Elsevier

Ophthalmology

Volume 120, Issue 9, September 2013, Pages 1728-1735
Ophthalmology

Original article
The Economic Burden of Vision Loss and Eye Disorders among the United States Population Younger than 40 Years

https://doi.org/10.1016/j.ophtha.2013.01.068Get rights and content

Objective

To estimate the economic burden of vision loss and eye disorders in the United States population younger than 40 years in 2012.

Design

Econometric and statistical analysis of survey, commercial claims, and census data.

Participants

The United States population younger than 40 years in 2012.

Methods

We categorized costs based on consensus guidelines. We estimated medical costs attributable to diagnosed eye-related disorders, undiagnosed vision loss, and medical vision aids using Medical Expenditure Panel Survey and MarketScan data. The prevalence of vision impairment and blindness were estimated using National Health and Nutrition Examination Survey data. We estimated costs from lost productivity using Survey of Income and Program Participation. We estimated costs of informal care, low vision aids, special education, school screening, government spending, and transfer payments based on published estimates and federal budgets. We estimated quality-adjusted life years (QALYs) lost based on published utility values.

Main Outcome Measures

Costs and QALYs lost in 2012.

Results

The economic burden of vision loss and eye disorders among the United States population younger than 40 years was $27.5 billion in 2012 (95% confidence interval, $21.5–$37.2 billion), including $5.9 billion for children and $21.6 billion for adults 18 to 39 years of age. Direct costs were $14.5 billion, including $7.3 billion in medical costs for diagnosed disorders, $4.9 billion in refraction correction, $0.5 billion in medical costs for undiagnosed vision loss, and $1.8 billion in other direct costs. Indirect costs were $13 billion, primarily because of $12.2 billion in productivity losses. In addition, vision loss cost society 215 000 QALYs.

Conclusions

We found a substantial burden resulting from vision loss and eye disorders in the United States population younger than 40 years, a population excluded from previous studies. Monetizing quality-of-life losses at $50 000 per QALY would add $10.8 billion in additional costs, indicating a total economic burden of $38.2 billion. Relative to previously reported estimates for the population 40 years of age and older, more than one third of the total cost of vision loss and eye disorders may be incurred by persons younger than 40 years.

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Section snippets

Methods

We estimated the prevalence of vision loss and the treated prevalence of diagnosed eye and vision-related disorders. Costs were estimated for each category listed by consensus guidelines. Direct costs include medical care attributable to diagnosed disorders, medical vision aids, undiagnosed vision loss, low-vision aids or devices, special education, school screening, and federal assistance programs. Indirect costs include productivity losses of adults, productivity losses of children's

Prevalence of Vision Loss and Diagnosed Disorders

Among persons younger than 40 years, the prevalence of best-corrected vision impairment and blindness was 1.30% (Table 1). The prevalence of visual impairment was 1.12% for mild impairment (<20/40–20/80) and 0.12% for moderate impairment (<20/80–20/200). The prevalence of blindness (<20/200) was low: 0.10% among adults 18 to 39 years of age and only 0.01% among children. More than 2 million persons younger than 40 years in the United States have uncorrectable vision impairment, and another 98

Discussion

This study provides the first estimate of the economic burden of vision loss and eye disorders among children and adults younger than 40 years in the United States. We estimated the economic burden of disorders of the eye, disorders of the ocular adnexa, and vision loss in this population to be $27.5 billion in 2012 dollars, including $5.3 billion for children younger than 18 years and $21.2 billion incurred by adults 18 to 39 years of age. Monetizing the cost of quality-of-life losses at $50

References (23)

  • J.G. Trogdon et al.

    Use of econometric models to estimate expenditure shares

    Health Serv Res

    (2008)
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    Group members listed online in Appendix 1 (available at http://aaojournal.org).

    Manuscript no. 2012-1444.

    Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

    Supported by the Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia (grant no.: 200-2008-27958). The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention, the National Opinion Research Center at the University of Chicago, RTI International, or Duke University.

    A complete listing of the Vision Cost-effectiveness Study Group is available at http://aaojournal.org.

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