Correction of refractive errors of the eye in adults

106 Pages·2013·2.07 MB·English

KCEREPORT202
CCOORRRREECCTTIIOONN OOFF RREEFFRRAACCTTIIVVEE EERRRROORRSS OOFF TTHHEE EEYE IN
ADULTS
PART 1: PERCEPTIONS AANNDD EEXXPPEERRIIEENNCCEESS
2013 www.kce.fgov.be

KCEREPORT202
HEALTHSERVICESRESEARCH
CCOORRRREECCTTIIOONN OOFF RREEFFRRAACCTTIIVVEE EERRRROORRSS OOFF TTHHEE EEYE IN
ADULTS
PART 1: PERCEEPPTTIIOONNSS AANNDD EEXXPPEERRIIEENNCES
WENDY CHRISTIAENS, LAURENCE KOHN, CCAARROOLLIINNEE OOBBYYNN,, LIESBETH DE WINTER, SIGRID GUSSÉ, NNOOÉÉMMIIEE DDEEFFOOUURRNNYY,, CHRIS DE LAET,
DOMINIQUEPAULUS
2013 www.kce.fgov.be
COLOPHON
Title: CCoorrrreeccttiioonnooffrreeffrraaccttiivveeeerrrroorrssoofftthheeeeyyeeiinnaadduullttss–Part1:Perceptiioonnssaannddeexxppeerriieenncceess
Authors: WWeennddyy CChhrriissttiiaaeennss ((KKCCEE)),, LLaauurreennccee KKoohhnn ((KKCCEE)),, Caroline Obyn ((KKCCEE)),, Liesbeth De Winter (Ipsos), Sigrid
GGuusssséé((GGffKKSSiiggnniiffiiccaanntt)),, NoémieDefourny(KCE),CChhrriissDDeeLLaaeett((KKCCEE)),,DDoommiinniiqquueePPaauulluuss((KKCCEE))
Reviewers: SStteepphhaannDDeevvrriieessee,, CarineVanDeVoorde
Externalexperts: JJaaccqquueess BBoollyy ((AAlllliiaannccee NNaattiioonnale de Mutualités Chrétiennes), AAnnnn CCeeuuppppeennss ((OOnnaaffhhaannkkeelliijjkkee ZZiieekkeennffoonnddsseenn)),,
IIllssee CCllaaeerrhhoouutt ((AZ Maria Middelares - Campus Sint-Jozef - GGeennttbbrruuggggee)),, IIggnnaaccee FFrraannssmmaann ((Algemene
PPrrooffeessssiioonnele Opticiens en Optometristen Bond van België), VVéérroonniiqquuee GGoosssseellaaiinn ((UUnniivveerrssiittéé ccaatthhoolliiqquuee ddee
LLoouuvvaaiinn)),, JJooss RRoozzeemmaa ((UUnniivveerrssiittaaiirr ZZiieekkeennhhuuiiss AAnnttwweerrppeenn)),, JJoohhaann VVaann ddeerr HHeeyyddeenn ((WWeetteennsscchhaappppeelliijjkk IInnssttiittuuuutt
VVoollkkssggeezzoonnddhheeiidd, Brussel), Rob Van Horenbeeck (Belgian SSoocciieettyy ooff CCaattaarraacctt aanndd RReeffrraaccttiivvee SSuurrggeeoonnss), Bert
WWiinnnneenn((RRIIZZIIVV)),,AntonineWyffels(INAMI)
Acknowledgements: KKKaaarrreeennn LLLeeefffeeevvveeerrr,,, (((GGGfffKKK SSSiiigggnnniiifffiiicccaaannnttt))),,, EEElllllleeennn LLLoooiiixxx (((GGGfffKKK SSSiiigggnnniiifffiiicccaaannnttt))),,, HHHiiillldddeee MMMuuueeerrrmmmaaannnsss (((IIIpppsssooosss))),,, XXXaaavvviiieeerrr SSStttooorrrmmmsss (Ipsos),
MMaarriiee-José Tassignon (UZ Antwerpen)),, AAnnnniicckk VVaann DDeenn HHeeuuvveell ((BBrraaiilllleelliiggaa)) aanndd aallll ppeerrssoonnss wwhhoo aannsswweerreedd ttoo
tthheetteelleepphhoonneessuurrvveeyyaannddppaarrttiicciippaatteeddttootthheeiinntteerrvviieewwss..
