Prevent Blindness is dedicated to preventing blindness and preserving sight by advancing the full spectrum of vision care and eye health. Research has shown that the prevalence and associated cost of vision problems are expected to increase dramatically for the foreseeable future. It is the goal of Prevent Blindness to align federal policy to slow the growth of vision problems, saving both sight and dollars for federal and state governments, as well as private individuals and institutions.
The Centers for Disease Control and Prevention (CDC) addresses our national vision impairment and eye disease burden by conducting public health surveillance, research, and evidence-based public health interventions designed to complement state and community health efforts. Prevent Blindness has consistently advocated for increased and sustained federal funding for two programs at the CDC dedicated specifically to vision and eye health: the Vision Health Initiative and Glaucoma programs, which are part of the CDC’s national efforts to address chronic disease prevention and health promotion.
Vision Health Initiative
The CDC has long been working to address vision and eye health through national health policy goals. In 2005, the CDC established the Vision Health Initiative (VHI) to coordinate national efforts around preventing vision impairment and vision loss through eye diseases and improve the nation’s vision and eye health using a public health approach involving key national, state, and community partners. The VHI recognizes that vision impairment and eye disease has considerable personal and economic consequence in the United States, and that these problems will only increase as our population ages, as chronic disease rates increase, as access to care decreases, and as health care costs rise.
Understanding a problem is a part of solving it, which is why the CDC relies on public health surveillance and evaluation tools to determine the scope of vision impairments and eye diseases and to understand who is at highest risk for vision loss. By tracking state-level data on vision loss and eye disease, the VHI can evaluate data for variances across population subgroups and demographics to find out what vision impairments and eye diseases are most prevalent and who is most affected by them. The VHI can then use this information to implement state and community public health interventions based on evidence and strategically targeted to reach people who are at the highest risk for vision loss and eye disease.
- Prevent Blindness Advocacy: In order to accomplish its work, the VHI needs a steady funding level allocated through the annual federal appropriations process. Prevent Blindness has long advocated for this funding because it enables work that is essential to guiding and improving public policy, implementing the right program interventions, and delivering critical sight-saving information to the public. We also consistently advocate to Congress to sustain funding for the CDC’s work in glaucoma to ensure early detection and prevention services can continue to meet the needs of high-risk populations.
- Federal Outlook: Federal budgetary policies designed to rein in spending over the last decade have resulted in resource levels that keep the VHI from conducting public health surveillance, which is necessary to understand how trends over the past decade have affected vision and eye health in the United States. Prevent Blindness continues to advocate to Members of Congress to increase the CDC’s funding for the VHI so that we can determine who is facing vision impairment and eye diseases and ensure Americans of all ages, racial and ethnic backgrounds, and socioeconomic circumstances can enjoy a life of healthy vision and eyesight.
The CDC also conducts essential prevention services aimed at reaching those who may be at high risk of developing glaucoma. Prevention is especially important for glaucoma because, once the disease has progressed to a point when a patient notices changes to his or her vision, any vision lost is irreversible and permanent. The CDC conducts glaucoma detection and prevention programs that have proven successful in providing direct glaucoma detection, referral to care, and sustained eye care services through innovative service models at the community level for people who need it most.
Fact Sheets and Information
Analysis of Vision and Eye Health Policies in President Biden’s Fiscal Year 2022 Budget Request to Congress
Fiscal Year 2022 Appropriations Overview
Fact Sheet – Vision and Eye Health at the CDC
Fact Sheet – Vision and Eye Health in the U.S.
Fact Sheet – The Cost of Vision Problems in the U.S.
