The Burden of Vision Loss
More than 3.4 million (3%) Americans aged 40 years and older are either legally blind (having visual acuity [VA] of 20/200 or worse or a visual field of less than 20 degrees) or are visually impaired (having VA of 20/40 or less) (Eye Diseases Prevalence Research Group, 2004). The Federal Interagency Forum on Aging Related Statistics (2008) estimates that 17% of the age 65 and older population report “vision trouble.” Twenty-one million Americans report functional vision problems or eye conditions that may compromise vision. (Pleis & Lethbridge-Çejku, 2007). Older people are more likely to experience vision loss because of age-related eye diseases (Table 1). State level data are available from the Vision Loss and Access to Eye Care Module of the Behavioral Risk Factors Surveillance System (BRFSS). A 2006 CDC study revealed that self-reported vision loss (a little, moderate, or extreme difficulty) ranged from 14.3% to 20.5% among five states. The Vision Module of the BRFSS allows states to estimate population and describe the characteristics of people aged 40 years and older who experience vision loss. Despite the magnitude of the population at risk for vision loss as well as the grave consequences of vision loss and blindness, many individuals do not benefit from available cost-effective early detection, timely treatments, and interventions to promote health.
Table 1. Estimated specific prevalence rates for blindness among Americans aged 40 years and older, by age group and race/ethnicity.
An analysis of the 1999 Survey of Income and Program Participation (CDC, 2001) revealed blindness or vision problems to be among the top 10 disabilities among adults aged 18 years and older. Vision loss has serious consequences for the individual as well as those who care for and about people who have compromised vision because it impedes the ability to read, drive, prepare meals, watch television, and attend to personal affairs. Reduced vision among mature adults has been shown to result in social isolation, family stress, and ultimately a greater tendency to experience other health conditions or die prematurely (Ellwein, Friedlin, McBean, & Lee, 1996).
During the next three decades, the population of adults with vision impairment and age-related eye diseases is estimated to double because the rapidly aging U.S. population. In addition, the epidemic of diabetes as well as other chronic diseases will contribute to an increasing population of people who experience vision loss.
A recent CDC investigation (Saaddine, Honeycutt, Narayan, Zhang, Klein, & Boyle, 2008) revealed that eye diseases associated with diabetes are likely to surge during the next four decades reflecting overall changes in the population as well as improved treatment of diabetes and survival among those who experience diabetes. The number of people who experience diabetic retinopathy is expected to triple between 2005 to 2050 from 5.5 million to 16 million people.
Bailey RN, Indian RW, Zhang X, Geiss LS, Duenas MR, & Saaddine JB. Visual impairment and eye care among older adults—five states, 2005. MMWR 2006;55(49):1321–1325.
Eye Diseases Prevalence Research Group. Causes and prevalence of visual impairment among adults in the United States. Archives of Ophthalmology 2004;122: 477–485.
Federal Interagency Forum on Aging-Related Statistics. Older Americans 2008: Key Indicators of Wellbeing. [PDF–3.34MB] Washington, DC: U.S. Government Printing Office 2008.
Pleis JR, Lethbridge-Çejku M. Summary health statistics for U.S. adults: National Health Interview Survey, 2006. National Center for Health Statistics. Vital Health Stat 2007;10(235).
Ellwein LB, Friedlin V, McBean AM, Lee PP. Use of eye care services among the 1991 Medicare population. Ophthalmology 1996;103:1732–1743.
Saaddine JB, Honeycutt AA, Venkat Narayan KM, Zhang X, Klein R, & Boyle, JP. (2008). Projection of diabetic retinopathy and other major eye diseases among people with diabetes mellitus. Archives of Ophthalmology 2008;126(12): 1740–1747.
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