WebMD Medical News
Laura J. Martin, MD
May 19, 2011 -- A large number of people who have problems with their eyesight don't visit eye doctors because of the cost or because they don't have health insurance that covers eye care, a CDC survey shows.
The survey shows that others don't get regular eye exams because they don't think they have eye problems, or for a variety of other reasons, such as having to travel too far to see doctors or specialists or having no transportation to get to their offices.
In a study involving 11,503 adults aged 40 and over who were considered to have moderate-to-severe visual impairment, 39.8% said they had skipped seeking care in the past year because of costs or lack of insurance.
Almost 35% said they didn't seek eyesight care because they felt they didn't need it, while 4.5% said they could not get an appointment.
The percentage of those citing cost or lack of insurance was greater among adults between 40 and 64 at 42.8%, compared to 23.3% of people 65 and older, according to the CDC's Morbidity and Mortality Weekly Report for May 20.
The CDC analyzed data from 21 states taking part in Behavioral Risk Factor Surveillance System surveys that covered the period between 2006 and 2009.
Survey participants were asked to state the last time they had their eyes examined. Those who said their last eye exam was over one year ago were asked about the main reason for not seeing an eye care professional.
The participants were considered visually impaired if they said they had trouble recognizing a friend across the street or difficulty reading newspapers, magazines, recipes, menus, or numbers on telephones.
The report says the percentage of people 65 and over saying they had no need to go to an eye doctor was 43.8% compared to 32.9% in the 40- to 64-year-old age group. And 41.7% of men said they had no need for eye care, compared to 28.7% of women.
CDC researchers said 36.9% of people who reported no age-related eye disease reported no need to go to eye doctors compared with those who reported age-related eye disease (28.2%).
The reasons survey participants gave for failing to seek eye care varied by age, sex, presence of eye disease, state the person lived in, race, ethnicity, and education level.
"The large proportion of persons aged 65 and over reporting no need as their main reason for not seeking care is of concern because this population has the highest prevalence of visual impairment," the CDC report says. "A possible reason for this is that older adults might regard impairment as a normal part of aging."
The researchers note that previous studies have indicated that many people often aren't aware they have eye health needs because of the lack of attention given to the subject by primary care providers.
The CDC says differences were noted among the 21 states for which information was available. The percentage of respondents not seeking eye care was lowest both for adults 40-64 and for those 65 and older in Massachusetts, the state with the smallest proportion of residents with no health insurance.
Such information can be used to inform policy makers about unmet health care needs, according to the CDC. The researchers say public health interventions are needed to increase awareness among both adults 65 and older and the health care providers who take care of them.
In Massachusetts, 21.6% of people aged 40 to 64 said they didn't seek eye care because of costs or lack of insurance, compared to 60.4% of people in that age group in Tennessee.
For people 65 and older, 8.9% in Massachusetts did not seek eye checkups due to cost or lack of insurance, compared to 48% in West Virginia.
The percentage reporting no need for eye exams ranged from 25.4% in Florida to 41.9% in Arizona in the 40-64 age range, and from 29.7% in West Virginia to 61% in Massachusetts among those aged 65 and over.
SOURCE:Morbidity and Mortality Weekly Report, May 20, 2011; vol 60.
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