Prevent Blindness FY2021 Overview
CDC Improving the Nation’s Vision FY2021
Vision and Eye Health 2020 Opportunity
Cost of Vision Problems – FY2021
Investing in the CDC’s Vision and Eye Health Programs – FY2021
Vision and Eye Health in States and CommunitiesVision and Eye Health in States and Communities
Vision Health Initiative – CDC
CDC Fact Sheet: Looking Ahead: Improving Our Vision for the Future
January 31: Essential Health Benefits, CMS 9898-NC
May 19: FY2022 Statement for the Record to House Labor-HHS-Ed. Subcommittee on Appropriations
March 10: Prevent Blindness leads coalition of 117 organizations requesting FY2022 appropriations for vision and eye health – House and Senate
November 13: Senate Releases Long-Awaited FY2021 Appropriations Legislation
July 16: House Appropriations Committee Introduces FY2021 Legislation for CDC’s Vision and Eye Health Programs
May 22: Prevent Blindness submits testimony to the Senate Labor-HHS-Education Appropriations Subcommittee
March 23: Prevent Blindness FY2021 House Approps. Labor-HHS Subcomm. Written Testimony
February 24: Prevent Blindness Leads 83 Vision and Eye Health Organizations Asking Congress to Support CDC in FY2021 (House)
February 24: Prevent Blindness Leads 83 Vision and Eye Health Organizations Asking Congress to Support CDC in FY2021 (Senate)
February 10: President’s FY2021 Budget Proposes to Eliminate CDC Vision and Eye Health Programs
December 20: Congress Passes FY2020 Appropriations Legislation
September 20: Senate FY2020 Labor-HHS-Ed. Appropriations Bill Fails to Restore CDC’s Vision Health Initiative
May 1: House FY2020 Labor-HHS-Ed. Appropriations Bill Doubles Funding for CDC’s Vision Health Initiative
October 1: FY 2019 Spending Law Includes Funding for Vision and Eye Health
May 31: Prevent Blindness asks Senate appropriators to address vision and eye health in Fiscal Year 2019 appropriations
March 23: Prevent Blindness applauds Congress for Increasing FY18 investments to CDC’s vision health programs
June 2: Testimony to Senate Appropriations Subcommittee on FY18 Labor-HHS appropriations
Access to care is definable by a number of ways. For example, if a patient cannot afford medication or treatment or lives in a location that does not have a nearby eye care provider, care becomes inaccessible. On the other hand, coverage—whether offered through a public program or a private insurance plan—can provide a means to accessing care so long as the plan’s design is such that it reduces obstacles to care, such as cost, and ensures continuity.
Prevent Blindness advocates for policies that promote access to care for patients as well as coverage options that allow patients to prioritize their vision health and eye care as a part of their overall health and well-being.
Accessibility and Affordability of Drugs and Treatments
Pharmaceuticals are a key part of the treatment plan for many eye diseases. Patient assistance programs provide a much-needed safety net in both commercial and publicly funded health plans for patients who cannot afford the burgeoning costs of their treatments. As well, at the advice of their eye care provider, patients should be able to make their own decisions regarding treatment, and treatment options must be accessible, affordable, and safe for patients. As well, plan designs may include utilization management techniques such as step therapy, which can present undue hardships to patients who face progressive vision loss and do not have the luxury of time to try less effective medications. Such policies circumvent the patient-provider relationship, and could add significant costs on the back end if the patient experiences harmful side effects or experience irreversible vision loss while waiting to access treatment that can save their sight.
- Prevent Blindness Advocacy: As a patient advocacy organization, Prevent Blindness works with stakeholders and policymakers to encourage a healthy balance of policies that ensure the burden does not fall disproportionately on one entity of the healthcare system. We believe policies should promote consumer choice while mitigating over-utilization and over-consumption, and provider behavior with appropriate oversight mechanisms on purchasers, payers, manufacturers, and other players in the marketplace to ensure the responsibility to lower cost and improve access falls on all stakeholders. Additionally, we advocate for patient protections and policies that discourage use of step therapy and protect the patient-provider relationship in treatment decisions.
- Federal Outlook: Several legislative attempts to lower prescription drug costs are under consideration in Congress. Lowering prescription drug costs to the patient and the national system are a major priority for the Administration.
Generally, aging Americans rely on Medicare for their overall healthcare needs. However, because traditional Medicare does not provide for routine and preventive eye care services (including eyeglasses, contact lenses, or devices for low vision conditions), patients who need vision and eye care may need to pay out of pocket or access care through another program. Private Medicare Advantage plans often cover these services and Medigap policies can offer cost assistance. However, out-of-pocket costs may pose a barrier in accessing coverage of care or treatment.
