In 2006 we used the NHANES national survey data to estimate the extent of visual impairment in the United States due to uncorrected refractive error (JAMA 2006;295:2158-2163). We subsequently followed up with an analysis of the cost of refractive correction in the United States realizing that many people already have refractive correction (e.g. eyeglasses or contacts lenses) and others need new or better refractive correction (e.g. a new pair of eyeglasses or a new contact lens prescription) to allow them to see well. Conservatively, the annual direct cost of correcting visual impairment is $4 billion per year, of which $1 billion represents the cost required to provide an initial set of glasses to those in need. In 2008 we investigated, using the NHANES data, the impact of refractive error in Americans ages 12 and older. As an adjunct to these papers, data from the National Health Interview Survey were analyzed to determine the extent of age-related eye diseases and degree of visual impairment reported by American adults. In addition, using focus group discussions, we investigated the factors which influence individuals to seek out preventive eye care services. Our findings indicate that communication between patients and their primary health care providers could facilitate improved access to eye care. NHANES retinal data (collected in 2005-2008 with the support of the Centers for Disease Control and Prevention) are also available to the public. In a 2010 analysis of NHANES data on adults over age 40 with diabetes, almost 32% of men and 26% of women, were estimated to have diabetic retinopathy. Numerous scientific papers have resulted from analyses of the NHANES data, including deriving estimates on the magnitude and describing the impact of visual impairment due to refractive errors and to eye disease. NHANES data have also been used for surveillance of disparities in vision and eye health. Given the wide array of NHANES data, the eye data has been analyzed in conjunction with non-ocular indicators of health, disease, and functional impairment.

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Cotch, Mary Frances (2016) Public Health Surveillance-The Integral Role of Community-Based Studies. JAMA Ophthalmol :
Fisher, Diana E; Ward, Michael M; Hoffman, Howard J et al. (2016) Impact of Sensory Impairments on Functional Disability in Adults With Arthritis. Am J Prev Med 50:454-62
Zebardast, Nazlee; Friedman, David S; Vitale, Susan (2016) The prevalence and demographic associations of presenting near-vision impairment among adults living in the United States. Am J Ophthalmol :
Kirtland, Karen A; Saaddine, Jinan B; Geiss, Linda S et al. (2015) Geographic disparity of severe vision loss - United States, 2009-2013. MMWR Morb Mortal Wkly Rep 64:513-7
Li, Chuan-Ming; Zhang, Xinzhi; Hoffman, Howard J et al. (2014) Hearing impairment associated with depression in US adults, National Health and Nutrition Examination Survey 2005-2010. JAMA Otolaryngol Head Neck Surg 140:293-302
Morgan, Ian G; Cotch, Mary Frances (2013) Birth order and myopia: what are the messages to readers? Ophthalmic Epidemiol 20:333-4
Ramasamy, Dhivya; Joseph, Sanil; Valaguru, Vijayakumar et al. (2013) Cluster randomized trial to compare spectacle delivery systems at outreach eye camps in South India. Ophthalmic Epidemiol 20:308-14
Zhang, Xinzhi; Bullard, Kai McKeever; Cotch, Mary Frances et al. (2013) Association between depression and functional vision loss in persons 20 years of age or older in the United States, NHANES 2005-2008. JAMA Ophthalmol 131:573-81
Cotch, Mary Frances; Freeman, Ellen E (2013) Health care services: addressing the global challenge of universal eye health. Ophthalmic Epidemiol 20:255-7
Chou, Chiu-Fang; Cotch, Mary Frances; Vitale, Susan et al. (2013) Age-related eye diseases and visual impairment among U.S. adults. Am J Prev Med 45:29-35

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