Other Eye Disorders

What to know

VEHSS identifies the annual prevalence of the following diagnosed eye disorders based on the presence of International Classification of Diseases (ICD)-9 and ICD-10 codes in patient claims or electronic health record (EHR) systems.

Older woman getting a retinal detachment exam

Overview

VEHSS identifies the annual prevalence of the following diagnosed eye disorders based on the presence of International Classification of Diseases (ICD)-9 and ICD-10 codes in patient claims or electronic health record (EHR) systems. Patients with one or more diagnosis codes associated with a VEHSS subgroup are assigned to that subgroup. Diagnosis codes may be primary or secondary. Only one instance of a diagnosis code is required for assignment to the subgroup. Note that diagnosis codes in claims data are intended for billing purposes. Codes may not be present in cases where diagnosis codes are not required to justify payment. Diagnosed prevalence will also not identify any undiagnosed conditions, will not include patients not covered by the insurer, and will not identify prevalence among patients without a visit in the calendar year of data.

Cancer and neoplasms of the eye

Diagnosed cancer and neoplasms of the eye include a patient having one or more diagnosis codes indicating one or more of the subgroups listed below.

Subgroup

Indicated conditions

Cancer and neoplasms of the eye, any stage

Category total – includes any clinical stage below.

Malignant neoplasm of the eye

Malignant neoplasm of the eye includes diagnosis codes indicating malignant neoplasm of the eye or carcinoma in situ of the eye.

Benign neoplasm of the eye

Benign neoplasm of the eye includes diagnosis codes indicating benign neoplasm of the eye.

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The data sources available for this category include Medicare (default), IRIS Registry, Medicaid, Managed Vision Care, and MarketScan commercial insurance claims.

Cornea disorders

Diagnosed cornea disorders include a patient having one or more diagnosis codes indicating one or more of the subgroups listed below.

Subgroup

Indicated conditions

Cornea disorders, any stage

Category total – includes any clinical stage below.

Keratoconus

Keratoconus includes diagnosis codes indicating keratoconus or conical cornea conditions.

Endothelial dystrophy (including Fuchs)

Endothelial dystrophy includes diagnosis codes indicating endothelial or Fuchs dystrophy.

Other corneal disorders

Other corneal disorders include diagnosis codes indicating corneal scars, opacities, and other disorders of the cornea.

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The data sources available for this category include Medicare (default), IRIS Registry, Medicaid, Managed Vision Care, and MarketScan commercial insurance claims.

Disorders of the optic nerve and visual pathways

Diagnosed disorders of the optic nerve and visual pathways include a patient having one or more diagnosis codes indicating one or more of the subgroups listed below.

Subgroup

Indicated conditions

Disorders of the optic nerve and visual pathways, any stage

Category total – includes any clinical stage below.

Optic nerve disorders

Optic nerve disorders include diagnosis codes indicating optic neuritis and other disorders of the optic nerve.

Disorders of the visual pathway and visual cortex

Disorders of the visual pathway and visual cortex include diagnosis codes indicating disorders of visual pathways and visual cortex.

Explore data in the VEHSS application‎

The data sources available for this category include Medicare (default), IRIS Registry, Medicaid, Managed Vision Care, and MarketScan commercial insurance claims.

Infectious and inflammatory diseases

Diagnosed infectious and inflammatory diseases include a patient having one or more diagnosis codes indicating one or more of the subgroups listed below.

Subgroup

Indicated conditions

Infectious and inflammatory diseases, any stage

Category total – includes any clinical stage below.

Infectious diseases

Infectious diseases include diagnosis codes indicating an infection of the eye or ocular adnexa.

Keratitis

Keratitis includes diagnosis codes indicating keratitis, including corneal ulcer, other and unspecified superficial keratitis without conjunctivitis, keratoconjunctivitis, corneal neovascularization, or other or unspecified forms of keratitis.

Conjunctivitis

Conjunctivitis includes diagnosis codes indicating most forms of conjunctivitis, including mucopurulent, acute, chronic, blepharoconjunctivitis, or other disorders of the conjunctiva, including pterygium, conjunctival degenerations and deposits, or conjunctival scars, hemorrhage, vascular disorders, or cysts.