- Prevent Blindness Advocacy: Prevent Blindness continues to advocate for including vision and eye health in Medicare, and encourage lawmakers to adapt policies that address vision and eye health as a part of healthy aging. Routine and preventive eye examinations offered at age-appropriate and evidence-based intervals will protect patients from preventable vision loss and ensure that seniors can age independently while avoiding long-term costs associated with injury from falls, social isolation, depression, and cognitive decline, all of which can be consequences of vision problems.
- Policy Outlook: Congress continues to debate several legislative approaches that would expand vision and eye health in the Medicare program. Current debates center on the cost and scope of a vision benefit as well as how to promote vision as part of healthy aging endeavors, such as falls prevention, cognitive health, independent aging and managing chronic disease like diabetes.
Medicaid is a program that offers medical coverage for individuals with limited means or income. Because states manage their own Medicaid programs and determine the services covered, coverage for adult vision and eye services and treatment vary from state to state. The Affordable Care Act also allows states the option of expanding their Medicaid programs to cover individuals who meet certain income criteria. If adults qualify for coverage under their state’s expanded Medicaid program, they can receive coverage for vision and eye care services as outlined by their state. Medicaid also includes vision services for children up to age 21 as part of the Early Periodic Screening, Diagnostic, and Treatment benefit.
- Prevent Blindness Advocacy: Medicaid programs are vital coverage opportunities for individuals who need vision and eye care services and treatment but also for those who may face chronic diseases that could threaten their vision health. As such, we advocate for policies that protect Medicaid expansion and current funding formulas that make it possible for states to retain comprehensive healthcare coverage, including vision and eye health services and treatment, for vulnerable populations. We encourage states to retain vision and eye health services as an essential component of overall health, economic productivity, independence, and well-being.
- Policy Outlook: The Centers for Medicaid and Medicaid Services, which oversees the federal government’s directive role of the Medicaid program, has allowed states to waive some federal requirements on eligibility, funding, and program design. Recent policy attempts have also proposed changing the federal funding structure from a matching formula to a block grant, per capita program, which could cause states to lose funding and cut program eligibility or eliminate vision and eye care services and treatment to save on costs.
Children’s Health Insurance Program (CHIP)
CHIP provides coverage for children who come from families whose income disqualifies them from receiving Medicaid but may still be too low to access private plans. CHIP is a vital pathway for children to receive treatment for common childhood conditions that affect vision and the eye; without which, could cause permanent vision impairment with impacts to motor, cognitive, and socio-emotional development.
- Prevent Blindness Advocacy: Prevent Blindness successfully advocated for the long-term funding of CHIP, as accomplished in early 2018 with funding extended through 2027. Working with stakeholder organizations, we continue to promote policies that contribute to the long-term viability of CHIP, such as moving it out of the discretionary side of the federal budget.
- Policy Outlook: While CHIP has funding through 2027, Congress has often considered CHIP’s contingency fund (which provides for additional funding to states due to unforeseen circumstances such as unplanned public health emergencies and enrollment inflation) as a means to achieve unrelated federal spending goals by rescinding its funding. Additionally, states have cut vision and eye care services from CHIP as a means to achieve shortfalls in state spending if their CHIP programs face higher than normal spending.
Essential Health Benefits
The Affordable Care Act established a base level of care for patients by requiring insurers offering plans on state-based marketplaces and cover services related to 10 categories of care. These categories, called “essential health benefits,” emphasize prevention and ongoing care management and includes vision and eye health for children and chronic disease management for adults with potentially sight-impacting illness and co-morbid vision impairment.
- Prevent Blindness Advocacy: We continue to promote policies that protect essential health benefits through applicable legislative and regulatory channels. When appropriate, we raise awareness to states of the importance of vision and eye health as a measure of prevention and health.
- Policy Outlook: Consumers facing high costs due to premiums or deductibles can now enroll in short-term limited duration health plans and association health plans, which do not offer essential health benefits, as a means of saving money. Because these plans are designed to be affordable, the coverage may not be comprehensive and may lead to higher costs in the long term if patients face a significant medical situation without adequate coverage.
