Abstract
Purpose :
Eye exams are recommended annually for individuals with diabetes but are underutilized. We performed an electronic medical record chart abstraction to compare sociodemographic factors and visual health outcomes with eye care usage for individuals with diabetes.
Methods :
This study included adults with diabetes at a single tertiary health system over an 11-year period (Jan-1-2012 to March-1-2023). We divided participants into eye care usage groups. We defined routine use as having an initial eye exam within 12 months of diabetes diagnosis and every 12 months after during the study period. Sensitivity testing with 18 and 24 months did not vary significantly. We defined non-use as having no eye exams after diabetes diagnosis and further delineated based on the presence or absence of exams prior to diagnosis. We defined all other use as underuse. We recorded sociodemographic factors and visual health outcomes for all groups and used multivariate logistic regression models to assess the association with eye care use.
Results :
We analyzed medical records from 248,505 participants with 59,173 total visits (Table 1). We identified 673 (0.3%) routine users of eye care, 11,543 (4.6%) underusers, 3,310 (1.3%) non-users with prior eye exams, and 232,979 (93.8%) non-users without prior eye exams. Individuals with non-proliferative diabetic retinopathy were more likely to be routine users than underusers (OR=2.35, p=.009). Those with Medicare (OR=0.47, p<.0001), diagnosis of kidney failure (OR=0.66, p=.004), or diagnosis of non-healing foot ulcers (OR=0.44, p=.04) were less likely to be routine users than underusers. Female participants (OR=1.70, p<.0001) and those with a PCP (OR=4.82, p<.0001) were more likely to be non-users with prior exams than non-users without prior exams. Participants identified as uninsured (OR=0.03, p<.0001), Black/African American (OR=0.74, p=.01), or Hispanic/Latina/o/x (OR=0.66, p=.01) were less likely to be non-users with prior exams than non-users without prior exams. Intraocular pressure and visual acuity did not significantly differ across groups.
Conclusions :
Our analysis indicates that most individuals with diabetes do not receive consistent annual eye care. Underuse and non-use without prior exams are associated with lack of insurance, racial/ethnic disparities, and diabetes comorbidities. Visual health outcomes did not vary significantly despite differences in eye care use.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.