Keratoconus in the Medicare Population

Purpose To investigate the population-based prevalence of keratoconus in US individuals aged 65 years and older. Design Multiyear retrospective cross-sectional claims analysis. Methods Fee-for-service claims from a 5% national sample of Medicare beneficiaries aged 65 years and older were reviewed. Claims records were queried on an annual basis for the years 1999 through 2003 for ICD-9 codes specific to keratoconus. The number of beneficiaries with keratoconus-related claims was counted for each calendar year. Results The number of beneficiaries receiving care for keratoconus rose steadily from 15.7/100,000 beneficiaries in 1999 to 18.5/100,000 in 2003, averaging 17.5/100,000 across the 5 years of the study. Keratoconus rates declined with increasing age but did not differ by gender. Keratoconus care was more prevalent in whites than in other races. Conclusions Keratoconus is an uncommon disease in the Medicare population. Longitudinal analysis of Medicare claims data may provide a useful tool for monitoring uncommon diseases, such as keratoconus, in the elderly.