Survey Instrument Indicators

Survey questions related to vision and eye health in each survey are organized in a two-level categorization structure based on indicator topic. The following sections provide the survey, survey question(s), and responses included in each indicator topic and category. VEHSS prioritized selected survey instruments for analysis. More vision-related survey questions will be added over time.

Self-Reported Eye Health Conditions include survey questions about diagnosis history of major eye diseases, including cataracts, diabetic retinopathy, glaucoma, and age-related macular degeneration.

Table 1. Self-Reported Cataracts

Table 1. Self-reported Cataracts
Survey Question
BRFSS Have you been told by an eye doctor or other health care professional that you NOW have cataracts?
NHIS Have you EVER been told by a doctor or other health professional that you had Cataracts?
MCBS Have you/Has survey participant ever been told by a doctor that you/he/she had…Cataracts?

Table 2. Self-Reported Diabetic Retinopathy

Table 2. Self-reported Diabetic Retinopathy
Survey Question
NHIS Have you EVER been told by a doctor or other health professional that you had diabetic retinopathy?
MCBS Have you/Has survey participant ever been told by a doctor that you/he/she had…Diabetic retinopathy?
NHANES Has a doctor ever told you/survey participant that diabetes has affected your/his/her eyes or that you/s/he had retinopathy (ret-in-op-ath-ee)?

Table 3. Self-Reported Glaucoma

Table 3. Self-reported Glaucoma
Survey Question
BRFSS Have you been told by an eye doctor or other health care professional that you had glaucoma?
MCBS Have you/Has survey participant ever been told by a doctor that you/he/she had…Glaucoma?
NHIS Have you EVER been told by a doctor or other health professional that you had Glaucoma?
NHANES Have you/Has survey participant ever been told by an eye doctor that you have/s/he has glaucoma (gla-co-ma), sometimes called high pressure in your/his/her eyes?

Table 4. Self-Reported Age-Related Macular Degeneration

Table 4. Self-reported Age-Related Macular Degeneration
Survey Question
BRFSS Have you EVER been told by an eye doctor or other health care professional that you had (age-related) macular degeneration?
MCBS Have you/Has survey participant ever been told by a doctor that you/he/she had…Macular degeneration or age-related macular degeneration, also called AMD?
NHIS Have you EVER been told by a doctor or other health professional that you had Macular Degeneration?
NHANES Have you/Has survey participant ever been told by an eye doctor that you have/s/he has age-related macular (mac-u-lar) degeneration?

Survey questions in four of the national surveys included in the VEHSS system support estimates of service utilization, including exam with dilation and cataract surgery.

Table 1. Self-Reported Eye Exams

Table 1. Self-reported Eye Exams
Survey Question
BRFSS When was the last time you had eye exam in which the pupils were dilated? This would have made you temporarily sensitive to bright light.
NHIS When was the last time you had an eye exam in which the pupils were dilated? This would have made you temporarily sensitive to bright light.

Table 2. Self-Reported Cataract Surgery

Table 2. Self-reported Cataract Surgery
Survey Question
MCBS Have you/Has survey participant ever had an operation for cataracts?
NHIS Have you ever had cataract surgery?
NHANES Have you/Has survey participant ever had a cataract operation?

Survey questions in all six of the national surveys included in the VEHSS system support estimates of visual function, including difficulty seeing with glasses, vision impairment, far-sightedness, near-sightedness, blindness or difficulty seeing, and vision correction.

Table 1. Difficulty Seeing with Glasses Indicators

Table 1. Difficulty Seeing with Glasses Indicators
Survey Question
NSCH Has a doctor or other health care provider ever told you that [CHILD] had vision problems that cannot be corrected with glasses or contact lenses?
ACS Is this person blind or does he/she have serious difficulty seeing even when wearing glasses?
BRFSS Has a doctor, nurse or other health professional ever said that you have vision impairment in one or both eyes, even when wearing glasses?
Do you have any trouble seeing, even when wearing glasses or contact lenses?
Are you blind or do you have serious difficulty seeing, even when wearing glasses?
MCBS Which statement best describes your/survey participant’s vision (while wearing glasses or contact lenses)?
NHIS Do you have any trouble seeing, even when wearing glasses or contact lenses?
Do you have difficulty seeing, even when wearing glasses?
If child is under age 2 years: Does [CHILD] have any trouble seeing?
If child is aged 2 to 17 years: Does [CHILD] have any trouble seeing, even when wearing glasses or contact lenses?

