Asian female was referred forevaluation of decreased acuity O.D. and O.S., nystagmus,and strabismus. The patient’s ocular history was negativefor injuries, surgeries, and night blindness. Her medicalhistory was positive for asthma, obesity, and polydactyly.Best-corrected visual acuity with a Bailey-Lovie logMarchart was O.D. 20/276 and O.S. 20/350 with a moderate,compound myopic prescription. Cover test revealed a 25�

constant left exotropia at both distance and near. EOMs andconfrontation visual fields were full in each eye. A high-frequency, small-amplitude jerk nystagmus was noted. Di-lated fundus exam revealed attenuated vessels but wasotherwise normal. The patient displayed classic signs ofBardet-Biedl syndrome and was referred for genetic testingand low vision rehabilitation.Conclusion: Bardet-Biedl syndrome is a rare condition withocular signs found in 93% of patients. As the appearance ofthe retina can be quite variable, clinicians must be attuned toother ocular signs as well as systemic signs to most appro-priately manage these patients. Detailed results of lowvision recommendations along with the latest genetic re-search on this condition will be presented.

Public Health

Poster 80

InfantSEE® Becomes a Toddler: Two Years of ResultsTimothy A. Wingert, O.D., Ralph P. Garzia, O.D., andJeffrey L. Weaver, O.D., M.B.A., M.S., University ofMissouri–St. Louis, College of Optometry, One UniversityBoulevard, Saint Louis, Missouri 63121

Background: The American Optometric Association an-nounced InfantSEE� in June of 2005. InfantSEE is a publichealth program that attempts to identify infants between 6and 12 months of age who are visually at risk, so that anycondition requiring intervention, e.g., amblyopia, may beidentified to maximize treatment effectivity.Method: The records of all infants seen by an InfantSEEparticipant voluntarily submitted to the Clinical Care Groupof the American Optometric Association were collected foranalysis from the launch of the program in June 2005 untilthe end of 2006. All patient-identifying information waseliminated to maintain patient anonymity according toHIPAA privacy standards. The information from each as-

sessment was entered into a database for descriptive statis-tical analysis.Results: Some records were eliminated from considerationbecause they became illegible during submission and thedata could not be extracted reliably. Therefore, the resultsare based on the actual number reporting results for eachparticular survey item. These data extend the results fromthe first 6 months of the program previously reported.Discussion: The InfantSEE program has now become atoddler. In its first 21 months, results were reported on over10,000 infants. The rates at which concerns were expressedare in broad agreement with the literature on the prevalenceof vision problems reported in this population.

As the program becomes more widely known and thenumber of infants seen increases, there exists the opportu-nity to positively impact the number of untreated visionproblems in children. With early and proper treatment,many of these vision problems can be improved. This wouldbe an important step in ensuring the visual welfare ofchildren, improving children’s visual performance and qual-ity of life throughout their lifetimes.

Poster 81

Prevalence of Myopia Among African-American andUgandan SoldiersWilliam H. McAlister, O.D., M.A., M.P.H., andTimothy A. Wingert, O.D., University of Missouri–St.Louis, College of Optometry, One University Boulevard,Saint Louis, Missouri 63121

Background: Controversy exists as to whether refractiveerror is determined by heredity or more influenced byenvironmental causes. This topic has been debated withinoptometry and ophthalmology for years. An often-usedargument by the environmental theorists is the differencethat has been reported in the distribution of refractive errorsbetween those from developed and developing countries.This has led many to hypothesize that environmentalcauses, specifically prolonged and detailed near work, leadto the development of myopia. However, those who areproponents of heredity as the causal factor argue that allinherited traits are not present at birth.Method: As part of the Uganda African Crisis ResponseInitiative, U.S. Army optometric personnel provided visionscreening, examination, and treatment to a battalion sizetask force from the Ugandan Army. All of those screened aspart of this mission were young African men in their earlytwenties. For comparison 3,247 U.S. soldiers were screenedat the 43rd reception battalion at Fort Leonard Wood,Missouri. Of these, 627 were African-American. Thosefrom Uganda who failed had the spherical component oftheir refractive error compared with those U.S. soldiers ofAfrican ancestry who had failed the previous vision screen-ing and were of the same age group. Soldiers from bothgroups were only examined if they failed vision screeningbased on distance visual acuity and/or reported symptoms.

303Poster Presentations

Results: During this mission, 692 Ugandan soldiers werescreened, and 104 failed the screening. Of the 627 Americansoldiers of African ancestry, 218 failed the screening. Therewas a statistically significant difference in the amount ofmyopia exhibited by these men with the Ugandan meanrefractive error of -0.24D � 1.01 and the U.S. soldiershaving a mean refractive error of -1.27D � 1.97.Discussion: Among those who were symptomatic and/orhad decreased distance acuity, the rate of myopia amongage- and race-matched soldiers was significantly higheramong those from the United States compared with thosefrom Ugandan.

