Glaucoma vision loss leads to more health problems

A new study of Medicare beneficiaries with glaucoma demonstrates that vision loss is associated with a greater risk of depression, nursing home admission, and femur fracture.

Care became more costly as vision worsened, Dr. Thomas Bramley of Xcenda in Salt Lake City and colleagues also found, ranging from $8,157 for patients with no vision loss to $18,670 for those with complete blindness.

Glaucoma accounts for about three quarters of all cases of visual impairment, Bramley and his team note in their report. Recently, they add, Medicare has been emphasizing awareness of glaucoma and progression of the disease.

To better understand the economic impact of the adverse consequences of vision loss in people with glaucoma, the researchers looked at a nationally representative sample including 5 percent of all Medicare patients.

Their analysis included 181,922 people diagnosed with glaucoma between 1999 and 2004; of these subjects, 92.1 percent had no vision loss. Another 4.3 percent were classified as having moderate vision loss, 1.9 percent had severe vision loss, and 1.7 percent were blind.

The risk of all adverse events that the researchers looked at rose as vision worsened. Patients with any degree of vision loss were more than twice as likely as those with intact vision to be placed in a nursing home. Patients who vision loss were also 63 percent more likely to develop depression, 67.4 percent more likely to sustain a femur fracture, and 58.6 percent more likely to suffer a fall or accident.

“Results from this study showed that as visual field limitations increased, resource consumption, adverse consequences, and intensity of care also increased,” the researchers write. Inpatient care was the main factor driving the increased costs, they found.

SOURCE: Archives of Ophthalmology, June 2008.

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