Consumers Overconfident About Eye Health

Jenni Laidman

July 19, 2012

July 19, 2012 — People around the world are ignorant about eye care, a new study shows, but they think they are knowledgeable. The result is risky behaviors and neglect that could endanger not only vision but also overall health, according to a survey funded by Bausch + Lomb, the eye-care device and pharmaceutical giant.

The Barometer of Global Eye Health, sponsored by Bausch + Lomb and conducted by the marketing and opinion research firm KRC Research, surveyed 11,000 people in 11 countries, including the United States, using questions derived from interviews with eye health practitioners around the world. The online surveys included 1000 people in each market, including Germany, France, Italy, Spain, Brazil, the United Kingdom, China, Japan, Russia, and India. The survey results were announced in a Bausch + Lomb news release.

"The survey really affirmed the importance of actually spreading the message that eye health conditions can be asymptomatic," Emily Colligan, director, KRC Research, told Medscape Medical News. "When we probed a little deeper and asked, how much do you know about different behaviors, again and again and again, people were not as knowledgeable as they thought they were."

The survey showed that 7 in 10 believe they were very knowledgeable or somewhat knowledgeable about eye health and eye care, although 44% incorrectly believed that eye tests are only necessary if there is a problem. A similar proportion — 42% — said they believe, "If I can see, my eyes must be healthy." Another third believe, "If it doesn't hurt, it's not serious."

"Eyes Are the Window to Systemic Health"

"The survey validates things that a lot of practitioners of eye care have thought but never had any real proof of — that there are a lot of very common misconceptions, not only in the US, but globally," said Christopher Starr, MD, assistant professor of ophthalmology and director of refractive surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York City. Dr. Starr was not associated with the study.

"Eyes are the window to systemic health," Dr. Starr told Medscape Medical News. "Some things ophthalmologists can see first, such as hypertension, diabetes, some thyroid conditions, and even some cancers such as melanoma. Those are the big ones that are picked up fairly frequently." Further, many eye diseases are asymptomatic in their earliest stages, where treatment is more likely successful, so without regular exams, "you could have unchecked, undiagnosed untreated glaucoma or other conditions," he said.

Worldwide, 68% of consumers who had not seen an eye physician in 5 years said that they did not need a visit because they had no symptoms. Some 64% said they could "see just fine," so they did not require an exam. The cost of examination was cited as a reason for skipping exams about a third of the time (39%), as was the time involved (31%).

Few were aware of the ways in which lifestyle and environment contribute to poor eye health, the survey showed; 65% did not know obesity could be a contributor, 51% did not know smoking could damage eye health, and 37% were surprised that pollution could affect eye health.

Married people were more likely than single people to take eye-healthy actions such as wearing sunglasses (81% of married people vs 76% of single people), spending time outside regularly (83% vs 78%), eating a healthy diet (82% vs 74%), maintaining healthy weight, (78% vs 75%), refraining from smoking (79% vs 74%), and having regular eye examinations (69% vs 56%), according to a KRC Research news memo.

Similarly, per the same news memo, women were more likely than men to take eye-healthy actions, such as wearing sunglasses (81% of women vs 77% of men), eating a healthy diet (82% vs 75%), maintaining a healthy weight (78% vs 75%), refraining from smoking (79% vs 73%), and getting regular eye examinations (66% vs 61%). Women were also more likely to know that computer use (84% vs 78%), exposure to ultraviolet radiation (77% vs 73%), diabetes (74% vs 67%), and dry air (61% vs 51%) are bad for eyes.

Eye experts would not be surprised by those data. In preparing the survey questions, KRC conducted an online survey of ophthalmologists and optometrists selected from a list provided by Bausch + Lomb. Those experts overwhelmingly (94%) said that women take better care of their eyes than men.

Of the eye health professionals surveyed, 90% said people older than 45 years take better care of their eyes than younger people. This prediction was also borne out by the Bausch + Lomb survey, which found that half of those aged 55 years and older and 45% of those aged 45 to 54 years had an eye exam in the past year. Among those aged 18 to 24 years, only 36% had had an eye exam.

Consumers Would Give Up 10 Years of Life to Preserve Eyesight

Despite less than stellar performance on eye healthcare, consumers placed a high value on their vision and said they would give up their sense of taste (79%), hearing (78%), a limb (68%), or even 10 years of life (67%) to preserve eyesight. Three fourths said they would rather lose half of their pay than suffer a 50% decline in vision quality.

Fifty-nine percent of those surveyed said vision loss would severely hurt life quality, even more than diabetes, hearing loss, and poor dental health. Still, those surveyed were more likely to get regular physicals and make routine dental appointments than they were to have their vision checked regularly.

"[Eighty] percent of visual impairment is preventable if detected and treated early enough," a Bausch + Lomb news release said. It further said that regular eye examination could lead to early detection of as many as 150 serious health conditions such as diabetes, elevated cholesterol, and hypertension.

Colligan said her research firm ensured that respondents were representative by setting a series of quotas for sex, age, income, and region for each country in the survey, and every market within the country. So, for instance, when researchers met their quota for a region, they would stop accepting respondents from that region.

To reduce bias caused by respondent self-selection, those surveyed were not told the nature of the survey until they had completed all questions relating to demographics and were accepted into the survey. "We strategically put the demographic information up front so we could control who was even allowed in after they qualified," she said.

The survey showed that people in the United States suffered from the same overconfidence as others around the world, and were no more likely to follow good eye-care practices. Colligan said 79% of Americans reported they were very knowledgeable or somewhat knowledgeable about eye health, whereas Germans were most likely to say they did not know enough, with 55% of participants saying they were not knowledgeable. Spaniards had the highest confidence levels, at 88%.

Young people in the United States (those aged 18 - 29 years) were among those least likely to have an annual eye exam, with only 21% saying they have an exam at least annually. Of those who did not, 58% said eye health simply was not a concern, and 57% said they did not have an exam because they had no symptoms. However, it was not just young people who neglected annual visits: Only 21% of those aged 40 to 54 years reported having an eye exam at least annually. In that group, 55% said they had no symptoms, and thus did not need an exam, and 52% said eye exams were too expensive.

Perhaps unsurprisingly, those aged 55 years and older were most likely (36%) to have annual eye exams. When this older group did not have an annual exam, 60% said it was because they had no symptoms and 62% said it was because they could see fine.

Those in the youngest cohort, aged 18 to 29 years, were least likely (40%) to have an eye physician, and those in the oldest cohort (aged 55 years or older) were more likely to have an eye physician, with only 25% reporting they had no eye physician.

Americans were just as likely to admit they fell for eye care health myths as people in other countries, with 35% saying they thought you only went to an eye physician if something was wrong with your vision and the same percentage saying that if they could see well, their eyes were good. Some 27% reported that if there was no pain, a problem could not be serious. Those aged 18 to 29 years were most likely to report accepting these beliefs, with 51% saying that if one sees well, their eyes must be healthy, 46% saying eye physician visits are only for vision correction, and 39% reporting that if there was no pain, a problem could not be serious.