Costs keep eye patients away

Atlanta-Why would adults who have moderate-to-severe visual impairment not seek eye care? Cost or lack of insurance, and perception of no need, are the most common reasons, according to an analysis of data conducted by the Centers for Disease Control and Prevention (CDC).

To ascertain why adults aged at least 40 years who have moderate-to-severe visual impairment did not seek eye care in the preceding year, the CDC analyzed data for 21 states from its 2006-2009 Behavioral Risk Factor Surveillance System (BRFSS) surveys.

Self-reported visual impairment was defined by asking respondents how difficult it was for them to identify a friend across the street or how much difficulty they had reading print in a newspaper, magazine, recipe, menu, or numbers on the telephone. Those who answered “moderate difficulty,” “extreme difficulty,” or “unable to do because of eyesight” were classified as having moderate-to-severe visual impairment.

Respondents also were asked whether they had been told by an eye doctor or other health-care professional that they had cataract, glaucoma, age-related macular degeneration, or diabetic retinopathy. Those responding affirmatively were classified as having “any age-related eye disease.”

Respondents were asked about the last time they had their eyes examined by any doctor or eye-care provider. Those reporting “greater than 1 year” also were asked the main reason for not visiting an eye-care professional in the past 12 months. Overall, the most common reason given for not seeking eye care was cost or lack of insurance (39.8%).

The percentage of those reporting cost or lack of insurance as the main reason was greater among adults aged 40 to 64 years (42.8%) than among adults aged at least 65 years (23.3%). However, the percentage of those reporting no need to visit as the main reason was greater among adults aged at least 65 years (43.8%) than those aged 40 to 64 years (32.9%). A greater percentage of men than women reported no need to visit (41.7% versus 28.7%, respectively), and a greater percentage of those with no age-related eye disease reported no need than those with any age-related eye disease (36.9% versus 28.2%, respectively).

BRFSS is an annual, state-based, random-digit-dialed telephone survey of the non-institutionalized U.S. civilian population aged at least 18 years. It provides socio-demographic and other information on health behaviors, chronic illness, and access to health care.

For this report, CDC analyzed data from the BRFSS Vision Impairment and Access to Eye Care Module, which was implemented for at least 1 year during 2006-2009 by 21 states. The study sample consisted of 11,503 adults aged at least 40 years who had self-reported moderate to severe visual impairment and had not visited an eye-care professional in the previous year; the sample constituted 6.96% of those interviewed.

The full results of the study were reported in the CDC’s Morbidity and Mortality Weekly Report May 20 (60[19];610–613).