High quality care is important for everyone, but different communities face different risks.
The intersection of race and health in the US is a complicated topic. Communities can have widely differing experiences with the healthcare system, resulting in health outcomes that vary along racial and economic lines. The causes of these differences are a combination of factors—some are genetic, but others are social and cultural, often rooted in a history of inequality.
Eye health is no exception. The health of your eyes is tied to your whole body’s health, and reflects your overall health in important ways. That’s why it’s crucial to be aware of the ways race and ancestry can interact with and impact the health of your eyes. When you’re aware of the risk factors that affect you, you can work with your care provider to be your own best advocate.
As a Black-owned company based in Detroit, Heritage believes firmly in the value of high-quality vision care for everyone, and we work hard to help people gain access to care who might otherwise struggle to find it. Regular eye exams can catch a wide range of health problems in their early stages—and not just eye conditions, either. Taking advantage of your vision care benefits is an important way to look out for your overall well-being, and knowing your medical risk factors helps you take the best advantage possible.
With that in mind, here are some important things to know about the intersection of race and eye health.
Some communities are more at risk than others for certain eye diseases.
Whether it’s due to biological or social factors, the risk of having to deal with certain eye conditions varies along racial lines. That’s not to say that any group is immune from common eye health issues, and any good care provider should always investigate your symptoms thoroughly.
But knowing your risks can help you identify problems early, and motivate you to seek care even if you’re only experiencing mild symptoms (or no symptoms at all!). Here’s how race can impact your risk of some of the most common eye conditions.
Glaucoma
Glaucoma is a disease resulting from increased pressure inside the eye. There are several types of glaucoma with different causes, but every type can cause damage to the optical nerve, which sends information from your eye to your brain. This damage can result in permanent vision impairment or loss.
Among Black and Latino communities, glaucoma is the leading cause of blindness. Proportionally more Black and Latino people suffer from glaucoma, and the disease appears to worsen faster and more aggressively for them. Primary open-angle glaucoma is diagnosed, on average, ten years earlier in Black patients than white ones, and is six times more likely to cause blindness. Additionally, some East Asian and Asian-American populations, as well as Scandinavians, are at increased risk of certain less common types of glaucoma.
Some studies indicate that genetics might play a part in these outcomes, but they also point out that access to high-quality care plays a bigger and more urgent role, especially for marginalized communities in the US. In its early stages, glaucoma often doesn’t have noticeable symptoms, so it’s important to keep up with regular eye exams in order to catch it early.
Age-related Macular Degeneration
Age-related macular degeneration, or AMD, is a disease that causes vision blurriness or loss in the center of your range of vision. It is associated with aging, and while it doesn’t usually result in complete vision loss, it can get worse over time.
Age is the most commonly discussed risk factor for AMD, but studies also show that it’s more prevalent in white patients. Light-colored eyes may also increase your risk for AMD, but scientists haven’t been able to determine it definitively. A 2016 study showed that Latino and Chinese-American communities are also at a slightly higher risk for AMD, although not as high as white populations, with Black patients having the lowest risk of the groups studied.
Like glaucoma, AMD often doesn’t have symptoms in its earliest stages. A regular check-up can help identify early signs, and you may be able to slow the progression of the disease with medical interventions and lifestyle changes.
Cataracts
A cataract occurs when the lens of the eye becomes cloudy enough to affect the quality of your vision. The most common cause of cataracts is age, but as we’ll see later, cataracts can also result from illnesses that aren’t specific to the eye.
A study on cataracts in Black and white populations showed that different types of cataracts were more common in each community. Black patients were more likely to experience cortical cataracts, in which cloudiness appears first around the edge of the lens. In white patients, nuclear cataracts—cloudiness in the center of the lens—were more common. The way each type of cataract progressed also differed along racial lines.
It’s possible to reduce your risk for cataracts, or slow their progress, with lifestyle changes like diet adjustments, wearing sunglasses, and stopping smoking—but, like the conditions above, early detection is key. If the impact to your vision becomes too severe, cataract surgery is also an option.
Systemic conditions can also affect eye health.
Because eye health is so closely tied to whole-body health, even diseases that aren’t eye-specific can have impacts on your vision. And in many cases, these diseases are especially prevalent in historically marginalized communities.
Diabetes disproportionately affects Native Americans and non-Hispanic Black people in the US. Although their rates are at or below average for the country as a whole, Latino and Asian American people also experience higher rates of diabetes than white people. Diabetes impacts the small blood vessels in the body, and with so many small blood vessels running through the eyes, it can have serious effects on eye health.
When diabetes damages the blood vessels in the retina, the light-sensitive membrane at the back of the eye, it can lead to impaired vision and, eventually, vision loss. This condition is called diabetic retinopathy, and it’s one of the leading causes of blindness in the US. In addition, diabetes can also contribute to cortical cataracts, which we mentioned earlier. Groups with a higher incidence of diabetes will also be at risk for higher rates of diabetic retinopathy and cortical cataracts.
Autoimmune diseases that cause inflammation—such as lupus, rheumatoid arthritis, multiple sclerosis, and others—can also affect the health of your eyes. Inflammation can damage tissues inside your eyes, affecting your vision, and may lead to a more serious condition called uveitis.
The numbers seem to indicate that rates of autoimmune diseases in general are broadly similar across racial groups. But some autoimmune conditions are more common than others in specific communities, and uveitis is a bigger risk with some conditions than with others, so it’s important to consult your doctor on your specific risk factors.
Everyone deserves access to quality vision care that meets their unique needs.
Open communication with your care provider, along with regular eye exams, can help you stay informed about your eye health. At Heritage, we encourage our members to take full advantage of their vision benefits, because information and early detection are essential for the best health outcomes.
For more information about the benefits that your Heritage plan entitles you to, contact your company’s benefits specialist, or reach out to Heritage today.