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). "Blindness and low vision can lead to loss of independence and reduced quality of life," said Elias A. Zerhouni, M.D., Director of the NIH. "As our population lives longer, eye disease will be an ever greater concern. These data underscore NIH's commitment to the support of vision research that will prevent, delay, and possibly cure eye diseases."
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.
There were other significant findings from the study:
- AMD is strongly associated with increasing age, particularly after age 60. AMD rises dramatically in whites over age 80; more than one in 10 white Americans over age 80 has vision loss from AMD.
- Glaucoma is almost three times as common in African Americans as in whites.
- The prevalence of glaucoma rises rapidly in Hispanics over age 65.
- Cataract is the leading cause of low vision among all Americans, responsible for about 50 percent of all cases.
- One in every 12 people with diabetes age 40 and older has vision-threatening diabetic retinopathy.
"These data will help identify areas where we should direct our research efforts," said NEI Director Paul A. Sieving, M.D., Ph.D. "Also, health professionals and state and local agencies can use study data to prioritize public health programs emphasizing the importance of early detection and timely treatment. Developing blindness prevention strategies could help address the potentially devastating impact of the increased prevalence of eye diseases in the next few decades."
Frederick Ferris III, M.D., director of clinical research at the NEI, said that the estimates of low vision and blindness "are the first to take full advantage of information derived from several excellent eye disease studies reported since 1990. These data, collected from different populations, allow us to identify the most common eye diseases and give us good estimates of their relative magnitudes."
The study was conducted by the Eye Disease Prevalence Research Group, a consortium of principal investigators who have conducted population-based eye disease studies. The Eye Disease Prevalence Research Group produced prevalence estimates of blindness and low vision in people age 40 and over by analyzing standardized data from several high quality studies. The derived prevalence rates were then modeled to the U.S. population using 2000 census data, and projected to 2020 based on 2020 US census estimates.
A list of the eye disease studies of various populations analyzed by the Eye Disease Prevalence Research Group, and their respective authors, is attached.
The National Eye Institute (NEI) conducts and supports research that leads to sight-saving treatments and plays a key role in reducing visual impairment and blindness. The NEI is part of the National Institutes of Health (NIH), an agency of the U.S. Department of Health and Human Services.
Summary of Eye Disease Prevalence Data
| Years | Cataract - Persons | (%) | Advanced AMD - Persons | (%) | Intermediate AMD - Persons | (%) | Glaucoma - Persons | (%) |
| 40-49 | 1,046,000 | 2.5% | 20,000 | 0.1% | 851,000 | 2.0% | 290,000 | 0.7% |
| 50-59 | 2,123,000 | 6.8% | 113,000 | 0.4% | 1,053,000 | 3.4% | 318,000 | 1.0% |
| 60-69 | 4,061,000 | 20.0% | 147,000 | 0.7% | 1,294,000 | 6.4% | 369,000 | 1.8% |
| 70-79 | 6,973,000 | 42.8% | 388,000 | 2.4% | 1,949,000 | 12.0% | 530,000 | 3.9% |
| = 80 | 6,272,000 | 68.3% | 1,081,000 | 11.8% | 2,164,000 | 23.6% | 711,000 | 7.7% |
| Total | 20,475,000 | 17.2% | 1,749,000 | 1.5% | 7,311,000 | 6.1% | 2,218,000 | 1.9% |
Prevalence of Cataract, Age-Related Macular Degeneration, and Open-Angle Glaucoma Among Adults 40 Years and Older in the United States*
Prevalence of Diabetic Retinopathy Among Adults*
| Years | Type 1 Diabetes - Persons | (%) | All Diabetes 40 Years and Older - Persons | (%) |
| 18-39 | 278,000 | 0.3% | NA | NA |
| 40-49 | 172,000 | 0.4% | 589,000 | 1.4% |
| 50-64 | 1,582,000 | 3.8% | ||
| 65-74 | 317,000 | 0.4% | 1,068,000 | 5.8% |
| = 75 | 824,000 | 5.0% | ||
| Total767,000 | 0.4% | 4,063,000 | 3.4% |
Prevalence of Blindness and Low Vision Among Adults 40 Years and Older in the United States*
| Years | Blindness - Persons | (%) | Low Vision - Persons | (%) | All Vision Impaired- 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% |
*Archives of Ophthalmology, Volume 122, April 2004
Eye Disease Prevalence Study Group
The Baltimore Eye Survey, Baltimore, MD: James M. Tielsch, Alfred Sommer, Joanne Katz, Harry A. Quigley
The Barbados Eye Studies, Barbados, West Indies: M. Cristina Leske, Suh-Yuh Wu, Barbara Nemesure, Anselm Hennis, Leslie Hyman, Andrew Schachat
The Beaver Dam Eye Study, Beaver Dam, WI: Barbara E.K. Klein, Ronald Klein, Kristine E. Lee, Scot E. Moss, Sandra C. Tomany
The Blue Mountains Eye Study, Sydney, New South Wales, Australia: Paul Mitchell, Jie Jin Wang, Elena Rochtchina, Wayne Smith, Robert G. Cumming, Karin Attebo, Jai Panchapakesan, Suriya Foran
The Melbourne Visual Impairment Project, Melbourne, Australia: Hugh R. Taylor, Cathy McCarty, Bickol Mukesh, LeAnn M. Weih, Patricia M. Livingston, Mylan Van Newkirk, Cara L. Fu, Peter Dimitrov, Matthew Wensor
Proyecto Vision Evaluation Research, AZ: Sheila K. West, Beatriz Muñoz, Jorge Rodriguez (deceased), Aimee T. Broman, Daniel Finklestein, Robert Snyder
The Rotterdam Eye Study, Rotterdam, the Netherlands: Paulus T.V.M. de Jong, Johannes R. Vingerling, Roger C.W. Wolfs, Caroline C.W. Klaver, Albert Hofman, Redmer van Leeuwen, M. Kamran Ikram, Simone de Voogd
The Salisbury Eye Evaluation Project, Salisbury, MD: Sheila West, Gary Rubin, Karen Bandeen Roche, Beatriz Muñoz, Kathy Turano, Oliver D. Schein, Donald Duncan
Resource Centers
Meta-Analysis Coordinating Center, Baltimore, MD: Nathan G. Congdon, David S. Friedman, John H. Kempen, Benita J. O'Colmain
National Eye Institute, National Institutes of Health, Bethesda, MD: Frederick L. Ferris III
Journal
Archives of Ophthalmology