You've likely heard of best-selling author Stephen King and Academy Award-winning actress Judi Dench and could name several of his books or her films. And although you may have heard of age-related macular degeneration, it's significantly less likely that you could name the disease's warning signs, debilitative effects and resulting high costs.
And that, vision care experts say, is the problem.
AMD is a disease affecting the macula, the pencil eraser-size part of the retina where precise vision forms, resulting in the loss of central vision and making everyday activities like reading and driving much harder. Sadly, both King and Dench suffer from the disease. Dench has said that she now needs to have scripts read to her, and King has said that the illness has robbed him of "the part of my vision that I want to keep, both as a man and as a writer." They are among the 10 million Americans who currently have AMD, and still millions more are projected to be diagnosed in the next 15 years.
Although eye care professionals cite multiple ways to help slow the progression of AMD, one thing they agree cannot wait any longer is the public relations campaign to raise awareness of the disease and eye health in general.
"We've found that eye health in general is something that a lot of people don't think about," says Susan Egbert, director of eye health strategies at VSP Vision Care.
Pat Huot, director of managed vision care at Transitions Optical, concurs. "There's still so much work to be done in terms of getting employees more comfortable around the concept of the best ways to protect their sight and the connection between eye health and health care."
Still, he says that to help raise awareness, "We found things that can help - whether it's during an enrollment period or connecting eye health to other [workplace wellness] campaigns. [There] are vision simulators that can show people what having the disease would be like [so they can see] the reality of losing their sight."
Few warning signs
According to Huot, women are twice as likely as men to develop AMD, and the disease is more prevalent among whites than other ethnic groups. However, he admits that in general "AMD doesn't give a lot of warning signs, and then when it's diagnosed, it's devastating trying to treat it."
Still, there are a few telltale symptoms, he says, that patients should immediately raise with their vision care provider or primary care physician. These include blurred vision and straight lines appearing wavy. The problem "is getting people to take those cues seriously," he says.
Leveraging benefits to reduce AMD risk
"Early identification and treatment are the best defenses against almost any eye-related condition," says Egbert, which give vision benefits and regular eye exams even greater importance.
"People who have standalone vision plans are twice as likely to get an eye exam than those who have their vision benefit bundled with their medical plan," she notes, citing a study by the National Association of Vision Care Plans.
In addition, "beyond the vision exam, a vision plan that provides actionable data to employers that facilitates the treatment of people that are identified as having [AMD or other eye-related conditions] is important in helping reduce overall health care costs and absenteeism," she adds. "That's really what employers should be looking for - a comprehensive benefit that employees are most likely to use."
Egbert also says plans featuring low copays, richer material benefit and lower out-of-pocket costs will be more popular with employees.
From a materials perspective, "once you develop the disease, UV protection becomes of the utmost importance, so products like photochromics are ones that we'd like to see eye care professionals support," Huot says.
Disease most prevalent in 50s and 60s
"Any vision plan would have to have a comprehensive eye exam to provide that window to the rest of the body," adds Huot, citing demographic statistics showing that someone in the United States will turn age 60 every 10 seconds until the year 2023. And many of those individuals currently are or will stay in the workforce for decades to come. Meantime, AMD is most prevalent among individuals in their 50s and 60s, making prevention a key concern for employers.
"If you think about the changes to our eyes that will occur in our 60s, compared to our 20s, it speaks to the need for high-quality benefits to maintain and improve the quality of our sight," says Huot.
Egbert drives home the significance of vision benefits. "It's important for employers to see the vision benefit as part of health care as a health risk assessment tool, because through the eye's blood vessels you can see a lot going on in the body that can't be identified through any other mechanism," she says. "It's an early warning opportunity that's only provided through the eye exam. So, not having a comprehensive eye benefit could mean missing that opportunity."
Unsightly costs
The annual financial burden of AMD is $575 million in outpatient and pharmaceutical services, and is projected to increase to $845 million in the next 15 years. However, screening patients beginning at age 60 results in an average cost saving of $48 per year per employee with AMD. If the first screening is done at age 50, savings are $76 per year per employee.