Poster 82

Need for Health Care Among Uninsured Low IncomePatients in a Community-Based ProgramJanis Winters, O.D., Illinois College of Optometry/IllinoisEye Institute, 3241 South Michigan Avenue, Chicago,Illinois 60616

Purpose: It has been estimated that 14.3% of people inIllinois who are uninsured and may not have access tohealth care. Eye care can prevent vision impairment, whichimpacts quality of life and life expectancy. The Vision ofHope Health Alliance (VOHHA) was a community serviceprogram that provided comprehensive eye care to unin-sured, low-income adults who were referred by partnerservice agencies (SAs) or Federally Qualified Health Cen-ters (FQHCs). VOHHA connected patients to health centerswhen indicated. Patients seen through the VOHHA programdemonstrated the unmet need among the uninsured, low-income population.Methods: Case workers coordinated referrals from SAs andFQHCs, met with VOHHA patients and recorded demo-graphic information. Retrospective record review was per-formed to determine self-reported last medical exam(LME), last eye exam (LEE), and history of hypertension(HTN), diabetes mellitus (DM), ocular disease, and visionimprovement.Results: Of the 336 patients served, 59.5% were womenand 40.5% were men. A total of 46.5% were black, 34.5%Hispanic, 8.6% white, 7.7% Asian, and 0.9% other. Averageage was 49.4 years (SD 12.6). One hundred seventeen werereferred by SAs, 189 by FQHCs and 31 through self-certification (SC). For patients who reported time since LEE(221/316), 133 (60.1%) reported LEE was �15 months; 89(40.3%) reported LEE was �3 years. Ninety-five (30.1%)were unsure of LEE. Seventy-two (22.9%) reported a his-tory of any ocular disease. The mean increase in visualacuity was 2.3 lines (SD 2.5). A total of 123 (36.6%)patients were identified as suffering from visually threaten-ing ocular disease. Treatment of any ocular disease wasinitiated in 121 (38.8%) after the exam. For all patients whoreported time since LME (239/316), 168 (70.3%) reportedLME was �7 months; 43 (18%) reported �18 months. Thisincreased to 29 (32.6%) when only those referred from SAs

were considered. Seventy-seven (24.3%) did not know howlong since LEM. A total of 245 (77.8%) reported a historyof systemic disease. For those referred from an FQHC, theprevalence of DM and HTN was higher than those referredfrom SAs (47%, 47.7% and 15.4%, 34.5% respectively).While many factors may contribute, the prevalence amongthose from SAs is likely underestimated because 59 (47.3%)report not having a PCP, while 3 (1.6%) from FQHCs reportno PCP. Of the 71 patients without PCPs, 21 (29.5%) keptappointments with PCPs recommended after their eye ex-ams.Conclusions: Although there is variability based on referralsource, a large number of patients haven’t had a recent eyeexam or medical exam and have either been diagnosed withor are at risk for disease. The VOHHA program demon-strated a model for health care delivery and underscores theneed for health care in this population.

(The Vision of Hope Health Alliance is supported by agrant from the Robert Wood Johnson Foundation.)

Poster 83

Healthy People 2010 Community Collaborative:Integration of Vision and Eye Health Education Into aNational Diabetes Community Rural Health EducationProgramNorma K. Bowyer, O.D., M.S., M.P.H., West VirginiaUniversity, 243 Wagner Road, Morgantown, WestVirginia 26501

Healthy People 2010 (HP 2010) outlines the public healthgoals and objectives for the nation. It is the first HealthyPeople document in a series of public health documentsoutlining the nation’s priorities over the past 4 decades todesignate a specific chapter to vision and eye health. In thestate-based document that translates these national objec-tives to state needs, Healthy West Virginia 2010: A Health-ier West Virginia 2010, vision and eye health objectives arealso designated as priorities. To encourage disseminationand implementation of these objectives, the American Op-tometric Association (AOA) has promoted the HP 2010program by developing a vision and eye health initiative,Healthy Eyes, Healthy People 2010™ (HEHP 2010). Twoof the 10 objectives in the vision chapter relate to enhancingthe health status of the nation by improving diabetic eyecare. Part of the AOA’s HEHP 2010 program offers smallcommunity-based grants through state optometric associationsto stimulate collaborative work at the state and local levels.

This presentation describes a prevention education pro-gram funded by an AOA HEHP 2010 grant provided byVSP and Luxottica, which develops and integrates visionand eye health information into an existing evidence-basedrural diabetes education program. The revised portion of theprogram educates West Virginians about how diabetes af-fects their vision and what actions they can take to minimizethe impact of diabetes on their vision. Also, this programinforms people who have diabetes and their families about

304 Optometry, Vol 78, No 6, June 2007