Do You Know the 3 Main Causes of Blindness in the U.S.?

By: Andrea Tooley, MD

Many people think vision loss is just a normal part of aging but it doesn’t have to be. There are many steps you can take to reduce your risk of blindness.

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Study after study has shown that people fear vision loss more than they fear cancer, stroke, heart disease, and other serious health problems. But a new study shows that Americans are scared about an issue they know very little about. And what they don’t know is putting them at risk of vision loss, including blindness.

A survey[1] conducted by The Harris Poll shows that while 81% of adults say they are knowledgeable about eye/vision health, less than 1 in 5 (19%) were able to correctly identify the three main causes of blindness in the U.S., which are glaucoma, age-related macular degeneration (AMD) and diabetic eye disease.

Why does this matter? Because most people are also unaware of key facts that could protect them from vision loss, according to the survey. For example, only around one-third of adults (37%) know you do not always experience symptoms before you lose vision to eye diseases. And less than half (47%) are aware your brain can make it difficult to know if you are losing your vision by adapting to vision loss.

The brain adapts to vision loss

Here are the facts:

  • Many forms of glaucoma have no warning signs. The effect is so gradual you may lose most of your vision before you realize it.
  • Diabetic retinopathy may cause no symptoms or only mild vision problems, at first. Eventually, it can cause blindness.
  • AMD is first noticed as blurriness or difficulty seeing colors and fine detail. Symptoms usually appear suddenly and worsen rapidly.

Ophthalmologists, physicians who specialize in medical and surgical eye care, have more tools than ever before to diagnose these eye diseases earlier and to treat them better. But these advances cannot help patients whose disease is undiagnosed.

Further, ophthalmologists cannot adequately care for patients who are unaware of the seriousness of their disease. Far too often, ophthalmologists witness the consequences of patients entering our office too late to avoid severe vision loss.

In 2020, we want all Americans to have a clear vision when it comes to eye health. That starts with educating yourself about eye diseases.

Eye disease is a growing epidemic

The consequences of failing to increase awareness about eye health can be dire. Right now, the number of Americans affected by these potentially blinding eye diseases is expected to double within the next 30 years, due mainly to the aging of the population [2].

  • In 2010, approximately 2.7 million persons in the United States aged 40 and older had glaucoma. By 2050, this number is projected to increase to 5.5 million persons.
  • Diabetic retinopathy will increase to 13.2 million persons by 2050, up from 7.7 million in 2010.
  • The population with AMD will double between 2010 and 2050, increasing from 2 million to 4.4 million.

It’s important to note that vision loss affects more than the eyes. Vision loss is also associated with the following:

  • increased risk of falls and injuries
  • social isolation
  • depression
  • other psychological problems

All of these complications of vision loss can worsen other chronic illnesses.

Eye disease doesn’t affect everyone equally

Another key finding from the Harris poll is that less than half (47%) of respondents were aware that vision loss and blindness does not affect all people equally. But your risk of developing an eye disease varies significantly by your age, ethnicity, family history, and whether you smoke. Here are some relevant facts:

  • African Americans are 6 to 8 times more likely to get glaucoma than white Americans.
  • Further, blindness from glaucoma is 6 to 8 times more common in African Americans than white Americans.
  • People with diabetes are 2 times more likely to get glaucoma than people without diabetes.
  • Asians are at an increased risk for the less common types of glaucoma: angle-closure glaucoma and normal-tension glaucoma.
  • AMD disproportionately affects whites. Nearly 90% of Americans with AMD are white. Black and Hispanic American populations each account for ~4% of AMD cases.
  • African Americans, Hispanics, American Indians, and Asian-Americans all have a higher risk of diabetes.
  • Some 45% of people with diabetes have some stage of diabetic eye disease.

Vision loss and blindness is not inevitable

The Harris poll also found that only around one-third of adults surveyed (37%) know that vision loss is not inevitable as you age. Many people think vision loss is just a normal part of aging but it doesn’t have to be. You can take many steps to reduce your risk of vision loss, including

  • Eat a healthy diet, including leafy greens such as spinach or kale
  • Maintain a healthy weight.
  • Know your family’s eye health history.
  • Wear sunglasses that block out 99% to 100% of UV-A and UV-B radiation (the sun’s rays).
  • Quit smoking or don’t start.
  • Get regular eye exams

Time for an exam?

Just because you can see well, doesn’t mean all is well. That’s why the American Academy of Ophthalmology recommends that healthy adults see an ophthalmologist or an eye care professional for a comprehensive, baseline eye exam by age 40 and have their eyes checked every year or two at age 65 or older.

People who have other risk factors will need to be seen more frequently. People with diabetes should have a dilated eye exam every year. African Americans, age 40 and older, and people with a family history of glaucoma should have a dilated eye exam every 2 years.

If you are concerned about the cost of the exam, the Academy’s EyeCare America® program may be able to help. This program provides eye care through volunteer ophthalmologists for eligible seniors 65 and older and those at increased risk for eye disease. See if you’re eligible, visit

Medicare provides an annual dilated eye exam for Medicare beneficiaries over 65 at high risk for glaucoma. Those eligible for this service are people with diabetes, family history of glaucoma, or African Americans over 50. To learn more, call 800–633–4227.

The bottom line

2020 is the year to get smart about eye health. For ophthalmologist-reviewed information about eye diseases and treatments, eye health news, and tools to locate an ophthalmologist, visit

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  1. This survey was conducted online within the U.S. by The Harris Poll on behalf of the American Academy of Ophthalmology among 3,512 U.S. adults ages 18 and over between August 8 and 27, 2019. Data by race/ethnicity were weighted where necessary by gender, age, region, income, education, household size, marital status, employment, and specific eye conditions of interest to bring them into line with their actual proportions in the population. The data for each race/ethnicity group was then combined into a grand total to reflect the proportions of each race/ethnicity within the U.S. adult population. Propensity score weighting was also used to adjust for respondents’ propensity to be online.
  2. The Future of Vision: Forecasting the Prevalence and Cost of Vision Problems. Prevent Blindness. Retrieved December 3, 2019, from
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Dr. Andrea Tooley is a fellow in Ophthalmic Plastic and Reconstructive Surgery in New York City. She completed her residency in Ophthalmology at Mayo Clinic in Rochester, Minnesota and an Ophthalmic Plastic and Reconstructive Surgery Fellowship at Columbia University and Manhattan Ear, Eye, and Throat Hospital in New York City.

Dr. Tooley is a committee member for the AAO Young Ophthalmology (YO Committee), the AAO Communications Committee and the Women in Ophthalmology program committee. She is a board-certified ophthalmologist through the American Board of Ophthalmology and has been writing through her time in college, medical school, residency, and fellowship.

She started a blog and YouTube channel in medical school documenting her journey and has published articles on the dangers of eye tattoos, as well as tips to keep your eyes healthy for Woman’s Health.

She’s also dedicated to research and has had many published peer-reviewed articles that can be found on

After obtaining her private pilot’s license at 17 years old, her experience flying eventually introduced her to ophthalmology. Dr. Tooley met a pilot who worked for Orbis, an ophthalmology non-profit, and fell in love with the eye and decided to devote her life to helping improve people’s vision.

She currently lives in New York City with her husband and dog, while completing her specialty fellowship training in oculoplastics.

Dr. Tooley is passionate about education and leadership within ophthalmology, and this year was awarded the “Emerging Leader” award from Women in Ophthalmology.

Originally published at on January 14, 2020.

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