Hundreds of thousands of Americans with glaucoma are not receiving the care they need. A new Northwestern University study suggests that race, income, and where patients live play a major role in that gap.
Scientists found the odds of receiving the recommended optic nerve follow-up exam were 56% lower for patients living in isolated rural communities compared to urban areas, 17% lower for Black patients compared with White patients, and 9% lower for patients residing in more impoverished communities. Adobe Stock.
Glaucoma is a leading cause of irreversible blindness, affecting more than 3 million people in the U.S. and 76 million worldwide. Because the disease progresses gradually and often without symptoms, regular evaluations are essential for detecting damage before significant vision loss occurs.
The study analyzed data from 13,582 adults with glaucoma treated at 12 major U.S. health systems over a nearly four year period using the SOURCE Ophthalmology Big Data Consortium. While previous research focused mainly on racial and ethnic disparities, this study used a novel approach to also calculate how geographic and economic factors influenced patient care.
The scientists incorporated the Distressed Community Index Score, which measures a community’s socioeconomic distress by zip code, to assess how neighborhood affluence impacted glaucoma monitoring. They also used RUCA codes, which classify U.S. census tracts by population density and other factors, to measure the effect of urban versus rural living on access to care.
The American Academy of Ophthalmology recommends most patients with glaucoma undergo at least two follow-up visits per year, including an annual evaluation of the optic nerve.
Yet, the study found that only 57% of glaucoma patients across all demographics received an optic nerve exam within three years following a glaucoma diagnosis. The odds of receiving the recommended optic nerve follow-up exam were 56% lower for patients living in isolated rural communities compared to urban areas, 17% lower for Black patients compared with White patients, and 9% lower for patients residing in more impoverished communities.
The study identified several strategies to improve glaucoma care for vulnerable populations.