Economic Studies

U.S. economic burden of vision loss and blindness

This study estimates the economic burden of vision loss in the United States. Information for this study comes from people who self-identified as blind or having trouble seeing even with glasses. It does not include costs of vision or eye care that are not associated with vision loss.

2017 cost estimates for the U.S. economic burden of vision loss and blindness are as follows:

• Total: $134.2 billion
• Medical, nursing home, and supportive services (direct): $98.7 billion
• Absenteeism, lost production, and informal care (indirect): $35.5 billion

The largest cost components are:

• Medical: $53.5 billion
• Nursing home: $41.8 billion
• Reduced labor force participation: $16.2 billion

Nationally, vision loss and blindness cost an average of $16,838 annually per person affected.

Publication: Rein DB, Wittenborn JS, Zhang P, et al. The Economic Burden of Vision Loss and Blindness in the United States. Ophthalmology. 2022;129(4):369–378. doi:10.1016/j.ophtha.2021.09.010

Detailed estimates by state, cost category, age group, and sex are available on the CDC website.

Prevalence of diagnosis of major eye diseases and their associated payments in the Medicare fee-for-service program

The study estimates the prevalence of the four eye disorders below plus the 2018 related payments among Medicare fee-for-service (FFS) beneficiaries. The study does not include payments for other services related to vision loss and blindness.

• AMD
• Cataracts
• DR
• Glaucoma

Medicare is the largest payer of medical expenses for eye diseases. 41% of beneficiaries had at least one claim related to the four vision conditions.

Medicare paid $10.2 billion for these four conditions as follows:

• AMD: $3.5 billion
• Cataracts: $3.6 billion
• DR: $0.8 billion
• Glaucoma: $2.2 billion

These eye conditions accounted for 4% of all Medicare Part B and 1% of all Medicare Part D spending among FFS beneficiaries.

The average annual costs of treating these disorders per person are as follows:

• AMD: $1,290
• Cataracts: $360
• DR: $781
• Glaucoma: $543

Publication: Wittenborn JS, Gu Q, Erdem E, et al. The Prevalence of Diagnosis of Major Eye Diseases and their Associated Payments in the Medicare Fee-for-Service Program. Ophthalmic Epidemiol. Sep 16 2021:1-13. doi:10.1080/09286586.2021.1968006

Economic burden of visual disorders in American adults

This study estimated the economic impact of AMD, cataracts, DR, glaucoma, and refractive error among Americans 40 years and older. The study estimated a total financial burden of major visual disorders of $35.4 billion in 2004:

• Direct medical costs: $16.2 billion
• Other direct costs: $11.1 billion
• Productivity losses: $8 billion

Annually, the federal government and state Medicaid agencies pay at least $13.7 billion of these costs.

Publication: Rein DB, Zhang P, Wirth KE, et al. The Economic Burden of Major Adult Visual Disorders in the United States. Arch Ophthalmol 2006;124(12):1754–1760.

Cost-effectiveness model for AMD

This study simulated the incidence and progression of AMD with and without vitamin therapy*.

Vitamin therapy was found to prevent advanced vision-threatening disease. It reduced the percentage of patients with early AMD who ever developed visual impairment in the better-seeing eye to 5.6% from 7.0% without such therapy.

• Vitamin therapy is more cost effective than other interventions.
• Vitamin therapy reduced vision impairment for patients with AMD.

*Vitamin therapy refers to prophylactic antioxidant vitamin plus zinc supplements.

Publication: Rein DB, Saaddine JB, Wittenborn JS, et al. Cost-effectiveness of Vitamin Therapy for Age-related Macular Degeneration. Ophthalmology 2007;114(7):1319–1326. Abstract of Cost-effectiveness of Vitamin Therapy for Age-related Macular Degeneration.

Report: economic impact of vision problems

This report updates the prior estimate of the economic burden of eye problems released by Prevent Blindness America in 2007. The updated estimate of the total economic burden of eye disorders and vision loss is $139 billion. This is based on the 2011 U.S. population in 2013 dollars. Uncorrectable vision loss was estimated to result in a social burden of 283,000 disability adjusted life years (DALYs) lost.

Impact of Vision Problems [PDF - 197KB]

Cost-effectiveness model for glaucoma

Using a computer model, this study simulated glaucoma incidence, natural progression, diagnosis, and treatment. The study evaluated whether routine assessment and treatment of glaucoma enhances quality of life at a reasonable cost.

Publications:

Rein DB, Wittenborn JS, Lee PP, Wirth KE, Sorensen SW, Hoerger TJ, Saaddine JB. The Cost-effectiveness of Routine Office-based Identification and Subsequent Medical Treatment of Primary Open-angle Glaucoma in the United States. Ophthalmology 2009;116(5):823–832.
Abstract of The Cost-effectiveness of Routine Office-based identification and Subsequent Medical Treatment of Primary Open-angle Glaucoma in the United States.

Rein DB, Wirth KE, Johnson CA, Lee PP. Estimating Quality-adjusted Life Year Losses Associated with Visual Field Deficits Using Methodological Approaches. Ophthalmic Epidemiol 2007;14(4):258–264.
Abstract of Estimating Quality-adjusted Life Year Losses associated with Visual Field Deficits Using Methodological Approaches.