Externalvalidators: CCaatthheerriinne Fallon (Université de Liège), An Jacobs (Vrriijjee UUnniivveerrssiitteeiitt BBrruusssseell)), Jean Macq (Université catholique
ddeeLLoouuvvaaiinn))
Conflictofinterest: TTThhheee eeexxxpppeeerrrtttsss cccooonnnsssuuulllttteeeddd wwwiiittthhhiiinnn ttthhhiiisss rrreeepppooorrrttt wwweeerrreee ssseeellleeecccttteeeddd bbbeeecccaaauuussseee ooofff ttthhheeeiiirrr ssstttaaakkkeeehhhooollldddeeerrr rrrooollleee iiinnn ttthhheee ssseeeccctttooorrr ooofff
oooppphhhttthhhaaalllmmmooolllooogggyyy (((iiinnncccllluuudddiiinnnggg oooppptttiiiccciiiaaannnsss aaannnddd rrreeeiiimmmbbbuuurrrssseeemmmeeennnttt)))... TTThhheeerrreeefffooorrreee,,, bbbyyy dddeeefffiiinnniiitttiiiooonnn,,, aaallllll cccooonnnsssuuulllttteeeddd eeexxxpppeeerrrtttsss hhhave a
cceerrttaaiinnddeeggrreeeeooffccoonnfflliiccttooffiinntteerreessttttootthhiissttooppiicc..
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commentswerediscussed during meetings.Theydid not co-aauutthhoorrtthheesscciieennttiiffiiccrreeppoorrttaannddddiiddnnoott
necessarilyagreewithitscontent.
 SSSuuubbbssseeeqqquuueeennntttlllyyy,,, aaa (((fffiiinnnaaalll))) vvveeerrrsssiiiooonnn wwwaaasss sssuuubbbmmmiiitttttteeeddd tttooo ttthhheee vvvaaallliiidddaaatttooorrrsss... TTThhheee vvvaaallliiidddaaatttiiiooonnn ooofff ttthhheee rrreeepppooorrrttt rrreeesssuuullltttsss
ffrroomm aa ccoonnsseennssuuss oorr aa vvoottiinngg pprroocceessss bbeettwweeeenn tthhee vvaalliiddaattoorrss.. TThhee vvaalliiddaattoorrss did not co-author the
sscciieennttiiffiiccrreeppoorrttaannddddiiddnnoottnneecceessssaarriillyyaalllltthhrreeeeaaggrreeeewwiitthhiittssccoonntteenntt..
 FFiinnaallllyy,,tthhiissrreeppoorrtthhaassbbeeeennaapppprroovveedd bycommonassentbbyytthheeEExxeeccuuttiivveeBBooaarrdd..
 OOOnnnlllyyyttthhheeeKKKCCCEEEiiisssrrreeessspppooonnnsssiiibbbllleeefffooorrreeerrrrrrooorrrsssooorrrooommmiiissssssiiiooonnnsssttthhhaaatttcccooouuullldddpppeeerrrsssiiisssttt...TTThhheee policyrecommendations
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Publicationdate: 2288JJuunnee22001133
Domain: HHeeaalltthhSSeerrvviicceessRReesseeaarrcchh((HHSSRR))
MeSH: RRReeefffrrraaaccctttiiivvveeeeeerrrrrrooorrrsss;;;RRReeefffrrraaaccctttiiivvveeesssuuurrrgggiiicccaaalllppprrroooccceeeddduuurrreeesss;;;llleeennnssseeesss;;;qqquuuaaallliiitttaaatttiiivvveeerrreeessseeeaaarrrccchhh;;;eeepppiiidddeeemmmiiiooolllooogy
NLMClassification: WWWW330000
Language: EEnngglliisshh
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Legaldepot: DD//2200113/10.273/26
Copyright: KKKCCCEEErrreeepppooorrrtttsssaaarrreeepppuuubbbllliiissshhheeeddduuunnndddeeerrraaa“““bbbyyy///nnnccc///nnnddd”””CCCrrreeeaaatttiiivvveeeCCCooommmmmmooonnnsssLLLiiiccceeennnccceee
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Howtorefertothisdocument? CChhrriissttiiaaeennss WW,, KKoohhnn LL,, OObbyynn CC,, DDee WWiinntteerr LL,, GGuusssséé SS,, DDeeffoouurrnnyy NN,, De Laet C, Paulus D. Correction of
rreeffrraaccttiivvee eerrrroorrss ooff tthhee eeyyee iinn aadduults – Part 1: Peerrcceeppttiioonnss aanndd eexxppeerriieenncceess.. Health Services Research (HSR)
BBrruusssseellss::BBeellggiiaannHHeeaalltthhCCaarreeKKnnoowwlleeddggeeCCeennttrree((KKCCEE))..2200113..KKCCEERReeppoorrtts202.D/2013/10.273/26.
