Cataract and Barriers to Cataract Surgery in a US Hispanic Population

Abstract

To report the prevalence of visually significant cataract and cataract surgery and to determine demographic and socioeconomic factors that influence use of cataract surgery in a US Hispanic population. Methods: Proyecto VER is a population-based study of Hispanic individuals, 40 years or older, living in southern Arizona. Visual acuity was measured monocularly, and a dilated ophthalmic examination was performed to determine lens opacities. Visually significant cataract was defined as severe levels of opacity and acuity worse than 20/40. Risk factors were compared between those who obtained cataract surgery in the past and those having visually significant cataract. Results: A majority of the 4774 participants in this study were of Mexican descent; 2.8% had visually significant cataract and 5.1% had undergone bilateral cataract surgery. Among those currently or previously needing surgery, having medical insurance (odds ratio, 2.88; PϽ.001) and speaking English (odds ratio, 1.80; P=.04) were significantly associated with having obtained surgery in the past. Conclusions: Visually significant cataract appears to be high among US Hispanic individuals of Mexican descent, as evidenced by rates of cataract and cataract surgery. Language and financial barriers in this population impede access to surgery. Further work to remove these barriers and provide sight restoration is warranted among Hispanic individuals of Mexican descent living in the United States.

The Impact of Race and Ethnicity on Cataract Surgery in the Nationwide All of Us Cohort

“… 31 However, a clinic-based study looking at cataract surgery risk factors did not find significant associations between lower socioeconomic status and likelihood of cataract surgery. 32 Our results contrast with previous studies among Latino patients which suggested that financial barriers impede access to surgery 33 and national health survey studies which showed that education status was also a significant factor in having eye care visits. 34 Furthermore, lower income individuals have multiple barriers to care including cost, lack of insurance, and concerns about transportation and lost wages that could lead to later presentation of cataracts.…”

The Impact of Race and Ethnicity on Cataract Surgery in the Nationwide All of Us Cohort

“… 31 However, a clinic-based study looking at cataract surgery risk factors did not find significant associations between lower socioeconomic status and likelihood of cataract surgery. 32 Our results contrast with previous studies among Latino patients which suggested that financial barriers impede access to surgery 33 and national health survey studies which showed that education status was also a significant factor in having eye care visits. 34 Furthermore, lower income individuals have multiple barriers to care including cost, lack of insurance, and concerns about transportation and lost wages that could lead to later presentation of cataracts.…”

Prevalence of Cataract Surgery and Visual Outcomes in Indian Immigrants in Singapore: The Singapore Indian Eye Study

“…Thus, the fact that diabetic retinopathy and posterior capsular opacification were the primary causes of almost 40% of visual impairment in the cataract-operated eyes in this study cohort is of significant concern. This is in contrast to studies from the western world, where age-related macular degeneration is found to be the leading cause of visual impairment after cataract surgery [31], [32]. The public health impact of the increasing prevalence of diabetes and diabetic retinopathy on cataract surgery services demand and outcomes, as shown by our data, will be relevant for planning healthcare strategies in Singapore and many other Asian countries.…”

Prevalence of Visually Significant Cataract and Factors Associated with Unmet Need for Cataract Surgery

“…Age-specific prevalences of visually significant cataract of persons in the LALES population (Table 2) are similar to those noted in Proyecto VER19, a population-based study of Mexican Americans in Arizona. In Proyecto VER, where visually significant cataract was defined as having best-corrected visual acuity less than 20/40 with presence of severe lens opacity according to the Wilmer Cataract Grading Scheme, the age-specific prevalences of visually significant cataract were: 0.1% among those ages 40-49, 0.23% among those ages 50-59, 3.0% among those ages 60-69, 8.9% among those ages 70-79, and 18.5% among those ages 80 and over.…”

The Impact of Race and Ethnicity on Cataract Surgery in the Nationwide All of Us Cohort

“… 31 However, a clinic-based study looking at cataract surgery risk factors did not find significant associations between lower socioeconomic status and likelihood of cataract surgery. 32 Our results contrast with previous studies among Latino patients which suggested that financial barriers impede access to surgery 33 and national health survey studies which showed that education status was also a significant factor in having eye care visits. 34 Furthermore, lower income individuals have multiple barriers to care including cost, lack of insurance, and concerns about transportation and lost wages that could lead to later presentation of cataracts.…”

Prevalence of Cataract Surgery and Visual Outcomes in Indian Immigrants in Singapore: The Singapore Indian Eye Study

“…Thus, the fact that diabetic retinopathy and posterior capsular opacification were the primary causes of almost 40% of visual impairment in the cataract-operated eyes in this study cohort is of significant concern. This is in contrast to studies from the western world, where age-related macular degeneration is found to be the leading cause of visual impairment after cataract surgery [31], [32]. The public health impact of the increasing prevalence of diabetes and diabetic retinopathy on cataract surgery services demand and outcomes, as shown by our data, will be relevant for planning healthcare strategies in Singapore and many other Asian countries.…”

Prevalence of Visually Significant Cataract and Factors Associated with Unmet Need for Cataract Surgery

“…Age-specific prevalences of visually significant cataract of persons in the LALES population (Table 2) are similar to those noted in Proyecto VER19, a population-based study of Mexican Americans in Arizona. In Proyecto VER, where visually significant cataract was defined as having best-corrected visual acuity less than 20/40 with presence of severe lens opacity according to the Wilmer Cataract Grading Scheme, the age-specific prevalences of visually significant cataract were: 0.1% among those ages 40-49, 0.23% among those ages 50-59, 3.0% among those ages 60-69, 8.9% among those ages 70-79, and 18.5% among those ages 80 and over.…”

The Impact of Race and Ethnicity on Cataract Surgery in the Nationwide All of Us Cohort

“… 31 However, a clinic-based study looking at cataract surgery risk factors did not find significant associations between lower socioeconomic status and likelihood of cataract surgery. 32 Our results contrast with previous studies among Latino patients which suggested that financial barriers impede access to surgery 33 and national health survey studies which showed that education status was also a significant factor in having eye care visits. 34 Furthermore, lower income individuals have multiple barriers to care including cost, lack of insurance, and concerns about transportation and lost wages that could lead to later presentation of cataracts.…”

Prevalence of Cataract Surgery and Visual Outcomes in Indian Immigrants in Singapore: The Singapore Indian Eye Study

“…Thus, the fact that diabetic retinopathy and posterior capsular opacification were the primary causes of almost 40% of visual impairment in the cataract-operated eyes in this study cohort is of significant concern. This is in contrast to studies from the western world, where age-related macular degeneration is found to be the leading cause of visual impairment after cataract surgery [31], [32]. The public health impact of the increasing prevalence of diabetes and diabetic retinopathy on cataract surgery services demand and outcomes, as shown by our data, will be relevant for planning healthcare strategies in Singapore and many other Asian countries.…”

Prevalence of Visually Significant Cataract and Factors Associated with Unmet Need for Cataract Surgery

“…Age-specific prevalences of visually significant cataract of persons in the LALES population (Table 2) are similar to those noted in Proyecto VER19, a population-based study of Mexican Americans in Arizona. In Proyecto VER, where visually significant cataract was defined as having best-corrected visual acuity less than 20/40 with presence of severe lens opacity according to the Wilmer Cataract Grading Scheme, the age-specific prevalences of visually significant cataract were: 0.1% among those ages 40-49, 0.23% among those ages 50-59, 3.0% among those ages 60-69, 8.9% among those ages 70-79, and 18.5% among those ages 80 and over.…”