By Denis Langlois

Canada’s rapidly aging population is contributing to an “emerging vision crisis,” says the Canadian Association of Optometrists.

A 2019 position statement by the national organization says the financial cost of vision loss will rise significantly in the coming years as the prevalence of eye disease among Canada’s aging population increases.

The total cost of vision loss could top $30 billion annually by 2032 in Canada.

The statement also notes that vision loss has significant indirect costs as well, such as lost productivity, and can affect seniors both physically and psychologically. The impacts can include depression, loss of independence, financial hardship and limited social interaction.

The CAO has released a policy position that says primary eye care for seniors must become a public health priority.

It is calling for the creation of a national comprehensive eye health and vision care strategy that aims to maximize the health, independence and economic participation of seniors, who are at greater risk of vision loss and blindness.

Optical Prism recently spoke with CAO president Dr. Michael Nelson about the organization’s policy positions, the need for a national vision care strategy and CAO’s concern about the rise in vision issues in the senior population.

  1. Dr. Nelson, who should create the comprehensive eye health and vision care strategy and what should it include?
  2. Since the release of the Federal Role Paper on Eye Health and Vision Care in 2017, CAO has been advocating for a pan-Canadian Framework for Action on Eye Health with a focus on seniors, children and Indigenous peoples, developed collaboratively by eye and health care vision providers, rehabilitation professionals and vision research funders, other stakeholders and governments. The strategy would be based on population health strategies defined by the Public Health Agency of Canada that would improve the overall quality of life and productivity of Canadians.


  1. Why is such a strategy so important at this time?
  2. The four major causes of vision loss in Canada are age-related macular degeneration, glaucoma, diabetic retinopathy and cataracts, and the occurrence of each increases with age.  Vision loss in seniors is not reflected in public health agendas and community programs. By 2024, Statistics Canada data indicates seniors will account for 20 per cent of Canada’s population, a major contribution to the emerging crisis in eye health and vision care.


  1. What is the impact of vision loss on seniors?
  2. I see this impact almost every day in my clinic. Seniors deal with significant visual demands – driving, phones, work, travel, sports – and reduced vision can really affect their quality of life and the ability to enjoy these activities. Vision loss doubles the difficulties of daily living, advances nursing home admissions, doubles social dependence and the risk of falls, triples the rate of depression, quadruples the risk of hip fractures and doubles the mortality rate.


  1. The CAO says vision loss represents a large proportion of the economic burden of illness in Canada. Why is this a concern to CAO and why should it be a concern to Canadians as well?
  2. An analysis of data by Deloitte Access Economics shows that vision loss accounts for approximately eight per cent of the economic burden of illness in Canada, and that vision loss has the highest direct health care costs of any disease category in Canada – more than diabetes, cancer, mental disorders, respiratory diseases, arthritis or cardiovascular disease.  And yet according to the World Health Organization (WHO), 80 per cent of vision loss is avoidable. CAO believes that nobody in Canada should be needlessly visually impaired and that if comprehensive eye care services were an integral part of our primary health care and health systems development, we could better help everyone achieve their full potential.


  1. What role should eye care professionals be playing to address the increase in age-related eye disease in Canada?
  2. Eye care professionals should continue to encourage their patients to get a regular comprehensive eye exam, which is one of the least invasive steps to protect overall health.  CAO developed frequency guidelines for eye exams, but an optometrist will ultimately determine what works best for their patients based on their assessment of overall eye health.