More Adults at High Risk for Vision Loss, Study Says

The number of US adults at high risk for vision loss increased from 2002 to 2017, according to an observational study based on national survey data.

The number of US adults at high risk for vision loss increased from 2002 to 2017, according to an observational study based on national survey data. The study, published in JAMA Ophthalmology, compiled self-reported data from 30,920 respondents of the 2002 National Health Interview survey, and compared it to 32,886 survey respondents in 2017.

High-risk adults included those who were 65 years or older, had self-reported a diabetes diagnosis, or had vision or eye problems.

“In 2017, more than 93 million US adults (37.9%; 95% CI) were at high risk for vision loss compared with almost 65 million (31.5%; 95% CI) in 2002, a difference of 6.4 (95% CI) percentage points,” researchers found. The rise could be attributable in part to an aging population.

In addition, the 2017 survey findings showed individuals with lower income were more likely to report eyeglasses as unaffordable (13.6%; 95% CI) compared with 5.7% of those with higher income (95% CI). In 2017, 8.7% of respondents said they could not afford eyeglasses compared with 8.3% in 2002.

During the study window, use of eyecare services did improve, with 56.9% of respondents reporting they visited an eye care professional annually in 2017, compared with 51.1% in 2002. However, researchers note a larger proportion of the population reported eyeglasses as unaffordable in 2017.

Prevalence of refractive error, age-related eye diseases, or both conditions increased from 9% in 2002 to 10.6% in 2017.

Vision loss can result in adverse health consequences such as an increased risk for falls, social isolation, and reduced health-related quality of life and daily functioning. In 2013 US dollars, vision loss and eye problems cost the United states $139 billion annually. These costs come in the form of medical costs, indirect costs, and lost productivity.

“Focusing resources on populations at high risk for vision loss, increasing awareness of the importance of eye care, and making eyeglasses more affordable could promote eye health, preserve vision, and reduce disparities,” authors said.

In addition, some common eye diseases, including age-related macular degeneration, diabetic retinopathy, and glaucoma can result in irreversible vision loss in their most sever forms.

“Preventing vision loss and treating vision disorders begin with understanding gaps in eye care, especially for adults at high risk for vision loss,” authors said. Currently the American Academy of Ophthalmology recommends regular eye exams every 1 to 2 years for most adults at high risk for vision loss.

An aging population, estimated to double from 43 million in 2012 to almost 65 million in 2050, and increasing prevalence of diabetes will contribute to growth of the US population at high risk for vision loss and in need of eye care. Improvements in eye care along with affordable options for eyeglasses may help prevent vision loss and mitigate consequences of population growth, researchers concluded.


Saydah SH, Gerzoff RB, Saaddine JB, et al. Eye care among US adults at high risk for vision loss in the United States in 2002 and 2017 [published online March 12, 2020]. JAMA Ophthalmol. doi: 10.1001/jamaophthalmol.2020.0273.

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