Introduction

Disorders of the eye and resulting vision loss impose a significant burden to the United States, both economically and socially. Eye disorders and vision loss are typically chronic conditions that will affect individuals for the duration of their lives, whether through on-going medical expenses to treat patients with chronic disorders, or through the high economic and social costs of debilitating vision loss. As with most chronic disease costs, the burden of eye disorders and vision loss are likely to continue to grow with an aging population and the continued rapid development of more effective, but more costly treatments. In an environment where the current and future cost and coverage of diseases and healthcare are at the forefront of public concern, establishing a comprehensive understanding of the cost of eye related conditions is of paramount importance.

The primary estimate of the burden of visual loss and eye disease is the landmark 2007 Prevent Blindness America report “The Economic Impact of Vision Problems, The Toll of Major Adult Eye Disorders, Visual Impairment and Blindness on the U.S. Economy”, which has stood as the primary estimate of the economic burden of eye and vision problems since its publication. However, this study was subject to a number of limitations which may have led to an underestimate of costs. Some costs not captured in the prior study include:

  • Costs among persons younger than age 40.
  • Medical costs for conditions other than AMD, cataract, glaucoma, and diabetic retinopathy
  • Optometry visit costs,
  • Costs paid by vision insurance plans,
  • Costs paid out-of-pocket,
  • Prescription drug costs for persons aged 65 or older, and
  • Productivity losses for persons other than aged 40-64.

Finally, the prior estimates were based in 2004, using data from periods even earlier. In the subsequent 9 years, costs may have changed due to general increases in medical costs, and also due to the emergence of new but often costly therapies for eye diseases, particularly macular degeneration.

This report serves as an update to the 2007 PBA report. We build on the previous studies using more recent data and updated methodologies. We followed the consensus guidelines for research on the cost of vision loss which were developed and published under the auspices of the Association for Research in Vision and Ophthalmology in 2010. These guidelines delineate definitions for analysis perspectives and specific cost categories that should be included in economic studies of vision loss. We include direct and indirect costs due to uncorrectable vision loss, refractive errors, and diagnosed disorders of the eye and ocular adnexa. We also report the impact of vision loss on disability and quality of life losses and separately estimate the possible monetized value of this burden. We include costs for all ages, all payers, all eye and vision disorders, and all providers to generate a comprehensive estimate of the complete economic burden of eye and vision disorders in the United States.[1]

These guidelines delineate definitions for analysis perspectives and specific cost categories that should be included in economic studies of vision loss. We include direct and indirect costs due to uncorrectable vision loss, refractive errors, and diagnosed disorders of the eye and ocular adnexa. We also report the impact of vision loss on disability and quality of life losses and separately estimate the possible monetized value of this burden. We include costs for all ages, all payers, all eye and vision disorders, and all providers to generate a comprehensive estimate of the complete economic burden of eye and vision disorders in the United States.

The Cost of Vision Problems