Eye care gap found between Americans, Canadians

Americans with vision problems who lack health insurance receive less care than Canadians or those Americans with insurance, according to doctors who suggest focusing on those at greatest risk of losing their sight.

Researchers at the U.S. Centers for Disease Control and Prevention in Atlanta looked at differences in eye care based on more than 2,000 Canadians and 2,900 Americans with vision problems who responded to a survey between 2002 and 2003.

In both countries, general health insurance covers payments for:

• Eye injury
• Cataract.
• Glaucoma.
• Diabetic retinopathy.

Optional vision insurance covers eye exams, contact lenses, eyeglasses and/or frames, and sometimes part of the cost for elective laser surgery to correct vision, the researchers said.

"Among adults with vision problems, a public health gap exists in actual access to eye-care services between Canada and the United States, primarily owing to the population without health insurance in the United States," Dr. Xinzhi Zhang and colleagues wrote in the August issue of the Archives of Ophthalmology. 

The researchers found 8.2 per cent of Americans with vision problems did not have health insurance.

This group had the lowest rate of eye-care service use at 42 per cent. In comparison, 67 per cent of Americans with private health insurance, 55 per cent with public health insurance and 56 per cent of Canadians had visited an eye care professional in the previous year.

"The difference in use of eye-care services between Americans without health insurance and Canadians narrowed when adjusted for income level and was almost eliminated when adjusted for having optional vision insurance," the researchers wrote.

"Therefore, public health interventions targeting adults with vision problems without health insurance might be more beneficial if they focused on those at risk for serious vision loss, especially those in the lowest income group," the authors concluded.

Half of Americans report poor eyesight

A second study appearing in the same issue found about half of Americans age 20 and older had a vision problem, mostly myopia or astigmatism — higher than previous estimates.

More than 33 per cent of those surveyed were nearsighted and 36 per cent had astigmatism that distorts vision. About 3.6 per cent were farsighted, meaning they see at a distance but not up close.

Previous U.S. studies estimated the prevalence of myopia at 25 per cent.

About 12,000 people completed the survey between 1999 and 2004.