I am starting this Blog with the goal of providing information on eye diseases and on vision rehabilitation to CNIB clients and their families, as well as eye care professionals and the general public. The information I provide will be accurate, factual and up-to-date. Information will be drawn from numerous sources – from the research literature, from CNIB's research and from CNIB's experience. This Blog is not intended to take the place of good medical advice. Since all medical situations are individual, it is important that you always consult your eye doctor regarding your eye condition.
Where possible, some references will be provided for some of the data so that you can continue reading in more detail if you so desire, however, the reference list will not be totally comprehensive.
My secondary goal is to initiate a conversation in the community about issues that we as Canadians face with respect to vision health and vision rehabilitation, and the role that governments, both federal and provincial, should play in optimizing the delivery of eye care services and vision rehabilitation services. I hope that you will participate in this dialog, both via the Blog and through direct communication with your provincial and federal representatives. I look forward to this conversation.
Setting the Scene.
In order to understand the issues facing eye care in Canada, it is important to understand the potential crisis that Canada is facing as our population ages. I would, therefore, like to devote this initial Blog to describing some of these issues.
Canadian eye care is facing a "perfect storm" caused by the combination of an aging population and the fact that the major eye diseases causing vision loss are all age-related.
Canada has no national vision care plan to deal with this situation. The idea that Canada needs a strategic national approach to vision health is not new. In 2003, the Canadian government was instrumental in helping pass a resolution called the Global Initiative for the Elimination of Avoidable Blindness (also known as Vision 2020: The Right to Sight) at the World Health assembly, the highest decision-making body of the World Health Organization (WHO). This resolution called on member states to develop national vision health plans with the goal of eliminating avoidable blindness in the world by the year 2020. Countries such as Canada that signed this resolution agreed to create national vision health plans by the year 2005, and to implement them by 2007. We are now way past either of these deadlines and there is still no initiative to develop a federal vision health plan in Canada. By comparison, over 100 countries, many with fewer resources than Canada, have developed national vision health plans.
If we are to deal effectively with the looming "demographic tsunami", it is essential that the federal government develop without delay a plan that incorporates the full spectrum of vision health from prevention through diagnosis, treatment and rehabilitation.
In 2008, CNIB together with the Canadian Ophthalmological Society commissioned a study on the cost of vision loss in Canada. This study looked at the total economic effect that vision loss has on the Canadian economy. The Cost of Vision Loss in Canada study built on existing, authoritative sources of Canadian data and research, taking into account Canada's multicultural society and projected demographics. It used known costs, accurately reflecting real expenditures and federal and provincial government policies.
This study found that the annual price tag associated with blindness and partial sight in Canada is exceptionally large – much higher than previous estimates. At $15.8 billion
(in 2007 dollars), the cost amounts to 1.19 per cent of Canada's GDP. In spite of this extraordinary sum there are still more than 800,000 Canadians living with blindness and partial sight, far too many of whom live in social isolation, experience poverty, and face unemployment and discrimination.
The direct costs to our health care system amounted to $8.6 billion
annually. Comparing this number with studies done using similar methodology for other disease categories3 revealed that vision loss had the highest direct health care costs of any disease, costing Canadians much more than diabetes, cancer, cardiovascular disease, mental disorders, respiratory diseases, arthritis or osteoporosis. After health care costs, the second-highest financial cost from vision loss results from lost productivity – what people with blindness or partial sight would earn if they were able to fully participate in the workforce – which amounts to $4.4 billion a year. Canadian government statistics estimate that only 35% of working age Canadians with vision loss are employed, in spite their having similar training to their sighted colleagues. This is another issue that needs to be seriously addressed by government, but is a subject for another Blog.
Vision loss has wide-ranging implications. It affects work, income, self-esteem, dignity, family relationships, the ability to drive, leisure activities, community involvement and the activities of daily living. People who lose their sight may not enjoy the same rights and benefits that other Canadians enjoy, and they may experience social isolation and stigma. And while vision loss itself may not be fatal, it can precipitate other serious health impacts, such as clinical depression, and for seniors, falls and early admission to nursing homes.
In order to address the societal, economic and health impacts that vision loss has on Canadians it is essential that Canada develop a vision health plan as soon as possible.
We are calling on the Canadian government to honour its 2003 commitment to the WHO
- Access Economics Pty Ltd. The Cost of Vision Loss in Canada. Toronto: CNIB; 2008, Available at: www.cnib.ca/covl.
- CNIB. Paying the Price: What Vision Loss Costs Canadians and What We Should Do About It. Toronto: CNIB; 2009, Available at: www.cnib.ca/covl
- CNIB and Canadian Ophthalmological Society. The Cost of Vision Loss in Canada: Summary Report. Toronto: CNIB; 2009. Available www.cnib.ca/covl.