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Health and Interprofessional Practice
Volume 1 | Issue 4
eP1033
A Survey of Eye Disease in Adult Latino Patients in
Boston: A Community Health Center Perspective
Amy R. Moy, Kristen Brown, Elizabeth Hoppe, Li Deng, Linh Trang
Moy, AR, Brown, K, Hoppe, E, Deng, L, Trang, L. (2013). A Survey of Eye Disease in Adult Latino Patients in Boston: A Community
Health Center Perspective. Health and Interprofessional Practice 1(4):eP1033.
Available at: http://dx.doi.org/10.7772/2159-1253.1033
© 2013 Moy et al. This open access article is distributed under a Creative Commons Attribution License, which allows unrestricted use, distribution,
and reproduction in any medium, providing the original author and source are credited.
HIP is a quarterly journal published by Pacific University | ISSN 2159-1253 | commons.pacificu.edu/hip
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A Survey of Eye Disease in Adult Latino
Patients in Boston: A Community Health
Center Perspective
Amy R. Moy OD, FAAO New England College of Optometry/New England Eye
Kristen Brown OD, FAAO New England College of Optometry/New England Eye
Elizabeth Hoppe OD, MPH, DrPH Western University
Li Deng PhD New England College of Optometry
Linh Trang OD New England College of Optometry
Abstract
INTRODUCTION The purpose of this study was to survey the prevalence of ocular disease and associated systemic
conditions in an adult Latino population of mostly Caribbean individuals seeking eye care in two Boston community
health centers.
METHODS Records of 301 Latino patients more than 40 years old were reviewed in a retrospective chart study from
Eye Clinics in two community health centers. Data was collected on demographics and ocular diagnoses including
cataracts, glaucoma, diabetic retinopathy, and macular degeneration (AMD), as well as hypertension and dry eye.
RESULTS 223 of the 301 (74%) eligible patients were female. 62.1% were Dominican, and 22.6% were Puerto Rican.
91 patients (30.2%) had Type II diabetes, 20 (6.6%) had diabetic retinopathy; 13 patients (4.32%) had glaucoma; 186
patients (61.8%) had cataracts; and 1 patient had AMD. In addition, 113 patients (38.70%) had hypertension and 62
patients (21.23%) had dry eye.
CONCLUSION Adult Latino patients seeking eye care in the two health centers were mainly female, of Caribbean
descent, and likely to have nuclear sclerosis and dry eye. There was a low prevalence of diabetic retinopathy, AMD and
open-angle glaucoma. More research is needed to understand the ocular health of Latinos, the fastest growing minority
group in the United States.
Received: 07/07/2012
Accepted: 02/26/2013
Published: 04/02/2013
© 2013 Moy et al. This open access article is distributed under a Creative Commons Attribution License, which allows unrestricted use,
distribution, and reproduction in any medium, provided the original author and source are credited.
Health & Interprofessional Practice | commons.pacificu.edu/hip
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Eye Disease in Adult Latino Patients
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Introduction
This study seeks to survey the prevalence of common
ocular and systemic conditions in a self-selected population of adult Latinos seeking eye care from two Boston
eye clinics in community health centers. In addition,
the results of the study will contribute to the greater
knowledge and understanding of ocular disease for
certain subsets of Latinos of Caribbean descent, since
the majority of our sample of Latino patients were from
the Dominican Republic and Puerto Rico.
