Shedrawy J, Olofsson S, Persson S, Göransson C, Lace I, Bay Højsted B, Källstrand J

Health economic consequences of interventions for undetected visual impairment in older adults

Visual impairment is a growing public health challenge in ageing societies. Many older adults live with undetected vision problems that affect daily functioning, safety, and independence. This new report from the IHE investigates the clinical, economic, and quality-of-life consequences of systematic vision screening among adults aged 75 and older in Sweden and Denmark.

The study was carried out within the EU-funded Interreg Undetected Visual Impairment project and includes data from primary care, optician settings, and homecare services.

Key findings

• High prevalence of undetected visual impairment was found across all settings.
• Vision problems were common even among individuals who had checked their eyesight within the past year.
• A large share of participants were recommended further clinical assessment, and about two-thirds followed these recommendations.
• Most follow-up treatments involved minor corrective measures, such as new glasses, while a smaller number required medical treatment.

Economic perspective

The report provides detailed estimates of both direct screening costs and broader societal costs related to visual impairment.

• The direct cost of screening was estimated at approximately 375–520 SEK per person, depending on setting and staff time.
• The most expensive screening component was fundus photography.
• Falls related to visual impairment were uncommon but costly, with an average estimated cost of 92,800 SEK per fall.
• Informal care generated additional societal costs, even though most participants remained largely independent.
• These results highlight how even a small number of preventable injuries or care needs can lead to substantial economic consequences, however the screening programs did not show any impact on the prevalence of falls/injuries.

Quality of life

Vision-related quality of life was measured using the NEI VFQ-25 and converted into health utility values for economic analysis.

• Health-related quality of life remained relatively stable over six months, however it decreased for some subgroups.
• No clear improvements were observed following screening, likely due to:
  • Short follow-up time
  • baseline health status
  • Lack of a control group

The study therefore cannot determine whether screening leads to measurable quality-of-life gains.

Why this matters

• Systematic vision screening has the potential to:
  • Detect problems earlier
  • Prevent avoidable falls and injuries
  • Support safe ageing at home
  • Reduce long-term healthcare and care needs

However, the report concludes that larger studies with longer follow-up and control groups are needed to determine whether vision screening is cost-effective.

IHE REPORT 2025:17, IHE: Lund, Sweden