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Clinical science
Socioeconomic deprivation and serious ocular trauma in Scotland: a national prospective study
  1. Liying Low1,
  2. James Hodson2,
  3. Daniel Morris3,
  4. Parul Desai4,
  5. Caroline MacEwen5
  1. 1Academic Unit of Ophthalmology, University of Birmingham, Birmingham and Midland Eye Centre, Birmingham, UK
  2. 2University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK
  3. 3Cardiff Eye Unit, University Hospital of Wales, Cardiff, Wales, UK
  4. 4 Moorfields Eye Hospital NHS Foundation Trust, London, UK
  5. 5Department of Ophthalmology, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
  1. Correspondence to Dr Liying Low, Academic Unit of Ophthalmology, University of Birmingham, Birmingham, B15 2TT, United Kingdom; l.low{at}bham.ac.uk

Abstract

Objective To identify the population at risk of serious ocular trauma by exploring relationships with socioeconomic factors.

Design National, prospective, population-based, cross-sectional and follow-up study.

Participants Patients with serious ocular trauma requiring hospital admission in Scotland.

Methods Case definition and ascertainment—cases of serious ocular trauma necessitating admission to hospital under the care of a consultant ophthalmologist were identified using the British Ophthalmological Surveillance Unit reporting scheme. Using the postcode of residence, we assigned a Scottish Index of Multiple Deprivation (SIMD) score, SIMD quintile ( 0%–20% most deprived; 20%–40%, 40%–60%, 60%–80%, 80%–100% least deprived areas), geographical access score as well as the estimated travel time to the nearest general practitioner (GP) practice using either car or public transport for each patient. Population estimates were obtained from the General Register Office for Scotland.

Main outcome measure Serious ocular trauma requiring hospital admission.

Results A total of 104 patients (85.6% male) were reported as being admitted with ocular trauma with a median age of 32 years (IQR 24–54). There was a trend for increasing incidence of serious ocular injury with increasing socioeconomic deprivation (p=0.034). Patients from the most deprived areas (SIMD: 0%–20%) were twice as likely to sustain ocular injury compared with those from the least deprived (SIMD: 80%–100%) areas (relative risk: 2.19, 95% CI 1.02 to 4.81). There was no significant difference in the drive/public transport time to GP practices across the SIMD quintiles.

Conclusions Increasing socioeconomic deprivation was associated with a higher incidence of serious ocular injury. Targeted interventions are needed to address inequality in eye healthcare in deprived areas.

  • Trauma
  • Public health

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/bjophthalmol-2016-309875

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    Footnotes

    • Poster presentation at the Royal College of Ophthalmologists Annual Congress 2015, Liverpool, UK.

    • Contributors LL—conception of study question, interpretation of data, prepared first draft of the manuscript, critical review of manuscript; JH—data analysis, critical review of manuscript; DM and PD—establishment of the database, data acquisition, interpretation of data, critical review of manuscript; CJM—conception of study question, establishment of database, data acquisition, interpretation of data, critical review of manuscript. All authors have given the final approval of the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding This study was funded by the WH Ross Foundation (Scotland). LL is funded by a Fight for Sight Clinical Fellowship award.

    • Competing interests None declared.

    • Ethics approval Newcastle and North Tyneside 1 Research Ethics Committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.