Eyelid disorders

Eyelid disorders include diagnosis codes indicating hordeolum and chalazion or other inflammation of the eyelid, including blepharitis, noninfectious dermatosis, or other inflammation of the eyelid.

Other inflammatory conditions

Other inflammatory conditions include diagnosis codes indicating inflammation of the eye or ocular adnexa not otherwise classified.

Lacrimal system and orbit inflammation

Lacrimal system and orbit inflammation include diagnosis codes indicating disorders of the lacrimal system and inflammatory disorders of the orbit.

Endophthalmitis

Endophthalmitis includes diagnosis codes indicating endophthalmitis and disorders of the globe including degenerative myopia and uveitis.

Explore data in the VEHSS Application‎

The data sources available for this category include Medicare (default), IRIS Registry, Medicaid, Managed Vision Care, and MarketScan commercial insurance claims.

Injuries, burns, or surgical complications of the eye

Diagnosed or treated injury, burns, and surgical complications of the eye include a patient having one or more diagnosis codes indicating one or more of the subgroups listed below.

Subgroup

Indicated conditions

Injury, burns, and surgical complications, any stage

Category total – includes any clinical stage below.

Injury

Injury includes diagnosis codes indicating injury to the eye or ocular adnexa due to trauma, foreign bodies, penetrating wounds, bites, abrasions or other causes, or injury secondary to other ocular disorders.

Burn

Burn includes diagnosis codes indicating any type of burn or corrosion of the eye or ocular adnexa.

Surgical complication

Surgical complication includes diagnosis codes indicating or typically associated with surgical complications, including postprocedural inflammation or infection, mechanical complications, cataract fragments, and other conditions usually associated with procedures.

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The data sources available for this category include Medicare (default), IRIS Registry, Medicaid, Managed Vision Care, and MarketScan commercial insurance claims.

Retinal detachment and defects

Full list of ICD-9 and ICD-10 codes [PDF – 2.1 MB]

Information on data sources‎

The data sources available for this category include Medicare (default), IRIS Registry, and Medicaid.

Orbital and external disease

Diagnosed orbital and external disease includes a patient having one or more diagnosis codes indicating one or more of the disease subgroups listed below.

Subgroup

Indicated conditions

Orbital and external disease, any stage

Category total – includes any clinical stage below.

Congenital anomalies

Congenital anomalies include diagnosis codes indicating congenital malformations of the eye and ocular adnexa.

Other/unspecified orbital or external disease

Other/unspecified orbital or external disease includes diagnosis codes indicating non-inflammatory disorders of the orbit.

Lacrimal diseases

Lacrimal diseases include diagnosis codes indicating disorders of the lacrimal system, including dacryoadenitis, epiphora, stenosis and insufficiency of lacrimal passages, or other changes or disorders of the lacrimal system.

Eyelid disorders

Eyelid disorders includes diagnosis codes indicating non-inflammatory disorders of the eyelid, including entropion, ectropion, lagophthalmos, ptosis, blepharochalasis, xanthelasma disorders of the eyelid, or other nonspecified, non-inflammatory eyelid disorders.

Dry eye syndrome

Dry eye syndrome includes diagnosis codes indicating dry eye syndrome.

Disorders of the globe

Disorders of the globe include diagnosis codes indicating disorders of the globe, excluding endoophthalmitis, degenerative myopia, and hypotony of the eye.

Explore data in the VEHSS application‎

The data sources available for this category include Medicare (default), IRIS Registry, Medicaid, Managed Vision Care, and MarketScan commercial insurance claims.

Other retinal disorders

Diagnosed other retinal disorders include a patient having one or more diagnosis codes indicating one or more of the subgroups listed below.

Subgroup

Indicated conditions

Other retinal disorders, any stage

Category total – includes any clinical stage below.

Retina vascular disease, occlusive (arterial, venous)​

Retina vascular disease, occlusive (arterial, venous) includes diagnosis codes indicating unspecified or transient retinal vascular occlusion.

