Race, Gender, and Ethnicity Differences in Ocular Disease

The American Academy of Ophthalmology (AAO) has its Task Force on Disparities in Visual Health and Eye Care to address health equity in eyecare. This group will help address social determinants of health and medical care, access to care, and outcomes.20

It also has released a collection of seminal articles that address inequities in eye care Telehealth options will likely increase going forward. Telehealth can be a favored option to reach a greater percentage of patients who require care.21 However, physicians and their staff must make sure that patients have access to the technology required for Telehealth and that they are comfortable with it.

Including more patients from underrepresented minority groups in clinical trials can give a broader perspective on side effects and outcomes related to certain treatments.22

Personalized patient education and/or education via video can help increase awareness of health conditions and overcome barriers related to health literacy.16 Sleath et al. conducted a randomized controlled trial focused on encouraging Black patients to ask more questions of their glaucoma providers after watching a video that empowered them to do so. Compared with a control group, the intervention group patients were more likely (odds ratio, 5.4) to ask one or more questions of their providers. This simple type of measure may help improve medication adherence and reduce intraocular pressure23

Reminders regarding health appointments and help with scheduling follow-up are effective ways to ensure that patients maintain eye appointments.24

Adding eye exam lanes to community health centers can highlight the importance of vigilant eyecare24

More eye doctors in “provider deserts” can help reach a broader range of patients who otherwise may not have access to eyecare.24 This approach also gives more patients a stable provider, which can improve adherence to appointments and care.

Identification of patients with lapses in care can be useful both to encourage these patients to seek more frequent eye care but also so providers can make treatment decisions that may last longer compared with patients who can return more frequently.10

Awareness of implicit bias could help address perceptions of disrespect or lack of courtesy perceived by some non-White patients9

Childcare or adult caregiving resources could help patients who do not come for regular appointments due to challenges in these areas9

Artificial intelligence and other new, effective technologies can enhance point-of-care exam for DR among pediatric patients with diabetes. AI-assisted visits led to an exam completion rate of 100% versus 22% among the control group. Of those with an abnormal result, 64% followed up with a provider compared with 22% in the control arm.25


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