Burden and predictors of undetected eye disease in Mexican-Americans - The Los Angeles Latino eye study

Background: Latinos have one of the highest rates of visual impairment associated with eye disease in the United States. Although little is known about the prevalence and risk of undetected eye disease (UED) in this population, it is known that Latinos encounter disproportionate barriers in accessing health care, which may influence the burden of UED. Objective: To estimate the burden and to evaluate factors associated with UED among Latinos, a majority of whom were Mexican-American. Research Design: Population-based, cross-sectional study. A detailed interview and eye examination were performed on participants. Subjects: A sample of 6357 Latinos (95% of whom had Mexican ancestry), aged >= 40, in 6 census tracts in Los Angeles, California. Main Outcome Measure: UED (macular degeneration, glaucoma, diabetic retinopathy, cataract, and refractive error) was defined as those persons with eye disease and no reported history of that eye disease. Results: Fifty-three percent (3349 of 6357) of the participants had eye disease. Sixty-three percent (2095 of 3349) of them had UED. Major risk factors for UED included older age [odds ratio (OR): 4.7 (age >= 80)], having diabetes mellitus (OR: 3.3), never having had an eye examination (OR: 2.4), being uninsured (OR: 1.6), lower educational attainment (OR: 1.4), and low acculturation (OR: 1.3). Conclusions: These findings provide evidence of the burden of UED among Latinos. Interventions that address the modifiable risk factors (lack of insurance, never having had an eye examination, etc.) may improve detection of eye disease and decrease the burden of visual impairment in this high-risk minority population.