title: Strabismus among aged fee-for-service Medicare beneficiaries.
abstract: OBJECTIVE
  To describe the prevalence of strabismus and strabismus surgery in the aged Medicare fee-for-service population.
  
  
  METHODS
  A 5% random sample of Medicare Part B physician claims was used to identify beneficiaries ≥ 65 years of age with strabismus and those undergoing strabismus surgery between 2002 and 2010.
  
  
  RESULTS
  In 2010 there were 1,237,469 beneficiaries. The diagnosis of strabismus was made in 8,470 (0.68%), more often in females (56%) and in whites (92%). Common diagnoses were paralytic strabismus, exotropia, and esotropia, with each reported in 22%. Strabismus surgery in 2010 was performed on 197 patients (0.016% of all beneficiaries), or approximately 2.3% of patients with the diagnosis of strabismus. Horizontal surgical codes were reported most frequently (68%). Reoperations were reported for 23% and adjustable sutures for 23% of cases. The prevalence of strabismus surgery ranged from 183 to 236 cases annually (0.015%-0.018%). Review of pooled data (2002-2010) found that the prevalence of strabismus increased with age from 65 to 89 years of age (P < 0.0001) and that whites underwent strabismus surgery more often than African Americans (0.017% vs 0.007%, respectively; P < 0.0001).
  
  
  CONCLUSIONS
  Less than 1% of aged Medicare beneficiaries are diagnosed with strabismus each year, with the rate increasing significantly with age. Strabismus surgery is performed annually in 16 of 100,000 of aged Medicare beneficiaries; the surgery rate is significantly lower among African Americans. Understanding the reasons for the difference by race/ethnicity deserve further study.
authors.affiliation: The Zanvyl Krieger Children's Eye Center, Wilmer Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-9028, USA. mrepka@jhmi.edu
authors.forename: Michael X
authors.initials: MX
authors.lastname: Repka
authors.forename: Fei
authors.initials: F
authors.lastname: Yu
authors.forename: Anne
authors.initials: A
authors.lastname: Coleman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D018588:Fee-for-Service Plans; D005260:Female; D006801:Humans; D008297:Male; D016345:Medicare Part B / Q000706:statistics & numerical data*; D009801:Oculomotor Muscles / Q000601:surgery; D013508:Ophthalmologic Surgical Procedures / Q000706:statistics & numerical data*; D015995:Prevalence; D012086:Reoperation; D013285:Strabismus / Q000453:epidemiology* / Q000601:surgery; D014481:United States