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

Abstract

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, Correspondence: John S. Wittenborn, BS, National Opinion Research Center, University of Chicago, 1981 Grace Point Road, Morrisville, NC 27560. wittenborn-john@norc.org; JohnSWittenborn@gmail.com. * A complete listing of the Vision Cost-effectiveness Study Group is available at http://aaojournal.org. * Group members listed online in Appendix 1 (available at http://aaojournal.org). Financial Disclosure(s):The author(s) have no proprietary or commercial interest in any materials discussed in this article. HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript $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.Disorders of the eye and resulting vision loss impose a significant burden on the United States, both economically and socially. In addition to medical costs, the debili...

Air pollution and emergency department visits for conjunctivitis: A case-crossover study

“…However, the study tested the cumulative exposure, accumulated in the period of up to 5 days preceding the ED visit. The Taiwan study [21] conjunctivitis [37,38], a cost-benefit analysis may be of the essence in future studies. The findings from this study must be interpreted in light of the limitations that are commonplace in the population based investigations of the air pollution that intensify health services utilization.…”

“…Also social differences, as self-care habits vs. accessibility of professional help, may play important role. Since most interventions for conjunctivitis involve self-care and products purchased over-the-counter [37,38], the relationships reported in this study can be expected to represent more extreme cases of conjunctivitis which cause ED utilization. Also, individuals are exposed to a multi-pollutant environment, with many compounds that are not measured by current air monitoring stations; the individual pollutants measured in this study may also serve as a proxy for unmeasured pollutants, or a multi-pollutant mixture.…”

“…While air pollution is linked to eye discomforts, conjunctivitis in particular, in several studies of cellular microbiology and tissue pathology, and in individual-level reports [24][25][26][27][28][29][30][31][32][33][34][35][36], the population burden of these disorders is not well characterized. The majority of the direct costs, as well as the treatment of conjunctivitis, are managed by patients and families through self-care with use of the over-the-counter products [37,38]. In this paper, correlations between exposure to ambient air pollution and emergency department (ED) visits for conjunctivitis are investigated.…”

“…An estimated 15-40% of the population in developed countries are affected by conjunctivitis [40,41]. Inflammatory eye disorders are increasingly linked to cost, quality of life, unnecessary antibiotic use, and lost school/ work productivity [37,[42][43][44][45]. In addition, conjunctivitis is among the most common reasons for emergency department (ED) visits, particularly for children [46,47].…”

Vision-specific and psychosocial impacts of low vision among patients with low vision at the eastern regional Low Vision Centre

“…The challenge of managing low vision is enormous with huge economic implications. 6,7 Low vision is said to have implications for visual function and psychosocial well-being which may include the ability to perform activities of everyday living, depression or mental health and driving. 8,9,10 In developed countries, many studies have been conducted to understand the specific visual, functional and psychological challenges patients with low vision face which have informed management, intervention programs and services in those countries.…”