Table 1

Characteristics of included studies

AuthorCountryDesign and populationCost components evaluatedObjectiveVision categories
Bramley et al15USARetrospective cohort analysis of a nationally representative Medicare 5% random sample; patients older than 65 years with newly diagnosed glaucoma; regression analysisDirect medical costs, intangible effectsTo measure costs of visual impairment due to progressing glaucomaNo vision loss, moderate vision loss, severe vision loss, blindness
Brezin et al16FranceNational survey of a random stratified sample; 16 945 affected persons answered questionnaires; 4091 caregiver answered questionnairesIndirect costs, intangible effectsTo document the prevalence of self-reported visual impairment and its association with disabilities, handicaps and socioeconomic consequencesBlind or light perception only, low vision, other visual problems and no visual problems
Chou et al17Australia150 persons completed cost diaries for 12 months and were evaluated; costs categorised into four sections: (1) medicines, products and equipment, (2) health and community services, (3) informal care and support, (4) other expensesDirect medical costs, direct non-medical costsTo describe and evaluate the process used to collect personal costs (out-of pocket) associated with vision impairment using diaries≥ 6/12 with restricted fields; <612–6/18; <6/18–6/60; <6/60–3/60; <3/60
Clarke et al18UKRegression-based approach to estimate the short-term and long-term annual hospital and non-hospital costs associated with seven major diabetes-related complications in the UK Prospective Diabetes Study: myocardial infarction; stroke, angina or ischaemic heart disease; heart failure; blindness in one eye; amputation and cataract extraction; 5102 patients with newly diagnosed type 2 diabetesDirect medical costsTo estimate the immediate and long-term health-care costs associated with seven diabetes-related complicationsBlind in one eye
Cruess et al19 (in combination with Gordon et al20)CanadaPrevalence-based approach; population projections for the whole population were compiled using data from the Statistics Canada 2006 Population Projections for Canada, Provinces and Territories 2001-2031Direct medical costs, direct non-medical costs, indirect costs, intangible effectsTo investigate costs of vision loss in Canada to inform healthcare planningNo details
Frick et al21USARetrospective cohort study; patients with blindness matched to non-blind selected from managed care claims databaseDirect medical costsTo evaluate total and condition-related charges incurred by blind patients in a managed care population in the USABlind, non blind
Frick et al22USAData from the medical expenditure panel survey 1996—2002 for adults older than 40 years with visual impairment or blindnessDirect medical costs; direct non-medical costs; other direct costs; intangible effectsTo estimate the economic impact of visual impairment and blindness in persons aged 40 years and older in the USAVisual impairment; blindness
Javitt et al23USARetrospective cohort analysis of a nationally representative Medicare 5% random sample, excluding Medicare managed-care enrolleesDirect medical costsTo assess and identify the costs to the Medicare programme for patients with either a stable or progressive vision loss and estimate the impact on eye-related and non-eye-related careMild, moderate, severe vision loss (VA ≤20/200), blindness (VA ≤ 20/400)
Keeffe et al24Australia114 participants of the Melbourne Visual Impairment Project completed diaries for 12 months; the burden of caregiver and opportunity costs for losses in work time was calculated (in combination with methods and data from Chou et al)Other direct costsTo analyse prospective data on providers, types and costs of care for people with impaired vision in AustraliaVA <20/40
Kymes et al25USADecision analytic approach; Markov model to replicate health events over the remaining lifetime of someone newly diagnosed with glaucomaIncremental costs of illnessTo evaluate the incremental cost of primary open-angle glaucoma considering the visual and non-visual medical costs over a lifetimeNo details
Lafuma et al26FranceInterviews with a sample population (665 000) from a national survey of persons living in institutions or in the community (with a caregiver at home)Direct non-medical costs, other direct costs, indirect costsTo estimate the annual national non-medical costs due to visual impairment and blindnessBlind (light perception), low vision (better than light perception?, low vision and controls
McCarty et al27AustraliaPopulation-based study; evaluation of the data from the Melbourne Visual impairment project; population ≥40 years was analysed in causes of deathIntangible effectsTo describe predictors of mortality in the 5-year follow-up of the Melbourne Visual impairment projectVisual acuity <6/12
Morse et al28USA2 552 350 discharges from hospital in the state of NY >5.764 patients had visual impairmentDirect medical costsTo assess whether visual impairment contributes to the average length of stay within inpatient care facilitiesNo details
Porz et al29GermanyRetrospective study of 66 patients using a cost-related and a vision-related quality of life questionnaire (impact of vision impairment questionnaire)Direct non-medical costs, intangible effectsTo capture the costs of medicines, aids and equipment, support in everyday life and social benefits, as well as vision-related quality of lifeVisual acuity ≥0.3, Visual acuity <0.3
Rein, et al30USAPrivate insurance and Medicare claims dataDirect non-medical costs, indirect costsTo estimate the societal economic burden and the governmental budgetary impact of the following visual disorders among US adults aged 40 years and older: visual impairment, blindness, refractive error, age-related macular degeneration, cataracts, diabetic retinopathy and primary open angle glaucomaRefractive errors
Roberts et al31JapanPrevalence-based approach; adopted using data on visual impairment, the national health system and indirect costsDirect medical costs, direct non-medical costs, indirect costs and intangible effectsTo quantify the total economic cost of visual impairment in JapanLow vision 6/12–6/60; blind <6/60; visual impairment>6/12
Schmier et al32USAUsing a questionnaire that included items on demographic and clinical characteristics and on the use of services, assistive devices and caregiving; 761 persons were includedDirect non-medical costs, other direct costsTo assess the use of devices and caregiving among individuals with diabetic retinopathy and to evaluate the impact of visual acuity on useGroup 1 (20/20 or better), group 2 (20/ 25–20/30), group 3 (20/40–20/50), group 4 (20/60–20/70), or group 5 (20/80 or worse)
Schmier et al33USASurvey with interviews on Daily Living Tasks Dependent on Vision Questionnaire; 803 respondentsOther direct costsTo assess the patient-reported use of caregiving among individuals with age-related macular degeneration and evaluation of impact of visual impairment level on this use1. VA >20/32; 2. VA 20/32—> 20/50;
3. VA 20/50—>20/80;
4. VA 20/80—> 20/150;
5. 20/150—>20/250;
6. VA ≤ 20/250
Vu, et al34AustraliaStratified random sample of 3040 participants from the Melbourne Visual Impairment Project; 2530 attended the follow-up studyIntangible effectsTo investigate whether unilateral vision loss reduces any aspects of quality of life in comparison with normal visionUnilateral and bilateral vision loss (correctable and non-correctable)
Wong et al35AustraliaProspective cohort study; participants of any age to complete a diary for 12 months answering four categories: (1) medicines, products and equipment, (2) health and community services, (3) informal care and support and (4) other expensesDirect costs (medical and non-medical), other direct costsTo determine the personal out-of-pocket costs of visual impairment and to examine the expenditure pattern related to eye diseases and the severity of visual impairmentVisual acuity ≥6/18 with constricted. fields;
Wood et al36Australia76 community-dwelling individuals with a range of severity of AMD; completing a diary for 12 monthsIntangible effects; costs of adverse eventsTo explore the relationship between AMD, fall risk, and other injuries and identified visual risk factors for these adverse eventsBinocular visual acuity, contrast sensitivity and merged visual fields
  • AMD,age-related macular degeneration; IHD, ischaemic heart disease; MI, myocardial infarction; UKPDS, UK Prospective Diabetes Study; VA, visual acuity.