Can an eye exam be effectively performed in a bathroom? It’s something we’ll likely never know now, but there was a time when Pennsylvania College of Optometry (PCO) students made house calls and that possibility existed.

“We were trying to teach them how to use the portable equipment, how to actually examine patients in different settings,” said Satya Verma, OD ’75, FAAO, FNAP, Diplomate, when reminiscing about the Community Home Eye Care Service program that PCO pioneered starting in 1980 and was originally funded by the PEW Foundation of the Glenmede Trust. “We made the home our office. The patients were not only homebound, but in most cases were bed-bound. We actually examined patients in every room of the house except the bathroom.”

Community Eye Care Van
The program is long gone now, but the idea was that if the patients couldn’t make it to an eye exam, then the eye exam would come to the patients. In the 1970s, when PCO’s clinical site was located on Spring Garden Street in Philadelphia and things got a little slow, an instructor would assign a student to go see one of the elderly patients at their home.

“We wanted to reach out to these people and provide the needed care,” said Dr. Verma. “So we set up a program in which we assigned a faculty member and two students to go to individual homes.” In the 1950s and 1960s, Dr. Verma adds, physicians used to provide healthcare to homebound patients, but the practice stopped and home health nurses took over. It was unheard of at the time that eye examinations could be performed in homes.

The Community Home Eye Care Service program got plenty of support in the early years. The William Penn Foundation funded the “Eyeglass for the Needy” aspect of the program in 1983 and 1984. Support from the United Way of Southeastern Pennsylvania came from 1982 through 1987. And PCO had a contract for several years with the Philadelphia Corporation for Aging (PCA) to provide in-home eye care and eye health education and eye care at senior centers in Philadelphia.

With the PEW Foundation grant – the first grant PCO ever received from PEW according to Dr. Verma – PCO bought a van and portable eye exam equipment. Dr. Verma would receive referrals from social workers, or sometimes there would be patients at The Eye Institute (TEI) who had family members unable to get to TEI for eye care.

“We’d set up a couple of visits a day, for two or three students to go out and provide eye care,” said Dr. Verma. “We were using portable equipment and doing eye exams the best we could do in those home settings. That was better than anything they were getting, which was nothing. If they needed glasses, we would measure them for glasses, order the glasses for them, and then send a student out to their house to drop off the glasses when they were ready. The patients were thrilled to see us and happy they were getting service.”

Dr. Verma recalls one woman telling him that she was so excited she could not sleep the night before when she was told that he and the PCO students would be visiting her the next day. But she was also a little worried. “She was worried as to how we would get such heavy and bulky equipment through her door. Would we have to break down the door?” said Dr. Verma.

Unfortunately, the program ran its course for a variety of reasons, not the least of which was that the funding dried up. That and the fact that the environments in which the students found themselves conducting eye exams wasn’t always comfortable for them.

“Part of the reason (the program ended in 1998) was because of the time consumption, that it wasn’t cost-effective and because the students were not happy. The environment they were going into was not comfortable. I would say to them, ‘I understand it’s not the most comfortable environment, but keep in mind the service we are providing and are very much needed that no one else is providing,’” said Dr. Verma, who currently serves on the board of PCA.

When PCO ended the program, Dr. Verma himself continued to make house calls, without students in tow, and see patients who couldn’t receive eye care in a clinical setting. He just stopped making those house calls within the past three years.

“It was time consuming for me because I’m here (at the University) all the time, so I’d go on Saturdays,” said Dr. Verma. “I still feel that there is a great need. Are you a do-gooder or a feel-gooder? My theory is that if you do good, you will feel good. If you do something just to feel good, you may not have done any good.”