Abstract
center dot PURPOSE: Glaucoma is the leading cause of irreversible blindness, a crippling disability resulting in higher risks of chronic health conditions. To better understand dispari-ties in blindness risk, we identified risk factors of blind-ness on first presentation to a glaucoma clinic using a large clinical database.center dot DESIGN: Retrospective cross-sectional study.center dot METHODS: We used electronic health records of glau-coma patients from the Duke Ophthalmic Registry. In-ternational Classification of Diseases codes were used to identify glaucoma and exclude concurrent diseases. Blindness classification was based on the definition of le-gal blindness. Risk factors included gender, race, mari-tal status, age, intraocular pressure, diabetes history, in-come level, and education. Odds ratios (ORs) and 95% CIs were calculated for risk factors using univariable and multivariable logistic regression.center dot RESULTS: Our cohort consisted of 3753 patients, with 192 (5%) blind on first presentation. In univariable mod-els, African American / Black race (OR 2.48, 95% CI 1.83-3.36), single marital status (1.74, 95% CI 1.25-2.44), prior diabetes diagnosis (2.23, 95% CI 1.52-3.27), and higher intraocular pressure (1.29 per 1 SD higher, 95% CI 1.13-1.46) were associated with in-creased risk of presenting blind, whereas higher annual income (0.75, 95% CI 0.65-0.86) and education (0.77, 95% CI 0.69-0.85) were associated with lower risk. These associations remained significant and in the same direction in a multivariable model apart from income, which became insignificant. center dot CONCLUSIONS: Using a large real-world clinical database, we identified risk factors associated with pre-sentation with blindness among glaucoma patients. Our results highlight disparities in health care outcomes and indicate the importance of targeted education to reduce disparities in blindness.(c) 2023 Elsevier Inc. All rights reserved.)