focus on low vision
If Not Now, When?
by Tara A. Cortes, PhD, RN
FLASHBACK TO 1905: The world was a simpler place when Lighthouse International was founded 103 years ago—and the needs of people with vision loss were significantly more straight-forward than they are today. At that time, blindness was in the spotlight and the term "low vision" had not yet been coined.
DATELINE 1953: Demographic shifts and advances in medicine changed the profile of vision loss, prompting the Lighthouse to establish the first low vision service in the U.S. to diagnose and provide rehabilitation for post-war Americans with partial sight.
FAST FORWARD TO TODAY: Science has continued to press ahead and we have new and exciting treatments for some diseases that cause vision impairment, but scarcely enough for more elusive culprits that rob sight from millions of people.
WIDE SWATH
The aging of our population and the increasing incidence of diseases—like macular degeneration and diabetes, the leading cause of new cases of legal blindness among people ages 20 to 74, are cutting a wide swath across this country, leaving vision loss in their wake in record numbers.
In just two short years, 20 million Americans age 45 and older will self-report impaired vision—and countless millions more will be at risk, pre-symptomatic and undiagnosed.
The vision loss epidemic sits squarely on our doorstep, yet we are woefully unprepared as a country to respond. There simply are not enough trained professionals to serve the ballooning number of people confronting low vision's disabling consequences, such as falls and depression, along with the numerous, complex comorbidities of aging.
Why? Too few clinicians-in-training are exposed to low vision in their curriculum and residency programs, and too few established practitioners are adding the specialty of low vision care to their practices despite the surging demographic needs.
| Vision Loss: The Statistics Are Compelling |
|---|
| Age-Related Macular Degeneration (AMD) ■ An estimated nine million Americans have some form of AMD. (Source: The Eye Diseases Prevalence Research Group) ■ As our population ages, more elderly people will become legally blind from macular degeneration than from glaucoma and diabetic retinopathy combined. (Source: National Advisory Eye Council) Diabetes and Diabetic Retinopathy ■ There are nearly 24 million Americans who have diabetes. In addition, 57 million people have pre-diabetes. (Source: American Diabetes Association) ■ Diabetic retinopathy is the leading cause of new cases of legal blindness among people between the ages of 20 and 74. (Source: American Diabetes Association) ■ The longer a person has diabetes, the greater the chance of retinopathy. Virtually everyone who is diagnosed with diabetes before age 30 has diabetic retinopathy within 15 years of diagnosis. About three quarters of those who are diagnosed after age 30 have diabetic retinopathy within 15 years of diagnosis. (Source: Prevent Blindness America) Glaucoma ■ Glaucoma is the leading cause of blindness among African Americans. (Source: National Eye Health Program/NIH) ■ There are 2.29 million Americans with glaucoma. Two million more are estimated to have the disease and not know it. (Source: Prevent Blindness America) |
IN THE DARK
If, simultaneously, too few eye doctors are aware that low vision and rehabilitation services are available, and referrals to specialists continue to remain low, where does that leave millions of Americans—our families, friends, and ourselves—as we all get older? It will leave far too many of us underserved—literally and figuratively "in the dark."
Our charge, as a field, is to educate clinicians about the benefits of low vision and vision rehabilitation for patients whose loss of sight cannot be corrected by traditional lenses, medication, or surgery. These vital services help patients maximize their remaining vision, function safely and independently, and enjoy an enhanced quality of life.
In tandem, our charge is to educate other healthcare professionals and the general public about the importance of regular eye exams, as well as the prevention and early detection of eye diseases, in the hopes of staving off vision impairment altogether.
Both of these educational undertakings are challenging if we are to achieve success on a nationwide basis, but clearly, the risks of not rising to meet these professional responsibilities are too great. We have the technology needed to share knowledge, teach low vision clinical skills, and increase access to low vision care for millions who need it. We also have the ability to advocate for reimbursement, as well as support the quest to eradicate eye disease through the sciences.
If not now, when? EB
Tara Cortes, PhD, RN, is the president and CEO of Lighthouse International.
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