According to new demographic research addressing blindness, vision impairment, and low vision, the number of older Americans who have visual impairments or are blind is projected to double by 2050.
This important – and urgent – research, entitled Visual Impairment and Blindness in Adults in the United States: Demographic and Geographic Variations from 2015 to 2050, has been published “online first” in the May 19, 2016 edition of JAMA Ophthalmology. JAMA Ophthalmology is an international peer-reviewed journal published monthly by the American Medical Association.
The authors are Rohit Varma, MD, MPH; Thasarat S. Vajaranant, MD; Bruce Burkemper, PhD, MPH; Shuang Wu, MS; Mina Torres, MS; Chunyi Hsu, MPH; Farzana Choudhury, MBBS, MPH, MS, PhD; and Roberta McKean-Cowdin, PhD, who represent the following institutions: the Keck School of Medicine of the University of Southern California, Los Angeles, and the University of Illinois at Chicago Eye and Ear Infirmary.
Dr. Varma is also a co-author of a recent Los Angeles Latino Eye Study publication that examined the risk and prevalence of early and late stage age-related macular degeneration and its impact on quality of life for older Latinos.
About the Research
With the youngest of the baby boomers hitting 65 by 2029, the number of people with visual impairment or blindness in the United States is expected to double to more than 8 million by 2050, according to projections based on the most recent census data and from studies funded by the National Eye Institute, part of the National Institutes of Health. Another 16.4 million Americans are expected to have difficulty seeing due to correctable refractive errors such as myopia (nearsightedness) or hyperopia (farsightedness) that can be fixed with glasses, contact lenses, or surgery.
The researchers estimate that 1 million Americans were legally blind, meaning a visual acuity of 20/200 vision or worse, in 2015. Meanwhile, 3.2 million Americans had visual impairment in 2015 — meaning they had 20/40 or worse vision with best possible correction. Another 8.2 million had vision problems due to uncorrected refractive error.
Over the next 35 years, Varma and his colleagues project that the number of people with legal blindness will increase by 21 percent each decade to 2 million by 2050. Likewise, best-corrected visual impairment will grow by 25 percent each decade, doubling to 6.95 million.
The greatest burden of visual impairment and blindness will affect those 80 years or older, because advanced age is a key risk factor for diseases such as age-related macular degeneration and cataract.
In terms of absolute numbers, non-Hispanic whites, particularly white women, represent the largest proportion of people affected by visual impairment and blindness, and their numbers will nearly double. By 2050, 2.15 million non-Hispanic white women are expected to be visually impaired and 610,000 will be blind. “Based on these data, there is a need for increased screening and interventions across all population, and especially among non-Hispanic white women,” [study co-author] Dr. Varma said.
African Americans currently account for the second highest proportion of visual impairment, but that is expected to shift to Hispanics around 2040, as the Hispanic population — and particularly the number of older Hispanics — continues to grow.
Hispanics have particularly high rates of diabetes, which is associated with diabetic eye disease, a treatable cause of visual impairment. African Americans are expected to continue to account for the second highest proportion of blindness and are at disproportionately high risk for developing glaucoma.
More about the study from JAMA Ophthalmology
Edited and excerpted from the study abstract:
Importance: The number of individuals with visual impairment and blindness is increasing in the United States and around the globe as a result of shifting demographics and aging populations. Tracking the number and characteristics of individuals with VI and blindness is especially important given the negative effect of these conditions on physical and mental health.
Objectives: To determine the demographic and geographic variations in visual impairment and blindness in adults in the U.S. population in 2015 and to estimate the projected prevalence through 2050.
Design, Setting, and Participants: In this population-based, cross-sectional [i.e., at one specific point in time] study, data were pooled from adults 40 years and older from six major population-based studies on visual impairment and blindness in the United States. Prevalence of visual impairment and blindness were reported by age, sex, race/ethnicity, and per-capita prevalence by state using the U.S. Census projections (January 1, 2015, through December 31, 2050).
Results: In 2015, a total of 1.02 million people were blind, and approximately 3.22 million people in the United States had visual impairment (VI), whereas up to 8.2 million people had visual impairment due to uncorrected refractive error. By 2050, the numbers of these conditions are projected to double to approximately 2.01 million people with blindness, 6.95 million people with VI, and 16.4 million with VI due to uncorrected refractive error.
The highest numbers of these conditions in 2015 were among non-Hispanic white individuals (2.28 million), women (1.84 million), and older adults (1.61 million), and these groups will remain the most affected through 2050. However, African American individuals experience the highest prevalence of visual impairment and blindness.