Latinos are the fastest growing segment of the population in the United States. As of July 2006, Latinos made
up 14.8% of the US Population of 299 million (US
Census Bureau, 2009). Latinos are projected to make
up 20.1% of the US population by the year 2020 (US
Census Bureau, 2009). The term “Hispanic” is widely
ambiguous, but generally refers to a member of an ethnic group that traces its roots to 20 Spanish-speaking
nations from Latin America and Spain (Passel and Taylor, 2009). The term “Latino” is viewed as more socially
comfortable, less formal, and refers to people of Latinderived languages. “Latino” is often used by community-based initiatives to reflect an actual connection to
the community (Vasquez, 2004). According to the Pew
Hispanic Center in a 2006 survey, “48% of Latino adults
generally describe themselves by their country of origin
first; 26% generally use the terms Latino or Hispanic
first; and 24% generally call themselves American on
first reference (Passel and Taylor, 2009).” A 2008 Pew
Hispanic Center survey found that 36% of respondents
prefer the term “Hispanic,” 21% prefer the term “Latino” and the rest have no preference (Passel and Taylor,
2009). The U.S. Census Bureau bases its information
about Latinos and Hispanics on anyone self-reporting
as Hispanic. In 2010, the U.S. Census form collected
data regarding Hispanic origin in a new format, and in
greater detail (US Census Bureau, 2010). Now that data
from the census is available, health care providers have
more information available to them that differentiates
self-identification based on country of origin. Between
2000 and 2006, Latinos accounted for half of the population growth in the United States (US Census Bureau,
2009). The growth rate of Latinos is more than 3 times
that of the total U.S. population of 1% (US Census Bureau, 2005). Health care professionals are taking greater notice of this population as a group. An example of
this increased attention is the establishment of cultural
competence guidelines by the Association of Schools
CROSS CULTURAL ISSUE IN CARE
and Colleges of Optometry (ASCO) for schools and
healthcare organizations (Association of Schools and
Colleges of Optometry, 2008).
In urban community health centers, health professionals often encounter specific ethnic groups that depend
on them for comprehensive medical care. Two community health centers in Boston are The Dimock Center
and the Martha Eliot Health Center (MEHC), serving
the Boston communities of Roxbury and Jamaica Plain,
MA, respectively. The percentage of Latino patients at
the health centers has been approximately 40% at Dimock and 85% at MEHC. In their respective zip codes,
there were 5,856 and 9,025 Latinos, both approximately
25% of the total population of each zip code (US Census Bureau, 2005). With such a significant Latino population at these health centers specifically and in the
nation generally, it is helpful to learn more about specific ocular tendencies of the Latino subgroups. Greater
knowledge of prevalent ocular and systemic conditions in these populations may also help primary care
providers to have greater awareness of when a patient
would need referral for eye care.
Methods
This study is a clinic-based, retrospective, cross-sectional study designed to estimate the prevalence of eye
disease in a specific population: a predominantly Dominican population, 40 years and older seeking eye care
at MEHC and The Dimock Center in the Boston area.
Institutional Review Board/Ethics committee approval
to conduct this study was obtained from the New England College of Optometry, Boston Children’s Hospital,
and Beth Israel Deaconess Medical Center.
Charts of patients who had visited the Eye Clinics in
either health center for a comprehensive eye exam between August 15, 2003 and August 15, 2005 were randomly selected and assessed for eligibility based on age
(>40 years old) and Latino descent. The charts were
originally selected by searching random birthdates of
patients who would be older than 40 years in the computer database. The patients’ charts were requested
if they were listed as Spanish-speaking in the demographics, and if they had been seen during our specific
date range for a complete eye exam. All charts that met
the inclusion/exclusion criteria were requested. Of the
410 charts pulled, 301 were eligible for this study. The
remaining 109 charts of the 410 were mostly excluded
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Figure 1
Gender Distribution of Patients Reviewed
78
All
223
41
Dimock
102
Male
Female
37
MEHC
0
121
50
100
150
200
250
300
350
Number of Patients
due to missing information in the chart or no record of
country of origin.
The following information was collected from each
eligible chart: date of birth, country of origin, gender,
preferred language, systemic health (specifically the diagnosis of Type II diabetes mellitus and hypertension),
and diagnosis of any ocular disease including: diabetic
retinopathy, type and grade of lens opacities (cataract),
open angle glaucoma, age-related macular degeneration (AMD), presence of dry eye, meibomian oil gland
dysfunction in the eyelids, pingueculae and pterygia
(callous-like growths over the conjunctiva or cornea).
