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Vision
Loss in Canada: Q&A Document
How many Canadians are affected by blindness or vision loss?
Statistics Canada, in its report entitled A Profile of Disability in
Canada 2001, identified 610,950 Canadians with a seeing disability
(defined as “difficulty seeing ordinary newsprint or clearly seeing
the face of someone from four metres”).
However, that was three years ago. There are likely hundreds of
thousands more when you consider that the chances of developing an
irreversible, serious loss of vision are one in nine by age 65 – and
this figure jumps to one in four by age 75.
How does this compare with figures worldwide?
The World Health Organization (WHO) estimates that there are currently
44 million people in the world who are blind and an estimated 180
million who are visually impaired. So rampant is vision loss, the WHO
states, that one person in the world loses his or her sight every five
seconds, and a child loses his or her sight every minute.
Who is at risk?
While there are several factors related to vision loss, such as
lifestyle, diet, smoking, and family history, seniors are the group
most at risk in Canada. The country is experiencing an unprecedented
rise in the incidence of age-related blindness, led by age-related
macular degeneration (AMD), with the incidence of eye diseases such as
glaucoma and diabetic retinopathy also soaring.
How does vision loss affect a person’s quality of life?
Those who are losing or have lost their vision speak of their loss of
independence as they can no longer drive, read, or see the faces of
those around them. People who are blind or visually impaired often
must rely on help from their families, friends, and health-care
professionals to carry out daily activities such as shopping,
cleaning, or paying bills.
Canadians who are visually impaired are also frustrated at the lack of
information available in alternative formats such as electronic copy,
large print, or braille. Just three per cent of printed material is
available in alternative format, making access to information
extremely difficult.
What is the leading cause of blindness in Canada?
Age-related macular degeneration (AMD) is Canada’s leading cause of
blindness, with 78,000 new cases diagnosed in 2003. And that figure is
expected to triple over the next 25 years.
What is the difference between macular degeneration, glaucoma,
diabetic retinopathy, and cataracts?
Age-related) Macular Degeneration (AMD) – AMD causes the deterioration
of the macula, which is located in the centre of the retina, resulting
in a gradual or sudden loss of central vision. There are two types of
AMD: the dry and wet forms. The most common is the dry form, which is
associated with the appearance of small deposits called “drusen” on
the macula.
Wet AMD is characterized by the formation of abnormal blood vessels.
These vessels leak fluid and cause scar tissue to form on the macula.
Although wet AMD only accounts for approximately 15 per cent of all
cases, it is responsible for 90 per cent of severe vision loss
associated with the disease. Wet AMD develops rapidly, and the
majority of patients can lose their central vision within a few weeks
to a few months of being diagnosed.
Glaucoma – Glaucoma is caused by increased pressure within the eye.
One of the most common causes of blindness, it affects one in 100
Canadians over age 40. Although it often occurs in older people, it
can develop at any age. People with glaucoma probably lose their sight
because increased pressure in the eye as well as other factors, such
as poor blood flow, affect the optic nerve at the back of the eye. The
eye slowly loses nerve function and side (peripheral) vision. This
occurs painlessly, even unnoticeably.
Diabetic Retinopathy – This is a change in the tiny blood vessels that
feed the retina. In the early stages, the blood vessels weaken and
leak fluid or tiny amounts of blood. This causes swelling of the
retina. This is called “non-proliferative” or “background”
retinopathy. At this stage, vision may be normal, or it may be blurred
or changed. About one in four people with diabetes has some non-proliferative
retinopathy.
Cataracts – A cataract is a clouding of the lens of the eye, which is
located near the front of the eye. The lens focuses light on the
retina, at the back of the eye, to form the images we see. A cataract
may affect just a small part of the lens, or it may cloud the entire
lens.
Why is vision loss soaring among Aboriginal People?
A rise in diabetes leading to diabetic retinopathy is at the root of
increased vision loss among Canadian Aboriginal people. Because of
poor diet, Aboriginals are developing diabetes earlier in life,
allowing more time for complications (such as blindness) to develop.
What is the purpose of The Cost of Blindness: What it means to
Canadians?
Top Canadian and international researchers, health-care providers,
insurers, advocacy groups, and health policy makers are gathering to
discuss the financial and social impacts connected to blindness and
vision loss.
The goal of the CNIB and Canada’s leading vision-care partners is to
establish a body of research that clearly identifies the prevalence of
blindness and vision loss in Canada and what measures can be taken to
reduce these financial and social strains.
