This Saturday is World Optometry Day 2024, and TFS HealthScience (TFS), with thousands of optometrists, ophthalmologists, and eye care professionals worldwide, would like to shine a light on the importance of preventive eye care. According to the World Health Organization (WHO), approximately 2.2 billion people worldwide have vision impairment. Of these, at least 1 billion have an impairment that could have been prevented or has yet to be treated. Regular eye examinations are important as corrected vision can improve the quality of day-to-day life. Regular eye exams also help detect eye conditions such as cataracts, glaucoma, and age-related macular degeneration (AMD), which are leading causes of blindness.

Optometry & Preventive Care

The World Council of Optometry (WCO) defines optometry as a healthcare profession that is autonomous, educated, and regulated, whereby optometrists are the primary healthcare practitioners of the eye and visual system, providing comprehensive eye and vision care. Optometrists play an essential role in preventive care, providing regular eye check-ups as part of routine eye care. Regular eye exams allow eye care specialists to manage vision changes or age-related eye problems, e.g., cataracts, glaucoma, and macular degeneration at an early stage.

Global Burden of Disease

According to the WHO, at least 2.2 billion people worldwide have a vision impairment. An estimated 11.9 million people globally have vision impairment (moderate or severe) or sight loss due to glaucoma, diabetic retinopathy (DR), or trachoma that could have been prevented1. The WHO warns that significant challenges lie ahead and that globally, eye care needs will increase sharply due to demographics and lifestyle choices. Population aging and lifestyle changes, such as increasingly unhealthy diets, are causing the prevalence of eye conditions and vision impairment to rise. The research community, including scientists, sponsors, and ophthalmology contract research organizations (CROs), have channeled resources to meet this growing health need. A recent study published in JAMA Ophthalmology estimates that funding for eye research grew 203% from $62.9 million in 2014 to $190.7 million in 2020.

Optometry: Preventing Eye Disease and Vision Impairment

Optometry stands as a cornerstone in preventing eye diseases and mitigating vision impairment. Regular optometric examinations serve as proactive measures against potential vision-related ailments. Optometry extends beyond mere diagnosis, encompassing personalized guidance on maintaining ocular wellness and addressing specific concerns. Optometry empowers individuals to safeguard their vision for a lifetime of clarity and visual acuity by emphasizing preventive care and fostering patient education.

The WHO promotes effective strategies to address the healthcare needs of patients with eye disease and vision impairment, including health promotion, prevention, treatment, and rehabilitation. In the World Report on Vision, the WHO describes the most feasible and cost-effective interventions, highlighting key evaluated examples of interventions that have been found successful in increasing the adoption of health-promoting behaviors. Specifically, health promotion campaigns focused on increasing awareness of the importance of optometry, regular eye examinations, and using eye care services have demonstrated their effectiveness among older populations and people with diabetes.

Importance of Getting Eyes Checked

As more than half of blindness is preventable, regular eye exams can help prevent or limit the damage caused by certain eye conditions such as cataracts, glaucoma, and AMD. In addition, an optometrist may be able to identify signs of broader health conditions that affect the eyes, including diabetes and hypertension. Regular eye examinations are vital for children to ensure that problems such as squint or short-sightedness (myopia) are detected early and treated accordingly.

Eye Exam Guidelines

Comprehensive eye examinations by an optometrist are essential to eye care, vision, and overall health. As many eye and vision conditions have no obvious symptoms, patients who do not have regular eye examinations might be unaware and end up being diagnosed and receiving treatment late. The American Optometric Association (AOA) describes what one can expect during a comprehensive eye exam, differentiates it from basic vision screening programs, and cautions us on the limitations of basic vision screening.

A comprehensive adult eye exam may include the following: patient history, visual acuity measurements, and preliminary tests such as evaluations of depth perception, color vision, eye muscle movements, peripheral or side vision, and the way pupils respond to light. Comprehensive eye exams may also include keratometry or topography to measure the cornea’s curvature, refraction to measure the lens power needed to compensate for any refractive error, eye focusing, eye teaming, and eye movement testing, and eye health evaluation. Additional testing may be required based on the results of the previous tests. The doctor will assess and evaluate all the test results, determine a diagnosis (if any), and develop a treatment plan. The AOA recommended eye examination frequency for pediatric patients and adults is below.

