Cataract surgery and eye care services utilization among African-Americans: A comparison with Whites

Background: Cataract is the leading cause of visual impairment among the elderly in the United States. Cataract surgery is the most effective and successful treatment and should be offered to all who can benefit from it. Objectives: To compare the prevalence of cataract, cataract surgery and eye care services between Whites and African-Americans (AA). Methods: Data from the 2006 – 2008 Behavioral Risk Factor Surveillance System's Vision and Access to Eye Care module were aggregated for these analyses. The module was administered to participants aged 40 years and older in 9 states in 2006, in 6 states in 2007, and in 12 states in 2008. Results: Among people age 40 years and older (N=115,018), the age-gender adjusted prevalence of cataract for AA and Whites was 12.8% and 12.1%, respectively (p=0.24). However, the cataract surgery rate was 6.0% and 10.1% for AA and Whites (p<0.001). For the people with cataract, even though AA had higher prevalence of visual impairment (24.2% vs. 15.1%, p<0.001), they had lower proportion of eye care visit (80.5% vs. 83.3%, p=0.02) and dilated eye exam (68.7% vs. 74.9%, p=0.008) during the past year. A higher proportion of AA (30.5% for AA vs. 19.4% for Whites, p=0.007) reported their failure to seek eye care visit on a regular basis was due to the cost. Conclusions: African-Americans had a greater burden of visual impairment associated with cataract compared with Whites. However, they had limited access to cataract surgery and less utilization of eye care services because of the cost.