TTThhhiiisssdddooocccuuummmeeennntttiiisssaaavvvaaaiiilllaaabbbllleeeooonnnttthhheeewwweeebbbsssiiittteeeooofffttthhheeeBBBeeelllgggiiiaaannnHHHeeeaaalllttthhhCCCaaarrreeeKKKnnnooowwwllleeedddgggeee Centre.

KCEReport202 Refractiveerrorsoftheeyeinadults 1
 TTAABBLLEE OOFF CCOONNTTEENNTTSS
 SCIENTIFICREPORT.........................................................................................................................................................10
1 BACKGROUNDANDSCOPEOFTHEREPORT.............................................................................................................10
11..11 INITIALQUESTIONSOFSTAKEHOLDERS......................................................................................................................10
11..22 SCOPEOFTHISREPORT.................................................................................................................................................10
11..33 REFRACTIVEERROR........................................................................................................................................................10
1.3.1 Thenormaleye.....................................................................................................................................................11
1.3.2 Refractiveerror......................................................................................................................................................11
1.3.3 PrevalenceooffrreeffrraaccttiivveeeerrrroorriinnWWeesstteerrnnppooppuullaattiioonnss..........................................................13
11..44 POSSIBLESOLUTIONS:GLASSES,CONTACTLENSSEESSOORRSSUURRGGEERRYY......................................14
1.4.1 Glasses.................................................................................................................................................................14
1.4.2 Contactlenses.......................................................................................................................................................14
1.4.3 LaserrefractiveSurgery........................................................................................................................................14
1.4.4 Intraocularrefractivesurgery................................................................................................................................15
2 REIMBURSEMENTMODALITIESINBELGIUM...............................................................................................................16
22..11 REIMBURSEMENTOFREFRACTIVEERRORCAREBYYTTHHEENNAATTIIOONNAALLIINNSSTTIITUTEFORHEALTH
ANDDISABILITYINSURANCE(RIZIV–INAMI)..................................................................................................................16
2.1.1 Reimbursementofglasses....................................................................................................................................16
2.1.2 Reimbursementofcontactlenses.........................................................................................................................16
2.1.3 Reimbursementofrefractiveeyesurgery.............................................................................................................16
22..22 COMPLEMENTARYINSURANCE.....................................................................................................................................16
22..33 VOLUNTARYINSURANCE................................................................................................................................................17
3 VISUAL ACUITYDISORDERSINBELGIUM:ATELLEEPPHHOONNEESSUURRVVEEYY........................................17
33..11 METHODOLOGICALNOTES.............................................................................................................................................17
3.1.1 Thetelephonesurvey............................................................................................................................................17
3.1.2 Questionnaire........................................................................................................................................................18
3.1.3 Datacleaning........................................................................................................................................................18
2 Refractiveerrorsoftheeyeinadults KCEReport202
3.1.4 Weightingofthedata............................................................................................................................................18
3.1.5 Descriptionofthesample......................................................................................................................................18
33..22 RESULTSOFTHETELEPHONESURVEY.......................................................................................................................20
3.2.1 Self-perceivedeyesightquality.............................................................................................................................20
3.2.2 Visualacuityproblems..........................................................................................................................................21
33..33 SEVERITYOFREFRACTIVEERROR...............................................................................................................................24
33..44 THEUSEOFCORRECTIONMETHOD(S)........................................................................................................................24
3.4.1 Theuseofcorrectionmethodsingeneral.............................................................................................................24
3.4.2 AAggeeaannddggeennddeerrddiiffffeerreenncceessiinntthheeuusseeooffggllaasssseess,,ccoonnttaaccttlleennsseessaannddrreeffrraaccttiivveeeeyyeessuurrggeerryy
..............................................................................................................................................................................25
3.4.3 Satisfactionwithglasses,,ccoonnttaaccttlleennsseessaannddrreeffrraaccttiivveeeeyyeessuurrggeerryy...................................26
33..55 GLASSES:ACTIVITIES,DRIVERS,PURCHASEOF NNEEWW GGLLAASSSSEESS............................................28
3.5.1 Specificactivitiesforwhichglassesareworn.......................................................................................................28
3.5.2 Driversforwearingglasses...................................................................................................................................28
3.5.3 Purchaseprocessofnewglasses.........................................................................................................................28
33..66 CONTACTLENSES:TYPE,ACTIVITIESANDDRIVERS.................................................................................................29
