Aging and vision loss: looking to the future

With an aging world population, visual impairment has become a pronounced public health problem.

In 2020, 1.1 billion people had distant vision or uncorrected presbyopia.

By 2050, this figure is expected to increase to 1.8 billion people. Common causes of visual impairment, including cataracts, glaucoma, age-related macular degeneration, diabetic retinopathy and presbyopia, occur more frequently later in life (> 60 years). Although the age-standardized prevalence of blindness and visual impairment has declined over the past 30 years, this decrease has been offset by a rapid aging of the population, which has resulted in an increase in the number of people, mainly adults over 60 with blindness and visual impairment worldwide.

Therefore, achieving the United Nations Sustainable Development Goals and the United Nations Decade for Healthy Aging (2020-30) goals will require coordinated action to address the growing number of people affected by poor aging. vision, especially later in life.

Over the past 30 years, there have been significant changes in the main causes of vision loss. Infectious causes such as trachoma and onchocerciasis have decreased, while chronic eye diseases such as glaucoma, age-related macular degeneration and diabetic retinopathy now account for a greater proportion of blindness and visual impairment in the world.

The Lancet Global Health Commission on Global Eye Health,

highlights how this epidemiological transition requires a refocused public health and clinical response.

Vision must be recognized as a key component of overall health. A growing body of evidence indicates that vision loss affects more than the way people see,

and has implications for physical, cognitive and mental health, and can exacerbate inequalities in employment, access to health care and income.

As a result, research cannot be limited to prevention, treatment and cures, as there is an urgent need to identify strategies that will equitably maximize the health and opportunities of people with visual impairments as they age. Such an approach is in line with the goals of the United Nations Decade for Healthy Aging, which aims not only to promote healthy aging, but also to reduce the inequalities associated with aging.

The role that society plays in the interplay between vision and aging cannot be ignored either. Research on aging has increasingly taken the perspective that society and the environment shape health and well-being; however, this perspective has not been as fully integrated into research on vision and eye health. WHO World Report on Aging and Health calls for a “rights-based approach to healthy aging” to remove social, structural and legal barriers to older people’s health.

In the same way, The Lancet Global Health Commission

stresses the need to frame vision loss in the context of human rights and stresses that the UN places a strong emphasis on the achievement of the Sustainable Development Goals by, for and with persons with disabilities, which includes people with vision loss. However, there remains a gap in connecting these efforts to achieve health equity and strengthen the human rights of aging people with vision loss.

Eye care must be included as a crucial part of health care for the elderly. Vision and eye health is often poorly integrated into primary health and prevention strategies in efforts to improve health care outcomes, quality and safety or when developing health interventions and programs behavior change.

As the prevalence of vision loss increases with age, these areas represent missed opportunities to optimize the health and well-being of older adults.

The Lancet Global Health Commission

is a clear call to action for a better integration of research, policy and clinical care in vision and aging. The high prevalence of vision loss in older people and its impact on health, well-being and existing inequalities remain substantial and will increase as the world’s population ages. Therefore, the eye care and aging communities must come together to recognize that our world will only be truly age friendly when it is sight friendly.