Addressing Disparities in Vision Health and Eye Care in the US
Abstract
Health disparities are a prevalent issue that continues to affect health outcomes. In ophthalmology, these disparities affect eye care utilization increasing the burden of eye care disorders and vision impairment/loss. Various factors contribute to disparities in vision care. They include age, gender, socioeconomic status, geographic location, and race and ethnicity. These factors make it difficult for people affected by eye conditions to access care. Addressing these disparities can help to increase eye care utilization and improve patient outcomes. Some measures that can address these disparities and increase utilization are providing patient education, increasing insurance coverage, implementing community-based eye care programs, using teleophthalmology, providing transport services, providing reminder alerts, and creating community centres that are federally funded among others. This review seeks to identify measures that can help to address disparities in vision and eye care in the US. The review also identifies drivers of health disparities in vision health and how they affect the ability to access care.
Keywords:
eye disorders, disparities, vision health, eye care, utilizationDOI
https://doi.org/10.37022/wjcmpr.v6i1.321References
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2. Arcaya MC, Arcaya AL, Subramanian SV. Inequalities in health: definitions, concepts, and theories. Global Health Action. 2015;8(1):27106. https://doi.org/10.3402/gha.v8.27106PMid:26112142 PMCid:PMC4481045
3. Flaxman AD, Wittenborn JS, Robalik T, et al. Prevalence of visual acuity loss or blindness in the US: a Bayesian meta-analysis. JAMA Ophthalmology. 2021;139(7):717-23. https://doi.org/10.1001/jamaophthalmol.2021.0527PMid:33983373 PMCid:PMC8120442
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5. Varma R, Vajaranant TS, Burkemper B, Wu S, Torres M, Hsu C, Choudhury F, McKean-Cowdin R. Visual impairment and blindness in adults in the United States: demographic and geographic variations from 2015 to 2050. JAMA Ophthalmology. 2016;134(7):802-9. https://doi.org/10.1001/jamaophthalmol.2016.1284PMid:27197072 PMCid:PMC5116104
6. Zhang X, Cotch MF, Ryskulova A, et al. Vision health disparities in the United States by race/ethnicity, education, and economic status: findings from two nationally representative surveys. American Journal of Ophthalmology. 2012;154(6):S53-62. https://doi.org/10.1016/j.ajo.2011.08.045PMid:23158224 PMCid:PMC4169111
7. Rein DB, Wittenborn JS, Zhang P, et al. The economic burden of vision loss and blindness in the United States. Ophthalmology. 2022;129(4):369-78. https://doi.org/10.1016/j.ophtha.2021.09.010PMid:34560128
8. Vision Health Initiative (VHI). Economic studies. 2022. Accessed 31 March 2024. https://www.cdc.gov/visionhealth/projects/economic_studies.htm#:~:text=Vision%20loss%20and%20blindness%20impose,States%20reaches%20approximately%20%2451.4%20billion.
9. Flaxman SR, Bourne RR, Resnikoff S, et al. Global causes of blindness and distance vision impairment 1990-2020: a systematic review and meta-analysis. The Lancet Global Health. 2017;5(12):e1221-34. doi:10.1016/S2214-109X(17)30393-5https://doi.org/10.1016/S2214-109X(17)30393-5PMid:29032195
10. Bourne RR, Flaxman SR, Braithwaite T, et al. Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis. The Lancet Global Health. 2017;5(9):e888-97.
11. Vision Health Initiative (VHI). Fast facts about vision loss. 2023. Accessed 31 March 2024. https://www.cdc.gov/visionhealth/basics/ced/fastfacts.htm
12. Elam AR, Tseng VL, Rodriguez TM, et al. Disparities in vision health and eye care. Ophthalmology. 2022;129(10):e89-113. https://doi.org/10.1016/j.ophtha.2022.07.010PMid:36058735 PMCid:PMC10109525
13. Vision Health Initiative (VHI). Common eye disorders and diseases. 2023. Accessed 31 March 2024. https://www.cdc.gov/visionhealth/basics/ced/index.html
14. Friedman DS, O'Colmain BJ, Munoz B, Tomany SC, McCarty C, De Jong PT, Nemesure B, Mitchell P, Kempen J. Prevalence of age-related macular degeneration in the United States. Arch Ophthalmol. 2004;122(4):564-72. https://doi.org/10.1001/archopht.122.4.564PMid:15078675
15. Vision and Eye Health Surveillance System (VEHSS). Prevalence of age-related macular degeneration (AMD). Accessed 31 March 2024. https://www.cdc.gov/visionhealth/vehss/estimates/amd-prevalence.html
16. Lundeen EA, Burke-Conte Z, Rein DB, Wittenborn JS, Saaddine J, Lee AY, Flaxman AD. Prevalence of diabetic retinopathy in the US in 2021. JAMA Ophthalmology. 2023;141(8):747-54. https://doi.org/10.1001/jamaophthalmol.2023.2289PMid:37318810
17. Teo ZL, Tham YC, Yu M, et al. Global prevalence of diabetic retinopathy and projection of burden through 2045: systematic review and meta-analysis. Ophthalmology. 2021;128(11):1580-91. https://doi.org/10.1016/j.ophtha.2021.04.027PMid:33940045
18. Dougherty M, Wittenborn J, Phillips E, Swenor B. Published examination-based prevalence of major eye disorders. Vision & eye health surveillance system. 2018.
19. Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014;121(11):2081-90.https://doi.org/10.1016/j.ophtha.2014.05.013PMid:24974815
20. Olson RJ, Braga-Mele R, Chen SH, Miller KM, Pineda R, Tweeten JP, Musch DC. Cataract in the adult eye preferred practice pattern®. Ophthalmology. 2017;124(2):P1-19. https://doi.org/10.1016/j.ophtha.2016.09.027PMid:27745902
21. Hu B, Liu Z, Zhao J, Zeng L, Hao G, Shui D, Mao K. The global prevalence of amblyopia in children: A systematic review and meta-analysis. Frontiers in Pediatrics. 2022;10:819998. https://doi.org/10.3389/fped.2022.819998PMid:35601430 PMCid:PMC9114436
22. Abdul Basith Khan M, Hashim MJ, King JK, Govender RD, Mustafa H, Al Kaabi J. Epidemiology of type 2 diabetes-global burden of disease and forecasted trends. Journal of Epidemiology and Global Health. 2020;10(1):107-11. https://doi.org/10.2991/jegh.k.191028.001PMid:32175717 PMCid:PMC7310804
23. Rasendran C, Tye G, Knusel K, Singh RP. Demographic and socioeconomic differences in outpatient ophthalmology utilization in the United States. American Journal of Ophthalmology. 2020;218:156-63. https://doi.org/10.1016/j.ajo.2020.05.022PMid:32446736
24. Fisher DE, Shrager S, Shea SJ, Burke GL, Klein R, Wong TY, Klein BE, Cotch MF. Visual impairment in white, Chinese, black, and Hispanic participants from the Multi-Ethnic Study of Atherosclerosis cohort. Ophthalmic Epidemiology. 2015;22(5):321-32. https://doi.org/10.3109/09286586.2015.1066395PMid:26395659 PMCid:PMC4768912
25. Deng Z, Fuller-Thomson E. Temporal trends over a decade in serious vision impairment in a large, nationally representative population-based sample of older Americans: Gender, cohort and racial/ethnic differences. Ophthalmic Epidemiology. 2022;29(1):39-48. https://doi.org/10.1080/09286586.2021.1889001PMid:33645427
26. Chan T, Friedman DS, Bradley C, Massof R. Estimates of incidence and prevalence of visual impairment, low vision, and blindness in the United States. JAMA Ophthalmology. 2018;136(1):12-9. https://doi.org/10.1001/jamaophthalmol.2017.4655PMid:29098289 PMCid:PMC5833607
27. Zambelli-Weiner A, Crews JE, Friedman DS. Disparities in adult vision health in the United States. American Journal of Ophthalmology. 2012 Dec 1;154(6):S23-30.https://doi.org/10.1016/j.ajo.2012.03.018PMid:22633355
28. Sommer A, Tielsch JM, Katz J, et al. Racial differences in the cause-specific prevalence of blindness in east Baltimore. New England Journal of Medicine. 1991;325(20):1412-7. https://doi.org/10.1056/NEJM199111143252004PMid:1922252
29. Richter GM, Chung J, Azen SP, Varma R, Los Angeles Latino Eye Study Group. Prevalence of visually significant cataract and factors associated with unmet need for cataract surgery: Los Angeles Latino Eye Study. Ophthalmology. 2009;116(12):2327-35. https://doi.org/10.1016/j.ophtha.2009.05.040PMid:19815276 PMCid:PMC2787839
30. Stein JD, Kim DS, Niziol LM, Talwar N, Nan B, Musch DC, Richards JE. Differences in rates of glaucoma among Asian Americans and other racial groups, and among various Asian ethnic groups. Ophthalmology. 2011 Jun;118(6):1031-7. https://doi.org/10.1016/j.ophtha.2010.10.024PMid:21310489 PMCid:PMC3109193
31. Friedman DS, Jampel HD, Munoz B, West SK. The prevalence of open-angle glaucoma among blacks and whites 73 years and older: the Salisbury Eye Evaluation Glaucoma Study. Archives of Ophthalmology. 2006;124(11):1625-30. https://doi.org/10.1001/archopht.124.11.1625PMid:17102012
