Preventing blindness in Americans: the need for eye health education

Black Americans are twice as likely to be blind as their white counterparts. Although blindness is preventable or curable in half of the patients studied, we have found that black Americans are only half as likely to be treated for glaucoma or cataract, which are the two leading causes of blindness in this population. Our data show that this treatment gap is not related to the supply of ophthalmologists or the patients' personal income, even among insured populations. In addition to the devastating financial costs incurred by blind individuals and their families, a single year of blindness for a working age American costs the federal government approximately $12,000. Research has shown that preventing blindness is often less expensive, in simple economic terms, than paying for the costs a blind individual incurs. These findings raise important questions about access to care and how it may improve within the context of health care reform. Government surveys show that black Americans, even those with health insurance, are significantly less likely to seek or obtain examination by an ophthalmologist. In studying utilization of care, we found that, in aggregate, black Americans who see an ophthalmologist are as likely as their white counterparts to be treated for glaucoma, cataract, and other blinding diseases. We propose that, beyond universal access to health insurance, eye health education that influences people to see an ophthalmologist may be the single most important step we can take to prevent needless blindness. Not only can education and preventive eye care save needless suffering, it may save scarce federal dollars as well.