The Cost of Vision report calculated the medical expenditures attributable to individual disorder categories. An important consideration is that these estimates did not represent the full cost of disease because they do not capture any costs of vision loss resulting from these conditions. The MEPS data used to estimate medical costs recorded medical expenditures as reported by medical providers and 3-digit ICD-9 codes assigned based on self-reported diagnoses and procedures. We used econometric methods to estimate the costs attributable to any diagnosed disorder (diagnosed disorders), medical costs attributable to self-reported low vision among individuals who had no eye or vision disorder diagnosis (undiagnosed low vision), and costs of optometry care and medical vision aids such as glasses and contacts (vision correction). MEPS collects vision correction costs separately, and unlike other medical costs, these costs are self-reported by patients and not associated with diagnosis codes. We therefor estimated vision correction expenditures using an accounting approach.
Figure 4.5.1 and Table 4.5.1 show projections of costs for all diagnosed disorders, vision correction costs, and undiagnosed low vision. Medical costs for diagnosed disorders are estimated to be $48.6 billion in 2014, and are projected to grow at a high rate in future years due to both the growing population of older Americans and projected increases in medical care intensity. Vision correction and undiagnosed low vision costs are projected to grow at a comparatively slower rate, largely because these costs are not as highly skewed towards older ages and thus not as sensitive to the growth of the older population.
Figure 4.5.1. Projected Medical Treatment Costs by Disorder Type, 2014 $billions
Figure 4.5.2 and Table 4.5.2 break down the Diagnosed Disorder costs into eleven disorder categories. As detailed in the Cost of Vision report, MEPS codes diagnoses at the 3-digit ICD-9 level. Several important disorders are coded at the 4th or 5th digit level, and thus cannot be distinguished in our data. These include AMD and diabetic retinopathy. To approximate the costs of these disorders, we grouped all retinal disorder costs and then report these costs separately for persons with and without diabetes. Full details and validation of this assumption is included in the Cost of Vision report.
Figure 4.5.2.Projected Medical Treatment Costs by Diagnosed Disorder, 2014 $billions
The highest cost disorder group is cataracts, followed by glaucoma. The category including conjunctivitis and disorders of the lacrimal system and eyelids is the third costliest before year 2014, but is projected to fall to the 6th costliest group after 2022. Retinal disorders among persons without diabetes are the third costliest beginning in 2014, while costs for persons with diabetes increases from 6th to 4th costliest by 2024.