Patient Impact in California

Glaucoma Disparities: Black Americans 5-6× Risk With ~10 Years Earlier Onset; AAPI Elevated Angle-Closure + Myopia Risk

Glaucoma Research Foundation: Black Americans face 5-6× higher open-angle glaucoma prevalence and 6× the blindness rate vs white peers. First diagnosis on average ~10 years earlier; disease progression 0.43 dB/year faster. Asian American/Pacific Islander populations face elevated angle-closure glaucoma risk due to anatomically shallower anterior chambers — up to 86% myopia in Singaporean-Chinese 15+. AAPI patients face elevated POAG risk where myopia is a key driver. FQHC implication: Black-majority FQHCs (Watts Healthcare, Charles Drew, Southern California Medical Center) and AAPI-majority FQHCs (NEMS, Asian Health Services, KHEIR, Operation Samahan, Nhan Hoa, Buddhist Tzu Chi) need protocolized glaucoma screening starting earlier than national guidelines suggest. Asian Health Services has NO on-site optometry — significant equity gap.

LALES Landmark Findings: ~50% of LA Latinos with Diabetes Have Diabetic Retinopathy; 75% of Latinos with Glaucoma Were Undiagnosed

Los Angeles Latino Eye Study (LALES) — landmark NEI study of 6,357 Los Angeles Latinos aged 40+ — established two staggering findings still cited 20 years later: (1) ~50% of Latinos with diabetes have diabetic retinopathy, with >10% having macular edema; (2) 75% of Latinos with open-angle glaucoma or ocular hypertension were UNDIAGNOSED before LALES screening. Open-angle glaucoma prevalence ~5% overall, climbing to 15% in those in their 70s. Despite landmark NIH/NEI evidence two decades old, most CA FQHCs do not have routine glaucoma screening protocols built into primary care. ACU + NACHC's 2025 expansion brief frames vision care AS primary care precisely to fix this. Critical for Latino-majority CA FQHCs (AltaMed, La Clínica de la Raza, Clínica Sierra Vista, Northeast Valley Health, Northeast Community Clinic).