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Brief Report
June 20, 2019

Self-reported Eye Care Use Among US Adults Aged 50 to 80 Years

Author Affiliations
  • 1Department of Ophthalmology and Visual Sciences, Center for Eye Policy and Innovation, University of Michigan, Ann Arbor
  • 2Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
  • 3University of Michigan Medical School, Ann Arbor
  • 4Child Health Evaluation and Research Center, University of Michigan, Ann Arbor
  • 5Veterans Affairs Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
  • 6Department of Internal Medicine, University of Michigan, Ann Arbor
  • 7Duke Eye Center, Duke University, Durham, North Carolina
  • 8Department of Epidemiology, University of Michigan, Ann Arbor
JAMA Ophthalmol. 2019;137(9):1061-1066. doi:10.1001/jamaophthalmol.2019.1927
Key Points

Question  What factors are associated with receipt of eye care among US adults?

Findings  Results of this cross-sectional online survey study showed that more than 80% of US adults aged 50 to 80 years reported undergoing an eye examination in the past 2 years. Respondents who were unmarried, had lower incomes, or resided outside the northeast were less likely to report recent eye care; common reasons for not undergoing an eye examination included not having an eye problem, cost, and lack of insurance coverage.

Meaning  Overall, eye care use among US adults appears to be high; however, there are socioeconomic and demographic differences that might be addressed through targeted policy interventions.

Abstract

Importance  Contemporary data on use of eye care by US adults are critical, as the prevalence of age-related eye disease and vision impairment are projected to increase in the coming decades.

Objectives  To provide nationally representative estimates on self-reported use of eye care by adults aged 50 to 80 years, and to describe the reasons that adults do and do not seek eye care.

Design, Setting, and Participants  The National Poll on Healthy Aging, a cross-sectional, nationally representative online survey was conducted from March 9 to 24, 2018, among 2013 individuals aged 50 to 80 years.

Main Outcomes and Measures  The proportion of US adults who received an eye examination within the past 2 years as well as the sociodemographic and economic factors associated with receipt of eye care.

Results  Among 2013 adults aged 50 to 80 years (survey-weighted proportion of women, 52.5%; white non-Hispanic, 71.1%; mean [SD] age, 62.1 [9.0] years), the proportion reporting that they underwent an eye examination in the past year was 58.5% (95% CI, 56.1%-60.8%) and in the past 2 years was 82.4% (95% CI, 80.4%-84.2%). Among those with diabetes, 72.2% (95% CI, 67.2%-76.8%) reported undergoing an eye examination in the past year and 91.3% (95% CI, 87.7%-93.9%) in the past 2 years. The odds of having undergone an eye examination within the past 2 years were higher among women (adjusted odds ratio [AOR], 2.00; 95% CI, 1.50-2.67), respondents with household incomes of $30 000 or more (AOR, 1.57; 95% CI, 1.08-2.29), and those with a diagnosed age-related eye disease (AOR, 3.67; 95% CI, 2.37-5.69) or diabetes (AOR, 2.30; 95% CI, 1.50-3.54). The odds were lower for respondents who were unmarried (AOR, 0.71; 95% CI, 0.53-0.96), from the Midwest (AOR, 0.55; 95% CI, 0.34-0.87) or West (AOR, 0.60; 95% CI, 0.38-0.94), or reported fair or poor vision (AOR, 0.43; 95% CI, 0.28-0.65). Reasons reported for not undergoing a recent eye examination included having no perceived problems with their eyes or vision (41.5%), cost (24.9%), or lack of insurance coverage (23.4%).

Conclusions and Relevance  In this study, the rate of eye examinations was generally high among US adults aged 50 to 80 years, yet there were several significant demographic and socioeconomic differences in the use of eye care. These findings may be relevant to health policy efforts to address disparities in eye care and to promote care for those most at risk for vision problems.

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