Socioeconomic deprivation and serious ocular trauma in Scotland: a national prospective study

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.