Finding affordable vision care is a prominent concern and challenge for many people in the United States. Approximately 12 million Americans aged 40 or older have vision impairment, and about 8 million have impairments resulting from uncorrected refractive errors.  

According to data from the same Centers for Disease Control (CDC) information referenced above, many U.S. adults avoid seeking vision care because they are worried about cost or unaware of all their options. Prices for eye care have increased by 99% percent over the past 40 years, and vision insurance plans often provide very limited coverage for medical eye care costs.   

While eye care can seem prohibitively expensive, untreated vision impairments can significantly compromise your quality of life and productivity, and may cost you more over time. Fortunately, there are a variety of ways to access vision care besides private insurance, and several steps you can take to reduce your risk of eye problems. 

Common eye diseases and disorders

There are a variety of prevalent eye problems that can lead to vision impairment and loss. In many cases, outcomes for these conditions can be significantly improved by early diagnosis and treatment by an eye doctor. Learning to recognize the signs and symptoms of eye problems can help you ensure that you get the right care and minimize your risk of long-term complications. 

Refractive errors

Refractive errors occur when the eye is unable to focus light onto the retina. They are the most common type of vision problem in America, affecting more than 150 million people. The most common symptoms of refractive errors are double vision, blurred vision, squinting, headaches, and seeing a glare or “halo” around bright lights. However, there are four main types of refractive errors that can each affect eyesight differently: 

• Astigmatism: A condition in which the cornea or the lens is misshapen, causing light to bend differently as it enters the eye. 
• Myopia (nearsightedness): A refractive error in which distant objects appear blurry, but nearby objects are clearly seen. 
• Hyperopia: A refractive error in which nearby objects appear blurry, but distant objects are clearly seen.
• Presbyopia: A condition in which the lens hardens and gradually loses its ability to focus light. Presbyopia is closely associated with aging and usually occurs in people over 45.  

With the exception of Presbyopia, most types of refractive errors begin during childhood. Individuals with a family history of low vision are at greater risk for refractive errors. Treatment for refractive errors usually involves corrective lenses like glasses or contacts, although some types can be treated with surgery. 

Age-related macular degeneration

Age-related macular degeneration (AMD) is a common vision concern for older adults. It occurs when the macula — the part of the retina that controls central vision — becomes damaged due to aging. Individuals with AMD have difficulty seeing objects that are directly in front of them and may struggle with activities such as reading and driving. There are two primary types of AMD: 

• Dry AMD: The most common type of AMD. This occurs when the macula gradually becomes thinner with age. Progression from early to late-stage dry AMD usually takes several years. While there is no way to reverse dry AMD, taking proper care of your eyes can help you prevent it from getting worse.  
• Wet AMD: Also called advanced neovascular AMD, wet AMD is caused by abnormal blood vessels growing in the back of the eye and damaging the macula. While less common, it can cause faster vision loss than dry AMD. Treatment of wet AMD often involves the use of anti-VEGF (Anti–vascular endothelial growth)  drugs, which can help prevent the growth of new blood vessels in the eye. 

The most notable risk factors for AMD are high blood pressure, smoking, being overweight, eating a high-fat diet, and having a history of macular degeneration in the family. You can reduce your risk by getting regular exercise and eating a healthy diet that includes leafy greens and fish. 

Cataracts

Cataracts are cloudy spots that appear in the lens of the eye. They usually form due to aging, as a result of proteins in the lens breaking down and clumping together over time. However, they can also be caused by exposure to radiation, or by injuries that damage the lens fibers. In some cases, cataracts can occur in children, although this is rare, and is usually a result of family genetics.  

The common symptoms of cataracts include blurry vision, double vision, sensitivity to light, difficulty seeing at night, and frequent changes in corrective lens prescriptions. The risk of cataracts generally rises with age, but factors like family history, smoking, alcohol abuse, injuries, excessive exposure to sunlight, diabetes, and steroids can increase it further.  

