About the Data: IRIS® Registry

Key points

  • The IRIS® Registry, developed by the American Academy of Ophthalmology, compiles information from participating ophthalmology practices’ electronic medical records systems.
  • Sample: Large convenience sample of patients visiting IRIS-participating ophthalmology practices, which includes around 95% of U.S. ophthalmology practices but an unknown percentage of ophthalmology patients.
  • Sample size: over 50 million patients per year.
  • VEHSS topics: Vision Problems and Blindness, Vision Care Services, Age-related Macular Degeneration (AMD), Cataract, Diabetic Retinopathy (DR), Glaucoma, Other Eye Disorders.
IRIS Registry logo

Where the data comes from

Access the data‎

Explore IRIS® Registry summary data in the VEHSS application.

Compiled by the American Academy of Ophthalmology (AAO), the IRIS (Intelligent Research In Sight) Registry is the nation's first comprehensive eye disease clinical registry. The IRIS Registry enables ophthalmologists to use clinical data to improve care delivery and patient outcomes and help practices meet the requirements of the federal Physician Quality Reporting System (PQRS). The IRIS Registry uses methods compliant with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to collect data from patient records directly from practices' individual electronic medical record (EMR) systems. These EMR systems periodically report health record data based on the IRIS Registry data fields on a nightly or weekly basis. The system tracks diagnosed disorders based on ICD-9/ICD-10 codes and includes procedures and visual acuity measures and other clinical data documented in the medical record.

IRIS Registry coverage began in 2013, and sample size has increased over time. As of 2019, IRIS Registry contained more than 50 million patients and 230 million encounters. In 2018, the IRIS® Registry collected data from a convenience sample of more than 95% of ophthalmology practices nationally.

The main advantages of the IRIS Registry are its wide coverage and availability of diagnostic test results such as acuity values. However, the IRIS® Registry is a convenience sample of ophthalmology practices and cannot by itself produce national prevalence estimates. The IRIS Registry has not been externally evaluated for data completeness, reliability, or validity. The IRIS Registry team provided summary-level frequencies and prevalence values to the VEHSS system and has not granted access to person-level data. This limits the ability to assess the quality of IRIS Registry data.

See Also: Download the full VEHSS IRIS Data Documentation Reports
See Also: Download the Claims and Registry Data Analysis Plan

Analysis overview

For the VEHSS project, AAO calculated prevalence of diagnosed eye and vision disorders and prevalence of receipt of eye care services in the IRI® Registry based on the presence of ICD-9 and ICD-10 diagnosis codes and CPT procedure codes on any patient record during the year of observation.

VEHSS reports summary prevalence rates for the topics and categories by the geographic levels and stratification factors listed below.

Note that patient counts and denominators for the IRIS Registry are not publicly released; VEHSS releases only prevalence percentage and confidence intervals. In addition, the IRIS Registry dataset is not available in the VEHSS data portal. Please contact AAO for further information on the IRIS Registry.

  • National and state

Data definitions

Included stratification factors (state and national estimates)

Age Group
  • All ages
  • 0-17
  • 18-39
  • 40-64
  • 65-84
  • 85+
  • 65+
Gender
  • All genders
  • Male
  • Female
Race/Ethnicity
  • All race/ethnicity
  • Asian
  • Black non-Hispanic
  • Hispanic any race
  • North American Native
  • White non-Hispanic
  • Other
  • Unknown
Risk Factors
  • Not available
Data Type
  • Crude prevalence

A detailed description of the analytical steps is described in the report "VEHSS Claims & Registry Data Analysis Plan."

Full analysis documentation is included in the "VEHSS IRIS® Registry Data Report."

AAO reported summary outcome statistics using VEHSS-defined data indicators and case definitions for visual function, eye examinations, and medical diagnoses. Some of the possible limitations include the following:

  • VEHSS does not have access to patient-level data nor details on the process of mapping EMR data to the IRIS Registry. The quality of underlying EMR data and the process of mapping EMR records to the IRIS Registry could not be validated.
  • IRIS Registry data represents a convenience sample of current ophthalmology patients and should not be considered representative of the general population. IRIS Registry rates contained in this report are calculated per 100 current ophthalmology patients.
  • The IRIS Registry does not include all ophthalmology practices and may be more likely to include private practices and practices that primarily serve Medicare patients because automated PQRS reporting is a motivating factor for providers to register with the IRIS Registry.
  • The IRIS Registry only includes patients of ophthalmology practices. However, about 20% to 30% of providers in the IRIS Registry are optometrists who work for mixed-provider practices participating in the IRIS Registry.
  • The IRIS Registry includes services provided regardless of payer but cannot identify the payer of specific procedures.
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Content Source:
National Center for Chronic Disease Prevention and Health Promotion