2016 VSP Summary Data Report For the Vision Eye health Surveillance System DATE PRESENTED TO PRESENTED BY JUNE20,2018 Jinan Saaddine John Wittenborn Division of diabetes translation NORC at the University of Chicago Centers for Disease Control and Prevention Phillip Kimura Mary Beth Richardson VSP Global Vision NORC &E EYE HEALTH H: SS SURVEILLANCE at the UNIVERSITYof CHICAgo SYSTEMI
2016 VSP Summary Data Report For the Vision & Eye Health Surveillance System DATE JUNE 20, 2018 PRESENTED TO: Jinan Saaddine, Division of Diabetes Translation, Centers for Disease Control and Prevention PRESENTED BY: John Wittenborn, NORC at the University of Chicago Phillip Kimura, MaryBeth Richardson, VSP Global
NORC I 2016 VSP Summary Data Report for the Vision& Eye Health Surveillance System Table of contents Dataset Description Analysis Overview 5 Data Indicators and Case definitions Service utilization- Eye EXams..….… 6 Medical Di 8 Denominators used to calculate Prevalence rates Stratification Facto Age Groups Sex Categories Race/ethnicity Categories States and Territories Suppression and Data Release Restrictions Potential limitations Service Utilization Indicators(Number of patients receiving service per 100 patients).15 Medical Diagnosis Indicators(Number of patients with diagnosis per 100 patients)
NORC | 2016 VSP Summary Data Report for the Vision & Eye Health Surveillance System | II Table of Contents Dataset Description ..................................................................................................................5 Analysis Overview ....................................................................................................................5 Data Indicators and Case Definitions ..................................................................................6 Service Utilization-Eye Exams ...................................................................................6 Medical Diagnoses ....................................................................................................8 Denominators used to Calculate Prevalence Rates ..........................................................11 Stratification Factors .........................................................................................................12 Age Groups .............................................................................................................12 Sex Categories ........................................................................................................12 Race/ethnicity Categories........................................................................................12 States and Territories ..............................................................................................12 Suppression and Data Release Restrictions .....................................................................13 Potential Limitations...............................................................................................................14 Service Utilization Indicators (Number of patients receiving service per 100 patients) ....15 Medical Diagnosis Indicators (Number of patients with diagnosis per 100 patients) ........18
NORC I 2016 VSP Summary Data Report for the Vision& Eye Health Surveillance System List of Tables Table 1. Service Utilization Topic Indicators Table 2. Procedure codes included in Exams Table 3. 2013 Eye Care Provider Categories Taxonomy Codes Table 4. Medical Diagnosis Categories and Subgroups Table 5. VEHSS State and Territory Abbreviations Table 7. Exam rate by Age Group, 201 0356 Table 8. Exam rate by Sex, 2016 Tabe9. EXam rate by State,2016…… Table 10. Treated Prevalence of Medical Diagnoses by Category and Subgroup, 2016......18 Table 11. Medical Diagnosis Categories by Age Group, 2016 Table 12. Medical Diagnosis Categories by Sex, 2016 Table 13. Medical Diagnosis Categories by State, 2016, Age related macular degeneration Table 14. Medical Diagnosis Categories by State, 2016, Blindness and low vision Table 15. Medical Diagnosis Categories by State, 2016, Cancer and neoplasms of the eye diseases Table 16. Medical Diagnosis Categories by State, 2016, Cataracts Table 17. Medical Diagnosis Categories by State, 2016, Cornea disorders 27 Table 18. Medical Diagnosis Categories by State, 2016, Diabetic eye diseases Table 19. Medical Diagnosis Categories by State, 2016, Disorders of optic nerve and visual pathways Table 20. Medical Diagnosis Categories by State, 2016, Refraction and accommodation Table 21. Medical Diagnosis Categories by State, 2016, Glaucoma Table 22. Medical Diagnosis Categories by State, 2016, Infectious and inflammatory diseases Table 23. Medical Diagnosis Categories by State, 2016, Injury, burns and surgical complications of the eye Table 24. Medical Diagnosis Categories by State, 2016, Orbital and external disease diseases Table 25. Medical Diagnosis Categories by State, 2016, Other retinal disorders
