All Avenues Need To Be Considered For Improving Vision

Presbyopia and cataracts are the most prevalent vision-robbing conditions older people.
A paper soon to be published in The Lancet (Volume 5, No. 9, e888–e897, September 2017) estimates that, in 2015, 36 million people in the world were blind and 217 million people were severely or moderately vision impaired. It also estimated that 1.1 billion people aged 35 years and older had near-vision impairment due to uncorrected presbyopia. This is the ability of the eye’s lens to readily adjust focus from far to near tasks, a common condition of aging.
The paper, published by the Vision Loss Expert Group, is part of an extensive initiative called Universal Eye Health: a Global Action Plan 2014–2019, which was adopted in 2013 by the World Health Organization.
Their report shows that presbyopia is the most common cause of vision impairment in senior adults, which is “at least as detrimental to quality of life as impairment of distance vision”. This places presbyopia alongside cataract as one of the most prevalent vision-robbing conditions in the older population.
The good news is that both impairments are correctable. Presbyopia can be corrected with reading glasses, and vision loss from dense cataracts can be corrected with surgical replacement of the lens. Furthermore, presbyopia can also be corrected during cataract surgery by implanting a multifocal lens.
Why is this important information for people affected by retinal degenerative diseases? Here is a case in point:
Eleanor, a 95-year-old woman with early-stage age-related macular degeneration (AMD), blames her retinal condition for her inability to read normal print. She knows that AMD is incurable and progressive, and that she has no cataracts, but she is unaware that she also has presbyopia. She has simply given up trying to read, not realizing that she might be able to solve her problem by simply donning inexpensive reading glasses and increasing the light.
Eleanor and others in her situation need to be reminded that their visual acuity can be affected by conditions secondary to AMD, and that all avenues need to be explored in order to help maintain their quality of life. This becomes the duty of their eye care professionals, rehabilitation specialists, and caregivers.
The Global Action Plan’s goals are “to reduce vision impairment as a global public health problem and to secure access to rehabilitation for people with vision impairment”. The initiative has the target of reducing the prevalence of avoidable vision impairment by 25% from 2010 to 2019. Public education about their findings is an important part of furthering their admirable mission.
Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis
Prof Rupert R A Bourne, MD, et al. (Published online 02 August 2017 in The Lancet.