Characteristics of included studies
| Author | Country | Design and population | Cost components evaluated | Objective | Vision categories |
|---|---|---|---|---|---|
| Bramley et al15 | USA | Retrospective cohort analysis of a nationally representative Medicare 5% random sample; patients older than 65 years with newly diagnosed glaucoma; regression analysis | Direct medical costs, intangible effects | To measure costs of visual impairment due to progressing glaucoma | No vision loss, moderate vision loss, severe vision loss, blindness |
| Brezin et al16 | France | National survey of a random stratified sample; 16 945 affected persons answered questionnaires; 4091 caregiver answered questionnaires | Indirect costs, intangible effects | To document the prevalence of self-reported visual impairment and its association with disabilities, handicaps and socioeconomic consequences | Blind or light perception only, low vision, other visual problems and no visual problems |
| Chou et al17 | Australia | 150 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 expenses | Direct medical costs, direct non-medical costs | To 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 al18 | UK | Regression-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 diabetes | Direct medical costs | To estimate the immediate and long-term health-care costs associated with seven diabetes-related complications | Blind in one eye |
| Cruess et al19 (in combination with Gordon et al20) | Canada | Prevalence-based approach; population projections for the whole population were compiled using data from the Statistics Canada 2006 Population Projections for Canada, Provinces and Territories 2001-2031 | Direct medical costs, direct non-medical costs, indirect costs, intangible effects | To investigate costs of vision loss in Canada to inform healthcare planning | No details |
| Frick et al21 | USA | Retrospective cohort study; patients with blindness matched to non-blind selected from managed care claims database | Direct medical costs | To evaluate total and condition-related charges incurred by blind patients in a managed care population in the USA | Blind, non blind |
| Frick et al22 | USA | Data from the medical expenditure panel survey 1996—2002 for adults older than 40 years with visual impairment or blindness | Direct medical costs; direct non-medical costs; other direct costs; intangible effects | To estimate the economic impact of visual impairment and blindness in persons aged 40 years and older in the USA | Visual impairment; blindness |
| Javitt et al23 | USA | Retrospective cohort analysis of a nationally representative Medicare 5% random sample, excluding Medicare managed-care enrollees | Direct medical costs | To 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 care | Mild, moderate, severe vision loss (VA ≤20/200), blindness (VA ≤ 20/400) |
| Keeffe et al24 | Australia | 114 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 costs | To analyse prospective data on providers, types and costs of care for people with impaired vision in Australia | VA <20/40 |
| Kymes et al25 | USA | Decision analytic approach; Markov model to replicate health events over the remaining lifetime of someone newly diagnosed with glaucoma | Incremental costs of illness | To evaluate the incremental cost of primary open-angle glaucoma considering the visual and non-visual medical costs over a lifetime | No details |
| Lafuma et al26 | France | Interviews 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 costs | To estimate the annual national non-medical costs due to visual impairment and blindness | Blind (light perception), low vision (better than light perception?, low vision and controls |
| McCarty et al27 | Australia | Population-based study; evaluation of the data from the Melbourne Visual impairment project; population ≥40 years was analysed in causes of death | Intangible effects | To describe predictors of mortality in the 5-year follow-up of the Melbourne Visual impairment project | Visual acuity <6/12 |
| Morse et al28 | USA | 2 552 350 discharges from hospital in the state of NY >5.764 patients had visual impairment | Direct medical costs | To assess whether visual impairment contributes to the average length of stay within inpatient care facilities | No details |
| Porz et al29 | Germany | Retrospective 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 effects | To capture the costs of medicines, aids and equipment, support in everyday life and social benefits, as well as vision-related quality of life | Visual acuity ≥0.3, Visual acuity <0.3 |
| Rein, et al30 | USA | Private insurance and Medicare claims data | Direct non-medical costs, indirect costs | To 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 glaucoma | Refractive errors |
| Roberts et al31 | Japan | Prevalence-based approach; adopted using data on visual impairment, the national health system and indirect costs | Direct medical costs, direct non-medical costs, indirect costs and intangible effects | To quantify the total economic cost of visual impairment in Japan | Low vision 6/12–6/60; blind <6/60; visual impairment>6/12 |
| Schmier et al32 | USA | Using a questionnaire that included items on demographic and clinical characteristics and on the use of services, assistive devices and caregiving; 761 persons were included | Direct non-medical costs, other direct costs | To assess the use of devices and caregiving among individuals with diabetic retinopathy and to evaluate the impact of visual acuity on use | Group 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 al33 | USA | Survey with interviews on Daily Living Tasks Dependent on Vision Questionnaire; 803 respondents | Other direct costs | To assess the patient-reported use of caregiving among individuals with age-related macular degeneration and evaluation of impact of visual impairment level on this use | 1. 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 al34 | Australia | Stratified random sample of 3040 participants from the Melbourne Visual Impairment Project; 2530 attended the follow-up study | Intangible effects | To investigate whether unilateral vision loss reduces any aspects of quality of life in comparison with normal vision | Unilateral and bilateral vision loss (correctable and non-correctable) |
| Wong et al35 | Australia | Prospective 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 expenses | Direct costs (medical and non-medical), other direct costs | To 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 impairment | Visual acuity ≥6/18 with constricted. fields; <6/18–6/60; <6/60 |
| Wood et al36 | Australia | 76 community-dwelling individuals with a range of severity of AMD; completing a diary for 12 months | Intangible effects; costs of adverse events | To explore the relationship between AMD, fall risk, and other injuries and identified visual risk factors for these adverse events | Binocular 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.