Prevalence of a particular disease was calculated as the
proportion of individuals with that disease among all
the individuals in that stratum. A 95% confidence interval was constructed for the estimated prevalence.
Results
Of the 301 charts reviewed at the two health centers, 158
were reviewed from Martha Eliot Health Center, and
143 were reviewed from The Dimock Center. The distribution of gender (Figure 1) showed 74 % (223/301)
of patients were female. The mean age was 55.07 years
old. Approximately one-third (32.2%) were between
ages 40 and 50 years old, 38.5% were between 50 and 60
Health & Interprofessional Practice | commons.pacificu.edu/hip
years old, and 29.2% were 60 years old or greater.
Nearly two-thirds (62.1%) of patients studied were of
Dominican origin, and 22.6% were of Puerto Rican descent. The remaining 15.3% patients were from Central
or South American countries, such as Colombia, Nicaragua, Honduras, Chile, Venezuela, and Peru. Of the
total, 98.3% (296/301) indicated Spanish as their preferred language.
Diabetes was commonly encountered, with 30.2%
(91/301) of all patients having a diagnosis of Type II
diabetes mellitus [95% C.I. (25.0%, 35.4%)]. Among
the 91 patients, 20 (21.98%) had diabetic retinopathy.
The overall proportion of diabetic retinopathy among
all patients was 6.6% (20/301) [95% C.I. (3.8%, 9.5%)].
The criteria for definite diabetes was the documentation of Type II Diabetes in the medical record’s problem plan list, a history of lab work done for Hemoglobin A1c and glucose levels, and documented treatment
with insulin, medication, or diet. It was noted whether
or not a patient had had their Hemoglobin A1c measured within a year prior to the date of their eye exam.
A majority, 82.3% and 64.3% of the patients at Martha
Eliot Health Center and at The Dimock Center respectively, had updated laboratory testing (Table 1, following page). A large percentage had evidence of Grade
1 cataracts (61.8%) while 19% were diagnosed with
Grade 2 cataracts. A diagnosis of open-angle glaucoma
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Table 1
Summary of Diabetic Findings
n
Percentage
95% CI
91
30.20%
(25%, 35.4%)
Males with Diabetes
21
26.90%
(17.1%, 36.8%)
Females with Diabetes
70
31.40%
(25.3%, 37.5%)
Dominicans with Diabetes
56
29.90%
(23.4%, 36.5%)
Puerto Ricans with Diabetes
26
38.20%
(26.7%, 49.8%)
20
6.60%
(3.8%, 9.5%)
Diabetes (all)
All Diabetic Retinopathy
was in 4.32% (13/301) of patient charts, and 15.3% of
all patients were considered glaucoma suspects. Only
one patient was diagnosed with age-related macular
degeneration (AMD).
Nine patients did not have recorded data for hypertension, meibomian gland dysfunction, or dry eye syndrome. Among the remaining 292 patients, 113 patients
(38.70%) had hypertension, 119 patients (40.75%)
had meibomian gland dysfunction, and 62 patients
(21.23%) had dry eye syndrome. Overall, 43.2% patients had pingueculae and 21.3% had pterygia in at
least one eye.
As shown in Table 2 and Figure 2 (following page), the
prevalence of diabetes, diabetic retinopathy, glaucoma
suspect, open angle glaucoma, pingueculae and pterygia (see Table 2 and Figure 2) did not differ significantly across the three nationality groups (Dominican
Republic, Puerto Rico and Other, which were Central
or South American countries) (all p>0.05). The only
significant difference was found in the prevalence of
hypertension, which was similar between Dominican
and Puerto Rican but significantly lower among the
Other group (p=0.006).
