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  • Trends in Eye Care Use and Spectacle Affordability

    By Lynda Seminara
    Selected and Reviewed By: Neil M. Bressler, MD, and Deputy Editors
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    Journal Highlights

    JAMA Ophthalmology, April 2019

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    In an analysis of data from the U.S. Na­tional Health Interview Survey (2008-2016), Varadaraj et al. looked at trends in eye care use and the affordability of eyeglasses. They found that those least likely to use eye care or to be able to afford eyeglasses were women, racial/ethnic minorities, and visually im­paired people, regardless of study year. Since 2014, spectacles were deemed more affordable than in previous years, which may relate to economic recovery and/or health care reform.

    Survey participants were adults 18 years and older. They were grouped into nine annual cross-sectional pop­ulation-based samples, ranging from 21,781 to 36,697 people. Visual im­pairment was defined as self-reported difficulty with seeing despite wearing eyeglasses. Outcome measures included visits to eye care professionals and the inability to afford eyeglasses if deemed needed in the preceding year. Survey logistic regression, with adjustment for demographics and other factors, was used to detect associations between survey years and eye care outcomes.

    Compared with the first year of the survey, the final year was associated with higher proportions of Asians, Hispanics, and older adults in the U.S. population. Throughout the study pe­riod, substantial trends were observed for both outcomes. The fully adjusted models showed that people were less likely to use eye care in 2016 than in 2008 (odds ratio [OR], 0.90; p < .001). Compared with 2008, spectacle afford­ability was easier from 2014 onward (2014 OR, 0.82; p < .001; 2015 OR, 0.81; p < .001; 2016 OR, 0.70; p < .001). After adjustment for all covariates, including survey year, visually impaired people were more likely than nonim­paired individuals to use eye care (OR, 1.54; p < .001), but they had greater difficulty affording eyeglasses (OR, 3.86; p < .001). Overall, women were more likely than men to use eye care (OR, 1.42; p < .001) and to have diffi­culty affording eyeglasses (OR, 1.68; p < .001). Compared with non-Hispanic whites, those who are Hispanic, Asian, or black were less likely to use eye care, and Asians and blacks were more able to afford eyeglasses.

    The original article can be found here.