NORC | 2016 VSP Summary Data Report for the Vision & Eye Health Surveillance System | III List of Tables Table 1. Service Utilization Topic Indicators .........................................................................6 Table 2. Procedure Codes Included in Exams ......................................................................7 Table 3. 2013 Eye Care Provider Categories Taxonomy Codes ...........................................8 Table 4. Medical Diagnosis Categories and Subgroups......................................................10 Table 5. VEHSS State and Territory Abbreviations.............................................................13 Table 7. Exam rate by Age Group, 2016.............................................................................15 Table 8. Exam rate by Sex, 2016........................................................................................16 Table 9. Exam rate by State, 2016 .....................................................................................17 Table 10. Treated Prevalence of Medical Diagnoses by Category and Subgroup, 2016.......18 Table 11. Medical Diagnosis Categories by Age Group, 2016 ..............................................21 Table 12. Medical Diagnosis Categories by Sex, 2016 .........................................................22 Table 13. Medical Diagnosis Categories by State, 2016, Age related macular degeneration.......................................................................................................23 Table 14. Medical Diagnosis Categories by State, 2016, Blindness and low vision...........24 Table 15. Medical Diagnosis Categories by State, 2016, Cancer and neoplasms of the eye diseases .......................................................................................................25 Table 16. Medical Diagnosis Categories by State, 2016, Cataracts.....................................26 Table 17. Medical Diagnosis Categories by State, 2016, Cornea disorders........................27 Table 18. Medical Diagnosis Categories by State, 2016, Diabetic eye diseases ................28 Table 19. Medical Diagnosis Categories by State, 2016, Disorders of optic nerve and visual pathways ..................................................................................................29 Table 20. Medical Diagnosis Categories by State, 2016, Refraction and accommodation ..................................................................................................30 Table 21. Medical Diagnosis Categories by State, 2016, Glaucoma....................................31 Table 22. Medical Diagnosis Categories by State, 2016, Infectious and inflammatory diseases ..............................................................................................................32 Table 23. Medical Diagnosis Categories by State, 2016, Injury, burns and surgical complications of the eye....................................................................................33 Table 24. Medical Diagnosis Categories by State, 2016, Orbital and external disease diseases ..............................................................................................................34 Table 25. Medical Diagnosis Categories by State, 2016, Other retinal disorders...............35
NORC I 2016 VSP Summary Data Report for the Vision& Eye Health Surveillance System Table 26. Medical Diagnosis Categories by State, 2016, Other eye disorders Table 27. Medical Diagnosis Categories by State, 2016, Other visual disturbances Table 28. Medical Diagnosis Categories by State, 2016, Retinal detachment and defects Table 29. Medical Diagnosis Categories by State, 2016, Strabismus and amblyopia ......39 N
NORC | 2016 VSP Summary Data Report for the Vision & Eye Health Surveillance System | IV Table 26. Medical Diagnosis Categories by State, 2016, Other eye disorders....................36 Table 27. Medical Diagnosis Categories by State, 2016, Other visual disturbances..........37 Table 28. Medical Diagnosis Categories by State, 2016, Retinal detachment and defects.................................................................................................................38 Table 29. Medical Diagnosis Categories by State, 2016, Strabismus and amblyopia ........39
