In a timely and deeply resonant fireside chat titled “Factors That Matter in Vision Research,” Dr. Ruth Shoge, Associate Clinical Professor and Chief Diversity Officer at UC Berkeley’s School of Optometry, moderated a rich conversation with Dr. M. Roy Wilson, President Emeritus of Wayne State University at the 2025 Focus on Eye Health Summit. The session unpacked how race, ethnicity, and social determinants of health (SDOH) shape both biomedical research and clinical outcomes in vision care. Three core themes included: the limitations of race as a biological proxy, the importance of SDOH in health outcomes, and actionable next steps for the vision health community.*

Race and Ethnicity: Inadequate Proxies for Biology

Dr. Wilson clarified that race and ethnicity, while frequently used in biomedical research, are not biologically grounded variables. “Race is a poor proxy for genetic variation,” he emphasized, noting that genomic studies have shown more intra-group (within a single group) than inter-group (between different groups) variation. 

A compelling example compared the genetic similarity of two white scientists with a Korean scientist, revealing closer genetic ties across races than within. This calls into question long-standing assumptions, such as the association between sickle cell anemia and Black populations, which Wilson explained is actually linked to malaria-prevalent regions, not race.

Centering Social Determinants in Clinical Practice

Both panelists underscored the pivotal role of SDOH—including income, education, insurance access, transportation, and safe environments—in shaping health outcomes. Dr. Wilson illustrated this with a powerful anecdote from his clinic, where three African-American glaucoma patients went blind in one eye largely due to barriers like lack of transport and insurance. 

“That’s three examples in just one week showing how social factors, not biology, can drive blindness,” he stated. They also highlighted “weathering,” the cumulative toll of chronic stress due to racism and systemic inequities, which produces real biological harm.

Toward Equitable Vision Health Research and Practice

Moving forward, the speakers called for:

• Better integration of SDOH into clinical evaluation and documentation, 
• Leveraging tools like electronic health record (EHR)-embedded questionnaires, and
• Addressing the root causes of vision disparities with nuanced, socially informed research and practice, not racial shorthand.

Dr. Wilson stressed the importance of adherence to new publication guidelines, citing research showing persistent misuse of race and ethnicity in ophthalmology literature. As for junior faculty, both urged resilience and strategic adaptability in a politically complex funding climate.

“Now is not the time to go backwards,” Wilson urged, “but for those of us with less to lose, to carry the torch.”

*Prevent Blindness. (2025, May 15). 2025 Focus on Eye Health Summit Fireside Chat: Factors that Matter in Vision Research [Video file]. https://www.youtube.com/watch?v=col4mRH9pSo

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