In this large epidemiological study, the authors sought to determine if neighbourhood wealth affects age-related ocular health. In particular they wished to see if there was a correlation between social deprivation and macular degeneration, cataract, diabetes-related eye complications, and glaucoma. Such research is of course open to confounders, including the effect of immigration, and for this reason a very large sample was used: approximately 4.5 million Swedish residents – almost half the country’s total population. For a decade (or until they came under the care of the ophthalmic services, died or emigrated) 2,060,887 men and 2,250,851 women aged 40 years were followed. Residents were divided up into cohorts of 1000 people and a deprivation scale calculated based on four variables: low educational level, low income, unemployment and receipt of social welfare payments. Logistic regression analysis, adjusting for confounders, showed that in men the odds ratio for developing macular degeneration, cataract, diabetes and glaucoma were all increased for those in more deprived neighbourhoods (odds ratios 1.08, 1.31, 1.36, and 1.11 respectively). The same was true for women (odds ratios 1.11, 1.36, 1.50, and 1.12 respectively). The authors concluded that their study implicates both individual and neighbourhood factors which could prove helpful in preventing age-related eye disease. This is the first largescale multilevel study to examine the effect of neighbourhood deprivation on age-related eye diseases but its results fit with previous work, such as in Scotland, where severity of glaucoma at presentation was associated with neighbourhood deprivation. A UK study, similarly showed an association between acute angle closure and higher levels of neighbourhood deprivation.

Neighborhood deprivation and risk of age-related eye diseases: a follow-up study in Sweden.
Hamano T, Li X, Tanito M, et al.

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Jonathan CP Roos

Harvard, Cambridge & Moorfields-trained Consultant Oculoplastic Surgeon and academic based in London at Publishes in the world’s leading medical journals and lectures internationally on aesthetics, eyelid diseases and thyroid eyes.

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