NORC I 2016 VSP Summary Data Report for the vision& Eye Health Surveillance System Dataset Description VSP Global is the nations largest vision insurance provider, operating as a nonprofit corporation for 60 years. Vision insurance is a specialized supplemental insurance provided through employers, commercial health plans, Medicare/Medicaid supplement plans, the federal employees health benefits program (FEHB), tribes, or purchased individually to provide routine vision care coverage. Generally, VSP data includes optometric exams and procedures, diagnoses(refractive errors, eye disease, systemic disease, acute issues), vision correction utilization, prescriptions and materials dispensed, costs, provider information, and patient demographics VSP does not report their patient volume but report that more than one in four Americans have VSP coverage. VSP processes claims in every state, but market penetration varies by state. VSP's national network contains about 33,000 eye care professionals. Approximately 85% are OD,'s(optometrist), and 15% are MD's(ophthalmologist) vSP claims contain the age of patients, but do not include race/ethnicity. Medical diagnosis coverage in VSP claims are Vision insurance claims typically include diagnosis codes for refractive error, but medical diagnoses are generally not required for payment of routine vision services thus their inclusion in claims by the billing practice is optional. This is especially true for non-refraction related codes. Diagnosis information in VSP claims cannot be considered as disease prevalence estimates but could be considered an indicator of vision care services Analysis Overview For the vess project, VSP analyzed their 2016 claims databases to estimate the annual prevalence rate of treated diagnoses and the rate of clinical procedures. VSP analyzed the claims data and provided NORC with de-identified summary reports of frequencies and rates, summarized by state and by age group, race/ethnicity, and sex NORC further analyzed the summary data files, mapping outcomes to VEHSS-defined categories calculating confidence intervals, cleaning data. Results were further suppressed if the numerator was 3 and the denominator was <30 NORC found that about 8%of VSP patients who had no claims filed during the year did not have a state of residence identified. State of residence for these patients was imputed based on the state-distribution of beneficiaries with a state location on file. VSP stated that they did not believe that there were any systematic reasons why the inclusion of beneficiary's address information would vary by state, and thus
NORC | 2016 VSP Summary Data Report for the Vision & Eye Health Surveillance System 5 Dataset Description VSP Global is the nation’s largest vision insurance provider, operating as a nonprofit corporation for 60 years. Vision insurance is a specialized supplemental insurance provided through employers, commercial health plans, Medicare/Medicaid supplement plans, the federal employees health benefits program (FEHB), tribes, or purchased individually to provide routine vision care coverage. Generally, VSP data includes optometric exams and procedures, diagnoses (refractive errors, eye disease, systemic disease, acute issues), vision correction utilization, prescriptions and materials dispensed, costs, provider information, and patient demographics. VSP does not report their patient volume, but report that more than one in four Americans have VSP coverage. VSP processes claims in every state, but market penetration varies by state. VSP’s national network contains about 33,000 eye care professionals. Approximately 85% are OD’s (optometrist), and 15% are MD’s (ophthalmologist). VSP claims contain the age and sex of patients, but do not include race/ethnicity. Medical diagnosis coverage in VSP claims are limited. Vision insurance claims typically include diagnosis codes for refractive error, but medical diagnoses are generally not required for payment of routine vision services, thus their inclusion in claims by the billing practice is optional. This is especially true for non-refraction related codes. Diagnosis information in VSP claims cannot be considered as disease prevalence estimates, but could be considered an indicator of vision care services. Analysis Overview For the VEHSS project, VSP analyzed their 2016 claims databases to estimate the annual prevalence rate of treated diagnoses and the rate of clinical procedures. VSP