Annie O'Neill, Post-Gazette Amy Zhang, a University of Pittsburgh medical student, examines a patient's eyes at the Birmingham Free Clinic on the South Side. The checkup is part of the Guerrilla Eye Service. Click photo for larger image.

Neatly dressed and polite as he waited for an eye exam, Robert Stockdale hardly gave the appearance of a man who lives under a bridge.

But Mr. Stockdale said he is homeless and sells his plasma to make ends meet. He also works construction jobs, but said he lacks health insurance to cover treatment of his bipolar disorder and other medical needs.

So when he began having trouble reading, Mr. Stockdale was relieved to find out about the Guerrilla Eye Service, a mobile clinic staffed by volunteers that provides eye care for free.

"I appreciate this place," Mr. Stockdale, 45, said as he sat in an examination area on the second floor of the Birmingham Free Clinic.

The South Side clinic, where Mr. Stockdale obtains his medication and other medical care, is just one place where the mobile eye service has set up shop.

Among other sites, the service has provided care to Greene County residents and to people with developmental disabilities at Verland community homes in Sewickley, said Dr. Evan Waxman, who directs the training program for ophthalmology residents at the University of Pittsburgh Medical Center.

Free eye care and other types of specialty medical treatment can be difficult to find in the Pittsburgh area, said Leslie Bachurski, operations manager for the Consumer Health Coalition.

And barriers to treatment are not always financial, Dr. Waxman said, noting that many people with developmental disabilities, for example, are covered by Medicaid but may have difficulty getting to regular eye care appointments.

The Guerrilla Eye Service tries to bring treatment more directly to people in need, he said, through a "mobile eye squad that can set up and break down quickly."

Annie O'Neill, Post-Gazette Dr. Evan Waxman, director of training for ophthalmology residents at UPMC, oversees the mobile clinic that takes eye exams to locations frequented by people in need. Click photo for larger image.

Dr. Waxman said he organized the service after realizing that Pitt's ophthalmology residents, who go on a medical missions trip to Honduras each year, could also make trips "to take care of the people who need us in Western Pennsylvania."

He obtained foundation grants to help purchase about $80,000 in equipment that could be disassembled and transported in his car. He and the residents, along with medical students and UPMC staff members, donate their time to conduct the clinics and provide comprehensive eye examinations.

Glasses are provided through LensCrafters, Lions clubs or other organizations, Dr. Waxman said.

To identify patients, the service often works through referrals from clinics that treat people in need. Eye examination results become part of the patient's medical record at those sites, and the eye service makes return visits to provide follow-up care.

Dr. Waxman said the service hopes to expand to more sites and has most often provided care at the Birmingham Free Clinic, operated by the Program for Health Care to Underserved Populations and located in a building owned by the Salvation Army at 54 S. Ninth St.

The clinic serves more than 2,300 patients a year with volunteer physicians, pharmacists, nurses and students. It is one of four free health clinics in Pittsburgh operated by the program, which is administratively located in the division of general internal medicine at the Pitt medical school.

	Annie O'Neill, Post-Gazette UPMC resident Dr. Gustavo Corrales gives an eye exam at the Birmingham Free Clinic on the South Side. Click photo for larger image.

The program is primarily supported by its volunteers and also by the medical school, the school of pharmacy, UPMC, United Way contributions and other donations.

About half the Birmingham clinic's patients are working but lack health insurance, said Mary Herbert, the health care program's clinical director.

A variety of patients lined up at the clinic for eye care on a recent evening. Unlike Mr. Stockdale, most asked that their names not be used.

Dr. Waxman knelt beside one seated patient to suggest that she have laser surgery for glaucoma.

"This isn't something we should wait on," he said.

Eye drops had been unsuccessful in controlling the disease, he said, and without additional treatment, her sight could be lost.

The eye service planned to make arrangements to obtain funding to pay for her laser treatment. The 64-year-old patient said she lost the health coverage she had through her employer when she retired.

Two men who came for treatment said through an interpreter that they were undocumented workers from Mexico. They said they held restaurant jobs here that did not offer health insurance. One received a prescription for glasses and the other eye drops for irritation related to an abnormal growth of the conjunctiva, a membrane that covers the white of the eye.

Mr. Stockdale, who also received a prescription for glasses, said he was grateful for the help provided by the clinic and the eye service.

"There should be more places like this."