Discussion
The types of Latino origin represented in our Bostonbased study were Dominican (62.1%), Puerto Rican
(22.6%), and Central or South American (15.3%). The
concentration of a mostly Dominican and Puerto Rican patient population in our study is likely a reflection of the health centers’ locations in an area heavily
populated by Dominicans and Puerto Ricans. Knowing the types of Latino subgroups in the health center
CROSS CULTURAL ISSUE IN CARE
patient population can help interprofessional providers
in knowing what kind of systemic and ocular conditions to anticipate.
One condition that is associated with higher risk for
Latinos is Type II diabetes mellitus (Office of Minority Health, 2012). The overall prevalence of diabetes in
the US Latino population is about 20 million, or about
8.2 % of all Latino Americans older than 20 years old
(National Diabetes Clearinghouse (NDIC), 2011). According to the National Diabetes Clearinghouse, data
from the 2007-2009 national surveys have shown that
compared with non-Hispanic white adults, the risk of
diagnosed diabetes is 66 percent higher among Hispanics/Latinos (NDIC, 2011). Among Hispanics/Latinos compared with non-Hispanic white adults, the risk
of diagnosed diabetes was about the same for Cuban
Americans and for Central and South Americans, 87
percent higher for Mexican Americans, and 94 percent
higher for Puerto Ricans (NDIC, 2011). The National
Diabetes Education Program (NDEP) has reported that
13.8% of Puerto Ricans in all age groups have diabetes
(National Diabetes Education Program (NDEP), 2011).
In our study of patients over age 40, 30.2% of patients
had Type II diabetes and 6.6% of all patients had diabetic retinopathy, such that 21.98% of our diabetic patients had retinopathy. Similarly, Emanuelli, Izquierdo
and Townsend (2005) found 7.5% prevalence of diabetic retinopathy in their chart review of 9,298 Puerto Rican patients at a hospital-based eye clinic. The Los Angeles Latino Eye Study (LALES) found that out of 6,357
eligible participants of mostly Mexican origin, 1457
(22.9%) had definite diabetes or probable diabetes mellitus. One thousand two hundred sixty-three (1,263) of
these participants (19.87% of all eligible participants)
had definite diabetes (Varma, Torres, Pena, Klein, Azen,
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Table 2
Prevalence of Systemic and Ocular Disease by Birth Country
Birth Country
Diabetes
Hypertension
Cataract
Glaucoma
Suspect
Glaucoma
Diabetic
Retinopathy
Pingueculae
Pterygium
Dominican
Republic
29.95%
41.11%
59.36%
17.11%
5.88%
7.49%
44.39%
25.13%
Puerto Rico
38.24%
46.27%
64.71%
11.76%
1.47%
7.35%
48.53%
14.71%
Others
19.57%
17.78%
67.39%
13.04%
2.17%
2.17%
30.43%
15.22%
All
30.23%
38.70%
61.79%
15.28%
4.32%
6.64%
43.19%
21.26%
Figure 2
Prevalence of Systemic and Ocular Disease by Birth Country
80%
70%
60%
50%
Dominican Republic
40%
Puerto Rico
Others
30%
20%
10%
0%
Diabetes
Hypertension
Cataract
Glaucoma
Suspect
Glaucoma
Los Angeles Latino Eye Study Group, 2004). Of these
1263 diabetics, 1217 (96%) had gradable retinal photographs, and 46.9% of the 1217 showed diabetic retinopathy (Varma et al, 2004). Because the LALES was a
randomized, population-based study in comparison to
our clinic-based, retrospective study, this may explain
why the LALES found a higher rate of diabetes and diabetic retinopathy. The presence of diabetic retinopathy
(both proliferative and non-proliferative) occurred in
20 of our 91 patients who had Type II diabetes mellitus.
