Dr. Eric Tseng says he’s had patients as young as 10 who come to him for their first visit to any eye doctor, and they are almost blind.
“It was completely unnecessary,” Tseng said. “All they needed was one doctor to catch their condition. Just one.”
In February 2010, Tseng, an optometrist, opened his private practice, Chicagoland Eye Associates, in Beverly. He said he sees a lot of low-income patients who have had eye exams, but many of their conditions went unnoticed or were misdiagnosed. Their inadequate eye care is part of the nation’s larger problems in providing quality health care to the poor and uninsured, Tseng said.
Tseng’s partner is Dr. Susan Park, also an optometrist. They have examined 800 patients since they started their practice.
“I mean, it’s frustrating. It’s like, if these people come from low-income communities, then you pretty much expect the worst almost. It’s like these people are just abandoned,” said Tseng.
The majority of his patients are receiving public aid. Tseng said his patients are the victims of “watered down eye care” because of their low incomes.
“Having your eye pressure checked is a standard procedure in an eye exam,” said Park. “When patients come in, and they’ve never gotten their eye pressure checked in their previous exams, then that alerts us right away that there is a huge problem here.”
Many of Tseng’s patients appreciate his care.
“The doctor I was going to previously I thought was nice at the time. But when I came here, I realized how much the old doctor was shortcutting.” said LaTasha Boston, 32, of the South Side. “They didn’t inform me about my eyes like Dr. Tseng. They just gave me glasses and pushed me out.”
Tseng said low-quality care is an age-old problem determined by income levels.
“It’s the same old discrimination. The ones who really need it don’t get the care they need,” said Tseng. “It’s a socioeconomic disparity.”
Tseng said people in poorer areas have the least access and the worst eye care because it’s not financially feasible for doctors to open clinics in those neighborhoods. He said optometrists do not want to accept Medicaid patients because the state doesn’t reimburse as much as private insurance companies. As a result, the clinics that do accept Medicaid in these neighborhoods are over-saturated, and the patients receive poor eye care.
“So someone may come in with five different issues, but for the sake of time and money, only one issue gets addressed,” said Tseng. “So the patients get pushed out the door with just a pair of eyeglasses, and they do not get educated or treated for their other conditions.”
This type of treatment directly affects children as well, he said.
“Undiagnosed vision in kids can have an adverse effect on their performance in school,” said Tseng.
According to the American Academy of Ophthalmology, it is estimated that 10 million children age 10 and younger have vision problems that hinder learning.
Tseng said he often sees young children with high levels of astigmatism, which if undiagnosed, can lead to permanent blindness.
“Because kids have a greater capacity to squint, to give them a good eye exam often requires them to be dilated. This takes more time, so many places aren’t willing to do it,” said Tseng. “But if you don’t dilate then you won’t get an accurate measurement. You can’t just take the first measurement and run with it. It’s a disservice to the patient.”
Park and Tseng graduated from Illinois College of Optometry on the South Side in 2007 and 2008 respectively. After working in different corporate optometry centers as well as clinics in low-income communities, they decided to open their practice to serve the South Side. Their mission is to provide quality vision care for all generations, they said.
“We want to provide the type of eye care that we were taught in school to give,” said Park.
Their patients said they receive quality care from the doctors.
“They really care here. The doctors take their time and really walk you through stuff,” said Boston. “You can tell it’s not just about collecting a paycheck.”
Tseng said what allows his practice to provide quality eye care at low cost is that he uses technology to “bridge the gap.” As part of his training for his doctorate degree, he worked at the Great Lakes Naval Base in 2007. There he learned how to use technology to do a more efficient and thorough eye exam, he said.
“They had high volumes, but they stressed the value of being absolutely thorough. But they also had the best equipment,” said Tseng.
Tseng said when they opened the practice they invested in the equipment first with hopes that the people would come. They are now using medical grade technology that’s offered in hospitals or at a specialist in a smaller setting.
“We’ve consolidated. We are short on staffing, but we use quality equipment and a good work-flow, which results in low costs for our patients,” said Tseng.
Tseng said their equipment allows them to diagnose and treat diseases. Two of the most common diseases he sees are glaucoma and diabetic retinopathy. These diseases are common in low-income communities.
“We have the opportunity of detecting diseases 10 years earlier than what is conventional,” said Tseng. We want to diagnose, manage and treat the diseases before it’s too late. What can anyone do if the patients are already blind?”
Park said what makes them different is that they are not focused on selling a product. After working in corporate-owned optometry centers since she graduated, Park said she’s noticed that these businesses want to use optometrists to simply sell their products. She said they grade optometrists on productivity, eyeglasses and contact lens sales.
“Corporate limits us on the time we can spend with each patient; they limit us on the equipment; they limit us on being able to provide the highest quality of care for our patients,” said Park.
She said she likes being able to educate her patients; whether, it’s about their high blood pressure, or some things as simple as dry eyes or a child needing to scrub their eyelids to remove bacteria.
“A patient came into my practice and we ran over $300 worth of tests, but we only charged $65,” said Park. “We don’t want our patients to go broke to determine if they have an eye disease. That’s the flexibility of having our own practice.”
Tseng said he agreed with Park.
“Doing the right thing isn’t the most financially savvy practice, but in the long-term it has the greatest benefits,” said Tseng, smiling. “When people are properly educated on their eyes and how to properly care for them it affects all aspects of the community.”