November 6, 2017 / 11:05 PM / in 9 months

Leading cause of impaired vision in U.S. is correctable

(Reuters Health) - Many people in the U.S. have vision problems that could be addressed with glasses, contact lenses or eye surgery, a recent study suggests.

Roughly nine in 10 children and adults under 45 years old with what’s known as refractive errors, or eyesight that may be improved with corrective lenses, could have their vision restored to at least 20/40 with glasses, contacts or surgery, researchers calculated.

This may also be true for up to about one-third of older people with refractive errors, researchers report in JAMA Ophthalmology.

“The most important message is to not confuse correctable with uncorrectable vision loss,” said senior study author Robert Massof, director of the Lions Vision Research and Rehabilitation Center at the Wilmer Eye Institute and Johns Hopkins University School of Medicine in Baltimore.

“Our study confirms that the leading cause of visual impairment in the U.S. population, particularly in children and younger adults is uncorrected refractive error, which can be corrected (usually to 20/20 or better) with glasses, contact lenses, or refractive surgery,” Massof said by email.

Massof and colleagues examined survey data for a nationally representative sample of 6,016 people nationwide.

In addition to examining refractive errors, researchers also looked at rates of blindness and what’s known as low vision.

Low vision can’t be corrected with glasses, contacts, medication or surgery, and it’s typically caused by age-related eye problems like diabetic eye disease, glaucoma or macular degeneration. People can lose a portion of their field of vision, and the vision loss may be mild or it might be severe enough to limit daily activities like reading or driving.

Nearly 3 million Americans have low vision but aren’t legally blind, and might benefit from vision rehabilitation, Massof said. Vision rehabilitation can involve corrective lenses as well as lighting or magnification devices or other non-optical aids.

“Although the risk of uncorrectable vision loss increases with age, vision rehabilitation can help people learn to use tools and strategies that will enable them to regain function,” Massof said.

One limitation of the study is that the survey excluded people living in nursing homes, assisted living facilities or other care settings, which might mean the rates of vision problems were underestimated, the authors note.

Even so, the results in the U.S. study mirror trends elsewhere in the world where blindness and vision rates are decreasing but the absolute number of cases is increasing due to the aging of the population, said Jill Keeffe, a researcher at the L.V. Prasad Eye Institute in Hyderabad, India, who wasn’t involved in the study.

“Ageing is one of the major risks of eye disease and vision loss,” Keeffe said by email.

“People should have their eyes examined at least every 2 years as many causes of vision can be treated and vision either restored or vision stopped from worsening,” Keeffe added. “It is not possible for all, but for many with vision loss, referral for low vision and rehabilitation services is important.”

Seeing a doctor matters especially for people who drive and may be able to correct their vision enough to avoid a restricted license, said Dr. Paul Lee of Kellogg Eye Center at the University of Michigan in Ann Arbor.

“The take-home message for those under the age of 44 is that if you don’t see well, you should see an eye doctor,” Lee, who wasn’t involved in the study, said by email.

“Around 90 percent or more of those in this age range with decreased vision can be corrected with glasses or contacts to 20/40 or better,” Lee advised. “This is the visual acuity level in most states for having an unrestricted driver’s license.  In addition, many of those older than 45 can also correct their vision to 20/40 or better with glasses or contacts.”

SOURCE: JAMA Ophthalmology, online November 2, 2017.

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