Vision insurance policies typically cover the cost of eye examinations as well as eyeglasses or contact lenses to correct refractive errors, and can facilitate referral and follow-up specialty care if an eye care provider notices symptoms of serious eye diseases during an eye exam. However, not every working adult has access to employee-sponsored vision insurance or has the option or financial capability to obtain a stand-alone plan.
- Prevent Blindness Advocacy: Prevent Blindness consistently encourages policies that incorporate vision benefits, including regular eye exams and coverage of corrective lenses, into medical plans as a manner of improving the chances that a serious medical eye problem can be caught and treated early. We are currently attentive of insurance reform efforts, such as plan design and utilization management efforts, to ensure that adult and children’s vision and eye health remains a part of the overall health care conversation.
- Policy Outlook: Health and Human Services Secretary Alex Azar has indicated that insurance reform is an essential aspect of his tenure. Policies should strike a balance between consumer empowerment and choice while mitigating over-consumption, and ensuring responsibility to promote access to care falls on all stakeholders in the marketplace.
Telemedicine provides the opportunity to expand access to eye care in communities where it is unlikely that the appropriate and necessary eye care provider(s) will be physically present. Telemedicine is not a substitute for the benefits of an in-person eye examination; however, if executed correctly, programmatic efforts to drive provision of initial screenings via telemedical technology can be a valuable access point for the detection of serious eye diseases and ultimately preventing vision loss.
- Prevent Blindness Advocacy: There is significant promise in telemedicine to create access and break down barriers; however, a strong evidence base must guide these opportunities and that policies do not drive up total cost of care for patients or lead to over-utilization of care.
- Federal Outlook: Numerous approaches to expanding telemedicine in areas such as provider reimbursement and closing gaps in care in the Medicare program, as well as increasing broadband capacity for rural areas, will likely be a major theme in the 116th Congress. As well, prior efforts concerning telehealth access established in the 21st Century Cures Act and Chronic Care Act will continue to build through regulatory and programmatic channels.
April 22: Prevent Blindness joins letter to HHS Secretary Becerra urging rescinding of step therapy for Part B drugs in Medicare Advantage
December 30: Prevent Blindness opposes efforts to reduce Medicaid-covered vision benefits
December 4: Prevent Blindness urges HHS to withdraw harmful SUNSET proposed rule
November 25: Prevent Blindness Opposes Trump Administration’s “Most Favored Nation” Policies
November 2: Prevent Blindness issues comment on CMS “Medicare Coverage of Innovative Technologies” pathway and urges stakeholder input on proposed “reasonable and necessary” definition
November 2: Prevent Blindness responds to Medicare Coverage of Innovative Technologies proposed rule
August 7: Prevent Blindness Statement on Trump Administration’s “Most Favored Nation” Executive Order
February 3: Prevent Blindness Statement on Medicaid Guidance
December 13: House Passes Lower Drug Costs Now Act of 2019
September 5: Prevent Blindness endorses Grassley-Casey legislation to expand telehealth services for chronic eye disease in Medicare
January 25: Letter to CMS Administrator Seema Verma regarding step therapy for Part B drugs in Medicare Advantage plans
December 31: Prevent Blindness to CMS: Part B model proposed rule needs to include clear, specific patient protections relating to access and costs to patients
June 5: Prevent Blindness letter to Congress opposing rescission of CHIP contingency funds
April 23: Prevent Blindness sends letter to CMS opposing Administration’s Short-Term Limited Duration Health Plans Proposed Rule
February 15: Prevent Blindness urges Congress to extend the Children’s Health Insurance Program
November 27: Prevent Blindness Letter to HHS on Essential Health Benefits requirements
October 3: Prevent Blindness letter to House Energy and Commerce Committee members requesting an extension of the Children’s Health Insurance Program
September 25: Statement for the record to the Senate Finance Committee regarding the Graham-Cassidy-Johnson-Heller amendment
September 14: Prevent Blindness Opposes Legislation to Weaken Essential Health Benefits and Protections for Patients with Pre-Existing Conditions
July 25: Prevent Blindness advocates for essential health benefits that includes children’s vision benefits
Vision and eye health is an essential aspect of childhood development. Children need healthy vision and eyesight to learn in school, play, engage with the world around them, and build self-confidence through strong social and emotional connections. Despite its importance to overall health and development, children often face a fractured system of care that leaves them vulnerable to conditions that could lead to permanent vision loss without the appropriate intervention.
