The American Indian population of Oklahoma faces a severe health problem. Approximately 25 percent of adults have non-insulin dependent diabetes. Many American Indian patients who reside in the 14-county area of the Cherokee Nation in northeastern Oklahoma receive primary health care through Hastings Indian Medical Center in Tahlequah or from one of four rural health clinics of the Cherokee Nation.
Prior to 1990, only one of the four rural clinics had facilities for vision testing. It became evident at that time that the Indian Health Services hospital was serving the needs of only those persons within a 40-mile radius of Tahlequah. Traveling long distances to a health care facility created an undue hardship on American Indians in this poverty stricken area, and in the more rural areas there were many people who rarely, if ever, saw an eye doctor. The resultant impact was that patients were going blind from preventable eye diseases (such as glaucoma and diabetic retinopathy) and many children were experiencing delayed development of important learning skills due to a lack of vision care.
In 1989, various outreach programs were funded through the National Eye Institutes (NEI). The Northeastern State University Oklahoma Collge of Optometry collaborated with the Cherokee Nation of Oklahoma and submitted a grant to the Kellogg Foundation for funding of a Mobile Eye Clinic (MEC) to rotate to these underserved rural areas. Each of the rural health clinics formerly served by the MEC now has a permanent eye clinic.
Many systemic diseases, especially diabetes and hypertension, have significant ocular complications. Visual symptoms and signs may be the first diagnostic clue for these diseases. Very often, persons have entered the health care system for the first time, seeking eye glasses for "blurry vision." This is especially true in rural areas where access to medical services may be poor, and many people do not receive routine health maintenance.
Our faculty and students serve an important role in solving health problems for rural communities in northeastern Oklahoma, and are well positioned to be the gateway to the health care system. Frequently, the optometrist is the sole source of referral for these patients to other medical disciplines. Annually, our students, residents, and faculty experience more than 50,000 patient encounters. Recent expansion of the Cherokee Nation rural health care system has included permanent optometry clinical facilities in the Wilma P. Mankiller Health Center in Stilwell, the Redbird Smith Health Center in Sallisaw, the Sam Hider Community Clinic in Jay, and the AMO Community Clinic in Salina.
It is evident that the Rural Eye Program and NSUOCO play a crucial role in early detection and diagnosis in these communities, and we are leading the profession and optometric education in the delivery of eye care in rural health care programs.