analyzed the claims data and provided NORC with de-identified summary reports of frequencies and rates, summarized by state and by age group, race/ethnicity, and sex. NORC further analyzed the summary data files, mapping outcomes to VEHSS-defined categories, calculating confidence intervals, cleaning data. Results were further suppressed if the numerator was <3 and the denominator was less than 30, or the numerator was ≥3 and the denominator was ≤30. NORC found that about 8% of VSP patients who had no claims filed during the year did not have a state of residence identified. State of residence for these patients was imputed based on the state-distribution of beneficiaries with a state location on file. VSP stated that they did not believe that there were any systematic reasons why the inclusion of beneficiary’s address information would vary by state, and thus
NORC I 2016 VSP Summary Data Report for the vision& Eye Health Surveillance System this adjustment would be unlikely to bias results. In addition, this adjustment is only relevant to state specific rates. National rates are not affected a detailed description of the analytical steps is described in the reportVEHSS Claims Registry Data Analysis Plan Data Indicators and case Definitions VSP estimates include data indicators representing two topics of the overall VEHSS project; "Service Utilization, and"Medical Diagnoses Service Utilization-Eye Exams Service Utilization measured in VSP claims is the proportion of patients who underwent an eye exam per year of observation. The rate of exams represents the proportion of patients who have at least one eye exam during the year of observation, and is a single number representing the average for each patient group. The Eye Exam indicators analyzed in VSP claims data are listed in Table 1 Table 1. Service Utilization Topic Indicators Eye exams By provider type By ophthalmologists and other physicians Eye exams were identified in claims based on the presence of Healthcare Common Procedure Coding System(HCPCSCodes, shown in Table 2. Four procedure codes specifically denote an eye exam (92002, 92004, 92012, 92014). All instances of these procedures were counted as an eye exam Other Evaluation Management(e M)codes(99***)are not specific to eye exams, but nonetheless are frequently billed for eye exams. In this case, we included all e m codes since by definition all claims billed to VSP are for eye care services. We identified eye care providers in VSP based on the provider types(also known as taxonomy), of ophthalmologist, optometrist or optician, or a general physician who coded for an ophthalmic procedure as indicated in Table 3
NORC | 2016 VSP Summary Data Report for the Vision & Eye Health Surveillance System 6 this adjustment would be unlikely to bias results. In addition, this adjustment is only relevant to statespecific rates. National rates are not affected. A detailed description of the analytical steps is described in the report “VEHSS Claims & Registry Data Analysis Plan.” Data Indicators and Case Definitions VSP estimates include data indicators representing two topics of the overall VEHSS project; ‘Service Utilization’ and ‘Medical Diagnoses.’ Service Utilization-Eye Exams Service Utilization measured in VSP claims is the proportion of patients who underwent an eye exam per year of observation. The rate of exams represents the proportion of patients who have at least one eye exam during the year of observation, and is a single number representing the average for each patient group. The Eye Exam indicators analyzed in VSP claims data are listed in Table 1. Table 1. Service Utilization Topic Indicators Category Subgroup Eye exams By provider type By ophthalmologists and other physicians By optometrists and opticians Eye exams were identified in claims based on the presence of Healthcare Common Procedure Coding System (HCPCS) Codes, shown in Table 2. Four procedure codes specifically denote an eye exam (92002, 92004, 92012, 92014). All instances of these procedures were counted as an eye exam. Other Evaluation & Management (E & M) codes (99***) are not specific to eye exams, but nonetheless are frequently billed for eye exams. In this case, we included all E & M codes since by definition all claims billed to VSP are for eye care services. We identified eye care providers in VSP based on the provider types (also known as taxonomy), of ophthalmologist, optometrist or optician, or a general physician who coded for an ophthalmic procedure as indicated in Table 3