Prevent Blindness, through its National Center for Children’s Vision and Eye Health (NCCVEH), is a national leader in practice, policies and partnerships that improve systems of care addressing children’s vision and eye health. Much of the work that the NCCVEH conducts through technical assistance and consensus-based recommendations to promote early detection and address health disparities complements Prevent Blindness’s advocacy efforts. As such, we work to elevate children’s vision and eye health as a natural aspect of childhood development and school readiness and close gaps in access to care.
Improving Early Detection and Intervention
Childhood vision disorders (such as amblyopia or strabismus) are largely treatable if found early; however, they can cause permanent vision loss if left undetected and untreated. Children from low-income and racial or ethnic minority populations often face disparities in care and worse outcomes as compared to their peers. Early intervention techniques like screening, detection, diagnosis, and treatment protocols will contribute to an effective public health and community health infrastructure while lowering health disparities and improving outcomes for children.
- Prevent Blindness Advocacy: Prevent Blindness recommends a continuum of eye care for children that includes both vision screening and comprehensive eye examinations as a complementary approach to children’s vision and eye health. We believe good vision is essential through the life spectrum, and we advocate for policies that ensure all children have clear vision as they begin school and have a strong foundation of vision and eye health for a lifetime.
- Federal Outlook: Funding levels allocated through the annual federal appropriations process for programs at the Centers for Disease Control and Prevention and the Health Resources and Services Administration’s Maternal and Child Health Bureau have not kept up with the need to promote spread of evidence-based best practices to targeted population through vision-related collaboration and integration. With adequate funding levels, states and communities can integrate evidence-based children’s vision health efforts into public health interventions and ensure a multilevel response to preventing vision loss and promoting overall eye health.
School-Based Health Care
School-based health care seeks to ensure that children have direct access to essential health services regardless of race, ethnicity, family status or income, or means of accessing care. School-based health care also helps to eliminate barriers to care, such as transportation or parental time away from work, promotes early intervention in the setting where the children are learning and developing, and promotes age-appropriate intervals of care.
- Prevent Blindness Advocacy: We encourage investments to states and communities for use in developing and implementing programs and fostering collaboration with local partners. School nurses, community health workers, and other trained professionals are indispensable players in a school health care model.
- Federal Outlook: The School-Based Health Centers program through the Health Resources and Services Administration expired in 2014; however, Prevent Blindness has endorsed legislation to reauthorize its funding and advocated that comprehensive eye care be included in the range of services provided to students.
Improving Surveillance Efforts
Public health surveillance, which allows for the monitoring of various conditions that could lead to vision loss and proper allocation of resources toward prevention efforts, is an important aspect of a public health approach to children’s vision and eye health. National surveillance of children’s vision and eye health is a significant public health challenge as there is currently no system in place to track screenings, follow-up eye exams, treatment, or outcomes, thus, making it difficult if not impossible to measure progress, identify and ameliorate inequities, and facilitate coordinated care across systems.
- Prevent Blindness Advocacy: Prevent Blindness has consistently advocated for increased funding to the CDC for public health surveillance, including children’s vision disorders. More work is necessary to understand and address the developing needs of children’s visual development within the 0-3-year-old age range, particularly as deficits to visual health and neurodevelopment are a consequence of maternal smoking, opioid use, and other substance use during pregnancy and due to contracting the Zika virus. As part of these efforts, we continue to endorse funding for programs that ensure long-term public health surveillance for mothers and babies through various federal-level appropriations efforts, including the Vision Health Initiative at the CDC and others.
- Federal Outlook: Public health has been chronically underfunded, which leaves states and communities to deal with long-term and unforeseen circumstances in their populations that were possibly avoidable with the right investments.
