Retinal detachment seems to be twice as common among the well off as it is among those living in areas of deprivation, suggests research published ahead of print in the British Journal of Ophthalmology.
Visual impairment and blindness are more usually associated with deprivation than with affluence.
Retinal detachment occurs when the retina separates from its connection at the back of the eye, usually as a result of a tear in the retina. If not treated promptly, it can lead to permanent loss of sight. Around 10 in 100,000 people will be diagnosed with the condition every year.
The authors assessed 572 patients diagnosed with primary retinal detachment in Scotland during a period of 12 months from November 2007 to October 2008.
Every patient was given a validated deprivation score (Scottish Index of Multiple Deprivation), based on their postcode. The score takes account of income, employment, health, education, housing, geography, and crime rates.
The scoring system indicated that the most affluent were more than twice as likely as the least affluent to be diagnosed with retinal detachment. The risk of diagnosis fell successively as deprivation scores rose.
The rate of diagnosis among the patients in the most affluent areas was 15.4 per 100,000 of the population, falling to 13.6 per 100,000 for the second most affluent group, and to 9.3 per 100,000 for the group below that.
In the most deprived group rates were 6.9 per 100,000 of the population.
Deprivation is associated with delayed diagnosis for several conditions which threaten eyesight, including diabetic eye disease, glaucoma, and developmental problems, such as squint.
The finding of an increased risk of retinal detachment among the most affluent sectors of the population is “unexpected,” say the authors, and has not been reported before.
“We have not found any satisfactory explanation for the greater incidence of [retinal detachment] in less deprived patients,” they write. “It is possible that a combination of small differences in known risk factors, such as myopia [short sightedness] and previous cataract surgery account for the difference.”
“However, we cannot exclude the possibility that affluence is associated with some other, hitherto, unknown risk factor,” they say.
Source
The British Journal of Ophthalmology