3.6.1 Profileofrespondentswhohavetriedcontactlenses ..........................................................29
3.6.2 Themostpopularcontactlens..............................................................................................................................29
3.6.3 Specificactivitiesforwhichcontactlensesareworn............................................................................................29
3.6.4 Driverstowearcontactlenses..............................................................................................................................29
33..77 REFRACTIVESURGERY:ATTITUDE,DRIVERSANDDIINNHHIIBBIITTOORRSS...............................................30
3.7.1 Generalattitudetowardssurgery..........................................................................................................................30
3.7.2 Driversforconsideringeyesurgery......................................................................................................................30
3.7.3 Inhibitors................................................................................................................................................................30
33..88 HEALTHSERVICEUSEFOREYESIGHTPROBLEMS....................................................................................................32
3.8.1 Consultationofanophthalmologist.......................................................................................................................32
3.8.2 Consultationofanoptician....................................................................................................................................32
3.8.3 CChhaarraacctteerriissttiiccssaassssoocciiaatteeddwwiitthhtthheeccoonnssuullttaattiioonnooffaannoopphhtthhaallmmoollooggiissttoorrooppttiicciiaann.............33
3.8.4 Peoplewitharefractiveerrorwhoneverconsulted..............................................................................................35
33..99 COSTS,REIMBURSEMENT,WILLINGNESSTOPAY .....................................................................................................35
KCEReport202 Refractiveerrorsoftheeyeinadults 3
3.9.1 Estimatedcostsofdifferenttypesofeyecorrection.............................................................................................35
3.9.2 Reimbursementofdifferenttypesofeyecorrection.............................................................................................37
3.9.3 Willingnesstopay.................................................................................................................................................38
33..1100 SUMMARYOFFINDINGS..................................................................................................................................................41
33..1111 LIMITATIONSINTHEINTERPRETATIONOFRESULTS.................................................................................................41
4 PERCEPTIONSOFTHEPATIENTSWITHREFRACTTIIVVEEEERRRROORR::AAQQUUAALLIITTATIVEAPPROACH
.............................................................................................................................................................................................43
44..11 INTRODUCTIONANDOBJECTIVES.................................................................................................................................43
44..22 METHODOLOGY................................................................................................................................................................43
4.2.1 Datacollection.......................................................................................................................................................43
4.2.2 Dataanalysis.........................................................................................................................................................45
44..33 RESULTS............................................................................................................................................................................45
4.3.1 Descriptionofachievedsample............................................................................................................................45
4.3.2 Diagnosisofrefractiveerror..................................................................................................................................46
4.3.3 Experienceofrefractiveerror................................................................................................................................46
4.3.4 SStteeppssffrroommggllaasssseessttoorreeffrraaccttiivveessuurrggeerryy::ppeerrcceeppttiioonnssrreellaatteeddttooggllaasssseess.............................46
4.3.5 SStteeppssffrroommggllaasssseessttoorreeffrraaccttiivveessuurrggeerryy::ppeerrcceeppttiioonnssrreellaatteeddttooccoonnttaaccttlleennses..................49
4.3.6 SStteeppssffrroommggllaasssseessttoorreeffrraaccttiivveessuurrggeerryy::ppeerrcceeppttiioonnssrreellaatteeddttootthheeiinntteerrvveennttiioonn................53
4.3.7 Opinionsonreimbursementofthheeddiiffffeerreennttppoossssiibbiilliittiieessooffccoorrrreeccttiioonn.................................63
5 DISCUSSIONANDCONCLUSIONS..................................................................................................................................66
 APPENDICES.....................................................................................................................................................................67
 REFERENCES....................................................................................................................................................................97
4 Refractiveerrorsoftheeyeinadults KCEReport202
LIST OF FIGURES
FFiigguurree11–Anatomyoftheeye...........................................................................................................................................................11
FFiigguurree22–Refractiveerrorinmyopia................................................................................................................................................12
FFiigguurree33–Refractiveerrorinhyperopia............................................................................................................................................12
FFiigguurree44–Refractiveerrorinastigmatism.........................................................................................................................................13
FFiigguurree55–HHoowwmmuucchhddiiddrreessppoonnddeennttssppaayyffoorrtthheellaassttggllaasssseesstthhaatttthheeyybboouugghhtt??...........................................35
FFiigguurree 66 – How mucchh ddiidd rreessppoonnddeennttss ppaayy ffoorr tthhee ggllaasssseess llaasstt bboouugghhtt ((bbrreeaakkddoowwnn aaccccoorrddiinngg ttoo aaggee ccaatteeggoorryy))??
