Purpose To assess vision health disparities in the United States by race/ethnicity, education, and economic status. Design Cross-sectional, nationally representative samples Methods We used national survey data from the National Health and Nutrition Examination Survey (NHANES) and the National Health Interview Survey (NHIS). Main outcome measures included, from NHANES, age-related eye diseases (i.e., age-related macular degeneration [AMD], cataract, diabetic retinopathy [DR], glaucoma) and from NHIS, eye care use (i.e., eye doctor visits and cannot afford eyeglasses when needed) among those with self-reported visual impairment. The estimates were age- and sex-standardized to the 2000 US census population. Linear trends in the estimates were assessed by weighted least squares regression. Results Non-Hispanic whites had a higher prevalence of AMD and cataract surgery than non-Hispanic blacks, but a lower prevalence of DR and glaucoma (all P < 0.001 in NHANES 2005–2008). From 1999 to 2008, individuals with less education (i.e., < high school vs. > high school) and lower income (poverty income ratio [PIR] < 1.00 vs. ≥4.00) were consistently less likely to have had an eye care visit in the past 12 months compared with their counterparts (all P < 0.05). During this period, inability to afford needed eyeglasses increased among non-Hispanic whites and Hispanics (trend P = 0.004 and P = 0.007; respectively), those with high school education (trend P = 0.036), and those with PIR 1.00–1.99 (trend P < 0.001). Conclusions Observed vision health disparities suggest a need for educational and innovative interventions among socioeconomically disadvantaged groups.

Most patients seeking LVR are geriatric and have macular disease with relatively preserved VA. The disparity between VA and subjective quality of vision suggests that LVR referrals are based on symptoms rather than on VA alone. Patients seen for LVR services have significant physical, psychological, and cognitive disorders that can amplify vision disabilities and decrease rehabilitation potential.

Purpose To understand the factors that influence glaucoma treatment adherence with medication taking, prescription refills, and appointment keeping in order to develop an intervention for a specific population. Patients and Methods In-depth interviews were conducted with 80 individuals diagnosed with open angle glaucoma, glaucoma suspect, or ocular hypertension. Additional eligibility requirements were that all participants were: between the ages of 18–80; White or African American; spoke and understood English; and were taking daily doses of topical glaucoma treatments for at least the past year. Cross-tabulations and Chi-square tests were conducted to compare adherent and non-adherent individuals, classified as such based on self-report and medical chart/pharmacy data. Results Compared to adherent participants, non-adherent participants were less likely to: believe their eye doctors spent sufficient time with them; ask their eye doctor if they had any questions; know of benefits to taking their glaucoma medication regularly; and have someone help them take their glaucoma medications or drive them to eye appointments. Conversely, compared to adherent individuals, non-adherent participants were more likely to have difficulty remembering to take their medications and to believe their glaucoma would affect their eye sight in the future. Conclusions Non-adherent glaucoma patients struggle with a variety of issues related to consistent use of glaucoma medicine and routine eye care. Interventions are needed to address these modifiable factors related to glaucoma treatment adherence.

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