By 2050, the highest prevalence of VI among minorities will shift from African American individuals (15.2% in 2015 to 16.3% in 2050) to Hispanic individuals (9.9% in 2015 to 20.3% in 2050).
From 2015 to 2050, the states projected to have the highest per capita prevalence of VI are Florida (2.56% in 2015 to 3.98% in 2050) and Hawaii (2.35% in 2015 and 3.93% in 2050), and the states projected to have the highest projected per capita prevalence of blindness are Mississippi (0.83% in 2015 to 1.25% in 2050) and Louisiana (0.79% in 2015 to 1.20% in 2050).
The Dilemma: How Can You Maintain Your Independence After Vision Loss?
If you have experienced any loss of vision, there are many services and devices that can help you continue to live independently in your home and community. Vision rehabilitation services can help you regain self-sufficiency, improve your quality of life, and help you function independently, just as occupational and physical therapy restore the ability to function after a stroke or other injury. Although there is not one specific “road map” that is right for everyone, the following steps can help you locate services and training that are right for you.
Step 1: Start with your eye care professional
The best place to begin the vision rehabilitation process is to make an appointment with your own eye care professional:
- An ophthalmologist is a medical or osteopathic physician who specializes in the medical and surgical care of the eyes and the prevention of eye disease. An ophthalmologist treats eye diseases, prescribes medications, and performs all types of surgery to improve, or prevent the worsening of, eye and vision-related conditions. An ophthalmologist will have the initials M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathy) after his or her name.
- An optometrist is a health care professional who specializes in function and disorders of the eye, detection of eye disease, and some types of eye disease management. An optometrist is trained to examine the eyes for visual defects, diagnose problems or impairments, prescribe corrective glasses and contact lenses, and, in some states, perform certain surgical procedures. An optometrist will have the initials O.D. (Doctor of Optometry) after his or her name.
Step 2: Have a low vision examination
If your vision loss cannot be completely corrected by your regular eye care professional, a low vision specialist can conduct the needed eye examination and help you make the best use of your remaining vision.
- Low vision optical devices use lenses to magnify images so that objects or print appear larger to the eye. Examples include magnifying reading glasses, stand magnifiers, hand-held magnifiers, and small pocket-sized telescopes. These special optical devices are different from regular glasses and magnifiers.
- Non-optical devices and modifications do not use lenses to magnify images. Instead, they increase lighting levels, improve contrast, decrease the effects of glare, or increase print size to make objects and print more easily visible. Examples include high-intensity table or floor lamps, large print reading materials, reading stands, and absorptive sunglasses.
- Adaptive daily living equipment includes devices that are designed to make everyday tasks easier to do with reduced or no vision. Clocks with large numerals, writing guides, needle threaders, large print or talking watches, large print and tactile labels, and talking pill bottles are examples of daily living equipment.
- In addition, you, your eye care specialist, and other low vision service providers, such as social workers and specially trained therapists, will also discuss how you are adapting emotionally to your vision loss, whether you are motivated to learn a different way of doing things, and whether you have family and friends to support you.
Step 3: Investigate additional vision rehabilitation services
Vision rehabilitation services can help you function safely and independently in several critically important daily living areas:
Independent movement and travel:
- Get around indoors
- Walk with a guide
- Use a long white cane
- Cross streets
- Use public transportation
- Use electronic travel devices
Independent living and personal management:
- Prepare meals
- Manage your money
- Label your medications
- Make home repairs
- Enjoy crafts and hobbies
- Go shopping
Communication and technology:
- Tell time with an adapted clock or watch
- Sign your name
- Use tablets and smartphones
- Use computers with speech or screen magnification
- Learn braille
Counseling and peer support:
- Join a peer support group
- Manage stress, depression, or anxiety
- Discuss your feelings and offer mutual support
- Move toward acceptance of, and adjustment to, life with a visual impairment
- Help your spouse, family members, and friends adjust to your vision loss
- Learn about resources, services, and devices
Source: Making Life More Livable: Simple Adaptations for Living at Home After Vision Loss, Third Edition. Used with permission.
- Use the The American Foundation for the Blind/VisionAware Directory of Services to locate professionals and services in your area.
- The VisionAware Getting Started Kit for People New to Vision Loss can connect you and your family members with specialized services and products available to assist with everyday life with vision loss.
- The VisionConnect™ app provides a searchable directory of services available in the United States and Canada for children and adults who are blind or visually impaired.
- Learn more about aging and vision loss research at the AFB Research Navigator: Age is Just a Number
- Meet Rebecca Sheffield, Ph.D., Senior Policy Researcher, AFB Public Policy Center