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Mapping disparities in diabetic eye exam adherence using geographic information systems
Neil Sai Dogra1, Michael Patrick Geiss2,3, Talia Gearinger1
1Department of Ophthalmology, Flaum Eye Institute, University of Rochester, Rochester, New York, United States of America.
Plos One
|February 13, 2026
Summary
Diabetic eye exam adherence is low, especially in underserved areas. Geographic Information Systems (GIS) reveal disparities linked to poverty and race, guiding targeted interventions to prevent vision loss.
Area of Science:
- Ophthalmology
- Public Health
- Health Services Research
Background:
- Diabetic retinopathy is a leading cause of preventable blindness.
- Timely retinal screening is crucial for early detection and intervention.
- Suboptimal adherence to diabetic eye exams, particularly in underserved populations, necessitates innovative solutions.
Purpose of the Study:
- To investigate geographic, socioeconomic, and racial disparities in diabetic eye exam adherence.
- To utilize Geographic Information Systems (GIS) for visualizing these disparities.
- To identify high-risk populations for targeted outreach.
Main Methods:
- Retrospective, cross-sectional study of 15,656 diabetic patients (aged 18-75) in Monroe County, NY (Nov 2020-Nov 2021).
- Eye exam adherence assessed using Healthcare Effectiveness Data and Information Set (HEDIS) criteria.
- Analysis of patient demographics and ZIP-code-level socioeconomic data using OLS regression and GIS choropleth maps.
Main Results:
- Overall non-adherence rate was 31.5%, with significant ZIP-code variations (13-50%).
- Non-adherence strongly correlated with higher poverty, unemployment, and lower educational attainment.
- Increased non-adherence observed with higher proportions of Hispanic and non-Hispanic Black residents, and decreased with higher proportions of non-Hispanic White residents.
Conclusions:
- Geographic, socioeconomic, and racial factors significantly impact diabetic eye exam adherence.
- GIS mapping effectively identifies high-risk areas and populations.
- Targeted outreach strategies informed by GIS data can help reduce vision loss in vulnerable communities.
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