Stat Tracker

Prevalence of Visual Impairment and Eye Disease Varies by State

Blindness and visual impairment are among the 10 most common causes of disability in the United States¹ and are associated with shorter life expectancy and lower quality of life.^2,3 Previously, state-specific prevalence of visual impairment and eye disease was estimated from national prevalence. In 2005, five states (Iowa, Louisiana, Ohio, Tennessee and Texas) provided state-specific estimates by using the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) vision module.

The self-reported prevalence of visual impairment and eye disease among persons 50 years or older varied among the five states. The prevalence of visual impairment ranged from 14.3% in Iowa to 20.5% in Ohio. Prevalence of cataract ranged from 29.0% in Texas to 34.3% in Iowa. Prevalence of glaucoma ranged from 5.0% in Tennessee to 7.4% in Louisiana, prevalence of macular degeneration ranged from 3.1% in Tennessee to 5.4% in Iowa and prevalence of diabetic retinopathy ranged from 2.7% in Ohio) to 4.3% in Louisiana.

The self-reported prevalence of workplace eye injury history ranged from 5.8% (Tennessee) to 9.0% (Iowa) among the five states. With the exception of diabetic retinopathy, women had higher prevalence of visual impairment and eye disease than men. Among age groups, prevalence of cataract and glaucoma increased with age, and prevalence of workplace eye injury history decreased with age.

Having eyecare insurance and use of eye care also varied among the five states. The percentage of participants reporting no eyecare insurance ranged from 46.2% (Ohio) to 55.0% (Tennessee). In addition, the percentage reporting they had not had a dilated eye examination during the preceding 12 months ranged from 40.6% (Iowa) to 46.2% (Texas). The percentage reporting no visit to an eye-care professional in the preceding 12 months ranged from 30.4% (Iowa) to 34.8% (Texas). Persons in the five states cited "no reason to go" (range: 42.8% in Louisiana to 60.9% in Iowa) and "cost/insurance" (range: 18.5% in Ohio to 22.1% in Tennessee) as the most common reasons for not having visited an eyecare professional in the preceding 12 months.

Overall, persons aged 50 to 59 years were least likely to report not having eyecare insurance. The percentage of persons who had not had a dilated eye examination or a visit to an eyecare professional in the preceding 12 months decreased with increasing age. Men were more likely than women to report not having had a dilated eye examination or not having had an eyecare visit.

Having eye care insurance and use of eye care also varied by race/ethnicity, education, and income. Hispanics were more likely than non-Hispanic whites to report not having eyecare insurance, not having had a dilated eye examination, and not having had an eyecare visit during the preceding 12 months. Respondents with less than a high school education or annual household income of less than $15,000 were least likely to use eyecare services. Moreover, the percentage without eyecare insurance decreased as education and income levels increased.

The report shows variation in disease prevalence and use of eye care among individual states and also among racial/ethnic populations and age groups within the five states combined.

The variability among state data suggests that state-specific surveillance of visual impairment and eye care and investigation by states to identify influencing factors might lead to creation of vision programs better suited to individual state needs. OM

References

1. CDC: Prevalence of disabilities and associated health conditions among adults — United States, 1999. MMWR. 2001;50:120-125.

2. McCarty CA, Nanjan MB, Taylor HR. Vision impairment predicts 5 year mortality. Br J Ophthalmol. 2001;85:322-326.

3. Vu HT, Keeffe JE, McCarty CA, Taylor HR. Impact of unilateral and bilateral vision loss on quality of life. Br J Ophthalmol. 2005;89:360-363.

About these data: CDC analyzed data from the module to determine the self-reported prevalence of visual impairment, eye disease, eye injury and lack of eyecare insurance and eye examination among persons aged >50 years in each of these five states and among certain socio-demographic populations. A total of 13,931 responses were analyzed using statistical software to account for the survey design complexity. Trends were assessed using linear regression by the weighted least squares method.

BRFSS is a state-based, random-digit-dialed telephone survey of the noninstitutionalized, U.S. civilian population aged >18 years. Response rates for the five states using the optional BRFSS vision module in 2005 were as follows: Iowa, 60.2%; Louisiana, 51.4%; Ohio, 49.5%; Tennessee, 59.6%; and Texas, 45.2%. Among the five states, Louisiana provided data only for January through August because of Hurricane Katrina.