The leading causes of vision impairment and blindness in the United States are primarily age-related eye diseases. The number of Americans at risk for age-related eye diseases is increasing as the baby-boomer generation ages. These conditions, including age-related macular degeneration, cataract, diabetic retinopathy and glaucoma, affect more Americans than ever before.
It is our hope that information contained in this website will allow you to better understand the age-related eye diseases and this may help prevent blindness.

There are many signs that can signal vision loss. For example, even with your regular glasses, do you have:

• difficulty recognizing faces of friends and relatives?

• difficulty doing things that require you to see well up close, such as reading, cooking, sewing, fixing things around the house, or picking out and matching the color of your clothes?

• difficulty doing things at work or home because lights seem dimmer than they used to?

• difficulty reading street and bus signs or the names of stores?

Vision changes like these could be early warning signs of eye disease. Usually, the earlier your problem is diagnosed, the better your chances of undergoing successful treatment and keeping your remaining vision. Regular dilated eye exams should be part of your routine health care. However, if you think your vision has recently changed, you should see your eye care professional as soon as possible.

What is Blindness? The term "blindness" can have many connotations and is difficult to define precisely. To many people, blindness refers to the complete loss of vision with no remaining perception of light. However, this ultimate form of complete blindness is rare. Far more people have a permanent loss of some, but not all, of their eyesight.
Legal blindness" represents an artificial distinction and has little value for rehabilitation, but it is significant in that it determines eligibility for certain disability benefits from the Federal Government. In the US, it is typically defined as visual acuity with best correction in the better eye worse than or equal to 20/200 or a visual field extent of less than 20 degrees in diameter.

Telling a person that he/she IS legally blind tends to categorize that person and leads to the assumption that “nothing more can be done”. Telling a person that he/she HAS a severe vision loss describes an attribute of that person and invites the question what can be done to alleviate the problem. In 2002 these considerations led the International Council of Ophthalmology (ICO) and the International Federation of Ophthalmological Societies (IFOS) to issue the following recommendations about the use of various terms:

• The term “BLINDNESS” should be used only for Total and Near-total Vision loss, i.e. for cases with little or no residual vision. These patients require mainly vision-substitution for rehabilitation.

• The term “LOW VISION” should be used for cases that have residual vision. These patients require vision-enhancement for rehabilitation.

• The term “VISION LOSS” can be used as a subsumptive term for all conditions. Vision loss can range from mild to moderate, severe, profound and total loss.

The term “VISUAL IMPAIRMENT” can also be used for all ranges (from Low Vision = partial impairment, to Blindness = total impairment), but indicates that the classification is based on a visual function measurement (acuity, field, etc.) rather than on an assessment of functional vision (e.g. the ability to read newsprint).

Using this terminology we would no longer launch programs aimed only at avoidable blindness, but, more broadly, aimed at avoidable vision loss. We would no longer speak about macular degeneration as a leading cause of blindness, but, more truthfully, as a leading cause of vision loss. The WHO and IAPB have set an example by dropping the word blindness from their current worldwide campaign, naming it Vision-2020 – the Right to Sight.
Further reading: Low vision and visual aids

What is vision impairment? Vision impairment is defined as having 20/40 or worse vision in the better eye even with eyeglasses. People with the least degree of vision impairment may still face challenges in everyday life. For instance, people with vision worse than 20/40 cannot obtain an unrestricted driver's license in most states.

How many Americans are blind or visually impaired? Blindness affects more than one million Americans age 40 and older. The visually impaired, including those who are blind, total more than 3.4 million older Americans. The number of Americans with age-related eye disease and the vision impairment that results is expected to double within the next three decades.

Prevalence of Blindness Among Adults 40 Years and Older in the United States

Age,	Blindness		Low Vision		All Vision Impaired
Years	Persons	(%)	Persons	(%)	Persons	(%)
40-49	51,000	0.1%	80,000	0.2%	131,000	0.3%
50-59	45,000	0.1%	102,000	0.3%	147,000	0.4%
60-69	59,000	0.3%	176,000	0.9%	235,000	1.2%
70-79	134,000	0.8%	471,000	3.0%	605,000	3.8%
>80	648,000	7.0%	1,532,000	16.7%	2,180,000	23.7%
Total	937,000	0.8%	2,361,000	2.0%	3,298,000	2.7%

Vision Loss from Eye Diseases Will Increase as Americans Age
With the aging of the population, the number of Americans with major eye diseases is increasing, and vision loss is becoming a major public health problem. By the year 2020, the number of people who are blind or have low vision is projected to increase substantially. These findings appear in the April 2004 issue of Archives of Ophthalmology.
Blindness or low vision affects 3.3 million Americans age 40 and over, or one in 28, according to study authors. This figure is projected to reach 5.5 million by the year 2020. The study reports that low vision and blindness increase significantly with age, particularly in people over age 65. People 80 years of age and older currently make up eight percent of the population, but account for 69 percent of blindness. The study provides the most robust and up-to-date estimates available of the burden of visual impairment. It was sponsored by the National Eye Institute (NEI), part of the Federal government's National Institutes of Health (NIH).
The study identifies age-related macular degeneration (AMD), glaucoma, cataract, and diabetic retinopathy as the most common eye diseases in Americans age 40 and over. The leading cause of blindness among white Americans is AMD, accounting for 54 percent of all blindness. Among African Americans, the leading causes of blindness are cataract and glaucoma. Among Hispanics, glaucoma is the most common cause of blindness. The study authors emphasize the importance of annual comprehensive eye examinations in preventing and/or delaying eye disease for those at higher risk for blindness, such as those over age 65, people with diabetes, or African Americans over age 40.
Study authors provide estimates of the number of Americans with each disease. The authors say that due largely to the aging of the population, the prevalence of low vision and blindness will increase markedly by 2020.

Vision problems in US - Full text of report

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