Sociodemographic Disparities in Cataract-Related Visual Impairment at Initial Presentation: A Sight Outcomes Research...

Area of Science:

• Ophthalmology
• Public Health
• Health Services Research

Background:

• Cataract surgery is a common procedure, but visual impairment (VI) persists in some patients.
• Social determinants of health (SDoH) and clinical factors are known to influence health outcomes.
• Understanding the interplay of these factors is essential for targeted interventions.

Purpose of the Study:

• To evaluate the influence of SDoH and clinical factors on visual impairment (VI) at the initial presentation of cataract patients.
• To identify specific demographic and socioeconomic variables associated with increased risk of VI.

Main Methods:

• A multi-institutional, cross-sectional study analyzed data from 137,847 cataract patients (aged ≥40) from the SOURCE Ophthalmology Data Repository.
• Visual impairment was categorized based on best-recorded vision (BRV).
• Logistic regression models assessed the impact of clinical factors (e.g., Charlson Comorbidity Index) and SDoH (e.g., Distressed Community Index, race, language) on moderate and severe VI.

Main Results:

• Black and Native American patients, non-English speakers, and current smokers had higher odds of severe VI.
• Increased economic distress, indicated by higher Distressed Community Index (DCI) quintiles, was significantly associated with severe VI.
• Factors such as race, language, smoking status, and community economic distress were independently associated with severe visual impairment.

Conclusions:

• This study highlights the significant impact of SDoH, particularly economic distress and race, on visual impairment in cataract patients.
• Findings underscore the need for interventions aimed at improving healthcare access and preventing VI in economically distressed communities.
• Addressing socioeconomic disparities is critical for reducing the burden of visual impairment related to cataracts.