Of the 91 diabetic patients in our study, 21 were male
and 70 were female. This uneven distribution of gender
Health & Interprofessional Practice | commons.pacificu.edu/hip
Diabetic
Retinopathy
Pingueculae
Pterygium
in our study does not allow for conclusions about gender and relationship to diabetic retinopathy, though it
does perhaps reflect the fact that 74% of retrospective
charts studied were those of female patients. According to NDEP, 10.8% of women in the US 20 years and
older have diabetes, while 11.8% of men 20 years and
older have diabetes (NDEP, 2011). Prevent Blindness
compiled data from 12 major epidemiological studies
and reported population data for ocular conditions for
different ethnic groups and applied statistical models
to population numbers from the 2010 US Census (Prevent Blindness, 2012a). The Prevent Blindness model
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showed a difference between genders with diabetic retinopathy in Latinos 40 years and older (Prevent Blindness, 2012b). The number of Latino women 40 years
and older with diabetic retinopathy was reported as
464,679 while 699,552 Latino men 40 years and older
were reported to have diabetic retinopathy (Prevent
Blindness, 2012b).
Practicing in an interprofessional setting often allows
for easier access to the patient’s entire medical record,
such as keeping track of patient compliance with diabetic care, including lab test results. In the process of
reviewing charts, it was noted whether a patient had
had routine labs performed within the past year of their
eye exam, including Hemoglobin A1c for diabetes, as
a sign that the patient had been in contact with their
physician in the past year. At the Martha Eliot Health
Center, 130 out of 158 (82.3%) charts were up to date
with Hemoglobin A1c testing. At The Dimock Center,
92 out of 143 (64.3%) charts were up to date. This information could be used for improving quality assurance
measures at each health center. Since the survey study
was conducted, both health centers have instituted data
programs that automatically recall diabetic patients for
their yearly diabetic exams. This has allowed for better
quality of care in a low-income population with a high
no-show rate.
Cataracts were a significant finding in this sample
patient population. In our study, 84% of the patients
greater than 60 years old had at least grade 1 lens opacities on a 0-4 scale, with 4 being worst. Of the 61.8%
of patients with at least Grade 1 cataracts, 57.5% had
nuclear sclerosis (diffuse central cataracts), followed by
13.3% with cortical (peripheral) opacities, and 4.32%
with posterior subcapsular (circumscribed central)
changes. Of the 19% of patients who had Grade 2 (early
operable) cataracts or more, nuclear sclerotic cataracts
were more common (16.94%) than cortical cataracts
(4.30%) and posterior subcapsular cataracts (1.66%).
The three categories of nuclear sclerosis, cortical, and
posterior subcapsular were not exclusive of each other.
In the Proyecto VER study of Mexican participants in
Arizona 40 years old and older, 2.8% of 4774 participants were reported to have visually-significant cataracts (Broman, Hafiz, Munoz, Rodriguez, Snyder, Klein
and West, 2005). Emanuelli et al (2005) reported a
prevalence of lens opacities in 22.1% of the charts surveyed of their Puerto Rican patients. Similarly to our
study, Emanuelli’s chart survey found more nuclear catCROSS CULTURAL ISSUE IN CARE
Eye Disease in Adult Latino Patients
aracts (67.1%) than cortical cataracts (23.5%) (Emanuelli et al, 2005). The LALES study reported a prevalence
of 20% for lens opacities of any kind in their study for
participants of mostly Mexican origin (Varma and Torres, 2004). There was a higher incidence of nuclear than
cortical opacities in the LALES study, but there was a
greater progression of cortical opacities than nuclear
opacities, and incidence and progression of posterior
subcapsular cataracts were low (Varma, Richter, Torres,
Foong, Choudhury, Azen, 2010).
Several studies have been done to learn more about
associations of cataract with amounts of exposure to
ultraviolet (UV) radiation (Sasaki, Hawakami, Ono,
Jonasson, Shui et al, 2003) (Sasaki, Jonasson, Shui, et al,
2002) (Johnson, Minassian, Franken, 1989). The Beaver Dam Eye Study found an association between high
levels of UV-B and higher incidence of cortical cataracts in men (Cruickshanks, Klein BE, Klein R, 1992).