Early treatment for cataracts usually involves new corrective lens prescriptions that can help you see more clearly. However, doctors will often recommend surgery if cataracts begin to interfere with everyday activities such as reading and driving. You can help reduce your risk of cataracts by avoiding smoking, maintaining a healthy diet, and protecting your eyes from injury and sunlight. 

Diabetic Retinopathy

Diabetic retinopathy is a condition caused by damage to the blood vessels in the retina. It occurs as a result of high blood sugar from diabetes. Over time, this excess sugar in the blood can clog the small vessels that flow to the retina, depriving it of vital nutrients. The eye will try to correct this by growing new blood vessels to replace the blocked ones, but these can leak and bleed easily, leading to further issues.  

Early-stage diabetic retinopathy often has no symptoms. However, as the condition progresses and blood vessels begin to leak, it can cause dark spots or streaks to appear in the eye. If left untreated, diabetic retinopathy can lead to other serious eye issues like diabetic macular edema, neovascular glaucoma, and retinal detachment, which can cause vision loss and blindness.  

Individuals with all types of diabetes are at risk for diabetic retinopathy. This risk gradually increases the longer you have diabetes. More than half of all people with diabetes will develop diabetic retinopathy at some point, but you can lower your risk by avoiding smoking and keeping your diabetes under control.  

To treat diabetic retinopathy, doctors will often administer anti-VEGF drugs or use laser treatments to reduce swelling in the retina. In patients with more severe scarring and bleeding, doctors may recommend a surgical procedure called a vitrectomy to remove vitreous fluid from the eye.

Glaucoma

Glaucoma is a group of eye diseases that cause damage to the optic nerve, which is the nerve responsible for carrying signals from the retina to the brain. There are many varieties of glaucoma, but the most common type is called open-angle glaucoma, which accounts for 90% of all glaucoma cases in America. It is unclear exactly what causes glaucoma, but research has shown that high eye pressure can increase your risk.  

In its early stages, glaucoma may not have any noticeable symptoms, which can make it difficult to identify. If it’s allowed to progress, glaucoma can cause gradual vision loss over time, with peripheral vision often being affected first. Eventually, untreated glaucoma can lead to blindness.  

While nerve damage from glaucoma cannot be repaired, doctors can use medications, laser treatments, and surgery to reduce pressure in the eye. This can help alleviate symptoms and slow the development of the disease. 

Amblyopia

Amblyopia, also called lazy eye, is a condition that affects the nerve signals between the brain and the eyes. It usually only occurs in one eye, although it can affect both eyes in some cases. Amblyopia develops during childhood and is the most common cause of vision loss among kids.  

The exact root causes of amblyopia are not known, but other vision problems like refractive errors can increase the risk of this condition. Signs of amblyopia in children include symptoms like poor depth perception and behaviors like shutting one eye or tilting the head to see, although it sometimes can be difficult for parents to identify amblyopia without the help of a doctor. 

Risk factors for amblyopia include premature birth, low birth weight, developmental disabilities, and a history of the condition in the family. Treatment for amblyopia usually involves the application of eye patches or medicated drops that obscure the vision in the child’s “good eye.” This forces the brain to utilize the weaker eye, which can help it become stronger over time. 

Strabismus

Strabismus is a condition in which both eyes are unable to look in the same direction at the same time. The most prevalent type of strabismus is commonly known as “crossed eyes.” Strabismus is a common problem in children, and is present at or shortly after birth in more than half of all cases, although it can also develop in adults as a result of injury or disease.  

The main indicator of strabismus is eyes that appear to look in different directions. Children with strabismus may also be frequently seen shutting one eye or tilting their heads to see more clearly. Strabismus is usually treated with corrective lenses or surgery on the eye muscles, although patching or blurring drops may be used if one misaligned eye is significantly weaker than the other. 

Preventing vision loss

While vision loss is irreversible in many cases, it is also very avoidable. Additionally, identifying eye problems early can help you stop them from progressing and ensure the best possible long-term outcome. Taking the following steps can help you prevent vision loss from a variety of different causes. 

