title: Trends in Prevalence of Diagnosed Ocular Disease and Utilization of Eye Care Services in American Veterans.
abstract: OBJECTIVE
  To assess trends in prevalence of diagnosed ocular disease and use of eye care services in the Veterans Affairs (VA) health care system.
  
  
  METHODS
  Prevalence study.
  
  
  METHODS
  We performed a retrospective study of all eligible veterans in the VA Capitol Health Care Network from 2007 to 2011. The VA database was used to abstract demographic and socioeconomic variables, including age, race, sex, marital status, service connection, prescription copay, homelessness, and VA facility. Primary outcome measures were the prevalence of diagnosed ocular disease and use of eye care. Ocular diagnoses were determined by International Classification of Diseases, 9th revision codes and use by prescription medication fills, visits to eye care clinics, and cataract surgery frequency.
  
  
  RESULTS
  The average age of veterans ranged from 59.8-60.9, most veterans were male (88.1-89.8%), and there was a high proportion of African Americans (29.5-30%). The prevalence of all ocular diagnoses increased from 20.5% in 2007 to 23.3% in 2011 (P < .01), a 13.7% increase. Similarly, the prevalence of diagnosed cataract increased by 35.7% (P = .02) from 7.1% in 2007 to 9.6% in 2011. Diagnosed glaucoma prevalence increased by 9.4% (P = .03) from 6.7 to 7.4%. The percent of patients seen in eye clinics increased 11.6%% in the 5-year study period to 24.0% in fiscal year 2011 (P = .05). The use of ophthalmic medications increased 20% (P < .01). The rate of cataract surgery did not change significantly during the study period.
  
  
  CONCLUSIONS
  The prevalence of diagnosed eye conditions among American Veterans is increasing, as is the use of eye care services. Cataract surgery rates did not increase, which may indicate a need to increase availability of these services.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland. Electronic address: osaeedi@som.umaryland.edu.
authors.forename: Osamah
authors.initials: O
authors.lastname: Saeedi
authors.affiliation: Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Hasan
authors.initials: H
authors.lastname: Ashraf
authors.affiliation: Department of Psychiatry, Division of Psychiatric Services Research, University of Maryland School of Medicine, Baltimore, Maryland; Veterans Affairs Capitol Healthcare Network Mental Illness Research, Education, and Clinical Center, Baltimore, Maryland.
authors.forename: Eric P
authors.initials: EP
authors.lastname: Slade
authors.affiliation: Department of Psychiatry, Division of Psychiatric Services Research, University of Maryland School of Medicine, Baltimore, Maryland; Veterans Affairs Capitol Healthcare Network Mental Illness Research, Education, and Clinical Center, Baltimore, Maryland.
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Medoff
authors.affiliation: Department of Psychiatry, Division of Psychiatric Services Research, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Lan
authors.initials: L
authors.lastname: Li
authors.affiliation: Glaucoma Center of Excellence, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
authors.forename: David S
authors.initials: DS
authors.lastname: Friedman
authors.affiliation: Department of Psychiatry, Division of Psychiatric Services Research, University of Maryland School of Medicine, Baltimore, Maryland; Veterans Affairs Capitol Healthcare Network Mental Illness Research, Education, and Clinical Center, Baltimore, Maryland.
authors.forename: Julie
authors.initials: J
authors.lastname: Kreyenbuhl
mesh_terms: D003430:Cross-Sectional Studies; D005006:Ethnicity; D005128:Eye Diseases / Q000175:diagnosis / Q000208:ethnology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data*; D014728:Veterans