Elsevier

Ophthalmology

Volume 117, Issue 2, February 2010, Pages 207-215.e1
Ophthalmology

Original article
Self-Reported Use of Eye Care among Latinos: The Los Angeles Latino Eye Study

https://doi.org/10.1016/j.ophtha.2009.07.015Get rights and content

Purpose

To identify the prevalence and determinants of self-reported eye care use in Latinos.

Design

Population-based ocular epidemiologic study in Latinos aged 40+ years living in La Puente, California.

Participants

A total of 5455 participants.

Methods

Univariate, multivariable, and stepwise logistic regression analyses were conducted to identify predisposing, enabling, and need variables associated with self-reported eye care use.

Main Outcome Measures

Prevalence of self-reported use: eye care visit, having had a dilated examination in the past 12 months, ever having had a dilated examination, and odds ratios for factors associated with self-reported use.

Results

Overall, 36% of participants reported an eye care visit and 19% reported having a dilated examination in the past year. Fifty-seven percent reported ever having had a dilated eye examination. Greater eye care use was associated with older age, female gender, bilingual language proficiency (English and Spanish), more education, having health insurance, having a usual place for care, having a regular provider of care, a greater number of comorbidities, visual impairment, and lower vision-specific quality of life scores.

Conclusions

Multiple modifiable factors are associated with greater use and access to eye care for Latinos. Modification of these factors should be a priority because visual impairment has significant impacts on well-being and mortality.

Financial Disclosure(s)

The authors have no proprietary or commercial interest in any materials discussed in this article.

Section snippets

Study Design

Details of the LALES study design, sampling plan, and baseline data have been reported.14 To summarize, a household census of all residents within 6 census tracts in La Puente, California, was conducted between February 2000 and May 2003 to identify eligible individuals. Demographic and socioeconomic characteristics of Latinos in the 6 census tracts of La Puente were similar to those of the Latino population in Los Angeles County. All eligible participants (aged ≥ 40 years at the time of the

Study Cohort

Of the 7789 eligible participants, 6870 (88%) completed the in-home questionnaire and 6357 (82%) completed both the in-home questionnaire and the full eye examination. Complete data were available on 5455 participants who were included in this study (Table 1). Twenty-one percent were age 65 years or older, 59% were female, 72% were married, 66% had a low acculturation score, 76% were foreign born, 67% had less than 12 years of education, and 51% preferred Spanish. Seventeen percent had an

Discussion

Recently published guidelines from the American Academy of Ophthalmology recommend that members of high-risk population groups, including Latinos, receive a comprehensive eye examination every 1 to 3 years between the ages of 40 and 54 years, every 1 to 2 years between the ages of 55 and 64 years, and every 6 to 12 months after the age of 64 years.27 In this population-based study of Latinos 40 years and older living in Southern California, only 36% reported having an eye care visit of any kind

Limitations

This study has several limitations. The reliance on self-reported measures of use of care poses a risk of recall bias, that is, participants may not accurately recall use of medical care and eye care services.37 To minimize recall bias, LALES only asked questions with a 12-month recall period or questions about ever having had a particular kind of visit.14 The use of retrospective questions about visits in the past year is supported by Roberts et al,38 who found that recollections of medical

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    *A list of members of the LALES study group appears in Appendix 1 (available at http://aaojournal.org).

    Manuscript no. 2008-1474.

    Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

    Supported by the National Eye Institute and the National Center on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland (grant nos. EY11753 and EY03040), and an unrestricted grant from the Research to Prevent Blindness, New York, New York. Dr. Varma is a Research to Prevent Blindness Sybil B. Harrington Scholar. Drs. Leo Morales and Ron Andersen received partial support for this research from the Resource Center for Minority Aging Research at UCLA under Grant P30AG02168 and the Drew-UCLA Project Export under Grant 2P20MD000182.

    Group members listed online in Appendix 1 (available online at http://aaojournal.org)

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