Referral and Follow-Up Care for Children
Medicaid and the Children’s Health Insurance Program (CHIP) are required to provide enrollees with an Early and Periodic Screening Diagnosis and Treatment (EPSDT) benefit, which includes screening, diagnosis, and treatment for children at early and appropriate intervals of care. However, a 2010 report from the Office of the Inspector General at the Department of Health and Human Services found that children are not receiving all required EPSDT screenings.
- Prevent Blindness Advocacy: We continue to advocate that vision and eye health for children is an essential aspect of healthy development, and encourage policies such as provider reimbursement and accountability measures to increase the percentage of children who receive vision and eye care.
- Federal Outlook: Informing lawmakers that these gaps in access exist and impede children from receiving a benefit granted by law can ensure appropriate oversight measures. Such measures include requiring states to report vision screening results and the completion of a referral to eye care for those who do not pass a vision screening as recommended by a 2014 follow-up to HHS OIG report.
State mandates and guidelines for addressing children’s vision and eye health vary widely, as there is no nationally standardized approach to address children’s vision and eye health. Children enrolled in Head Start and Early Head Start programs are required to have a record of a vision screening completed within 45 days of entry to the program—the only federal mandate. Requirements for children’s vision and eye health programs are determined at the state or even school district level for children entering preschool or school, resulting in wide disparities in eye health.
- Prevent Blindness Advocacy: Our NCCVEH provides technical assistance, including legislative development, to states seeking to make improvements to their children’s vision and eye health approaches. Prevent Blindness advocates that state program and policy decision makers create multiple points of entry to the system of services that affect children’s vision and eye health and create actions that strengthen screening protocols and require evidence-based methods, improve access to diagnostic exams and treatment, and strengthen capacity for surveillance and performance measurement. This will contribute to the development and support of a comprehensive approach.
- Federal Outlook: Early detection and intervention for vision disorders in children are part of national goals and health care standards, such as the Healthy People 2020 objective to increase the number of children screened and the U.S. Preventive Services Task Force’s recommendation that children ages 3 to 5 years should have a vision screening.
Fact Sheets and Information
Consensus Statement on a Systems-Based Approach to Children’s Vision and Eye Health
Prevent Blindness Statement on School-Aged Vision Screening
CDC National Center for Health Statistics Brief: Vision Testing Among Children Aged 3-5 Years in the United States, 2016 – 2017
State Vision Screening Requirements
2019 State Fact Sheets on Children’s Vision
Prevent Blindness Advocacy Updates
Prevent Blindness is a proud member of First Focus’s Children’s Budget Coalition to promote policies that invest in children. For additional updates, including our coalition activities, please see our Letters and Statements library.
March 10, 2021, Prevent Blindness Letter re House E&C Committee Hearing – Kids Online During COVID
As we age, our eyes undergo many changes that can affect their function and our ability to see clearly. Vision diseases can further affect these changes in visual function without early identification and effective, timely treatment. While loss of sight is a natural aspect of aging and can be distressing and life altering, poor vision does not have to be an inevitable part of aging. Early detection and treatment can help slow the progression of vision loss and ensure that aging adults can age independently with good vision. In addition, community approaches to address vision loss in older adults can help mitigate the consequences of vision loss, including chronic disease management, social isolation and depression, risk of injury or death due to falls, and protecting cognitive health.
Prevent Blindness is actively engaged in advocacy efforts that seek to improve policies that address role of vision and eye health in aging programs and interventions. We work toward approaches that seek to bring vision and eye care where older adults need it most: in their communities, homes, and daily lives.
Fact Sheets and Updates
Global Coalition on Aging: A Life Course of Healthy Vision: A Critical Priority for the 21st Century
Prevent Blindness Advocacy Updates
July 1: Prevent Blindness issues recommendations on reauthorization of the Older Americans Act
June 26: Prevent Blindness asks Senate Aging Committee integrate vision and eye health into elderly falls prevention strategies and policies
For additional updates on our advocacy work on behalf of older adults, check out our coalition activity in our Letters and Statements library.