32. Klein R, Klein BE. The prevalence of age-related eye diseases and visual impairment in aging: current estimates. Investigative Ophthalmology & Visual Science. 2013;54(14):ORSF5-13. https://doi.org/10.1167/iovs.13-12789PMid:24335069 PMCid:PMC4139275
33. Umfress AC, Brantley Jr MA. Eye care disparities and health-related consequences in elderly patients with age-related eye disease. Seminars in Ophthalmology 2016; 31 (4),432-438. https://doi.org/10.3109/08820538.2016.1154171PMid:27116323 PMCid:PMC4990069
34. Solomon SD, Shoge RY, Ervin AM, Contreras M, Harewood J, Aguwa UT, Olivier MM. Improving access to eye care: a systematic review of the literature. Ophthalmology. 2022;129(10):e114-26. https://doi.org/10.1016/j.ophtha.2022.07.012PMid:36058739
35. Kirtland KA, Saaddine JB, Geiss LS, Thompson TJ, Cotch MF, Lee PP. Geographic disparity of severe vision loss-United States, 2009-2013. MMWR Morb Mortal Wkly Rep. 2015;64(19):513-7.
36. Rothman AL, Stoler JB, Vu DM, Chang TC. A geodemographic service coverage analysis of travel time to glaucoma specialists in Florida. Journal of Glaucoma. 2020;29(12):1147-51. https://doi.org/10.1097/IJG.0000000000001648PMid:33264165
37. Tielsch JM, Sommer A, Katz J, Quigley H, Ezrine S. Socioeconomic status and visual impairment among urban Americans. Archives of Ophthalmology. 1991;109(5):637-41. https://doi.org/10.1001/archopht.1991.01080050051027PMid:2025164
38. Goyal A, Richards C, Patel V, Syeda S, Guest JM, Freedman RL, Hall LM, Kim C, Sirajeldin A, Rodriguez T, Arsenault SM. The Vision Detroit Project: visual burden, barriers, and access to eye care in an urban setting. Ophthalmic Epidemiology. 2022;29(1):13-24. https://doi.org/10.1080/09286586.2021.1884264PMid:33576279
39. Vajaranant TS, Nayak S, Wilensky JT, Joslin CE. Gender and glaucoma: what we know and what we need to know. Current opinion in ophthalmology. 2010 Mar 1;21(2):91-9. https://doi.org/10.1097/ICU.0b013e3283360b7ePMid:20051857 PMCid:PMC4326058
40. Abou-Gareeb I, Lewallen S, Bassett K, Courtright P. Gender and blindness: a meta-analysis of population-based prevalence surveys. Ophthalmic Epidemiology. 2001;8(1):39-56. https://doi.org/10.1076/opep.8.1.39.1540PMid:11262681
41. Ulldemolins AR, Lansingh VC, Valencia LG, Carter MJ, Eckert KA. Social inequalities in blindness and visual impairment: a review of social determinants. Indian Journal of Ophthalmology. 2012;60(5):368-75. https://doi.org/10.4103/0301-4738.100529PMid:22944744 PMCid:PMC3491260
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43. Killeen OJ, Cho J, Newman-Casey PA, Kana L, Woodward MA. Barriers and facilitators to obtaining eyeglasses for vulnerable patients in a Michigan free clinic. Optometry and Vision Science. 2021;98(3):243-9. https://doi.org/10.1001/jamaophthalmol.2015.8PMid:25674781
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2024-04-30
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Addressing Disparities in Vision Health and Eye Care in the US. World Journal of Current Med and Pharm Research [Internet]. 2024 Apr. 30 [cited 2026 Jan. 27];6(1):58-64. Available from: https://www.wjcmpr.org/index.php/journal/article/view/321
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How to Cite
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Addressing Disparities in Vision Health and Eye Care in the US. World Journal of Current Med and Pharm Research [Internet]. 2024 Apr. 30 [cited 2026 Jan. 27];6(1):58-64. Available from: https://www.wjcmpr.org/index.php/journal/article/view/321