Get regular eye exams

Many types of eye diseases have no symptoms in their early stages and can go unnoticed for a long time, allowing them to progress unchecked. By visiting an ophthalmologist who is trained to identify these issues for regular eye exams, you can get any problems you may have diagnosed and receive proper treatment much earlier.  

Early detection and treatment can help prevent vision loss from conditions like cataracts, glaucoma, AMD, and diabetic retinopathy. In addition to regular preventive checkups, it’s also important to stay vigilant for any symptoms and visit an eye doctor if you believe it’s necessary, as this can help minimize the risk of permanent damage and improve the effectiveness of vision loss prevention treatment. 

Maintain blood sugar levels

Over time, high blood sugar levels can damage the blood vessels in the eye and alter the shape of the lens. For diabetics, this can increase the risk of a variety of serious issues that may lead to vision loss or blindness, including diabetic retinopathy and diabetic macular edema.  

People with diabetes are also about twice as likely to develop common eye problems such as cataracts and glaucoma. Along with getting your eyes checked regularly, keeping your blood sugar and cholesterol under control can help prevent diabetes-related eye problems.  

Know your family history

Family history is a major risk factor for many common eye problems, including refractive errors, cataracts, glaucoma, macular degeneration, and amblyopia. By knowing your family history, and sharing this information with your ophthalmologist, you can gain a more complete understanding of your own vision risks and develop an effective prevention strategy that suits your unique needs. 

Maintain a healthy diet

Nutrition is critical for supporting healthy vision. Eating a poor diet can cause or contribute to many different eye problems. Fortunately, there are a variety of foods that can benefit eye health: 

• Vitamin A: Critical for preventing dry eye and supporting retinal function. Vitamin A can be found in foods like carrots, tomatoes, sweet potatoes, leafy greens, milk, and eggs.  
• Vitamin C: Helps protect the eyes from environmental damage and promotes new tissue growth. Vitamin C can be found in foods like bell peppers, broccoli, strawberries, and citrus fruits. 
• Lutein and Zeaxanthin: Antioxidants that are critical for protecting the macula. They are found in kale, spinach, collard greens, lettuce, turnips, broccoli, peas, and eggs.  
• Zinc: A mineral that can support retinal health and help strengthen the eyes against damage from light. Zinc can be found in kidney beans, lima beans, black-eyed peas, lean red meat, poultry, oysters, and fortified cereals. 

By maintaining a healthy diet that incorporates these items, you can ensure that your eyes get the oxygen and nutrition that they need. This can help promote good vision and lower your risk of eye diseases. 

Avoid smoking

Just as it can harm other areas of your body, smoking can do significant damage to your eyes. Individuals who smoke are twice as likely to develop age-related macular degeneration, and two to three times more likely to develop cataracts. While quitting smoking is the best way to protect your eyes, getting regular exercise, eating a healthy diet, and protecting your eyes from the sun can also help mitigate this risk. 

Protective eyewear

Eye damage from traumatic injuries or light exposure can increase the risk of several serious issues such as cataracts and strabismus, and eyeglasses alone cannot provide adequate protection. Using protective eyewear when playing sports or performing hazardous work can help prevent these injuries and any complications they may cause.  

The optimal eye protection for you can vary depending on the situation. When performing manual labor at work or around the house, you should always use safety glasses that meet the ANSI (American National Standards Institute) standards for eye and face protection devices. Looking for products with the label “ANSI Z87.1” can help you ensure that your eye protection meets these standards. 

Get plenty of rest

Sleep deprivation is a common problem that can negatively impact your eyes in several ways. Studies have shown that poor sleep can affect stem cells in the cornea and the tear film on the cornea’s surface. Over time, this can compromise the cornea’s ability to repair itself, which can lead to issues like dry eyes and hyperemia.

You can help prevent this by maintaining a healthy sleep schedule, which will vary depending on your age. For adults, experts recommend getting at least seven hours of sleep per night, while children aged 13-18 should get 8-10 hours.  

