Closing the Research Gap

Although more than $5.4 billion is spent on tackling visual impairment in the US annually, racial and ethnic inequities mean that not all are given access to the healthcare they need. With chronic diseases such as diabetes becoming more common within the growing population, the risk of eye disease is at an all time high. If not addressed soon, the imminent demand in ophthalmic care could exacerbate current inequities.

Although racial and economic inequities have been studied in the past, several obstacles prevent more thorough research into the impact of these inequities. For example, although Black investigators are more likely to propose studies that address health inequities, they are significantly less likely to receive National Institutes of Health R01 grants than White researchers – preventing them from conducting health-related research.

To combat this matter, researchers conducted a scoping review to investigate the current gaps within health inequity research pertaining to ophthalmology (1). The study designs that were eligible for inclusion included – but were not limited to – systematic reviews, meta-analyses, scoping reviews, and literature reviews that related to ophthalmology between 2016 and 2021.

Out of the 75 studies included in the final sample, 93 percent pertained to race and ethnicity. Among the findings, six studies showed that White patients were more likely to follow up with an ophthalmologist than patients from other races. Several studies indicated that Hispanic individuals were more likely to develop conditions such as cataracts and myopia than White individuals; however, they were also less likely to adhere to annual eye examinations. Similarly, although several studies found that Black individuals were more likely to develop glaucoma than White patients, they were also found less likely to access ophthalmic care.

As well as race and ethnicity, 53 percent of the studies pertained to sex and/or gender. These findings were mixed; although several studies indicated that men were more likely than women to develop certain eye conditions, such as primary open-angle glaucoma. Other studies found that the male sex was associated with decreased risk of vision impairment. Similarly, where some studies found that women were more likely to be compliant and/or follow up with care, others found that women had higher eye screening failure rates and were less likely to undergo certain ophthalmic surgical procedures.

Other less commonly assessed factors included income, underresourced areas, educational level, occupational status, and LGBTQ identity – the least examined of all the demographic groups.

Although there seems to be a positive trend in health inequity ophthalmic research there are also clear gaps. The researchers concluded by recommending that future studies examine the barriers to clinical study, medical trainee recruitment, and the implementation of telemedicine in underresourced areas.