NORC I 2016 VSP Summary Data Report for the vision& Eye Health Surveillance System Table 2. Procedure codes included in Exams CPT/HCPCS Code Code Description Eye Exam Codes, Always Included Eye exam new patient 92012 Eye exam established patien 92014 Eye exam established patient General Exam Codes 99201 Office/outpatient visit new Office/outpatient vis Office/outpatient visit new 99204 Office/outpatient visit new 99205 Office/outpatient visit new 99212 Office/outpatient visit established 99213 Office/outpatient visit established 99214 Office/outpatient visit established 99215 Office/outpatient visit established 99241 Office consultation 99242 Office consultation 99243 sultation 244 Office consultation Office consultation Home visit new patient 9934 Home visit new patient 99343 Home visit new patient 99344 Home visit new patient 99345 Home visit new patient Home visit est patient Home visit est patient 99349 Home visit est patient 99350 Home visit est patient 7
NORC | 2016 VSP Summary Data Report for the Vision & Eye Health Surveillance System 7 Table 2. Procedure Codes Included in Exams CPT/HCPCS Code Code Description Eye Exam Codes, Always Included 92002 Eye exam new patient 92004 Eye exam new patient 92012 Eye exam established patient 92014 Eye exam established patient General Exam Codes 99201 Office/outpatient visit new 99202 Office/outpatient visit new 99203 Office/outpatient visit new 99204 Office/outpatient visit new 99205 Office/outpatient visit new 99212 Office/outpatient visit established 99213 Office/outpatient visit established 99214 Office/outpatient visit established 99215 Office/outpatient visit established 99241 Office consultation 99242 Office consultation 99243 Office consultation 99244 Office consultation 99245 Office consultation 99341 Home visit new patient 99342 Home visit new patient 99343 Home visit new patient 99344 Home visit new patient 99345 Home visit new patient 99347 Home visit est patient 99348 Home visit est patient 99349 Home visit est patient 99350 Home visit est patient
NORC I 2016 VSP Summary Data Report for the vision& Eye Health Surveillance System Table 3. 2013 Eye Care Provider Categories Taxonomy Codes VEHSS Provider Specialty Medicare Provider Provider Taxonomy Description Type Category Code Provider Type Taxonomy By ophthalmologists and other physicians Physician/ 207X0200X Allopathic Osteopathic Physicians/Ophthalmic Plastic and Physician/ 207oo000x Ophthalmology By optometrists and opticians 152W00000X Eye and visio 152WC0802X Eye and Vision Service Providers/Optometrist, Corneal and Contact Management 152L0500X Eye and Vision Service Providers/Optometrist, Low Vision Rehabilitation 152WX0102X Eye and Vision Service Providers/Optometrist, Occupational Vision 152WP0200X Eye and Vision Service Providers/Optometrist, Pediatrics 152WS0006X Eye and Vision Service Providers/Optometric 152WV0400X Eye and Vision Service Providers/Optometrist, Vision Therapy 96[5] Optician 156FX1800X Eye&Vision Service Providers/Technician/Technologist, Optician Medical Diagnoses Identification of prevalent cases Individual VSP beneficiaries were assigned to diagnosis categories and subgroups based on the presence of an included iCD10 diagnosis code on any patient claim during the year of observation. Diagnosis codes may be primary or secondary codes. Only one instance of a code is required to assign the patient to a diagnosis category and subgroup We used following identification algorithm Any observation of an indicated diagnosis code in any VSP claim by a patient The diagnosis code may be primary or secondary Only one instance of the diagnosis code is necessary to trigger classification to a diagnosis Patients may be assigned to multiple categories and subcategories
NORC | 2016 VSP Summary Data Report for the Vision & Eye Health Surveillance System 8 Table 3. 2013 Eye Care Provider Categories Taxonomy Codes VEHSS Provider Type Category Specialty Code Medicare Provider Type Provider Taxonomy Code Provider Taxonomy Description By ophthalmologists and other physicians 2 Physician/ General Surgery 207WX0200X Allopathic & Osteopathic Physicians/Ophthalmic Plastic and Reconstructive Surgery 18 Physician/ Ophthalmology 207W00000X Allopathic & Osteopathic Physicians/Ophthalmology By optometrists and opticians 41 Optometry 152W00000X Eye and Vision Service Providers/Optometrist 152WC0802X Eye and Vision Service Providers/Optometrist, Corneal and Contact Management 152WL0500X Eye and Vision Service Providers/Optometrist, Low Vision Rehabilitation 152WX0102X Eye and Vision Service Providers/Optometrist, Occupational