Vision and eye health is a critical aspect of daily living for people of all ages, racial and ethnic backgrounds, and socio-economic circumstances. Attention to vision and eye health is critical at all stages in life: from early in life as a part of healthy childhood development, for those in their working years seeking to make a productive living, and for older adults as they seek to maintain independence and a high quality of life through the aging process.
Prevention and early detection is a key strategy in preventing avoidable vision loss. Thus, a health strategy that emphasizes early detection, prevention, intervention, integration, and health promotion is especially critical to prevent some of the potentially devastating impacts of vision loss both personally and economically. By adapting a population and public health approach to vision and eye health across the age spectrum, Prevent Blindness seeks to aim federal policy efforts toward achieving a reversal in the national prevalence of vision problems, saving both sight and dollars for federal and state governments as well as individuals and private institutions.
Public Health Integration
By integrating evidence-based vision and eye health education into programs and other initiatives aimed at addressing other health issues that commonly co-exist with vision and eye health issues (such as diabetes, hypertension, smoking, falls prevention, early childhood development, learning readiness, mental health, and others), we can improve community health and wellness response and connect citizens to needed care, community support programs, and vision-specific services. Per the recommendations of the National Academies of Science, Engineering, and Medicine (NASEM), public health agencies and departments should strive to improve community health and wellness by coordinating responses that address multiple determinants of health and chronic disease, including vision impairment and eye disease, and strive to connect citizens to needed care, community support programs, services specific to vision.
- Prevent Blindness Advocacy: Working in tandem with organizations from the Vision 2020 USA coalition, we requested the U.S. Surgeon General issue a “Call to Action” pertaining to vision and eye health, which is the first recommendation of the NASEM report.
- Federal Outlook: Increased attention to the personal and economic toll of chronic disease and lack of access to care provides an opportunity to elevate vision and eye health as a natural aspect of overall health and well-being, with cost-saving potential to both individuals and the national health care system.
Disease Prevention and Health Promotion
Increasing awareness of the link between vision loss and other unhealthy behaviors, such as smoking or lack of proper eye protection from UV light, can encourage those at high risk to receive eye care and educate patients about the various risks associated with these modifiable behaviors or diseases.
- Prevent Blindness Advocacy: Nearly 75% of vision impairment are preventable with the right interventions. However, funding that supports disease prevention efforts has not kept up with the need. We advocate for stronger funding levels for public health disease prevention efforts, and encourage funding for programs that develop public messaging linking vision loss and modifiable risk factors as well as factors, such as family history or genetics, that are unmodifiable to ensure patients understand the links between overall health and vision.
- Federal Outlook: Public health programs have been chronically underfunded, and the need for stronger investments is championed by numerous organizations. For more information on our work to improve public health investments, visit Improving Vision and Eye Health at the CDC or check out our coalition activity through our Letters and Statements.
Public health screening is an efficient and cost-effective way to address vision and eye health at a population level. Implementing public health vision and eye health screening programs using methods that are proven to detect vision problems and eye diseases, including teleretinal imaging screening programs for individuals with diabetes in community settings such as pharmacies, senior centers, community health centers, and others create access points for care and promote early detection in high risk and underserved populations.
- Prevent Blindness Advocacy: We advocate for strong, consistent funding for programs that develop uniform practices for community screening programs and promote community-screening approaches as a cost-effective opportunity to detect and prevent disease and promote health and wellness. In addition, we reinforce the need for continued research into the effectiveness of public health community screening programs and encourage evidence-based guidelines to direct policy efforts toward reaching high-risk patients through community eye and vision care programs.
- Federal Outlook: Federally-coordinated community screening programs are piecemeal with supplemental and block grant funding used to provide for services through a variety of programs, including community health centers, FQHCs, and others at state and local levels. Research efforts to promote effective community screening best practices and build a framework for continuity of care remain active but continue to be subject to Presidential and Congressional scrutiny through the budget and appropriations process.
