Racial and Ethnic Disparities in Dry Eye Diagnosis and Care

ABSTRACT

Purpose

To investigate health disparities in racial and ethnic minorities with dry eye.

Methods

Medical records were reviewed for demographics, socioeconomic factors, treatments, and objective dry eye parameters. Race/ethnicity was self-reported as delineated by the U.S. Census. The reference group comprised of randomly selected White patients, with number equal to the largest minority group.

Results

The study included 465 patients (157 Black, 157 White, 85 Asian, and 66 Hispanic). Compared to White (3.2%) patients, larger proportion of minorities used Medicaid or lacked health insurance (Black 8.3%, P = .054; Asian 10.6%, P = .019; Hispanic 18.2%, P < .001). Black and Hispanic patients had lower estimated median household income than Whites (White $98,472, Black $75,554, P < .001; Asian $105,503, P = .088; Hispanic $86,839, P = .030). Prior to presentation, fewer minority patients received prescription treatments or procedures (White 61.8%; Black 30.6%, P < .001; Asian 43.5%, P = .006; Hispanic 43.9%, P = .014). Although at baseline visit minorities had worse mean conjunctival (White, 1.7; Black 2.2, P = .136, Asian 2.4, P = .022; Hispanic 2.6, P = .005) and corneal staining scores (White, 1.6; Black 2.5, P < .001; Asian 2.3, P = .003; Hispanic 2.4, P = .001), no differences were noted at final visit.

Conclusion

Minorities presented with worse objective dry eye parameters, and less prior dry eye care. Income and health care access may not fully explain the observed undertreatment at presentation. Differential management by eye care providers and patient attitudes warrant further investigation.

KEYWORDS:

• Dry eye
• socioeconomic status
• race
• minorities
• treatment

Acknowledgments

Financial support: This study was supported, in part, by an unrestricted research grant provided by the Clay and Dianne Querbes Charitable Gift Fund.

Disclosure statement

None of the authors have any relevant financial disclosures or conflicts of interest to disclose. This submission has not been published anywhere previously and is not simultaneous being considered for any other publication.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.