...........................................................................................................................................................................................................................................36
FFiigguurree 77 – HHooww mmuucchh ddiidd rreessppoonnddeennttss ppaayy ffoorr tthhee ggllaasssseess llaasstt bboouugghhtt ((bbrreeaakkddoowwnn aaccccoorrddiinngg ttoo ssoocciioo-economic
ccllaassss))??................................................................................................................................................................................................36
FFiigguurree88 –EExxppeecctteeddttiimmeeuunnttiillppuurrcchhaasseeooffnneewwggllaasssseessaammoonnggssttrreessppoonnddeennttsswwhhoobboouugghhttggllaasssseessbbeettwweeeenn11aanndd
22yyeeaarrssaaggoo........................................................................................................................................................................................36
FFiigguurree99 –YYeeaarrllyyccoossttooffccoonnttaaccttlleennsseess((cclleeaanniinnggpprroodduuccttssnnoottiinncclluuddeedd))::ccaallccuullaattiioonnbbaasseeddoonntthheeccoossttooffaassiinnggllee
ccoonnttaaccttlleennssaannddrreenneewwaalltteerrmm...........................................................................................................................................................37
FFiigguurree 1100 – Did respondents receive reimbbuurrsseemmeenntt ((eeiitthheerr ffrroomm hheeaalltthh iinnssuurraannccee oorr pprriivvaattee iinnssuurreerr)) ((bbrreeaakkddoowwnn
aaccccoorrddiinnggttooggllaasssseess,,lleennsseessoorrssuurrggeerryy))...........................................................................................................................................38
FFiigguurree1111–WWiilllliinnggnneessssttooppaayymmoorreettaaxxeessiinnoorrddeerrttoorreeiimmbbuurrsseeggllaasssseess,,lleennsseess orsurgery(Totalsample)..39
FFiigguurree 1122 –WWiilllliinnggnneessss ttoo ppaayymmoorree ttaaxxeess iinn oorrddeerr ggeett aa rreeiimmbbuurrsseemmeenntt ffoorr ggllaasssseess,, lleennsseess oorr ssuurrggeerryy((ssuubbggrroouupp
wwiitthhrreeffrraaccttiivveeeerrrroorrss)).........................................................................................................................................................................39
FFiigguurree 1133 – OOvveerrvviieewwooff tthhee iiddeennttiiffiieedd ccoonnsseeccuuttiivvee sstteeppss iinn tthhee sseeaarrcchh ffoorr tthhee ooppttiimmaall rreeffrraaccttiivvee eerrrroorr ttrreeaattmmeenntt oorr
mmaannaaggeemmeennttaammoonnggaassaammpplleeooffppaattiieennttsswwhhoohhaavveeccoonnssiiddeerreedd-ppllaannnneeddoorruunnddeerrggoonneessuurrggeerryy....................59
FFiigguurree1144–Age-ddiissttrriibbuuttiioonnoofftthheeaacccceessssiibbiilliittyybbyytteelleepphhoonneeiinntthheeBBeellggiiaannppooppuullaattiioonn..................................67
FFiigguurree1155–Budgetspentonlastboughtglasses(breakdownnaaccccoorrddiinnggttooggeennddeerr)).......................................88
FFiigguurree 1166 – BBuuddggeett ssppeenntt oonn llaasstt bboouugghhtt ggllaasssseess ((bbrreeaakkddoowwnn aaccccoorrddiinngg ttoo wwhheetthheerr ppaattiieennttss hhaadd eeyyee ssuurrggeerryy oorr
nnoott)).....................................................................................................................................................................................................88
FFiigguurree 1177 – BBuuddggeett ssppeenntt oonn llaasstt bboouugghhtt ggllaasssseess ((bbrreeaakkddoowwnn aaccccoorrddiinngg ttoo wwhheetthheerr ppeeooppllee aallssoo wweeaarr ccoonnttaacctt
lleennsseessoorrnnoott)).....................................................................................................................................................................................89
FFiigguurree1188–Budgetspentonlastboughtglasses(breakdownaccorddiinnggttooeexxppeecctteeddlliiffeeccyycclleeooffggllaasssseess......89
FFiigguurree 1199 – DDiidd rreessppoonnddeennttss rreecceeiivvee rreeiimmbbuurrsseemmeenntt eeiitthheerr ffrroomm hheeaalltthh iinnssuurraannccee oorr pprriivvaattee iinnssuurreerr bbrreeaakkddoowwnn
aaccccoorrddiinnggttooaaggee................................................................................................................................................................................90
FFiigguurree 2200 – DDiidd rreessppoonnddeennttss rreecceeiivvee rreeiimmbbuurrsseemmeenntt eeiitthheerr ffrroomm hheeaalltthh iinnssuurraannccee oorr pprriivvaattee iinnssuurreerr bbrreeaakkddoowwnn