Making Eye Health a Population Imperative: A Vision for Tomorrow—A Report by the Committee on Public Health Approaches to Reduce Vision Impairment and Promote Eye Health

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Excerpt

In 2014, the Health and Medicine Division (formerly the Institute of Medicine) of the National Academies of Science, Engineering, and Medicine convened a panel of experts representing a broad range of perspectives. They were tasked to develop strategies that could improve the nation’s eye health and reduce the impact of vision impairment. The committee’s official charge was “to examine the core principles and public health strategies to reduce vision impairment and promote eye health in the United States” (available at http://www.nationalacademies.org/hmd/Activities/PublicHealth/ReduceVisionImpairment.aspx). The initial scope of this project evolved, and by late 2016, the committee’s work included five meetings, two public workshops, one public comment session, one commissioned paper, and countless hours of committee calls and communications. The product of this effort was nine detailed core recommendations identifying short- and long-term eye and vision health priorities that cut across the health continuum. Through collaborative action, the committee identified and addressed issues involving health care settings, stakeholders, determinants of health, interrelated health conditions, surveillance and research needs, government roles, standard language and definitions, care integration and delivery, community and public health partnerships, provider workforce needs, and other key factors affecting eye health over the entire life span. These findings are summarized in a 450-page report, defined by the National Academies of Science, Engineering, and Medicine as a “document [of] evidence-based consensus of an authoring committee of experts… peer reviewed and approved by the National Academies….” This document provides a wealth of information for interested stakeholders. In addition to the core recommendations, it features new conceptual frameworks, visual diagrams, tables, figures, and other evidentiary tools and resources. These tools and resources are designed to help guide and support new initiatives, future policies, and planning by professionals, educators, researchers, decision makers, and the public.
There are numerous opportunities identified in this report that can lead to meaningful population health benefits. Initially framed as a smaller and more focused effort, the expansion of the report into additional chapters was a direct result of the committee’s thorough and systematic approach to identifying available evidence, understanding existing needs, and identifying essential gaps in current knowledge and practices.
A comprehensive continuum of eye and vision care is identified in the report that highlights prevention, early and accurate diagnosis, and proper care to reduce the impact of vision impairment. To improve eye and vision care and achieve health equity, a population health strategy was developed. This strategy identified specific objectives and included detailed conceptual models targeting specific determinants of health across the full life span. There is a wealth of information identifying clinical and translational research opportunities that will inform clinical researchers and clinicians alike regarding gaps in our current knowledge base. Because effective communication is so important, the report includes an in-depth attempt to define key terminology that will help stakeholders speak a common language. A substantial portion of the report directly calls for greater awareness by the medical community and the public for the important role that comprehensive eye and vision care has on population health. Three key examples include the following: that comprehensive eye examinations are recognized as the criterion standard for improving the nation’s eye, vision, and overall health; that doctors of optometry are recognized as physicians and have physician parity with colleagues in ophthalmology and medicine as per earlier Centers for Medicare & Medicaid Services (CMS) policy; and that irreversible vision impairment (e.g., due to diabetes, heart disease, glaucoma, and other major US chronic diseases and conditions) is also recognized as a true chronic condition.
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