MONDAY, Dec. 11 (HealthDay News) -- Major vision problems in people over 40 are costing the U.S. economy an estimated $35.4 billion a year, researchers report.

"Vision disorders that affect adults are a major health problem in the country and pose a major economic burden," said study author David B. Rein. "It's a major problem because these diseases affect a lot of people, and it's a major problem because they cost a lot."

As the population ages, millions of Americans have visual impairment, blindness or other eye diseases, including age-related macular degeneration (AMD), cataracts, diabetic retinopathy, primary open-angle glaucoma and refractive errors. Total costs include not only direct medical costs, but nursing home health care, the study found. In addition, there are costs associated with loss of productivity when people with visual impairment cannot work or earn lower wages than they had before, the researchers noted.

The report appears in the December issue of the Archives of Ophthalmology.

In the study, Rein and his colleagues from RTI International, in Research Triangle Park, N.C., looked at the cost of eye diseases in 2004. To compile the data, they used private insurance and Medicare claims to estimate direct medical costs. To estimate ancillary costs, they used published sources about costs associated with nursing home care, government purchase programs and guide dogs. In addition, they used data from a national survey about labor and income to estimate losses in productivity.

Rein's team found that major visual disorders cost an estimated $16.2 billion in direct medical costs, $11.1 billion in other direct costs and $8 billion in productivity losses, bringing the annual total to $35.4 billion. They estimated the annual governmental budgetary impact to be $13.7 billion.

In terms of specific diseases, direct medical costs were estimated to be $6.8 billion for cataracts, $5.5 billion for refractive error, $2.9 billion for glaucoma, $575 million for AMD and $493 million for diabetic retinopathy.

"It's time to pay attention to visual disorders, particularly as the U.S. population ages," Rein said. "As the population gets older, more and more people are going to be affected by these conditions."

Rein thinks that it is important for people to have their vision checked regularly, because many of these conditions are treatable. "We can treat cataracts, we can slow the progression of AMD, and glaucoma is very treatable," he said.

A large proportion of costs associated with vision problems are nursing home care. More people with vision problems die in nursing homes than people of the same age who don't have these problems, Rein said.

"In terms of prevention of disease, there is direct cost benefit to be gained by preventing visual impairment and blindness, because that leads to preventing people from being placed in nursing homes," Rein said. "There are also big quality-of-life gains that can be achieved."

One expert thinks new treatments for many of these vision problems are in the pipeline, but they, too, will cost a lot of money. "That's going to make that $35 billion number get even bigger," said Dr. Marco Zarbin, chairman of the Institute of Ophthalmology and Visual Science at New Jersey Medical School.

But the treatments are going to be more effective, Zarbin said.

"The result is that there will be less visual disability, so that's going to have a tendency to make that number get smaller," he said. "I see technology and innovation as costing money, but I also see it as saving money, because more people will continue to be productive and stay out of nursing homes -- live independently -- and have an improvement in their quality of life."

More information

The U.S. National Library of Medicine can tell you more about vision problems.