Trends in the Diagnosed Prevalence and Incidence of Major Eye Diseases in Medicare Part B Fee-for-Service Beneficiaries 68 Years of Age or Older.

Purpose: To study contemporary trends in the diagnosed prevalence and incidence of age-related eye diseases among Medicare Fee-for-Service (FFS) beneficiaries. Design: Analysis of Medicare administrative claims data. Participants: Medicare FFS beneficiaries 68 years of age and older from 2005 through 2020 who were enrolled continuously in both Part A and Part B for 3 years, including the index year and a 2-year lookback period. Methods: Annual cross-sectional diagnosed prevalence and incidence rates were calculated. Age stan-dardization was performed using the direct standardization method to account for changes in the age structure of the study population. Rates stratified by demographics (age, sex, race, and ethnicity) also were calculated. Main Outcome Measures: Annual prevalence and incidence of diagnosed age-related macular degenera-tion (AMD), diabetic retinopathy (DR) (among those with diabetes), and glaucoma. Results: At baseline, in 2005, 60% of included beneficiaries were female, 20% were 85 years of age or older, 86% were non-Hispanic White, and one-quarter had a diagnosis of diabetes. From 2005 through 2019, the prevalence of a diagnosis of any of the conditions studied increased from 16.4% (n = 3 628 996) to 17.9% (n = 3 731 281). Diagnosed incidence decreased over this period from 4.9% (n = 954 878) in 2005 to 4.2% in 2019 (n = 757 696). The diagnosed prevalence of AMD increased from 6.8% (n = 1 504 770) to 9.4% (n = 1 965 176); the diagnosed prevalence of any DR among those with diabetes decreased from 9.3% (n = 504 135) to 9.0% (n = 532 859), although the diagnosed prevalence of vision-threatening DR increased from 2.0% to 3.4%; and the diagnosed prevalence of any diagnosed glaucoma decreased from 8.8% (n = 1 951 141) to 8.1% (n = 1 692 837). In 2020, the diagnosed prevalence and incidence of all diagnoses decreased. During the study period, we detected demographic differences in the prevalence and incidence of diagnosis of each condition. Conclusions: This study presents updated data on the prevalence and incidence of diagnosed major chronic, age-related eye diseases among Medicare FFS beneficiaries. Compared with older epidemiologic es-timates, we found that the diagnosed prevalence of each condition studied was higher in more recent years. These findings may inform public health and policy planning and resource allocation to address the eye health of an increasingly older United States population.