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Medicare pays for glaucoma screening, cataract removal, and treatment of macular degeneration in some cases. It does not pay for routine eye examinations or glasses. These findings suggest that older adults, even those with substantial vision loss, may need to be educated about the importance of vision health and routine eye examinations. Primary care physicians also may need to be educated about the importance of referring patients to eye care specialists who can detect and treat eye diseases and conditions that affect vision. Since 1984, the BRFSS has helped states survey civilian, non institutionalized U.S. adults aged 18 years or older about a wide range of health risk behaviors, preventive health practices, and health care access. In 2008, about 350,000 people were surveyed through this state-based telephone surveillance system. The BRFSS provides data to help state and national public health agencies monitor population health, as well as identify trends and emerging health concerns. The core survey gathers demographic information (such as age, race, and education level), as well as information about self-reported mental and physical health, life satisfaction, and specific health conditions and behaviors (such as diabetes, tobacco use, and exercise). In addition, the 2008 BRFSS contained 23 modules that asked in-depth questions about various health concerns, including vision. The BRFSS is the world’s largest random-digit-dialed telephone survey, and its data are considered to be reliable and valid.18 Despite its breadth, BRFSS data do have some limitations. The survey excludes people who do not have a landline or who live in institutional settings. It may exclude people who have substantial hearing loss and do not use a conventional telephone. In addition, it may exclude people with impairments so severe that it is difficult to get to the telephone or participate in the interview. The BRFSS survey relies on self-reported answers, and responses are not confirmed. Self-reported eye diseases are not confirmed by clinical examinations.
The BRFSS Vision Module was developed by CDC’s Vision Health Initiative and first implemented in 2005. CDC provides financial support to states that implement the module, and states have begun using it since 2005. The Vision Module contains nine questions about visual function, eye diseases, frequency of eye examinations, and reasons for not seeking eye care. Two of the nine questions are about function (distance and near vision), four are about access to eye examinations (related to dilated eye examinations, reasons for not visiting an eye care professional, and vision insurance), and three are about specific eye diseases (cataracts, glaucoma, and age-related macular degeneration). Information about diabetic retinopathy is taken from the BRFSS’s diabetes module. The BRFSS Vision Module surveys adults aged 40 years or older. In this issue brief, we report data for those aged 65 or older from the 19 states that implemented the module during 2006–2008. These states are Alabama, Arizona, Colorado, Connecticut, Florida, Georgia, Indiana, Iowa, Kansas, Missouri, Nebraska, New Mexico, New York, North Carolina, Ohio, Tennessee, Texas, West Virginia, and Wyoming. Data collected by the BRFSS Vision Module can be used to promote public health in several ways. These data can be used to identify and address health conditions among people aged 40 years or older who have vision problems; to determine the level of access to eye care among members of this population; and to provide other evidence that can be used to improve the effectiveness, accessibility, and quality of eye care.
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