Table 2. Self-Reported Vision Impairment

Table 2. Self-reported Vision Impairment
Survey Question
NSCH Does [CHILD] currently have vision problems?
Would you describe his/her vision problems as mild, moderate, or severe?

Table 3. Self-Reported Near-Distance Visual Function

Table 3. Self-reported Near-distance Visual Function
Survey Question
BRFSS How much difficulty, if any, do you have reading print in newspaper, magazine, recipe, menu, or numbers?
NHIS Do you wear eyeglasses or contact lenses to read books or newspapers, write, or do other things that require you to see well up close, such as cooking, sewing or fixing things?
Even when wearing glasses or contact lenses, because of your eyesight, how difficult is it for you…to read ordinary print in newspapers?
Even when wearing glasses or contact lenses, because of your eyesight, how difficult is it for you…to do work or hobbies that require you to see well up close such as cooking, sewing, fixing things around the house, or using hand tools?
Does [CHILD] wear eyeglasses or contact lenses to read books, write, play hand-held games, or do other things that require (her/him) to see well up close?

Table 4. Self-Reported Far-Distance Visual Function

Table 4. Self-reported Far-distance Visual Function
Survey Question
BRFSS How much of the time does your vision limit you in recognizing people or objects across the street? How much difficulty, if any, do you have in recognizing a friend across the street?
NHIS Do you wear eyeglasses or contact lenses to drive, read road and street signs, watch TV, or see things in the distance?
Does [CHILD] wear eyeglasses or contact lenses to read road and street signs, see the blackboard, play sports, watch TV, or see things in the distance?
Can [CHILD] read the board from the back of the classroom? Even if wearing glasses or contact lenses?

Table 5. Self-Reported Blindness

Table 5. Self-reported Blindness
Survey Question
MCBS Have you/Has survey participants been told that you are/he is/she is legally blind?
NHIS Are you blind or unable to see at all?
Is [CHILD] blind or unable to see at all?
NHANES Are you/Is survey participant blind in both eyes?

Table 6. Self-Reported Vision Correction Indicators

Table 6. Self-reported Vision Correction Indicators
Survey Question
NHIS Do you currently wear eyeglasses or contact lenses?
Does [CHILD] wear eyeglasses or contact lenses?
Do you wear glasses?

Survey questions in two of the national surveys included in the VEHSS system support estimates of insurance and cost.

Table 1. Insurance Category

Table 1. Insurance Category
Survey Question
BRFSS Do you have any kind of health insurance coverage for eye care?
MCBS Do you/does survey participant have optical coverage through (CURRENT MEDICARE MANAGED CARE PLAN NAME), that is, for eyeglasses or contact lenses?

NHANES included visual acuity measurements 1999–2008.

Table 1. Visual Acuity Category

Table 1. Visual Acuity Category
Survey Acuity Type Responses Included in Analysis
NHANES
Presenting visual acuity
Presenting normal vision
Presenting any vision loss (≤20/32 in better eye)
Presenting visual impairment (20/32 – 20/160 in better eye)
Presenting visual impairment (20/32 – 20/63 in better eye)
Presenting visual impairment (20/70 – 20/160 in better eye)
Presenting US blind (≤20/200 in better eye)
Presenting monocular vision loss (≤20/70 in either eye)
Missing presenting acuity
Uncorrected Refractive Error (URE) Yes
Best-corrected visual acuity
Normal vision
Any vision loss (≤20/32 in better eye)
Visual impairment (20/32 – 20/160 in better eye)
Visual impairment (20/32 – 20/63 in better eye)
Visual impairment (20/70 – 20/160 in better eye)
US blind (≤20/200 in better eye)
WHO blind (≤20/400 in better eye)
Monocular vision loss (≤20/70 in either eye)
Missing acuity

NHANES included retinal images from 2005–2008.

NHANES included retinal images from 2005-2008.
Survey Retinal Image Diagnosis
NHANES Percentage of people with diabetic retinopathy, based on retinal images
NHANES Percentage of people with glaucoma, based on retinal images
NHANES Percentage of people with age-related macular degeneration, based on retinal images