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

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

Disclosure

The authors report no conflicts of interest in this work.

Additional information

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.