The State of Vision and Eye Health in The United States
The Role of Public Health in Optometry Practice
Prevalence of vision loss in the United States
- Approximately 6 million Americans have vision loss and 1.08 million are blind.
- A higher risk of vision loss among Hispanic and Black individuals than among White individuals.
- The prevalence of vision loss varies by state, ranging from 1.3% in Maine to 3.6% in West Virginia.
- More than 1.6 million Americans living with vision loss or blindness are younger than age 40.
- 20% of all people older than 85 years experience permanent vision loss.
- More females than males experience permanent vision loss or blindness.
These statistics are obtained from the vision and eye health surveillance systems:
Vision Health Disparities in the United States
- Non-Hispanic whites have a higher prevalence of Age-related macular degeneration whereas non-Hispanic blacks had a higher prevalence of diabetic related eye disease and glaucoma
- Older age is the most important risk factor for AMD and is the most common cause of blindness among elderly whites
- Among adults older than 40 with Diabetes the prevalence of DR was 46% and 84% higher in blacks and Hispanic respectively when compared to whites
- Significantly higher rates of Diabetic Retinopathy among rural versus urban areas
- Whites have higher prevalence to access of eyecare such as cataract surgery
Find out more at the Center of Disease and Control.
Public Health is a health care profession that is concerned with collective action to promote, protect and improve the health of people and their communities primarily through preventive strategies.
Optometry is a health care profession that is concerned with the eye and visual system.
Vision Impairment and Blindness: A Public Health Concern and Priority
Eye diseases are not life-threatening but may be indicative of a life-threatening condition. Eye diseases are sight-threatening and are of public health importance and priority. This is because blindness and vision impairment has long affected populations and studies have shown that most causes are preventable. Blindness and vision impairment has been shown to be associated with several social determinants of health and disparities exist. Prevalence and incidence projections show an upward trajectory. While eye diseases and conditions occur in different degrees, it affects all ages. It imposes disability, affects the quality of life, and it is more expensive to treat than to prevent. Blindness and vision impairment evokes fear among people.
Diabetes has widely been accepted as a public health problem, calling for mass public education, diet modification, open space in neighborhoods for exercise, addressing food deserts, etc. Public health efforts have been effective in diabetes awareness where now, the layperson may associate diabetes with high levels of sugar. However, this increased awareness has not translated to the importance of eye care even when diabetes is a leading cause of blindness in the US. A similar statement can be made for other systemic diseases that have ocular manifestations.
Vision impairment is often a comorbidity that makes the management of life-threatening diseases difficult, leading to poor health outcomes. Among other goals, public health seeks to protect and promote healthy lives, prevent disease and disability. Subsequently, since there is some protecting, promoting, and prevention to do, blindness and vision impairment remains a public health concern and warrants public health priority.
Public Health & Optometry: **Pubtometry**
By virtue of managing eye conditions of individuals who collectively make up the public, eye care should be public health oriented. Intersecting public health and optometry means using principles of both professions to improve the vision and eye health of populations. The management of eye conditions is done from a population perspective taking into consideration the disparities that occur by race, ethnicity, gender, socioeconomic status, geographic location, disability status, or sexual orientation.
Public health does not imply non-individual health but rather, recognizing that a person’s health outcome does not occur in isolation. Health outcomes occur in a web of socioeconomic factors and health determinants such as environment and communities. Individual health and population health are not absolute or independent concepts but complementary. It is knowing the public health implications of diseases like diabetes that allows public health to push for the availability of healthy food and open space in neighborhoods which allows an individual to access and possibly attain optimum care and management of their diabetes.
Public health optometrists can use their expertise to address infectious eye disease outbreaks, influence access to eye care, eye health policies, and funding. We have an increasing population, an aging population, and environmental changes, all of which affect the dynamics of our healthcare system. A fusion of the two professions is important because healthcare delivery will continue to change unpredictably, and the organization and administration of eye health delivery will have to follow suit. Optometry will very much benefit from active involvement in public health where eye health care policies and administration are concerned.
The Role of Optometry in Public Health and Global Health
The role of optometry in public health is integral in protecting vision and eye health in the United States and globally. We are not able to achieve holistic health care without addressing the state of vision and eye health in our communities. Advances made in medicine, health care delivery, and disease prevention have all contributed to increased life expectancy and longevity. This achievement brings challenges of chronic systemic diseases, many of which have ocular manifestations.
It is not news to hear of the burden of diabetes, heart disease, and cancer but their associated ocular implications often go unmentioned. Vision loss often does not occur in isolation and what have we truly achieved by increasing the longevity of lives but not the quality of said life? Vision loss is often a comorbidity to other health problems and can result in poor health outcomes if ill-managed. If blindness and vision impairment are eliminated from the hurdles of aging, the quality of life of the elderly will be much improved.
The United Nations’ Sustainable Development Strategy (SDS) goals to end poverty, fight inequalities and address climate change are not truly attainable without improving vision and eye health. Recognizing the vital role of vision and eye health in attaining the SDS goals led to the United Nations General Assembly to adopt the first-ever resolution on vision: Vision for Everyone. This calls for local action for global results.
The Role of Public Health in Optometry
There are multiple reasons why the importance of eyecare eludes the public’s awareness. It is often not prioritized in health programs and policies thus dismissing the substantial impact of blindness and vision impairment on economic and social development. Owing to the impact of vision loss and impairment on the overall health and quality of life, and the inequities that exist in eye care access, the need for public health-oriented optometry should be emphasized.
Principles of public health can serve optometry in promoting eye care and access in communities. Epidemiologic studies in eye care will provide foundational information for clinical practice. Eye care programs can be evaluated through a public health lens to ensure quality services are made available to communities. Public health can lead to the enactment of policies that lead to visual health equity.
On a national level, the Healthy People initiative identifies public health priorities and calls for a collective effort from individuals, communities, and organizations to improve health and eliminate health disparities over a decade. Specific to vision, the initiative aims to improve visual health through prevention, early detection, timely treatment, injury prevention, and rehabilitation.
A disclaimer notice: Cherish Eyesight & Vision’s website provides information that is meant to supplement and not substitute any advice or information given by a provider. The information we provide is from reliable sources and is accurate but is not a complete resource for all vision and eye health conditions.