Data from a national survey suggest that an estimated 60 million American adults are at high risk of vision loss, according to a report published in the March issue of Archives of Ophthalmology, one of the JAMA/Archives journals. Of those adults, one in 12 cannot afford eyeglasses when needed, and about one-half do not get dilated eye examinations on a yearly basis.
In 2000, about 3.3 million Americans age 40 or older were visually impaired and more than 11 million of those age 12 and older needed glasses or contact lenses, according to background information in the article. By 2020, these numbers could increase by 50 percent or more. Eye diseases and vision problems are associated with increased illness, increased risk of death and decreased quality of life. They also are causes of falls and injuries and can lead to depression and social isolation.
Xinzhi Zhang, M.D., Ph.D., Centers for Disease Control and Prevention, Atlanta, and colleagues used data on vision from the 2002 National Health Interview Survey to estimate the number of U.S. adults at high risk of vision loss and assess factors associated with the use of eye care services. A total of 30,920 adults age 18 or older participated in the survey, designed to be representative of the entire U.S. population.
Sixteen percent of the participants were age 65 years or older, 6.5 percent had diabetes and 19.5 percent had vision or eye problems. Based on these percentages, the authors project that an estimated 61 million American adults are at high risk of serious vision loss. The researchers estimated that of those, only half visited an eye doctor in the past 12 months and half had dilated eye examination, in which eyedrops are administered to widen the pupil, allowing a more thorough inspection of the eyes. Yearly exams are recommended for those with diabetes or who are age 65 or older. About one-third of the estimated 144 million U.S. individuals not at high risk of serious vision loss visited an eye doctor and one-third had a dilated eye examination in the past 12 months.
“Among the high-risk population, the probability of having a dilated eye examination increased with age, education and income,” the authors write. “The probability of receiving an examination was higher for the insured, women, persons with diabetes and those with vision or eye problems. Approximately 5 million high-risk adults could not afford eyeglasses when needed; being female, having low income, not having insurance and having vision or eye problems were each associated with such inability.”
As the population ages, providing access to preventive eye care services will become a larger public health concern, the authors note. “Many conditions causing visual impairment and blindness are often asymptomatic in their early, treatable stages,” they conclude. “There is substantial inequity in access to eye care in the United States. Better targeting of resources and efforts toward people at high risk may help reduce these disparities.”