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Objective To describe what information is or is not included in health care claims data, provide an overview of the main advantages and limitations of performing analyses using health care claims data, and offer general guidance on how to report and interpret findings of ophthalmology-related claims data analyses. Design Systematic review. Participants Not applicable. Methods A literature review and synthesis of methods for claims-based data analyses. Main Outcome Measures Not applicable. Results Some advantages of using claims data for analyses include large, diverse sample sizes, longitudinal follow-up, lack of selection bias, and potential for complex, multivariable modeling. The disadvantages include (a) the inherent limitations of claims data, such as incomplete, inaccurate, or missing data, or the lack of specific billing codes for some conditions; and (b) the inability, in some circumstances, to adequately evaluate the appropriateness of care. In general, reports of claims data analyses should include clear descriptions of the following methodological elements: the data source, the inclusion and exclusion criteria, the specific billing codes used, and the potential confounding factors incorporated in the multivariable models. Conclusions The use of claims data for research is expected to increase with the enhanced availability of data from Medicare and other sources. The use of claims data to evaluate resource use and efficiency and to determine the basis for supplementary payment methods for physicians is anticipated. Thus, it will be increasingly important for eye care providers to use accurate and descriptive codes for billing. Adherence to general guidance on the reporting of claims data analyses, as outlined in this article, is important to enhance the credibility and applicability of findings. Guidance on optimal ways to conduct and report ophthalmology-related investigations using claims data will likely continue to evolve as health services researchers refine the metrics to analyze large administrative data sets.

Globally, an estimated 252.6 (95% CI, 111.4-424.5) million people live with best-corrected visual acuity of 20/60 or worse in the better-seeing eye. 1 People in the US fear losing vision more than memory, hearing, or speech, and consider visual acuity loss among the top 4 worst things that could happen to them. 2 No existing estimates appear to have used empirical data to estimate geographic differences, created estimates for persons younger than age 40 years, or accounted for increased prevalence in group quarters.Previous studies have estimated national visual acuity loss or blindness prevalence for important age ranges. The Vision Problems in the United States (VPUS) study estimated uncorrectable visual impairment and blindness for persons ages 40 years and older to occur in 4.2 million individuals (2.9%) in 2010. 3 Using similar methods and data for 2015, Varma et al 4 estimated national and state visual acuity loss or blindness prevalence for persons ages 40 years and older and arrived at a similar estimate of 4.24 million cases (2.8%). Both of these studies 3,4 are limited, since they excluded persons younger than 40 years and persons living in group quarters, such as nursing homes and prisons. Both studies 3,4 relied on metaanalytic summaries of similar selected population-based study data, and no other data sources, to estimate prevalence by age group, sex, and race/ethnicity and then calculated state-level estimates by applying these summary estimates to each state's population distribution. This method may lead to inaccuracies because the population-based study data (while of high quality) were collected 8 to 36 years in the past from locally IMPORTANCE Globally, more than 250 million people live with visual acuity loss or blindness, and people in the US fear losing vision more than memory, hearing, or speech. But it appears there are no recent empirical estimates of visual acuity loss or blindness for the US.OBJECTIVE To produce estimates of visual acuity loss and blindness by age, sex, race/ethnicity, and US state.

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