Guest Editor's Page

Abstract

There are about 4 million older people in the United States who are blind or have severe vision impairment. This population is expected to double over the next 35 years to exceed 10 million. Among people who are older and have vision loss, there are some things we know very well: visual impairment is associated with age and, therefore, it is more prevalent in the oldest age groups. Vison impairment is more likely to affect women, racial or ethnic minorities, people who are poor, and people who have less education. Older people with vision loss report poorer health-related quality of life, they are more likely to report chronic conditions than their peers who are not visually impaired, they are more likely to fall and have injuries related to those falls, and older people with vision impairments have higher rates of mortality. Given the magnitude and complexity of the problem, this population is poorly served. People with vision loss have less access to eye care, medical care, and oral health care. Significant gaps remain in access to rehabilitation services, and the rehabilitation system remains fragmented; is poorly funded, with little third-party funding; has few standards of practice, few outcome measures; and is not linked to vision and eye care providers in a systematic way. If the past is a prologue, then the coming decades will see these disparities magnified, with hundreds of thousands or millions of older people without the ability to obtain quality vision rehabilitation services, good health, and high quality of life. Given the problems we can identify, all of them can be solved or greatly ameliorated with the knowledge we have. Although difficult to manage, these problems are not intractable. The field of vision rehabilitation has lamented for decades the fragmentation in service delivery and funding, and the apparent inability to compete with other disciplines. At the same time, others have anticipated the surging population of older people that is now driven by the first wave of aging baby boomers. What can be done? This Special Issue on Aging and Vision of the Journal of Visual Impairment & Blindness (JVIB) demonstrates the continuing commitment of leaders in vision rehabilitation to make a difference in the lives of older people with visual impairments. These examples are instructive and promising. Farrow and Steverson, for example, report on the funding for the older blind program, and they summarize the number of people served and the cost of services. The results are not encouraging insofar that the demand in all probability outstrips the capacity to provide services. As Sheffield and Rogers note in their commentary, only about 2% of older people with vision impairment receive vision rehabilitation services of any kind. In spite of funding constraints, novel and innovative strategies are emerging. Current and emerging telemedicine-like technology has the potential to revolutionize access to eye care. Ihrig, for example, demonstrates an example of how telemedicine strategies can reach underserved or remote populations. …