Nearly One in Five African American Adults with Eye Disease Don’t Know It

The African American Eye Disease Study sheds light on the critical need for improved access to eyecare services within the African American community. To reduce the percentage of these individuals living with undetected visual impairment, researchers propose solutions to several barriers that need to be addressed, including enhanced diabetes management programs, community-based vision screening initiatives and follow-up reminders for patients who miss their annual examinations. Photo: Jay Haynie, OD. Click image to enlarge. In 2020, it was estimated that over 5.5 million individuals in the US suffer from visual impairment or blindness. Although effective treatments exist for some age-related eye diseases, the most effective strategy remains early detection and management of previously undetected yet treatable eye conditions. Given that African American individuals are particularly vulnerable to visual impairment—facing a higher prevalence of ocular diseases, compounded by limited access to healthcare resources—a recent study in American Journal of Ophthalmology sought to determine the prevalence and predictors of undetected eye disease among this population. It revealed that more than half of African American adults suffered from an ocular disease, and over 20% of those were unaware of their condition. Various modifiable risk factors, such as improving access to eye examinations, could help reduce these numbers, researchers suggest.The study, known as the African American Eye Disease Study, included data from 6,347 self-identified African American individuals in California. All participants (aged 40 years or older) underwent a comprehensive ophthalmic examination along with an in-home questionnaire focused on various health behavior predictors related to undetected eye disease, including assessments for conditions such as age-related macular degeneration (AMD), glaucoma, diabetic retinopathy (DR), visually significant cataracts and refractive errors.A considerable 54% of participants were found to have eye disease, and of these, 22% were unaware of their condition. DR affected 82% of undetected cases, alongside 72% showing signs of AMD and 44% with cataracts. On a national scale, these numbers suggest that more than three million African American adults in the US are living with undetected eye disease. Combining these findings with estimates from the CDC and NEI, by 2050, African Americans are projected to face a disproportionate incidence of vision impairment and blindness relative to their population size.The researchers were able to identify several modifiable risk factors associated with higher odds of undetected eye disease, including a history of diabetes (odds ratio, OR: 3.52), never having had an eye examination (OR: 1.75), having had an eye examination over five years ago (OR: 1.66), having poor or very poor vision (OR: 1.89) and trouble obtaining glasses (OR: 1.57). Participants who were unemployed or retired also had a higher prevalence of undetected eye disease.To address these risk factors, the researchers advocate for enhanced diabetes management programs that emphasize regular eye exams and education about the ocular complications associated with diabetes, as well as community-based programs (especially targeting at-risk populations) to increase awareness about the necessity of routine eye exams. Furthermore, for individuals who had their last eye examination over five years ago, the researchers recommend reminders (via automated texts or phone calls) to encourage timely follow-ups.“By improving access to needed, routine eye care for this population, by addressing mutable factors such as expanding healthcare coverage, focusing on specific health behaviors of patients or addressing racial/ethnic bias, we may be able to lessen the threat of increasing visually impairing eye disease among a growing and aging African American population,” the study authors concluded in their AJO paper.Click here for the journal source. Dhablania N, Torres M, Burkemper B, et al. Burden and predictors of undetected eye disease in adult African Americans: African American Eye Disease Study (AFEDS). Am J Ophthalmol. July 2025. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.