ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
This article is part of the Research TopicThe Costs of Caring for Older AdultsView all 7 articles
Estimating The Costs and Quality of Life Impact of Vision Loss in an Elderly Population in Malta: Evidence from The Malta Eye Study
Provisionally accepted
- 1L-Universita ta' Malta, Msida, Malta
- 2Mater Dei Hospital, Msida, Malta
- 3MedMEtrics Inc., Ottawa, Canada
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Background: Visual impairment and related ocular conditions impose substantial direct, indirect, and intangible costs, encompassing healthcare expenses, productivity losses, and reduced quality of life. Despite the global relevance of visual impairment, no comprehensive cost analysis has yet been conducted for visual impairment in an elderly Maltese population 50-80 years of age. Methods: Prevalence estimates from the population-based Malta Eye Study were used to calculate indirect costs via the gross national income per capita method with disability weight assumptions. Direct medical costs for key ocular conditions, including refractive error, cataract, age-related macular degeneration, diabetic retinopathy, and glaucoma were estimated using prevalence, hospital and private data performance indices and relevant cost data, enabling estimation of service coverage and unmet care needs. Intangible costs were derived from quality-of-life measures using the National Eye Institute Visual Function Questionnaire – 39 to calculate disability weights and years-lived-with-disability (YLD). Results: The productivity losses from blindness and moderate-severe visual impairment, among individuals aged 50-80, were estimated to amount to €16.0 million per annum (95%CI €6.0-€43.0 million). The estimated annual direct medical costs, from the main ocular causes were estimated to sum up to € 53.4 million (95%CI €44.6-€67.0 million), with unmet needs amounting to €20.8 million (95%CI €15.5-€28.5million). Cataract (56.9%) and refractive error (24.5%) had the highest shares of such costs. Vision-related quality of life correlated with the severity and laterality of visual impairment. Mild unilateral visual impairment carried the highest YLD rate (2264.4 YLDs per 100,000 while Uncorrected Refractive Error carried the highest YLD rate among the visually impairing causes (2452.7 YLDs per 100,000). Discussion: Visual Impairment imposes a considerable economic and quality-of-life burden on an elderly population in Malta, driven largely by cataract, refractive error, and productivity losses. These results emphasize the need for preventive and treatment strategies and underscore the need for future cost–benefit and cost-effectiveness analyses to help guide eye health policy in Malta.
Keywords: visual impairment, Ocular disease, economic burden, cost analysis, productivity losses, Cataract, Refractive error, Visual disability
Received: 15 Sep 2025; Accepted: 06 Nov 2025.
Copyright: © 2025 Agius, Mamo, Calleja, Smith and Carbonaro. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: David Agius, david.agius@um.edu.mt
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