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Editors Selection IGR 17-4

Visual Function and Structure: Socioeconomic and clinical factors

Comment by Chris Johnson on:

23909 The influence of socioeconomic and clinical factors upon the presenting visual field status of patients with glaucoma, Sukumar S; Spencer F; Fenerty C et al., Eye, 2009; 23: 1038-1044

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In this paper, Sukumar et al. (942) examine the relationship between socioeconomic status and the extent of glaucomatous visual field loss at first presentation to the Manchester Royal Eye Hospital. They found that the lower socioeconomic group presented with more advanced visual field loss, lower educational attainment and were less aware of a family history of glaucoma in comparison to a more affluent group of patients.

Verifying clinical dogma and impressions through rigorous objective clinical research is important

Although these findings may appear to be obvious to some practitioners, they do emphasize the importance of verifying clinical dogma and impressions through rigorous objective clinical research. While many eye care guidelines are supported by research findings, unanticipated and surprising results can sometimes occur when proper clinical research is conducted. There are several other significant points raised by this paper: (1) A detailed, thorough and rigorous approach to clinical research is vital. Significant results from this investigation had not been reported in previous studies that had been conducted in a more loosely defined manner. (2) Health and eye care for socioeceonomically disadvantaged individuals is a major problem today and can benefit from our collective efforts to address them properly. (3) Early intervention for glaucoma and other ocular and neurological diseases is but one of many faced by the

Unanticipated and surprising results can sometimes occur when proper clinical research is conducted

socioeconimically disadvantaged. A long list of issues such as vision screening (Mansberger, et al., Ophthalmic Epidemiol, 2007, 14: 134-140; Nduaguba, Lee, Curr Opinion Ophthalmol, 2006, 17: 142-152), treatment adherence and compliance (Friedman, et al., Ophthalmology, 2009, 116: 1097-1105; Schwartz, Quigley, Surv Ophthalmol, 2008, 53: suppl S57-68) and health literacy (Muir, et al., Am J Ophthalmol, 2006, 142: 223-226) are also areas of public health concern for both eye and general health care for persons in lower socioeconomic groups. The authors of this paper are to be congratulated for effectively bringing this to our attention once again.

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