Younger children should generally get even more sleep; about 9-12 hours per day between ages 6 and 12, 10-13 hours per day between ages 3 and 5, and 11-14 hours per day between ages 1 and 2. Eyedrops with antioxidants can also help provide relief from the symptoms associated with sleep deprivation. 

Vision care assistance for people with fixed or low incomes

Many people with vision problems may be reluctant to seek medical attention due to the perceived cost of care. This issue is exacerbated by the fact that many vision insurance plans offer very limited coverage. Fortunately, there are a variety of eye care resources available for people with fixed or low incomes: 

• Lions Club International: Lions club international has a history of working to make vision care more accessible and affordable for people in underserved communities. Their scope of work includes delivering eye care services to these communities, training for eye care professionals, funding eye care infrastructure upgrades, informing the public about the importance of eye health, and improving access to education for people with vision loss and visual impairments. 
• Mission Cataract USA: Mission Cataract is an organization devoted to eradicating preventable blindness caused by cataracts. The program is made up of six surgeons who provide free cataract screening and surgery to patients who have no insurance and no other way to pay. 
• New Eyes for the Needy: New Eyes for the Needy is a non-profit organization operated by the united way that provides free prescription glasses to children and adults who cannot otherwise afford them. 
• VSP Eyes of Hope: VSP Eyes of Hope is a program that provides free vision care and eyewear to people affected by economic inequality and natural disasters. They operate by distributing certificates for free eye care to patients through their network of charitable partners, which include the National Association of School Nurses (NASN), the American Red Cross, and Lions Club International.  
• Eye Love Care: A program that offers no-cost prescription eyeglasses to people with fixed and low incomes. 
• American Glaucoma Society: An organization of healthcare professionals devoted to providing glaucoma care, and conducting research, education, and patient advocacy. In addition to connecting patients with care providers, the AGS works to improve our understanding of glaucoma and promote glaucoma awareness among policymakers and the general public.  

Living with an untreated vision problem can be very difficult. By utilizing one or more of these programs to access more affordable vision care, you can improve your quality of life without your finances at risk. 

Assistance for accessing medication

Medication is a major cost associated with healthcare. Because many vision insurance plans offer limited coverage for most types of eye care, patients may have difficulty paying for the medication they need. These programs can help patients with low or fixed incomes access more affordable medication for their eyes: 

• NeedyMeds: NeedyMeds is an organization that offers coupons, discount cards, and a variety of informational resources designed to help patients find affordable prescription medications, including price calculators, clinic locators, and links to additional assistance programs. 

• Partnership for Prescription Assistance: The Partnership for Prescription Assistance (PPA) is a service that helps connect uninsured and underinsured patients with resources for free and discounted medications. Patients can learn more about the programs available to them by filling out a form with information about their income and the type(s) of medication they’re looking for. 

• ScriptHero: A free online resource that helps patients to find new coupons for prescription medicines and allows them to compare prices from many different pharmacies. 

Resources for children

Many types of vision problems begin developing in early childhood, and it’s very important to identify and address them early. The following resources are intended to help children and infants access quality eye care:

• InfantSee: InfantSee is a public health program affiliated with the American Optometry Association (AOA). It provides comprehensive eye and vision assessments for infants aged 6-12 months at no cost to the family. 

• Sight for Kids: Sight for Kids is a program operated by Lions Clubs International and Johnson & Johnson Vision. It provides comprehensive vision services to students at low-income schools around the world, including specialized eye care for children with special needs. 
• Medicaid early screening, diagnostic, and treatment: While Medicaid’s coverage of vision care is limited, it does cover the diagnosis and treatments of some common vision problems for children. It’s important to research your state’s Medicaid rules to determine what degree of coverage you can receive.  

While it can sometimes be difficult to identify vision problems in young children, diagnosing and treating these issues sooner can help ensure better long-term outcomes, and potentially eliminate the need for more expensive care later on in life. 

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