A Cross Sectional Study on the Possible Association between Socioeconomic Status and Unmet Ophthalmic Medical Needs

Purpose: Health care research increasingly concentrates on the putative dependence of health care access of socioeconomic determinants. For the particular aspect of ophthalmic health care the intention of this cross sectional study was to assess a possible association between socioeconomic status and lacking ophthalmological health care supplementation.

Materials and Methods: Regular visitors to the “Muelheim Tafel” social project were recruited and contrasted to administrative hospital staff, both cohorts serving as model cohorts of different socioeconomic status. The cohorts were then compared alongside visual and refractive endpoints based on a total of 110 “Tafel” participants and 68 hospital staff members. The probands’ “presenting” visual acuity was assessed by means of vision charts (in case of probands wearing glasses, the presenting visual acuity was assessed while wearing these glasses, otherwise without glasses to imitate “daily life” vision); furthermore the probands’ “best achievable” corrected visual acuity was assessed by means of an autorefractometer. The primary endpoint was defined by – in at least one eye – a simultaneous presenting visual acuity of less than or equal to 0.5 and a corrected visual acuity of more than 0.5.

Results: The primary endpoint had a prevalence of 34% in the “Tafel” cohort and of 10% in the hospital staff cohort; this difference in prevalences was found statistically significant (Fisher p<0.001). This cohort gradient was reproduced for merely all secondary visual and refractive endpoints under consideration.

Conclusion: This cross sectional investigation demonstrated a statistically significant association between socioeconomic status and deficits in ophthalmic health care in terms of best achievable visual improvement.