Analysis of Socioeconomic Factors Affecting Follow-Up in a Glaucoma Screening Program

Patrick C Staropoli; Richard K Lee; Zachary A Kroger; Karina Somohano; Matthew Feldman; Jennifer D Verriotto; Adam Aldahan; Potyra R Rosa; William J Feuer; D Diane Zheng; David J Lee; Byron L Lam

doi:10.2147/OPTH.S346443

Analysis of Socioeconomic Factors Affecting Follow-Up in a Glaucoma Screening Program

Clin Ophthalmol. 2021 Dec 29:15:4855-4863. doi: 10.2147/OPTH.S346443. eCollection 2021.

Authors

Affiliations

¹ Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
² Ophthalmology Department, Baylor College of Medicine, Houston, TX, USA.
³ Ophthalmology Department, New York Presbyterian Hospital, New York, NY, USA.
⁴ Neurology Department, University of Miami Miller School of Medicine, Miami, FL, USA.
⁵ Dermatology Department, University of Minnesota, Minneapolis, MN, USA.
⁶ Department of Public Health Sciences, University Miami School of Medicine, Miami, FL, USA.

Abstract

Purpose: To determine what socioeconomic factors affect follow-up in a glaucoma screening program.

Patients and methods: This was a retrospective cohort study of six health fairs in South Florida from October 2012 to March 2013 among socially and economically disadvantaged populations. Visual acuity (VA), intraocular pressure (IOP), cup-to-disc ratio (CDR), and visual field testing were obtained to identify glaucoma suspects. Glaucoma suspects were defined as having intraocular pressure ≥24 mm Hg, cup-to-disc ratio of ≥0.6 in either eye, or glaucomatous defects on visual field testing. In July 2015, telephone surveys were administered to assess follow up and socioeconomic factors.

Results: Seventy-two out of 144 (50%) glaucoma suspects responded to the survey and were included in the analysis. Of the 72 respondents, average age was 52.8 years old and 65% were female. The most common race was African American (69%) and ethnicity was Haitian (51%). Glaucoma suspects who followed up were significantly more likely to have health insurance compared to those who did not follow up (74% vs 43%, p = 0.014). No significant difference in follow-up based on age (p = 0.125), education (p = 0.151), gender (p = 0.48), or ethnicity (p = 0.707) was identified. Of the 30 respondents, who did not follow up, the most common reasons were "no insurance" (57%, 17/30) and "not worried" (33%, 10/30).

Conclusion: Insurance was the main socioeconomic factor in determining whether glaucoma suspects followed up after community health screenings. Streamlining social services could increase clinical access of glaucoma suspects.

Keywords: epidemiology; follow-up; glaucoma; socioeconomics.

Grants and funding

NIH Center Core Grant P30EY014801, Research to Prevent Blindness Unrestricted Grant (GR004596). The sponsor or funding organization had no role in the design or conduct of this research.