Socioeconomic trends of adult strabismus in the United States: an analysis of the All of Us database.

Purpose: To determine associations of income and education level with a diagnosis of strabismus and to identify socioeconomic variables that may affect timely access to diagnosis.

Methods: Annual income, high level of education completed, and ZIP code income, high school completion, poverty, and socioeconomic deprivation metrics were collected from 413,360 participants in the database. A χ² test was used to determine significant differences in distributions of income, education, and ZIP code metrics in 3,734 strabismus patients compared with the overall database.

Results: Participants living in ZIP codes with lower multidimensional deprivation indices (less deprivation) are more likely to be diagnosed with strabismus. Participants with annual income below $10,000 (10.10%) or who completed education between fifth grade and a high school diploma or GED (20.06%) are less likely to receive a diagnosis for certain strabismus subtypes. Participants with annual income over $200,000 (7.07%), advanced degrees (27.02%), living in ZIP codes with higher income, and higher high school completion rates were more likely to be diagnosed with certain strabismus subtypes.

Conclusions: Participants diagnosed with strabismus tend to have higher incomes, an advanced degree, and reside in more affluent ZIP codes, whereas those with lower income and education levels are less likely to be diagnosed. These findings reveal potential socioeconomic disparities in access to ophthalmic diagnostic services and care. Findings emphasize the importance of addressing socioeconomic barriers in eye care to enable equitable access.