It’s no surprise that nearly all older people will need vision correction at some point, given the inevitability of presbyopia and the inability of cataract surgery to yield post-op emmetropia for all but a lucky few. But corrective lenses are least likely to be worn by older individuals who are nonwhite and less affluent, with lower educational levels and a history of cataract surgery, according to a recent analysis of Medicare data.

Researchers identified the number of beneficiaries who use eyeglasses and then cross-referenced their sociodemographic status. Using data from the 2015 US National Health and Aging Trends Study, the team evaluated 7,497 respondents who had distance or near vision impairment and either wore glasses or did not. Sample weights were applied so the data were representative of the estimated 43.9 million Medicare beneficiaries.

They found that of the nearly 45 million beneficiaries, approximately 40.5 million, or 92.3%, wore glasses for distance or near vision correction (about 27 million wore glasses for distance vision correction and 37.2 million for near vision correction). But the study notes significant differences in usage based on income and education levels.

Noting that Medicare only covers eyeglasses following cataract surgery, the researchers argue that “innovative public policy solutions are needed to address these disparities among the large number of Medicare beneficiaries who use eyeglasses.”

 Otte B, Woodward MA, Ehrlich JR, et al. Self-reported eyeglass use by US Medicare beneficiaries aged 65 years or older. JAMA Ophthalmol. July 12, 2018. [Epub ahead of print].