May 2007
Volume 48, Issue 13
ARVO Annual Meeting Abstract  |   May 2007
The Costs and Consequences of Progression to Glacuoma Related Visual Impairment
Author Affiliations & Notes
  • S. M. Kymes
    Ophthalmology/Visual Science, Washington Univ Sch of Med, St Louis, Missouri
  • Z. Zhou
    U.S. Outcomes Research, Pfizer Global Pharmaceuticals, New York, New York
  • M. R. Plotzke
    Economics, Washington University, St Louis, Missouri
  • J. Fain
    U.S. Outcomes Research, Pfizer Global Pharmaceuticals, New York, New York
  • Footnotes
    Commercial Relationships S.M. Kymes, Pfizer, F; Allergan, C; Pfizer, C; Allergan, R; Pfizer, R; Z. Zhou, Pfizer, E; M.R. Plotzke, None; J. Fain, Pfizer, E.
  • Footnotes
    Support Pfizer Grant to Kymes, "The Economic Burden of Glaucoma Related Visual Impairment"
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 1561. doi:
  • Views
  • Share
  • Tools
    • Alerts
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      S. M. Kymes, Z. Zhou, M. R. Plotzke, J. Fain; The Costs and Consequences of Progression to Glacuoma Related Visual Impairment. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1561.

      Download citation file:

      © ARVO (1962-2015); The Authors (2016-present)

  • Supplements

We measured increased non-vision care cost associated with progression to visual loss due to glaucoma using Medicare data.


We analyzed a random 5% sample of Medicare beneficiaries (1999-2003). Presence the ICD-9 code, 365.xx, in a 1999 claim was considered evidence of glaucoma. Inclusion required survival from 1999-2003. Moderate visual loss was defined as severe impairment in the worst seeing eye (ICD-9 ≥ 369.60). Severe visual loss was defined as severe impairment in best seeing eye (ICD-9 369.10 to 369.41). Blindness was defined as near total to profound impairment in both eyes (ICD-9 369.0 to 369.09). We identified those who reported depression, injury and living in long-term care settings. We report the mean total medical costs for each group and the increased risk of depression or injury, and living in an institutional setting associated with progression.


57,664 beneficiaries were reported as having glaucoma. 54,596 did not experience severe impairment in either eye, while 3,068 beneficiaries (5.3%) reported severe impairment in at least one eye during the five year period. Increased visual impairment was associated with higher overall medical costs in 2003. Those who were blind had the highest cost of those who did not progress ($11,568). Those who progressed from glaucoma to blindness had the highest overall cost ($16,109) . Among those who progressed to vision loss, progression to blindness had the highest incremental cost ($5,510). Those who progressed to any vision loss were more likely to be diagnosed with depression or injury, or to be in long-term care or skilled nursing facility than those who did not, including those who had visual impairment at the beginning of the period.


Among people with glaucoma, progression to loss of visual function in even a single eye is leads to much higher medical costs during the period in which progression occurs. A substantial portion of this cost is associated with avoidable conditions and institutionalization.  

Keywords: clinical (human) or epidemiologic studies: outcomes/complications • quality of life 

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.