A study of Chesapeake Bay watermen found an association between ultraviolet B exposure and the formation
of cataracts (Taylor, West, Rosenthal, Muñoz, Newland,
Abbey and Emmett, 1988). The Pathologies Oculaire
Lieés à l’Age (POLA) study in the French Mediterranean studied individuals who mainly had outdoor occupations, and found that those with high exposure
to ambient solar radiation had a 2.5 fold higher risk
of developing cortical and mixed cataract, but found
no significant association between ambient solar light
and the development of nuclear sclerotic or posterior
subcapsular cataracts (Delcourt, Carriere, Ponton-Sanchez, Lacroux, Covacho and Papoz, 2000). The reason
for higher prevalence of cataracts in our patient sample
compared to larger studies is one that needs to be further studied for factors such as gender, exposure to ultraviolet light, occupation, and sunglass protection.
While there was a 15.3% prevalence of suspicion of
glaucoma in our study, the prevalence of diagnosed
open-angle glaucoma in this chart review was 4.32%
(13/301). The LALES group found a prevalence of
4.74% for open angle glaucoma in its larger population-based patient sample of mainly Mexican patients
(Varma, Ying-Lai, Francis, Nguyen, Deneen, Wilson
and Azen, 2004). While our study is retrospective and
clinic-based, the similarity of these results in a mainly
Caribbean-based Latino patient sample can be built
on for further study into the various subcultures of
the Latino population. Another result potentially related to the clinic-based nature of our study was that
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only one patient in the chart review had a diagnosis of
AMD of any type. The LALES study reported that the
prevalence of early AMD increased with age from 6.2%
in those 40 to 49 years old to 29.7% in those 80 years
or older (P<0.0001) (Varma, Fraser-Bell, Tan, Klein,
Azen, 2004). Only 57% of the LALES participants who
had early or late AMD reported ever visiting an eye
care provider, and only 21% had done so in the last year
Varma, 2004). The LALES study was a predominantly
Mexican patient population living in Los Angeles. The
low prevalence of diagnosed AMD in our chart review of predominantly Puerto Ricans and Dominicans
raises the question of whether the difference is largely
due to the self-selective nature of our patient sample
that has already sought eye care, or may be affected by
possible differences between a mostly Mexican patient
population versus a mainly Caribbean patient population. Emmanuelli et al (2005) reported a prevalence of
2.1% with AMD in a chart review of 9,298 Puerto Rican
patients. Proyecto VER, studying Latinos in Arizona,
found that although early macular changes were very
common in their patient sample, the prevalence of late
AMD was low at 0.5% (Munoz, Kelin, Rodriguez, Snyder and West, 2005).
An ocular condition that had a higher prevalence in our
sample was dry eye, which was recorded as a diagnosis
in 21.23% of the charts reviewed. The Salisbury Eye
Study reported a prevalence of dry eye in 15% of their
Australian patients. A follow up study from the Beaver
Dam Eye Study cohort in Wisconsin reports 14.4% of
patients having dry eye (Moss, Klein and Klein, 2000).
Only recently have targeted studies been done on the
prevalence of dry eye in Latinos. Hom and DeLand
found that 43.6% of 463 Latinos from Southern California reported symptoms of dryness in a survey study
(Hom, DeLand, 2005). Age was a significant predictor
because as age increased, the severity of the dryness increased (Gayton, 2009). In general, women and elderly
patients are known to be more likely to have dry eye
issues (Gayton, 2009)(Moss, 2000)(Moss, 2004). Schaumberg, Sullivan, Buring, and Dana (2003) reported
in a prevalence survey of US women, that Latino and
Asian women were more likely to report more severe
dry eye symptoms than Caucasian women. They also
found that women with higher levels of education were
less likely to report dry eye symptoms (Schaumberg et
al, 2003). Our health center population is generally less
likely to be educated, and a significantly higher percentage—74% (222/301, 94% CI (69%, 79%))—of the
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patients in our study were female, as seen in Figure 1
(p. 3). The higher number of women in the study may
explain the 21.23% prevalence of dry eye found.
