Socioeconomic status and visual impairment and ocular disease in Canada

Socioeconomic status (SES) is a known social determinant of general health. The purpose of this review was to explore the association between SES and visual impairment and ocular disease in Canada.

Medline, Embase, CINAHL, and Cochrane were searched from inception to October 2024 for studies that explored the association between SES and visual impairment or ocular disease in Canadian patients. Descriptive statistics were used to summarize the findings. The review was registered in PROSPERO (registration number, CRD42024502490).

Twenty-eight studies were included in the review. The included studies covered all provinces and territories and included patients of all ages. Fourteen of the included studies explored the relationship between SES and visual impairment. Eleven of the 14 studies found that patients of lower SES were more likely to have visual impairment, while 3 studies found no significant differences. Fourteen studies have explored the association between SES and various ocular diseases. Glaucoma, macular diseases, diabetic retinopathy, and idiopathic intracranial hypertension were all noted to be of higher prevalence in patients with lower income levels. Patients of lower SES were at the greatest risk of having more severe cataracts (p = 0.001). Among patients with diabetes, those in the lowest SES quintile were at an increased risk of ophthalmological complications compared to higher earners.

SES is a determinant of ocular health in Canada. Higher rates of visual impairment and ocular diseases are associated with lower patient socioeconomic status. Efforts are required to mitigate this disparity and improve health equity.