A related conference was held in 1998 – the National Consultation on
the Crisis in Vision Loss. Although the conference resulted in the
creation of the National Coalition for Vision Health, little progress
actually occurred. Why do you expect a different outcome with the Cost
of Blindness?
The Consultation on the Crisis in Vision Loss, held in Toronto in
1998, predicted a looming crisis as the number of people who are blind
or visually impaired increased and the number of ophthalmologists
declined on a per capita basis. In the past six years, that prediction
has become a reality, and both waiting lists and concern have grown.
What outcomes would the CNIB and its partners like to see as a result
of the Cost of Blindness conference?
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Positioning of vision loss on the federal and provincial health-care
agendas
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Creation of awareness and demand for change among the public
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Determination of the cost/benefit implications of health,
rehabilitation, and research programs
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Change in social policy, specifically providing access to both
vision rehabilitation and reimbursement for treatment for age-related
blindness
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Establishment of a coordinated, nationwide research effort to
further investigate cost of blindness issues related to health care,
quality of life, and rehabilitation services
If the situation is as serious as you say it is, why are the different
levels of government doing so little?
We do not believe that governments have data on the cost of blindness
and on how a more proactive approach to research, prevention, and
rehabilitation might, in fact, reduce costs. Health departments at
every level of government need to establish branches responsible for
vision loss issues.
Why do Canadians have to wait up to 28 weeks to see an
ophthalmologist, and another 16 weeks to see an eye surgeon, even with
a referral from their GP?
It’s the result of the combination of a shortage of ophthalmologists,
government cutbacks, and the rate of retirement. For example,
government cutbacks are responsible for Canadian programs producing
only 20 ophthalmologists per year as compared with 40 a year in the
1980s. Meanwhile, the Canadian Medical Association reported over
one-third of practising ophthalmologists are over 55. And the demand
for ophthalmological services is predicted to jump 44% between 1997
and 2016.
How does vision loss contribute to higher costs in other health-care
fields?
Dr. Hugh Taylor, the director of the Centre of Eye Research in
Australia, concluded from his study that with vision loss, the
difficulty with daily living doubles, the risk of falls doubles, the
risk of depression triples, and the risk of hip fractures quadruples.
Though there are no specific figures available in Canada, the medical
costs related to treating these injuries and conditions are
substantial.
Where does funding for eye research in Canada come from?
Primarily from two federal agencies – The Canadian Institute of Health
Research (CIHR) and the Natural Sciences and Engineering Research
Council (NSERC). The Canadian Research Chair program (CRC) is
currently funding about 15 professorships in vision health–related
areas. Also involved in research on a smaller scale are the Quebec
Vision Health Research Network, the E.A. Baker Foundation for the
Prevention of Blindness (the research arm of the CNIB), the Foundation
Fighting Blindness (Canada), and the Glaucoma Research Society.
Isn’t that a lot of research dollars for eye research?
When you add up the budgets of all of these Canadian organizations,
the total amount is C$28 million a year. And this is double what was
spent in 1999. Compare this to The National Eye Institute of America
(and two major private research groups) that spent approximately
US$660 million (C$839 million) on blindness research in 2003.
How much does blindness cost in Canada?
There are no definitive figures, but the estimated annual cost of
blindness in Canada is C$1 billion annually. However, soaring
associated medical, rehabilitation, and social costs will have a
dramatic impact on the Canadian economy if nothing is done to address
blindness and vision loss.
How much could Canadians save on future health costs if we invested in
blindness prevention programs?
The potential future health savings through investing in blindness
prevention, new treatments, and early intervention have not been fully
documented but are likely substantial.
What support groups exist to help Canadians who are blind or visually
impaired?
The Canadian National Institute for the Blind
www.cnib.ca
The National Coalition for Vision Health
www.visionhealth.ca
The Foundation Fighting Blindness www.ffb.ca
AMD Alliance International www.amdalliance.org
What kinds of vision aids are available for Canadians who are blind or
visually impaired?
The CNIB offers a collection of devices in what can be divided into
two groups: low-tech and high-tech. Low-tech refers to devices such as
magnifiers, needle threaders, large print telephones, and calculators.
High-tech devices include computer or computer-related equipment, such
as talking books on CD, screen-reading software, braille displays, and
braille translation software. For more information, visit
www.cnib.ca/tech_aids/.
CONTACT:
Ellen Woodger, E Publicity (416) 483-2358
ellen.woodger@sympatico.ca
Sean McNeely, CNIB (416) 480-7021
sean.mcneely@cnib.ca
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