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David B. Rein, PhD; Ping Zhang, PhD; Kathleen E. Wirth, BA; Paul P. Lee, MD, JD; Thomas J. Hoerger, PhD; Nancy McCall, ScD; Ronald Klein, MD, MPH; James M. Tielsch, PhD; Sandeep Vijan, MD, MS; Jinan Saaddine, MD, MPH

Arch Ophthalmol. 2006;124:1754-1760.

Objective  To estimate the societal economic burden and the governmental budgetary impact of the following visual disorders among US adults aged 40 years and older: visual impairment, blindness, refractive error, age-related macular degeneration, cataracts, diabetic retinopathy, and primary open-angle glaucoma.

Design  We estimated 3 components of economic burden: direct medical costs, other direct costs, and productivity losses. We used private insurance and Medicare claims data to estimate direct medical costs; epidemiologic evidence from multiple published sources to estimate other direct costs, such as nursing home costs; and data from the Survey of Income and Program Participation to estimate productivity losses. We used budgetary documents and our direct medical and other direct cost estimates to approximate the governmental budgetary impact.

Results  We estimated that the annual total financial burden of major adult visual disorders is $35.4 billion ($16.2 billion in direct medical costs, $11.1 billion in other direct costs, and $8 billion in productivity losses) and that the annual governmental budgetary impact is $13.7 billion.

Conclusions  Major visual disorders among Americans older than 40 years result in substantial economic costs for the US economy. Well-designed public health programs may have the ability to reduce this burden in the future.

Author Affiliations: RTI International, Research Triangle Park, NC (Drs Rein, Wirth, Hoerger, and McCall); Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation, Atlanta, Ga (Drs Zhang and Saaddine); Duke University Center for Health Policy Law and Management, Durham, NC (Dr Lee); University of Wisconsin–Madison, Department of Ophthalmology and Visual Sciences, Madison (Dr Klein); Johns Hopkins University, School of Hygiene and Public Health, Baltimore, Md (Dr Tielsch); University of Michigan, Veterans Affairs Health Services Research, Development Center for Practice Management and Outcomes Research, Ann Arbor (Dr Vijan).

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