Improve the visual health of the Nation through prevention, early detection, timely treatment, and rehabilitation.
Vision is an essential part of everyday life, influencing how Americans of all ages learn, communicate, work, play, and interact with the world. Yet millions of Americans live with visual impairment, and many more remain at risk for eye disease and preventable eye injury.
The Healthy People 2020 Vision objectives focus on evidence-based interventions to preserve sight and prevent blindness. Objectives address screening and examinations for children and adults, early detection and timely treatment of eye diseases and conditions, injury prevention, and the use of vision rehabilitation services.
Why Is Vision Health Important?
The eyes are an important, but often overlooked, part of overall health. Despite the preventable nature of some vision impairments, many people do not receive recommended screenings and exams.1 A visit to an eye care professional for a comprehensive dilated eye exam can help to detect common vision problems and eye diseases, including:
Age-related macular degeneration (AMD)
These common vision problems often have no early warning signs. If a problem is detected, an eye care professional can prescribe corrective eyewear, medicine, or surgery to minimize vision loss and help a person see his or her best.
Healthy vision can help keep people safe when behind the wheel, participating in sports, or working with power tools in the yard or around the home. It can also help to ensure a healthy and active lifestyle well into a person’s later years. Educating and engaging families, communities, and the Nation is critical to ensuring that people have the information, resources, and tools needed for good eye health. Resources and tools include:
Understanding Vision Health
The need to promote and protect healthy vision continues through the entire lifespan and applies to all ethnic and racial groups. Research indicates that several diseases and eye disorders are more prevalent in certain racial and ethnic minority communities and disproportionately affect minority populations more than whites.2, 3, 4, 5
Access to Health Care
In 2005, the National Eye Institute (NEI) conducted a series of focus groups on factors that influence the receipt of preventive eye care. Participants indicated that the cost of services is prohibitive, particularly when it comes to receiving follow-up care.6
With the aging of the population, the number of Americans with major eye diseases is increasing, and vision loss is becoming a major public health concern. By the year 2020, the number of people who are blind or have low vision is projected to reach 5.5 million.7
Eye injuries are also a major eye health concern in the United States. Each day, more than 2,000 American workers receive some form of medical treatment due to eye injuries that happen at work.8 Nearly half of all eye injuries occur at home, and more than 1 in 4 occur during sporting and recreational activities, or on streets and highways.
Emerging Issues in Vision Health
Researchers are capitalizing on the remarkable progress made by the Human Genome Project and the Genome-Wide Association Studies. Datasets for AMD and a twin study of risk factors for glaucoma and myopia have been added to the public domain (known as dBGap). New studies are also working to identify the relationships of environmental exposures to gene-trait associations in common, complex diseases.
Researchers aim to understand the complex genetic and biological factors that cause glaucoma and to develop treatments that protect optic nerves from the damage that leads to vision loss.
Gene Transfer Therapy
Gene transfer therapy in patients with Leber congenital amaurosis—a severe, early-onset retinal disease—indicates that the treatment is safe, with evidence of lasting visual improvement. These findings could help usher gene-based therapies for other retinal diseases, such as retinitis pigmentosa and macular degeneration, into clinical trials.
Investigators are conducting several comparative effectiveness clinical trials to improve ophthalmic care.
- Laser treatment has been a standard of care for diabetic eye disease, where abnormal blood vessel growth damages the retina. However, recent clinical trials established that the anti-neovascular agents Lucentis, Avastin, and Eylea offer improved treatment.
- Retinopathy of prematurity is a disorder that can cause blindness in preterm infants if not treated in time. Unfortunately, rural and underserved community hospitals do not always have immediate access to a retina specialist. A National Eye Institute clinical trial demonstrated that telemedicine was as effective as in-person examinations and could be used to send retina images to specialists remotely to make treatment decisions.9
Rehabilitation research is improving the quality of life of people with visual impairments by helping them maximize the use of remaining vision and by devising improved aids and strategies to assist those without useful vision.
1Hartnett ME, Key IJ, Loyacano NM, et al. Perceived barriers to diabetic eye care. Arch Ophthalmol. 2005;123:387-91.
2Friedman DS, West SK, Munoz B, et al. Racial variations in causes of vision loss in nursing homes: The Salisbury Eye Evaluation in Nursing Home Groups (SEEING) Study. Arch Ophthalmol. 2004 Jul;122(7):1019-24.
3Varma R, Ying-Lai M, Klein R, et al.; Los Angeles Latino Eye Study Group. Prevalence and risk indicators of visual impairment and blindness in Latinos: The Los Angeles Latino Eye Study. Ophthalmology. 2004 Jun;111(6):1132-40.
4Kempen JH, O'Colmain BJ, Leske MC, et al.; Eye Diseases Prevalence Research Group. The prevalence of diabetic retinopathy among adults in the United States. Arch Ophthalmol. 2004 Apr;122(4):552-63.
5Higginbotham EJ, Gordon MO, Beiser JA, et al. The Ocular Hypertension Treatment Study: Topical medication delays or prevents primary open-angle glaucoma in African American individuals. Arch Ophthalmol. 2004 Jun;122(6):813-20.
6National Institutes of Health, National Eye Institute (NEI). Eye health information: Identification of variables that influence the receipt of eye care [Internet]. Bethesda, MD: NEI: 2005 Aug 25 [retrieved 2016 Apr 4]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941200/
7Kempen JH, O’Colmain BJ, Leske MC, et al. Eye diseases prevalence research group: Causes and prevalence of visual impairment among adults in the United States. Arch Ophthalmol. 2004;122:477-485.
8Centers for Disease Control and Prevention and National Institute for Occupational Safety and Health (NIOSH). National electronic injury surveillance system database [Internet]. Bethesda, MD: US Consumer Product Safety Commission. [retrieved 2016 Apr 4]. Available from: http://www.cpsc.gov/en/Research--Statistics/NEISS-Injury-Data/
9Quinn GE, Ying GS, Daniel E, et al. Validity of a telemedicine system for the evaluation of acute-phase retinopathy of prematurity. JAMA Ophthalmol. 2014 Oct;132(10):1178-84. doi: 10.1001/jamaophthalmol.2014.1604. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24970095