Surveillance, which allows for the monitoring of various conditions that could lead to vision loss and proper allocation of resources toward prevention efforts, is an important aspect of a public health screening approach. Utilizing appropriate data collection methods and instruments can contribute to efficient information collection necessary for interventions and appropriate resource allocation. Additionally, by utilizing community settings, screenings can help to track and address some of the obstacles to care (including transportation, childcare, time off work, and cost) that are not alleviated by the singular effort of ensuring an adequate number of providers are available in locations that are more convenient.
- Prevent Blindness Advocacy: We continue to champion the efforts of the Centers for Disease Control’s Vision Health Initiative in annual federal appropriations, and reinforce the need to include vision-related measures that assess vision loss, utilization of eye care, and disparities and include vision screening, eye exam, and outcomes data in state and national integrated health information systems, particularly for children.
- Federal Outlook: Funding levels of at least $5 million are necessary to achieve long-term policy goals related to surveillance. For additional information, please see Improving Vision and Eye Health at the CDC.
A national vision and eye health surveillance system, such as the Vision and Eye Health Surveillance System, which incorporates data from multiple sources contributes to a national overview of the burden of vision impairment and eye disease. This data provides scope and depth needed to determine the burden and need across a number of social, economic, racial, age, and gender groups. Ultimately, this allows for the interdisciplinary use of information to create targeted approaches for the public and allows the vision and eye health community to be more responsive to the shifting eye health needs.
- Prevent Blindness Advocacy: In addition to our advocacy efforts to improve federal resource allocations to the CDC for vision and eye health surveillance, we advocate for comprehensive data collection efforts to improve intervention programs.
- Federal Outlook: Without sustained and prolonged investments to the CDC’s Vision Health Initiative, the data collected and used to build the Vision and Eye Health Surveillance System will become increasingly outdated and patched together using the best data available that is not necessarily recent or comprehensive. For additional information, please see Improving Vision and Eye Health at the CDC.
Fact Sheets and Information
Building Public Health Capacity to Enhance Vision and Eye Health_FINAL 508 Compliant (01.07.20)
National Academies of Sciences, Engineering, and Medicine: Making Eye Health a Population Imperative: Vision for the Future (2016)
Prevent Blindness Advocacy Updates
June 7: Prevent Blindness response to National Eye Institute’s Draft Strategic Plan
June 26: Prevent Blindness urges Senate HELP Committee to prioritize vision and eye health in COVID-19 and future pandemic response strategies
January 23: Prevent Blindness urges the CDC’s Community Services Preventive Task Force to prioritize vision and eye health in its 5-year objectives
December 20: Letter to Secretary Azar in response to Prevention X initiative
For people who have low vision, particularly those who are visually impaired or blind, policies must align to ensure that they can live safely, fully, and independently. People with low vision experience a range of greater needs than individuals who have healthy vision or less debilitating vision impairment. People with low vision must have access to the tools and services they require to meet their unique needs.
Prevent Blindness continues to advocate for policies that ensure individuals who live with low vision can maintain full, engaging, and productive lives and have access to the services they need to adapt to the world around them.
Medicare and Low Vision
Medicare coverage for devices “with a lens” and examinations to detect, diagnose, and treat low vision conditions and reimburse providers who do so (including certified providers to help those who must adjust to a new lifestyle with low vision) is prohibited. Additionally, only specific professionals can legally bill Medicare for rehabilitative services related to use of low vision devices and adaptation to a low vision lifestyle.
- Prevent Blindness Advocacy: Prevent Blindness advocates to include low vision devices and services in Medicare plans. In so doing, we believe individuals who would benefit from use of these devices would experience improved function and quality of life. We also advocate for policies that adequately reimburse low vision professionals and rehabilitation specialists for services they provide to individuals who are blind, have recently lost their vision, or live with low vision. We encourage Congress to legislate coverage for low vision devices under Medicare.
- Federal Outlook: While several policies are pending in Congress to enhance the role of vision in the Medicare program, the path forward on any one policy is unclear. For more information about Medicare, please visit Access and Coverage.
Fact Sheets and Information
Living Well with Low Vision Resource
Prevent Blindness Advocacy Updates
June 2020: Coalition Position Statement on Medicare Coverage of Low Vision Devices and Assistive Technologies