Central retinal vein occlusion

Central retinal vein occlusion indicates diagnosis codes for central retinal vein occlusion, with or without macular edema or retinal neovascularization.

Branch retinal vein occlusion

Branch retinal vein occlusion indicates diagnosis codes for tributary (branch) retinal vein occlusion, with or without macular edema or retinal neovascularization, or venous engorgement.

Central retinal arterial occlusion

Central retinal arterial occlusion indicates diagnosis codes for central retinal arterial occlusion, with or without macular edema or retinal neovascularization.

Branch retinal artery occlusion

Branch retinal artery occlusion indicates diagnosis codes for tributary (branch) retinal arterial occlusion.

Retina vascular disease, non-occlusive

Retina vascular disease, non-occlusive includes diagnosis codes indicating hypertensive or exudative retinopathy, changes in retinal vascular appearance, retinal microaneurysms, retinal telangiectasis, neovascularization or vasculitis, intraretinal microvascular abnormalities, or unspecified background retinopathy.

Macular edema (cystoid or nondiabetic)

Macular edema (cystoid or nondiabetic) indicates diagnosis codes for cystoid macular degeneration.

Hereditary chorioretinal dystrophy

Hereditary chorioretinal dystrophy includes diagnosis codes indicating various types of chiorioretinal dystrophy, including circumpapillary, central choroidal atrophy, and choroideremia.

Myopic degeneration

Myopic degeneration includes diagnosis codes indicating progressive high (degenerative) myopia.

Other/unspecified retinal disorders

Other/unspecified retinal disorders include diagnosis codes indicating age-related choroidal atrophy, diffuse secondary atrophy of choroid, retinoschisis, retinal cysts, cyst of ora serrata, retinopathy of prematurity, nondiabetic proliferative retinopathy, unspecified separation of retinal layers, central serous chorioretinopathy, detachment of retinal pigment epithelium, macular cyst, hole, or pseudohole, toxic maculopathy, puckering of macula, various forms of retinal degeneration, retinal hemorrhage, and other or unspecified retinal disorders.

Explore data in the VEHSS application‎

The data sources available for this category include Medicare (default), IRIS Registry, Medicaid, Managed Vision Care, and MarketScan commercial insurance claims.

Other visual disturbances

Diagnosed Other Visual Disturbances includes a patient having one or more diagnosis codes indicating one or more of the subgroups listed below.

Subgroups

Indicated conditions

Visual Disturbances, any stage

Category total – includes any clinical stage below

Visual field defect

Visual field defect includes diagnosis codes indicating defects of the visual field, including scotoma, sector or arcuate defects, localized visual field defects, homonymous bilateral field defects or contraction of the visual field.

Color blindness

Color blindness included diagnosis codes indicating color vision deficiencies.

Night blindness

Night blindness includes diagnosis codes indicating night blindness, abnormal dark adaptation, and glare sensitivity.

Other/unspecified visual disturbances

Other/unspecified visual disturbances includes other disturbances or defects of sight including subjective visual disturbances, diplopia, other and unspecified disorders of binocular vision, and vision sensitivity deficiencies.

Full list of ICD-9 and ICD-10 codes

Explore data in the VEHSS application‎

The data sources available for this category include Medicare (default), IRIS Registry, Managed Vision Care, and MarketScan commercial insurance claims.

Strabismus and Amblyopia

Diagnosed strabismus and amblyopia includes a patient having one or more diagnosis codes indicating one or more of the subgroups listed below.

Subgroups

Indicated conditions

Strabismus and amblyopia, any stage

Category total – includes any clinical stage below

Amblyopia

Amblyopia includes diagnosis codes indicating amblyopia, including deprivation, strabismic, refractive, or unspecified amblyopia type, or ablyopia suspect.

Strabismus and amblyopia

Strabismus and amblyopia include diagnosis codes indicating strabismus or amblyopia.

Explore data in the VEHSS application‎

The data sources available for this category include Medicare (default), IRIS Registry, Medicaid, Managed Vision Care, and MarketScan commercial insurance claims.