This study evaluated whether the racial differences in surgical treatment for glaucoma are due to lower than expected rates of detection and initial drug treatment or to longer duration of drug therapy before surgery in blacks compared with whites. Data were derived from New Jersey Medicaid records for the 1980s.

The overall incidence of glaucoma was 11.5/1000 person years; for blacks it was 16.1, and for whites it was 10.4. The incidence of treated glaucoma was highest in the 80-84 year age group for blacks and in the 75-79 year age group for whites. After adjustment for age group, gender, nursing home residence, year of diagnosis, and number of prescription medications, the incidence rate of glaucoma treatment for blacks relative to whites was 1.56 (95% confidence interval=1.47 to 1.67). Treatment rates among the blacks were 21-39% of the rates that would be expected based on disease prevalence data. However, the authors point out that the finding of lower than expected rates of treatment for the elderly (relative to known prevalence data) might be due to patients who initiated treatment at younger ages. This explanation could apply to the lower than expected rates of treatment for blacks also, as there is some data to suggest that glaucoma occurs at younger ages for blacks.

The authors note that these findings are consistent with prior studies and rule out socioeconomic status as an explanation for racial differences in glaucoma care because all Medicaid enrollees (the source population for this study) are poor.