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HomemifeatureWorld First: Experts in Vision and Ageing Unite

World First: Experts in Vision and Ageing Unite

In an international first, experts from the areas of vision and ageing, from 12 countries, gathered to examine the co-morbid relationship between ageing and vision health. The Summit report, released in late September, outlined global strategies the experts believe will better respond to the needs of ageing populations at risk of vision impairment and loss.

As a world leader in raising awareness of macular disease, it comes as no surprise that the Macular Disease Foundation Australia (MDFA) was invited to partner with the International Federation on Ageing to plan and co-host the world’s first Global Ageing and Vision Advocacy Summit.

The MDFA’s CEO, Julie Heraghty described the summit as “one of the most fascinating and worthwhile projects at an international level” that will help build the capability, capacity and joint engagement of the vision and ageing communities.

“This is the first time we’ve ever brought together international experts from ageing and vision communities to discuss critical issues related to vision for what is an enormous ageing population across the world,” said Ms. Heraghty.

Vision loss is a major – yet unappreciated – cause of disability globally and its far-reaching impact is social, emotional and economic

“In the past these communities have largely operated independently. Now there is a realisation that there are many advantages to be had by working together.”

Vision loss is a major – yet unappreciated – cause of disability globally and, according to the Summit findings, its far-reaching impact is social, emotional and economic.

The World Health Organization (WHO) estimates 285 million people are visually impaired with more than 39 million people legally blind. It is estimated that four in every five cases of vision loss
are preventable.

Among older adults, vision loss is “the leading cause of disability” according to a report by the International Federation on Ageing, and the financial expenditure associated with vision loss is expected to amount to US$3.5 trillion by 2020.

For older populations in developed countries, vision loss is primarily due to age-related macular degeneration. Interestingly, in China, where the baby boom will occur almost a decade after that which has occurred in Europe, age-related macular degeneration is not yet the primary concern. Instead, cataract is this country’s number one cause of vision impairment and in response to this, the Government of the Republic of China has committed to millions of cataract surgeries.

Robust Debate

Ms. Heraghty said the calibre of the delegates who attended the Global Ageing and Vision Advocacy Summit in Barcelona was extraordinary and highlighted the eye health concerns held for our ageing population. Among the 28 delegates were Dr. Jacob Kumaresan Executive Director of the WHO office at the United Nations, John Seidler, the United Nations Representative for the AARP Office of International Affairs and experts in vision like Alan Cruess, the Professor and Head, Department of Ophthalmology and Visual Sciences at Dalhousie University in Canada.

Presentations by content experts and open discussion among delegates facilitated robust debate about the issues surrounding ageing and vision loss in different countries.

“The program was structured so that people could raise and robustly debate the issues being faced in their own and other countries,” said Ms. Heraghty.

“Representatives from China for instance, spoke about their country’s massive task in terms of managing cataract. Their baby boom will come 10 years after ours so they are learning from other countries about strategies to deal with age-related macular degeneration – knowing this is something coming their way.

“Canada has some very good approaches, including a public program that pays
75 per cent of assistive devices for people with vision impairment, although this
is not universally available across the entire country.

“We also heard from Italy, where a lot of great work is being done through outreach programs.”

Ms Heraghty spoke on how the Macular Disease Foundation Australia has significantly raised public awareness of the key issues surrounding macular degeneration: detection, symptom recognition and nutrition.

“I also presented on the work we are currently doing in partnership with National Seniors Australia to lobby the government to ensure the ageing community is not excluded from the National Disability Insurance Scheme (NDIS). This provided a perfect example for how representatives from the ageing and vision communities need to come together,” said Ms. Heraghty.

(Click here to view an illustrator’s visual description of Summit discussions)

She said the key issue for discussion was that vision loss is not a natural consequence of ageing and, with that in mind, there is a need for countries around the world – developed and developing – to work together to prevent unnecessary vision loss.

Platforms for Action

Ms. Heraghty said delegates at the Summit agreed on several common barriers that must be overcome to ensure vision needs of a globally ageing population can be appropriately managed.

Those barriers include:

  • A lack of awareness of the prevalence and ‘ripple effect’ of age-related vision impairment;
  • Inadequate access, equity and affordability of prevention, treatment and rehabilitation; and
  • Competition among various sectors, disciplines and across generations.

The outcome of the Summit was the identification of three key platforms, which will serve as the basis for ongoing communication and action among the participating countries.

These platforms were:

  • International research, including clinical studies and sociological studies, to more effectively explain the social and economic consequences of a growing ageing population with vision impairment and vision loss;
  • The development and sharing of key messages that resonate across countries and cultures, and aim to reduce the incidence and impact of vision loss in older people. The key messages being: a healthy lifestyle is good for your vision both now and as you age, regular eye checks throughout
    life are essential for good eye health, and you can live well with low vision; and
  • Global advocacy to build on the achievements of the World Health Organization and the International Agency for the Prevention of Blindness by further aligning the agendas of vision and ageing sectors, which, prior to the Summit, have been disparate.

Just the Starting Point

Ms. Heraghty said the Summit demonstrated the powerful outcomes that can be achieved when the agendas of ageing and vision groups are aligned. “As the first ever summit of its kind, this was just the starting point. The next step is for the delegates, who had the opportunity to share and learn, to go back to their own countries and start developing relationships between vision and ageing groups.

It’s a big journey but the catalyst is there to take the learnings and the skills and to advocate for the eye health of the older citizens of the world.”

The first Global Ageing and Vision Advocacy Summit was held in Barcelona from 17–18 April. The summit report was published in late September and is available from the Macular Disease Foundation Australia.

Economics of Vision Loss

Vision loss is not just a matter of public health and ethical responsibility. It’s also a matter of economic and fiscal imperative. According to a prevalence-based study conducted by the AMD Alliance International and Access Economics, the direct costs globally of vision loss in 2010 were US$2.3 trillion, and this cost is expected to increase to US$2.8 trillion by 2020.

Furthermore, a study in the United Kingdom found that people with wet AMD had, on average, annual health and service costs seven times higher than those without AMD. In Australia the total cost of vision loss (direct and indirect) associated with AMD was estimated at approximately US$5 billiion in one year.

Then there is the ‘ripple effect’ – people with vision impairment often face a number of other serious health and social consequences, including depression, and those who care for them can also be vulnerable to negative impacts on family, lifestyle, standard of living and physical health.

In the US, the sum of indirect costs related to vision loss is about US$650 billion annually and expected to increase significantly if preventable vision loss grows parallel with the ageing population.

Based on current projections, the financial expenditures associated with vision loss will amount to US$3.5 trillion by 2020.

Global Ageing and Vision Advocacy Summit, 2013. Produced by the Macular Disease Foundation Australia and the International Federation on Ageing.