PURPOSE: To describe the effect of health status and geographic region of the United States on the prevalence of strabismus and strabismus surgery in the aged Medicare fee-for-service population.METHODS: A 5% sample of Medicare claims was used to identify aged beneficiaries diagnosed with strabismus and those having strabismus surgery between 2002 and 2010. The Charlson Comorbidity Index (CCI), a measure of systemic health, was calculated. The regional analysis divided the United States into East, West, Midwest, and South. Analyses were adjusted for age, sex, race, CCI, and region.RESULTS: The 5% sample for 2010 included 1,237,469 unique beneficiaries. Strabismus was diagnosed in 8,470 (0.68%) and strabismus surgery was performed on 197 (0.016%). Pooled data from 2002 through 2010 found the prevalence of strabismus increasing significantly with increasing comorbidity (P < 0.0001): 0.52% (CCI, 0), 0.65% (CCI, 1-2), 0.77% (CCI, 3-4), and 0.82% (CCI, 5 or higher). Conversely, the prevalence of strabismus surgery declined slightly with increasing comorbidity (P = 0.088): 0.016% (CCI, 0), 0.017% (CCI, 1-2), 0.015% (CCI, 3-4), and 0.015% (CCI, 5 or higher). The diagnosis of strabismus was made least frequently in the South (P < 0.0001), whereas strabismus surgery was performed more often in the West (P = 0.006). All significant effects remained after adjustment.CONCLUSIONS: The prevalence of strabismus increases significantly with declining health status; however, health status had little effect on the rate of strabismus surgery. Regional rates of strabismus diagnosis and surgery differ widely.
Aged Aged, 80 and over