American Academy of Optometry
American Academy of Optometry
November 14, 2019
2 min read

U.S. must improve surveillance of vision problems

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Sandra Block

ORLANDO, Fla. – The U.S. must do a better job at identifying the true magnitude of the vision problem in the country, Sandra Block, OD, MPH, FAAO, said here at the American Academy of Optometry plenary session.

The session, which was partially sponsored by Primary Care Optometry News, focused on the WHO World Vision Report, for which Block served as an editor.

Block is also a professor at Illinois College of Optometry and was one of the authors of the first vision report from the National Academies of Sciences, Engineering and Medicine.

“The magnitude of myopia is growing,” she said. “Surveillance in the U.S. is not at a level we need. Here the world report on vision is talking about having a better number we can report on.”

We have done a great job at collecting data, “but is it the right data?” Block asked. “The CDC has started to work on that, but there’s a long way to go. Optometry needs to do a better job contributing to the data that’s out there.”
She continued, “The impact of visual impairment is far greater than we ever thought about. The world report on vision has some key messages, and one is universal health coverage. We need to think about models that do a much better job of integrating eye care into the health care system. We need to think about addressing increasing demand as the number of people who are vision impaired and blind increases; we need to think about how we can address their needs better.”

When WHO comes out with a report, the question is always how it affects the U.S. as a country, Block said.

“The fact is we think egocentrically,” she said. “Things are different here. But the reality is we do need to think about where we fit into the big picture.”

One of WHO’s sustainable development goals is universal health coverage, “ensuring everyone has access to eye care without it affecting them financially,” Block said.

Universal health coverage is a “birth-to-death” concept, she said. “The earlier you identify a vision problem in a child, the more likely the outcomes will be better. They will impact the academic performance of a child.”

The prevalence of chronic vision impairment in the U.S. is strongly age-related, Block said, and vision impairment is associated with cognitive decline.

“As people get older, they have multiple chronic conditions and this ultimate geriatric syndrome,” Block said. “We worry that the more conditions you have, the more likely you’ll be hospitalized or experience early death.

“Vision impairment leads to decreases in physical, cognitive, social and physiological function, leading to frailty, disability, comorbidity and mortality,” she said. “If we do a better job of identifying vision impairment, we can affect their outcomes.”
Other vulnerable populations include those with disabilities, those who live in rural communities, the poor and the indigent, Block said.

“We need to do a better job to expand services and invest more appropriately,” she said. “We need to move away from the siloed services to a continuum of care that is patient-centered.” – by Nancy Hemphill, ELS, FAAO


McMahon T, et al. Plenary session: Today’s research, tomorrow’s practice, WHO World Vision Report, opportunities for optometry to make an impact. Presented at: American Academy of Optometry meeting; Orlando, Fla.; October 23-27, 2019.

Disclosure: Block reports no relevant financial disclosures.