More Adults at Risk for Vision Loss,
Glasses Less Affordable

Nicola M. Parry, DVM

March 17, 2020

The number of adults at risk for vision loss has increased over the past 15 years, yet at the same time eyeglasses have become less affordable, according to a study published online March 12 in JAMA Ophthalmology.

"In 2017, more than 93 million US adults were at high risk for vision loss (an increase compared with 2002); however, only 56.9% visited an eye care professional annually, and only 59.8% received a dilated eye examination," write Sharon H. Saydah, PhD, from the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Hyattsville, Maryland, and colleagues.

"Among adults who reported needing eyeglasses, approximately 9 in 100 said they could not afford them, up slightly from 2002."

Awareness of gaps in eye care is critical to treating eye disorders and preventing vision loss, especially for higher-risk patients.

Adults have a greater risk of losing their vision if they are 65 years or older, or if they have a self-reported diabetes diagnosis, existing eye or vision problems, or a family history of eye disease.

To determine how many adults in the United States are at risk for vision loss and whether their use of eye care services has changed, Saydah and colleagues analyzed data from the National Health Interview Survey. They compared survey responses from 2002 (n = 30,920) and 2017 (n= 32,886) among adults aged 18 or older.

In particular, to evaluate different aspects of eye care access and use, they focused on three self-reported outcomes: whether, in the past 12 months, respondents had visited an eye care professional, received a dilated eye exam, or needed glasses but were unable to afford them.

Over the course of the study, they found a 40% increase in the percentage of US adults at high risk of losing their vision.

Specifically, approximately 93 million adults (37.9%; 95% confidence interval [CI], 37.0% - 38.7%) were at high risk for vision loss in 2017, compared with almost 65 million (31.5%; 95% CI, 30.7% - 32.3%) in 2002.

According to the authors, the rise reflects shifting demographics, including the aging population and an increased prevalence of diabetes.

Notably, the researchers also found that use of eye care services improved over the 15 period. In 2017, 56.9% of adults reported making annual visits to an eye care professional, up from 51.1% in 2002. In addition, the proportion reporting having received a dilated eye examination increased from 52.4%  to 59.8%.

However, the percentage of adults who indicated being unable to afford to buy glasses also rose from 8.3% to 8.7%.

People at low income levels were hardest hit, being more than twice as likely as those at high income levels to report eyeglasses as unaffordable (13.6%  vs 5.7%) in 2017.

"Increased public health efforts to enhance access, awareness, and affordability could reduce unnecessary vision loss in the United States," Saydah and colleagues conclude.

The authors have disclosed no relevant financial relationships.

JAMA Ophthalmol. Published online March 12, 2020. Full text

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