The influence of socioeconomic and clinical factors upon the presenting visual field status of patients with glaucoma

Abstract

Purpose To investigate the relationship between socioeconomic status and the extent of visual field loss in POAG and treated OHT patients at their first presentation to Manchester Royal Eye Hospital. Methods A cohort of 113 glaucoma patients seen between 1995 and 2005 was reviewed. The clinical parameters intraocular pressure, C: D ratio, family history of glaucoma, visual acuity, extent of visual field loss, and demographic parameters: age, gender, ethnicity, and residential postcode were extracted from hospital records. The socioeconomic status of each patient was estimated from the patient's residential postcode with the ACORN index (group 1: affluent and group 2: socioeconomically deprived). Results In comparison to group 1 (n49), patients in group 2 (n64) presented with more advanced field loss, lower educational attainment (18 vs 98% with no or unknown qualification), and were less aware of glaucoma in the family (27 vs 17%). Patients with a number of systemic health problems had worse vision, more severe visual field loss, and worse clinical attendance (P < 0.05). Conclusions The extent of visual field loss in glaucoma patients at first presentation is related to a combination of clinical and socioeconomic factors including the patient's postcode. This finding could be used to target future case-finding resources. © 2009 Macmillan Publishers Limited All rights reserved.