The annual cost associated with adult vision problems in the United States is estimated at $51.4 billion. Blindness and vision loss were also associated with an estimated $2.14 billion in non-eye–related medical costs in 2003,1 according to a study in Ophthalmology.

According to the study, patients diagnosed with vision loss incurred significantly higher costs than those with normal vision. These included personal and family costs associated with the disability, as well as the economic costs related to rehabilitation, nursing care (ie, skilled-nursing facilities and long-term care facilities), and loss of productivity. The 5-year retrospective cohort included Medicare beneficiaries with vision loss categorized as moderate, severe, or blindness. The objective was to identify Medicare costs for eye-related and non-eye–related medical care associated with blinding eye disease.

“Naturally, blinding eye disease is expected to be associated with costs to the Medicare program for eye-related medical care,” wrote Jonathan C. Javitt, MD, MPH, and colleagues from the Wilmer Eye Institute, Johns Hopkins University. “Recent studies, however, have also linked vision loss due to trauma (eg, vehicular accidents), to depression, other secondary complications, and nursing home placement.”

Compared with patients with normal vision, mean eye-related costs were $345, $407, and $237 annually for those with moderate loss, severe loss, and blindness, respectively. Additionally, non-eye–related costs were found to be $2,193, $3,301, and $4,443 respectively, for the same groups.

As vision loss progressed, direct medical costs increased in other areas, according to the study. This may be because any degree of progressive vision loss was also associated with an increased risk of depression, injury, or need for additional care, the authors suggested. These complications contributed to between 27% and 41% of the excess cost associated with vision loss, the report said.

The authors also found that at each level of vision loss, those progressing from a presumably normal state of vision at baseline incurred higher Medicare costs than those with that same level of vision loss, at baseline.

Dr. Javitt and colleagues concluded that with one in 28 Americans aged over 40 years suffering from vision loss, prevention is not only a medical imperative but also an economic one.

“Much of the vision loss associated with aging can be prevented with early detection and treatment,” said James Anderson, Board President of Prevent Blindness America. “Providing timely access to prevention programs and appropriate vision care is vital to address the growing number of people with or at risk of vision loss.”

Age-related macular degeneration affects nearly 2 million older Americans, and that number is expected to increase by at least 50% by 2020 without greater access to prevention or treatment. More than 4 million Americans aged >40 years with diabetes have diabetic retinopathy, and nearly 1 million more have advanced, vision-threatening signs of the disease. Overall, an estimated 80 million people in the United States have a potentially blinding eye disease, nearly 3.5 million have low vision, more than 1 million are legally blind, and 200,000 are more severely visually impaired.

1. Javitt J, Zhou Z, Willke R. Association between vision loss and higher medical care costs in Medicare beneficiaries. Ophthalmology. 2007;114:238-245.