243756 Epidemiology of Eye disease in a New York City Jail Population

Sunday, October 30, 2011

Tracy Wright, MD , Department of Ophthalmology, New York University, New York, NY
Milan Ranka, MD , Department of Ophthalmology, New York University, New York, NY
Gustavo De Moraes, MD , Department of Ophthalmology, New York University, New York, NY
Homer D. Venters, MD , Correctional Health Services, New York City Department of Health and Mental Hygeine, East Elmhurst, NY
Christopher C. Teng, MD , Department of Ophthalmology, New York University, New York, NY
Purpose: Incarcerated patients have access to ophthalmologic care that is often very limited in their community. The purpose of this study was to evaluate the epidemiology of eye disease in a New York City jail population seen at a large New York City public hospital. Methods: A retrospective review was performed of the medical records of 533 male inmates from Riker's Island Jail seen by the Bellevue Hospital Ophthalmology Consult Service from 2005-2010. Medical records were screened for socio-demographic data, medical history, and ocular morbidity. Results: Mean age in our study group was 39 ±13.2 years (range: 16-84). Of 533 patients evaluated, 319 (60%) were African American, 144 (27 %) were Hispanic, 53 (10%) were Caucasian, and 17 (3.0%) were other ethnicities including Asian and Middle Eastern patients. Two hundred and sixteen patients (41%) had no medical problems, 119 (22%) had hypertension, 102 (19%) had diabetes, and 50 (9%) were HIV positive. Two hundred and forty-four inmates (46%) had trauma-related diagnoses, including orbital fractures (13%), traumatic iritis (8.4%), blunt ocular trauma without fracture (5.4%), and ruptured globes (3.4%). The next most common diagnoses were glaucoma suspect (8.1%), nonproliferative diabetic retinopathy (7.3%), cataracts (6.6%), primary open angle glaucoma (5.1%), hypertensive retinopathy (4.9 %), proliferative diabetic retinopathy (2.1%) and retinal detachments (1.9 %). Of the 35 patients with cataracts, 8 (23%) had a history or trauma in the affected eye. Conclusions: Trauma-related injuries were the most common cause of eye disease seen in our inmate group, which was comprised largely of young, African-American males with no medical problems. In spite of a young age, individuals with a history of incarceration have a high burden of ocular morbidity, mostly due to trauma. Efforts to prevent acute trauma while incarcerated and improve screening for chronic ocular disease should be implemented in the correctional setting.

Learning Areas:
Advocacy for health and health education
Epidemiology

Learning Objectives:
To evaluate the epidemiology of eye disease in a New York City jail population seen at a large New York City public hospital.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an ophthalmology resident who has frequent interaction with the prisoner patient population at my hospital.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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