Table 1. Recommended examination frequency for the pediatric patient

Children with eye or visual signs and symptoms require timely, comprehensive eye examinations. Based on professional judgment, children with certain risk factors may need more regular exams. Risk factors that increase the risk of eye and vision problems in infants, toddlers, or children include prematurity, prolonged supplemental oxygen at birth, family history of myopia, strabismus, retinoblastoma, congenital cataracts, metabolic or genetic disease, mother’s infection during pregnancy (e.g., rubella, toxoplasmosis), and maternal smoking, use of alcohol or illicit drug during pregnancy, amongst others. A complete list of risk factors for pediatric patients can be found on the AOA website.

Table 2. Recommended examination frequency for the adult patient

Risk factors that increase the risk of eye and vision problems in adults include a personal or family history of ocular disease, being of certain racial and ethnic groups, and being in occupations that have a high potential of being hazardous to the eyes, amongst others. A complete list of adult risk factors can be found on the AOA website.

Comprehensive Eye Exam vs. Screening Programs

A comprehensive eye examination in optometry differs from vision screening as specialized equipment and procedures, which are usually not available for vision screening programs, are used to evaluate an individual’s eyes and vision adequately. Further, only an optometrist or ophthalmologist, doctors with specialized training, can conduct a comprehensive eye examination.

Vision screening programs can take many forms, such as periodic vision screenings in schools, screenings at local health fairs, or screenings as part of a driver’s license application. According to the AOA, vision screenings can detect some vision problems. Still, they can also miss more than they find and have the unintended consequence of preventing early diagnosis for individuals lulled into a false sense of security.

The AOA describes several limitations of vision screenings, including limited testing, as many vision screenings test only for distance visual acuity, are run by untrained staff, as administrative staff or volunteers with limited training often conduct vision screening, and lack adequate testing equipment. The AOA cautions that vision screening programs are not a substitute for regular professional vision care and that comprehensive eye examinations are the only effective way for children and adults to confirm or rule out eye disease or vision problems.

Common Causes of Blindness & Next-Level Eye Exams

Globally, glaucoma is the most common cause of irreversible sight loss. Many with glaucoma are asymptomatic early in the disease and require primary care physicians to know when to refer them for a comprehensive eye exam. Diabetes, one of the main causes of mortality and morbidity across the globe, contributes significantly to the global burden of disease. Diabetic retinopathy (DR) is a sight-threatening complication that is rising in global prevalence, necessitating the development of efficient and effective screening options.

Scientists have been working on low-cost imaging devices to aid in the early detection of vision-related conditions. To this end, Vilela et al. explored using artificial intelligence (AI), telemedicine, and smartphone eye examinations. The study found a high level of agreement between the conventional and smartphone eye examinations, indicating a potential alternative for screening and early diagnosis of the leading causes of blindness, such as cataracts, glaucoma, DR, and AMD.

Your CRO Partner: TFS HealthScience

TFS HealthScience (TFS) is a premier and innovative global mid-size CRO that partners with biotech and pharmaceutical companies throughout their clinical development. With nearly 800 professionals located across more than 20 countries in North America, Spain, Europe, and Asia Pacific, TFS partners with clients to deliver tailored clinical research services that match their needs when and where they need them.

The TFS ophthalmology team, led by Marcia Swank, provides clients with the experience and resources for customized ophthalmic clinical research solutions. We have in-house ophthalmologists and clinical research professionals with unique and extensive therapeutic expertise across indications. TFS combines internal scientific, medical, regulatory, and operational expertise with our innovative technology and network of trusted resources to get your product to market as efficiently as possible. In 2023, TFS announced its strategic acquisition of niche CRO Appletree CI Group to complement its mission to be the market leader in ophthalmology research.

Visit our Ophthalmology CRO website to learn more about the expertise TFS can offer for your next ophthalmic clinical trial, or connect with a TFS representative today!