State-specific vision survey suggests better way to estimate eye care needs

A telephone survey conducted across five U.S. states found variations in the prevalences of major eye diseases and the use of eye care services, according to a report from the Centers for Disease Control and Prevention. Data from state-specific surveys could help planners to develop better state vision care programs, rather than basing programs on national estimates, the authors of the report said.

"These data can enable CDC and states to better assess the need for eye care, identify groups at high risk for eye disease, reduce health disparities, allocate scarce resources and target effective intervention activities," the authors said.

Robert N. Bailey, OD, and colleagues at several U.S. institutions, including the CDC, reviewed estimates of visual impairment and eye diseases for 2005 provided by five states. The data were collected using the CDC Behavioral Risk Factor Surveillance System vision module, a random-digit-dialed telephone survey. The results of their study were published in the December 15 edition of Morbidity and Mortality Weekly Report.

The study included 13,931 responses from non-institutionalized persons aged 50 years and older in Iowa, Tennessee, Louisiana, Ohio and Texas.

The researchers found that cataract had the highest prevalence among four selected eye diseases. Its prevalence ranged from 29% in Texas to 34.3% in Iowa. The prevalence of glaucoma ranged from 5% in Tennessee to 7.4% in Louisiana, age-related macular degeneration from 3.1% in Tennessee to 5.4% in Iowa, and diabetic retinopathy from 2.7% in Ohio to 4.3% in Louisiana.

The prevalence of visual impairment ranged from 14.3% in Iowa to 20.5% in Ohio, and history of workplace eye injury ranged from 5.8% in Tennessee to 9% in Iowa. The rate of eye injuries decreased with age (P < .05), a finding that "appears counterintuitive and suggests a need for further study," the authors said.

The percentage of respondents who had not visited an eye care professional in the past year ranged from 30.4% in Iowa to 34.8% in Texas. Across all five states, most of these respondents said they had no reason to go or cited cost and insurance as deterrents.

"An annual dilated eye examination is recommended for persons with diabetes or aged 65 years [and older]; by comparison, approximately 44% of those aged 60 to 69 years and 32% of those aged 70 to 79 years had not had a dilated eye examination during the preceding 12 months," the authors said.

Use of eye care also varied by race or ethnicity, education and income (P < .05), with Hispanics more likely than whites to report neither having eye insurance nor having an eye-care visit within the past year. Respondents without a high school education or with an annual household income of less than $15,000 were least likely to use eye care services, according to the study authors.