Social determinants associated with loss of an eye in the United States using the All of Us nationwide database

Purpose: To identify common factors associated with the loss of an eye using the NIH All of Us database. Methods: In this case-controlled study, we extracted electronic health record and socio-demographic data for 231 cases of eye loss from All of Us enrollment sites. Controls (N = 924) matched the demographic characteristics of the 2020 United States Census. Bivariate analyses and multivariable logistic regression identified variables significantly associated with increased odds of eye loss. Outcome measures: Medical and social determinants associated with increased odds of losing an eye. Results: Among cases, the average age (standard deviation) was 60.1 (14.4) years. The majority (125, 54.1%) were male. 87 (37.7%) identified as African American, and 49 (21.2%) identified as Hispanic or Latino. Loss of eye was more likely in those with ocular tumor (odds ratio [OR] 421.73, 25 95% confidence interval [CI] 129.81–1959.80, p <.001), trauma (OR 13.38, 95% CI 6.64–27.43, p <.001), infection (OR 11.46, 95% CI 4.11–32.26, p =.001) or glaucoma (OR 8.33, 95% CI 4.43– 15.81, p <.001). African American (OR 2.39, 95% CI 1.39–4.09, p =.002) and Hispanic or Latino (OR 1.80, 95% CI 1.01–3.15, p =.04) participants were disproportionately affected. Conclusions: Racial and ethnic disparities exist among those with loss of an eye from underlying conditions. Addressing health inequities may mitigate the risk of this morbid outcome.