Eye Care in the United States

Abstract

To estimate the levels of self-reported access of eye care services in the nation.Methods: We analyzed data from the 2002 National Health Interview Survey (30 920 adults aged Ն18 years). We estimated the number of US adults at high risk for serious vision loss and assessed factors associated with the use of eye care services.Results: An estimated 61 million adults in the United States were at high risk for serious vision loss (they had diabetes, had vision or eye problems, or were aged Ն65 years); 42.0% of the 78 million adults who had dilated eye examinations in the past 12 months were among this group. Among the high-risk population, the probability of having a dilated eye examination increased with age, education, and income (PϽ.01). The probability of receiving an examination was higher for the insured, women, persons with diabetes, and those with vision or eye problems (PϽ.01). Approximately 5 million highrisk adults could not afford eyeglasses when needed; being female, having low income, not having insurance, and having vision or eye problems were each associated with such inability (PϽ.01). Conclusions:There is substantial inequity in access to eye care in the United States. Better targeting of resources and efforts toward people at high risk may help reduce these disparities.

Geographic Variation in the Rate and Timing of Cataract Surgery Among US Communities

“…37–39 Our finding regarding persons of lower socioeconomic status is particularly noteworthy given that this population has been documented generally to have lower utilization rates and poorer access to health care services. 40 …”

Non-adherence to eye care in people with diabetes

“…Clinical Care/Education/Nutrition/Psychosocial Research diabetes receive annual DFEs, 9 with rates even lower in underserved and racial/ethnic minority populations. [10][11][12] In order to reduce the prevalence of eye disease and improve patients' quality of life, Healthy People 2020 aims to increase the proportion of adults with diabetes who have comprehensive eye examinations. 9 One method to achieve this goal is to implement targeted interventions for patients at risk for low adherence.…”

“…[12][13][14] In our population, after adjusting for known risk factors, patients with visual impairment were more likely than patients with normal vision to adhere to initial follow-up DFE recommendations and use DFE services longitudinally. Presumably, visual loss motivates patients to obtain eye care.…”

“…12 14 16 This difference has been attributed to perceived need of care by each gender. According to the Behavioral Risk Factor Surveillance System, 42% of men with moderate-to-severe vision loss reported no need to have an eye examination compared with 29% of women with similar vision loss.…”

Vision Health Disparities in the United States by Race/Ethnicity, Education, and Economic Status: Findings From Two Nationally Representative Surveys

“…Addressing vision health disparities would help enhance public health programs and close the gaps to improve the nation’s vision and eye health. 23,24 A national and state surveillance system using national, state, and local surveys; birth and death certificates; and Medicare, Medicaid, and managed care data helps the nation’s policy makers analyze, interpret, and report on vision loss, risk factors, care practices, morbidity, and mortality.…”