Sociodemographic Disparities in Cataract-Related Visual Impairment at Initial Presentation: A Sight Outcomes Research Collaborative (SOURCE) Repository Analysis

To assess the impact of social determinants of health (SDoH) and clinical factors on visual impairment (VI) at initial presentation to academic centers in cataract patients. Multi-institutional cross-sectional study. We identified patients aged ≥40 years with cataract diagnosis using ICD-9 and ICD-10 codes from the Sight Outcomes Research Collaborative (SOURCE) Ophthalmology Data Repository. Best-recorded vision (BRV) at initial presentation, demographics, Charlson comorbidity index (CCI), cigarette smoking status, and Distressed Community Index (DCI) were recorded. BRV in the better eye was used to categorize VI as none/mild (BRV ≥20/40), moderate (20/40 < BRV < 20/200), and severe (BRV ≤ 20/200). Logistic regression models were used to assess the impact of clinical and sociodemographic factors on moderate and severe VI. Among 137,847 patients with a mean (SD) age of 67.4 (9.1), 58.6% (N = 77,425) were White, 22.5% (N = 29,725) were Black, and 8.8% (N = 11,562) were Hispanic/Latino. Adjusted logistic regression revealed Black patients (OR: 1.16; CI: 1.11–1.22), Native American patients (OR: 1.45; CI: 1.18–1.78), non-English speaking patients (OR: 1.79; CI: 1.69–1.91), and current smokers (OR: 1.29; CI: 1.22–1.37) had higher odds of severe VI. Higher DCI quintiles (more economically distressed) were associated with severe VI compared with the 1st (Prosperous) quintile: 2nd (OR 1.22; 95% CI 1.16–1.27), 3rd (OR 1.45; 95% CI 1.38–1.52), 4th (OR 1.56; 95% CI 1.47–1.64), and 5th (OR 1.36; 95% CI 1.29–1.44) quintiles. This is one of the largest studies examining the impact of DCI on cataract related VI, highlighting the need for interventions to improve access to healthcare and prevent VI in these communities.