Vision 152WP0200X Eye and Vision Service Providers/Optometrist, Pediatrics 152WS0006X Eye and Vision Service Providers/Optometrist, Sports Vision 152WV0400X Eye and Vision Service Providers/Optometrist, Vision Therapy 96[5] Optician 156FX1800X Eye & Vision Service Providers/Technician/Technologist, Optician Medical Diagnoses Identification of prevalent cases Individual VSP beneficiaries were assigned to diagnosis categories and subgroups based on the presence of an included ICD10 diagnosis code on any patient claim during the year of observation. Diagnosis codes may be primary or secondary codes. Only one instance of a code is required to assign the patient to a diagnosis category and subgroup. We used following identification algorithm: ■ Any observation of an indicated diagnosis code in any VSP claim by a patient. ■ The diagnosis code may be primary or secondary. ■ Only one instance of the diagnosis code is necessary to trigger classification to a diagnosis category. ■ Patients may be assigned to multiple categories and subcategories
NORC I 2016 VSP Summary Data Report for the vision& Eye Health Surveillance System Data is analyzed on an annual basis The development of this algorithm was based on the practices of the CMS Chronic Conditions Warehouse reporting system, feed back from project partners and experts, as well as the results of a literature review intended to identify normal and best practices for prevalence reporting from administrative data sources This literature review is included in Appendix A of the"Claims registry Analysis Plan"report Diagnosis Categories and Subgroup Indicators Medical Diagnoses are reported based on the VEHSS-defined medical diagnosis categorization structure As reported in detail in the VEHSS Medical Diagnosis Categorization Report, we identified all eye and vision related ICD9 and ICD10 diagnosis codes, and organized them into a 2-level categorization structure which has 17 Categories and 79 Subgroups(Table 4) For example, assume a beneficiary has 3 eye and vision related ICD9 codes in the year of observation 362.3 Retinal vascular occlusion, unspecified 3629 Retinal nerve fiber bundle defects 362. 11 Hypertensive retinopathy 362.3 and 362.9 are both assigned to subgroup ' Retina vascular disease, Occlusive(arterial, venous) 362. 11 is assigned to a different subgroup; Retina vascular disease, Non-Occlusive. Both of these subgroups are within one category(Other Retinal Disorders This beneficiary is counted as one prevalent case for subgroup Retina vascular disease, Occlusive (arterial, venous), and one case for subgroup ' Retina vascular disease, Non-Occlusive. This beneficiary would count as one case in the category "Other Retinal Disorders. Thus, individual patients can appear in multiple subgroups, but cannot be double counted within a specific category or subgroup. Patients may also appear in multiple separate categories Denominator used to calculate prevalence rates The patient population( denominator) includes those who were enrolled in VSP at any time during the calendar year. VSP enrollment data is based primarily on employer-provided enrollment data, and may not accurately reflect the actual number of patients enrolled in VSP over the course of the year. In addition, some patient enrollment data is incomplete, with 8%of enrollees not having a state of residence
NORC | 2016 VSP Summary Data Report for the Vision & Eye Health Surveillance System 9 ■ Data is analyzed on an annual basis. The development of this algorithm was based on the practices of the CMS Chronic Conditions Warehouse reporting system, feedback from project partners and experts, as well as the results of a literature review intended to identify normal and best practices for prevalence reporting from administrative data sources. This literature review is included in Appendix A of the “Claims & Registry Analysis Plan” report. Diagnosis Categories and Subgroup Indicators Medical Diagnoses are reported based on the VEHSS-defined medical diagnosis categorization structure. As reported in detail in the VEHSS Medical Diagnosis Categorization Report, we identified all eye and vision related ICD9 and ICD10 diagnosis codes, and organized them into a 2-level categorization structure which has 17 Categories and 79 Subgroups (Table 4). For example, assume a beneficiary has 3 eye and vision related ICD9 codes in the year of observation: ■ 362.3 Retinal vascular occlusion, unspecified ■ 362.9 Retinal nerve fiber bundle defects ■ 362.11 Hypertensive retinopathy 362.3 and 362.9 are both assigned to subgroup ‘Retina vascular disease, Occlusive (arterial, venous)’. 