Abstract
Purpose: :
To estimate the prevalence of visually significant cataract among U.S. Latinos, and to report predisposing, enabling, and health behavior characteristics associated with unmet need for cataract surgery in a U.S. Latino population.
Methods: :
Participants completed an in-home interview and underwent a comprehensive eye examination which included assessment of lens opacification, using the slit lamp-based Lens Opacities Classification System II (LOCS II), and best-corrected visual acuity (BCVA). Visually significant cataract was defined by: any LOCS II grading of 2 or higher, BCVA of <20/40 in cataractous eye, cataract as primary cause of vision impairment in that eye, and patient report that general vision was fair or worse. Unmet need for cataract surgery was considered in anyone with visually significant cataract in 1 or both eyes, regardless of surgical status in the second eye. Factors associated with unmet need for cataract surgery were evaluated.Main Outcome Measure: Visually significant cataract, unmet need for cataract surgery, and predictors of unmet need for cataract surgery.
Results: :
Of 6142 participants who completed an in-home interview and clinical examination, 118 (1.92%) had visually significant cataract. Of those with prior or present need for cataract surgery, 29.9% (118/344) had unmet need for cataract surgery. Predictors associated with this unmet need included: having last eye exam 5 or more years ago compared to <1 year ago (OR=3.76; P=0.001); being uninsured (OR=2.79; P=0.0036), having a household annual income less than $20,000 (OR= 2.60; P=0.0069), and having self-reported barriers to eye care (OR= 2.41; P=0.022).
Conclusions: :
Latinos in our study had a high prevalence of visually significant cataract and a consequent significant unmet need for cataract surgery. As Latinos who were uninsured, had low household income, had not had a recent eye examination, and had self-reported barriers to eye care were more likely to have a greater unmet need for cataract surgery, interventions to modify these factors may be beneficial in reducing the burden of visual impairment related to cataract in the U.S.
Keywords: cataract • clinical (human) or epidemiologic studies: prevalence/incidence • clinical (human) or epidemiologic studies: health care delivery/economics/manpower