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Cited by 764Ophthalmology and Visual Impairment StudiesGlaucoma and retinal disordersRetinal Diseases and Treatments

Racial Differences in the Cause-Specific Prevalence of Blindness in East Baltimore

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Sommer, Alfred, Tielsch, James M., Katz, Joanne, Quigley, Harry A., Gottsch, John D., Javitt, Jonathan C., Martone, James F., Royall, Richard M. +2 more·1991·New England Journal of Medicine
DOI 10.1056/nejm199111143252004
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Abstract

BACKGROUND: Bilateral blindness unrelated to simple refractive error is twice as prevalent among blacks as among whites, although the difference narrows among the elderly. The reasons for this race- and age-related pattern are uncertain. METHODS AND RESULTS: A randomly selected, stratified, multistage cluster sample of 2395 blacks and 2913 whites 40 years of age and older in East Baltimore underwent detailed ophthalmic examinations by a single team. We identified 64 subjects who were blind in both eyes. The leading causes of blindness were unoperated senile cataract (accounting for blindness in 27 of the total of 128 eyes), primary open-angle glaucoma (17 eyes), and age-related macular degeneration (16 eyes). Together, these three disorders accounted for 47 percent of all blindness in this sample. Unoperated cataract accounted for 27 percent of all blindness among blacks, among whom it was four times more common than among whites; whites were almost 50 percent more likely than blacks to have undergone cataract extraction before the age of 80 (P less than 0.002). Primary open-angle glaucoma accounted for 19 percent of all blindness among blacks; it was six times as frequent among blacks as among whites and began 10 years earlier, on average. By contrast, age-related macular degeneration resulting in blindness was limited to whites, among whom it was the leading cause of blindness (prevalence, 2.7 per 1000; 95 percent confidence interval, 1.2 to 5.4); it affected 3 percent of all white subjects 80 years of age or older. CONCLUSIONS: The pattern of blindness in urban Baltimore appears to be different among blacks and whites. Whites are far more likely to have age-related macular degeneration, and blacks to have primary open-angle glaucoma. The high rate of unoperated cataracts among younger blacks and among elderly subjects of both races suggests that health services are underused. Half of all blindness in this urban population is probably preventable or reversible.

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Research works printed but not linked: 5

  1. [15]15. Pearson ES, Hartley HO, eds. Biometrika tables for statisticians. 2nd ed. Vol. 1. Cambridge, England: Cambridge University Press, 1958:203.
  2. [14]14. Kahn HA, Sempos CT. Statistical methods in epidemiology. New York: Oxford University Press, 1989.
  3. [16]16. Taylor JM. Medicare payments and changes in the rate of cataract extraction. Ophthalmology 1981;88:41A-46A.
  4. [19]19. Cairns L, Sommer A. Changing indications for cataract surgery. Trans Am Ophthalmol Soc 1984;82:166-75.
  5. [22]22. Martin MJ, Sommer A, Gold EB, Diamond EL. Race and primary openangle glaucoma. Am J Ophthalmol 1985;99:383-7.

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Authors
Sommer, A., Tielsch, J. M., Katz, J., Quigley, H. A., Gottsch, J. D., Javitt, J. C., Martone, J. F., Royall, R. M., Witt, K. A., & Ezrine, S.
Affiliations
Johns Hopkins University (US)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1991-11-14
Volume
325
Issue
20
Pages
1412-1417
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199111143252004
OpenAlex
W2325814183
Cited by
764
References
21
Citations by year
2026: 8 · 2025: 10 · 2024: 24 · 2023: 18 · 2022: 20 · 2021: 28 · 2020: 14 · 2019: 19 · 2018: 17 · 2017: 18 · 2016: 29 · 2015: 27 · 2014: 30 · 2013: 35 · 2012: 20
FWCI
11.00
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01ey003605-10, 5r01ey005091-05, 1s10rr004060-01)
  • National Eye Institute (EY-05091, EY03605)
  • National Center for Research Resources (RR 04060)
Topics
  • Health Sciences › Medicine › Epidemiology › Ophthalmology and Visual Impairment Studies
  • Health Sciences › Medicine › Ophthalmology › Glaucoma and retinal disorders
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
Keywords
blindness, racial differences, primary open-angle glaucoma, age-related macular degeneration, senile cataract, cataract surgery, black-white disparities, urban population, East Baltimore, avoidable blindness
MeSH terms
Adult, Age Factors, Aged, Aged, 80 and over, Black or African American, Blindness, Cataract, Ethnicity, Glaucoma, Open-Angle, Health Services, Humans, Macular Degeneration, Middle Aged, Urban Population, Baltimore, Prevalence, Cluster Analysis, White People, Racial Groups

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