362.11 is assigned to a different subgroup; ‘Retina vascular disease, Non-Occlusive’. Both of these subgroups are within one category (Other Retinal Disorders). This beneficiary is counted as one prevalent case for subgroup ‘Retina vascular disease, Occlusive (arterial, venous)’, and one case for subgroup ‘Retina vascular disease, Non-Occlusive’. This beneficiary would count as one case in the category ‘Other Retinal Disorders’. Thus, individual patients can appear in multiple subgroups, but cannot be double counted within a specific category or subgroup. Patients may also appear in multiple separate categories. Denominator used to Calculate Prevalence Rates The patient population (denominator) includes those who were enrolled in VSP at any time during the calendar year. VSP enrollment data is based primarily on employer-provided enrollment data, and may not accurately reflect the actual number of patients enrolled in VSP over the course of the year. In addition, some patient enrollment data is incomplete, with 8% of enrollees not having a state of residence on file
NORC I 2016 VSP Summary Data Report for the vision& Eye Health Surveillance System Table 4. Medical Diagnosis Categories and Subgroups Category Subgroup Retinal Detachment and Defects Diabetic Eye Diseases Moderate /severe non-proliferative diabetic retinopathy Proliferative diabetic retinopathy Diabetic macular edema(dme, csme) Other/unspecified diabetes related eye conditions Age related macular degeneration(AMD) AMD, unspecified Early AMD Dry-form AMD GA, modifier for Dry-form Wet-form AMD CNV. modifier for Wet-form other Retinal Disorders Retina vascular disease, occlusive(arterial, venous) Central retinal vein occlusion Branch retinal vein occlusion Central retinal arterial occlusion Retina vascular disease. non-occlusive Macular edema(if not diabetic Hereditary chorioretinal dystrophy Myopic degeneration Other/unspecified retinal disorders Glaucoma Open-angle glaucoma Low-tension glaucoma Glaucoma suspect Primary angle-closure glaucoma Narrow-angle glaucoma Congenital glaucoma Neovascular glaucoma Other/unspecified glaucoma Cataracts Senile cataract Congenital cataract Posterior capsular opacity phakic and other disorders of lens Disorders of refraction and accommodation Hypermetropia Astigmatism Other disorder of refraction and accomodation Blindness and low vision Unqualified visual loss, both eyes Unqualified vision loss in one eye, or unspecified visual loss Vision impairment one eye Moderate or severe vision impairment better eye; profound vision impairment of lesser eye Moderate or severe vision impairment both eyes Profound vision impairment, bilateral, or legal blindness Strabismus and amblyopia
NORC | 2016 VSP Summary Data Report for the Vision & Eye Health Surveillance System 10 Table 4. Medical Diagnosis Categories and Subgroups Category Subgroup Retinal Detachment and Defects Diabetic Eye Diseases Early/mild diabetic retinopathy Moderate /severe non-proliferative diabetic retinopathy Proliferative diabetic retinopathy Diabetic macular edema (dme, csme) Other/unspecified diabetes related eye conditions Age related macular degeneration (AMD) AMD, unspecified Early AMD Dry-form AMD GA, modifier for Dry-form Wet-form AMD CNV, modifier for Wet-form Other Retinal Disorders Retina vascular disease, occlusive (arterial, venous) Central retinal vein occlusion Branch retinal vein occlusion Central retinal arterial occlusion Branch retinal artery occlusion Retina vascular disease, non-occlusive Macular edema (if not diabetic) Hereditary chorioretinal dystrophy Myopic degeneration Other/unspecified retinal disorders Glaucoma Open-angle glaucoma Primary open-angle glaucoma Low-tension glaucoma Glaucoma suspect Primary angle-closure glaucoma Narrow-angle glaucoma Congenital glaucoma Neovascular glaucoma Other/unspecified glaucoma Cataracts Senile cataract Non-congenital cataract Congenital cataract Posterior capsular opacity Pseudophakia Aphakia and other disorders of lens Disorders of Refraction and accommodation Myopia Hypermetropia Astigmatism Presbyopia Other disorder of refraction and accomodation Blindness and low vision Unqualified visual loss, both eyes Unqualified vision loss in one eye, or unspecified visual loss Vision impairment one eye Moderate or severe vision impairment better eye; profound vision impairment of lesser eye Moderate or severe vision impairment both eyes Profound vision impairment, bilateral, or legal blindness Strabismus and amblyopia
