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Infancy and Childhood (Birth to Age 18)
In the United States, the most prevalent disabling childhood
conditions are vision disorders including amblyopia, strabismus, and
significant refractive errors. Early detection increases the likelihood
of effective treatment; however, less than 15% of all preschool children
receive an eye exam, and less than 22% of preschool children receive
some type of vision screening. Vision screening for children scored on
par with breast cancer screening for women. Other eye diseases affecting
this age group include retinopathy of prematurity (ROP), congenital
defects, diabetic retinopathy (DR), and cancers such as retinoblastoma.
Adults Younger Than Age 40
Vision impairments in people younger than age 40 are mainly
caused by refractive errors, which affect 25% of children and
adolescents, and accidental eye injury. Approximately 1 million eye
injuries occur each year, and 90% of these injuries are preventable.
More than half (52%) of all patients treated for eye injuries are
between ages 18 and 45 and almost 30% of those are 30–40 years (McGwin,
Aiyuan, & Owsley, 2005). Additionally, diabetes affects this age
group and is the leading cause of blindness among the working-age group
20–74. Racial disparities occur in prevalence and incidence of some eye
conditions. For example, among specific high-risk groups such as
African Americans, early signs of glaucoma may begin in this age group,
particularly if there is a family history for glaucoma. Lifestyle
choices adopted during this period may adversely affect vision and eye
health in later years (e.g., smoking, sunlight exposure).
Adults Older Than Age 40
American adults aged 40 years and older are at greatest risk for
eye diseases; as a result, extensive population-based study data are
available for this age group. The major eye diseases among people aged
40 years and older are cataract, diabetic retinopathy, glaucoma, and
age-related macular degeneration. These diseases are often asymptomatic
in the early treatable stages. The prevalence of blindness and vision
impairment increases rapidly with age among all racial and ethnic
groups, particularly after age 75 (Prevent Blindness America, 2002).
Although aging is unavoidable, evidence is mounting to show the
association between some modifiable risk factors (i.e., smoking,
ultraviolet light exposure, avoidable trauma, etc.) and these leading
eye diseases affecting older Americans. Additional modifiable factors
that might lend themselves to improved overall ocular health include a
diet rich in antioxidants and maintenance of normal levels of blood
sugar, lipids, total cholesterol, body weight, and blood pressure
combined with regular exercise.
Bailey RN, Indian RW, Zhang X, Geiss LS, Duenas MR, Saaddine JB (2006). Visual impairment and eye care among older adults—five states. MMWR 2005:55:49; 1321–1325.
Centers for Disease Control and Prevention. Prevalence of disabilities and associated health conditions among adults—United States. MMWR 2001:50(7):120–5.
Prevent Blindness America, National Eye Institute. Vision Problems in the U. S.—Prevalence of Adult Vision Impairment and Age-Related Eye Disease in America [PDF–2.32MB]. Schaumburg, IL: Prevent Blindness America, 2002.
McGwin G, Aiyuan X, Owsley C. Rate of eye injury in the United States. Arch of Ophthalmol 2005:123;970–976.
Yawn BP, Kurland M, Butterfield L, Johnson B. Barriers to
seeking care following school vision screening in Rochester, Minnesota, J Sch Health 1998:68:8; 319–324.