It’s commonplace to be jaded about the epidemiology figures for eye diseases. We routinely see huge numbers tossed about—e.g., two million Americans have AMD, three million have glaucoma—and gloss over the human impact of those words. It brings to mind a quote often attributed to Joseph Stalin: “One death is a tragedy. One million deaths is a statistic.”
But there are real people behind these numbers, and it’s worth remembering that when we see the staggering figures in a new report from the World Health Organization on the pervasiveness of vision loss.
An array of numbers in the World Report on Vision tells the story of vision’s inherent fragility, beginning with top-line estimates of people affected by eye conditions capable of leading to impairment but not yet inflicting any. Figures for myopia (2.6 billion sufferers) and presbyopia (1.8 billion) highlight the silver lining: the most pervasive eye problems are at least the easiest ones to rectify. More intractable, of course, are those conditions brought on by disease processes like AMD, which affects 196 million people globally, diabetic retinopathy (146 million) and glaucoma (76 million).
The WHO puts the tally for those experiencing some kind of vision loss at 2.2 billion people, and says one billion could have been helped if they had gotten better—or, heck, any!— eye care. “As usual, this burden is not borne equally,” the report says. “It weighs more heavily on low- and middle-income countries, on older people, and on rural communities.”
Drilling down into that one billion figure, we see the lion’s share is comprised of uncorrected presbyopia, affecting 826 million people. Consider that for a minute. Something as simple as a pair of drugstore readers could make a profound difference for a group of people 2.5 times the size of the entire US population. Next highest is unaddressed refractive error (123.7 million), followed by cataract (65.2 million), glaucoma (6.9 million), corneal opacities (4.2 million), diabetic retinopathy (three million) and trachoma (two million).
So, using the WHO’s numbers, at least 950 million people just need glasses, by far the easiest thing in eye care to provide. It makes me think of the (frustrating, to us in optometry) use of the word optics in political parlance to mean bad PR. Clearly, the optics of it all doesn’t look good. Add in the need for preventive care and medical intervention for active eye disease, and the global burden seems nearly insurmountable.
One WHO recommendation involves giving optometry a boost. The profession sorely needs it. The scope, and very definition, of optometry varies wildly among countries. In many, it’s much more akin to opticianry. “In some countries,” the report states, “productivity may be diminished because a section of the health workforce, such as optometrists, are not accredited to carry out eye care services independently.”
The WHO report offers a sobering look at the work to be done. Building up optometrists globally—as both vision and eye health pros—could make a profound difference.