Epidemiology and Associated Ocular Conditions of Visual Impairment in the United States: A Decade of Data from TriNetX US Network

PURPOSE: To characterize the demographic profile, within-cohort prevalence of associated ocular conditions, and trends in the incidence and prevalence of visual impairment in the United States using a large, real-world clinical database. METHODS: We conducted a retrospective cohort study utilizing the TriNetX US Collaborative Network. Patients with visual impairment and associated ocular conditions potentially contributing to visual impairment were identified using ICD-10 codes between January 1, 2014 and January 1, 2026. Demographic characteristics, within-cohort prevalence of associated ocular conditions, and annual incidence and prevalence within the network were analyzed. RESULTS: A total of 805,428 patients with visual impairment were identified. The mean current age was 55.3 ± 26.0 years, with slightly more females (52.93%). Most patients were White (61.68%), followed by Black or African American (20.92%) and Hispanic or Latino (11.54%). Cataract (18.5%), glaucoma (13.9%), age-related macular degeneration (9.7%), and diabetic retinopathy (6.6%) were the most frequently observed associated ocular conditions in our cohort. Between 2014 and 2025, the annual incidence of visual impairment increased significantly from 124.56 to 212.69 per 100,000 persons (P < 0.001). Prevalence increased from 471.56 to 1433.70 per 100,000 persons (P < 0.001). CONCLUSION: Visual impairment affected a broad demographic spectrum, with cataract, glaucoma, age-related macular degeneration, and diabetic retinopathy being the leading associated ocular conditions. Network-based incidence and prevalence increased over the decade, reflecting both true epidemiologic trends and network expansion. These findings highlight the importance of targeted screening, early detection, and timely treatment, particularly among high-risk and underserved populations.