Also relating to the surface of the eye, 43.2% of our
study’s patients had pingueculae and 21.3% had pterygia in at least one eye. Proyecto VER’s study of a Mexican
population found an overall prevalence of 16% for pterygia (West and Munoz, 2009). The Blue Mountain Eye
Study in Australia found a prevalence of 7.3% of pterygia and 69.5% of pingueculae (Panchapakesan, Hourihan and Mitchell, 1998). Several studies have reported that there is an association between increased risk of
pterygium and increase in ultraviolet radiation and exposure to sunlight (Moran and Hollows, 1984). A study
of more than 100,000 Australian aboriginals showed a
positive correlation between pterygia and ultraviolet
radiation (Panchapakesan et al, 1998). Another study
found that people with outdoor occupations were 4-11
times more likely to have pterygia than those working
indoors (Mackenzie, Hirst, Battistuta and Green, 1992).
While not all of our patients had outdoor occupations,
Puerto Rico and the Dominican Republic are located
near the equator. The “pterygium belt” which refers to
a higher incidence of pterygia anywhere within 37 degrees latitude of the equator, includes both Puerto Rico
and the Dominican Republic since they are both approximately at 18 degrees latitude (Ang, Chua and Tan,
2007) (“Latitude of Dominican Republic,” 2013) (“Latitude of Puerto Rico,” 2013). Since most of our patient
sample was Dominican or Puerto Rican, their exposure
to higher amounts of UVB radiation by their location
could be a factor in the high prevalence of pingueculae
and pterygia in our study. Other factors could be climate change, genetics, and lifestyle behaviors (Ang et
al, 2007).
It is important to note some potential limitations of
this study. While the results accurately describe the patients presenting for care at the two community-based
eye care clinics, the results may not be generalized to
other populations comprised of different ethnic groups
and/or from different geographic regions. It should
also be noted that because Puerto Ricans are American citizens, issues of immigration are not a factor in
studying socioeconomic trends of their eye care. As this
study was conducted in a clinic-based setting, it may
not be reflective of population-based prevalence. The
retrospective nature of the study was such that the patient sample self-selected for eye exams and thus had
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access to health care. Thus, we were unable to assess
if those living in the community who did not seek eye
care had a higher prevalence of certain ocular conditions. The data presented, however, help describe the
characteristics of individuals who are seeking eye care
services in a community-based setting and potentially
provide valuable long-term planning information.
Conclusions
Since there is such diversity within the designation of
Latino ethnicity, it is difficult to make general conclusions about ocular patterns to the general category.
However, as a result of our survey, it is evident that several issues should be further investigated, including: access to care for adult male Latinos, primary care quality measures for updated lab work for diabetics (and
interprofessional coordination with other health care
providers), patient education about the effect of sun
exposure on the eyes, and further study on dry eye in
Latinos.
As different ethnic groups can have ocular characteristics distinct from each other, it is important to understand these differences in order to optimize eye care
to various patient populations. These cross-sectional
data help the involved community health centers to
better understand and address the needs of our adult
Latino patients, and adds to knowledge about subsets
of Latino groups and their eye conditions. With greater
understanding of various socioeconomic, cultural, and
environmental factors for our Latino patients, eye care
professionals can improve patient education, community outreach, and initiate further research.
Acknowledgements
The authors would like to thank Roger Wilson, OD,
Joyce Chien, OD, and Komal Thakore, OD for their
valuable assistance.
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Eye Disease in Adult Latino Patients
Corresponding Author
Amy R. Moy, OD, FAAo
Assistant Clinical Professor of Optometry
Chief Clinical Officer, New England Eye Institute
Director of Optometry, Martha Eliot Health Cente
New England College of Optometry
424 Beacon Street
Boston, MA 02115
[email protected]
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