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Seeking Funds to Prevent Avoidable Blindness: A Catch-22

I've always been weary of studies that estimate the "cost of blindness," as if the disability itself - and not the social implications that lead to isolation and unemployment - is the true drain on our collective purse. Of course, since many people will not support initiatives to prevent blindness either abroad or at home unless they see a cost-benefit analysis, this new trend towards calculating the cost of blindness could have a direct impact on how much is spent in preventing it. The downside is that blindness, a condition already associated with pathetic destitution, is being aggressively marketed as the enemy of productivity. That's not a good message - in fact, it could lead to even higher levels of avoidable blindness.

Recently, the BBC published a "cost of blindness" story that caught my eye, because the journalist who wrote the piece inadvertently stumbled over an even bigger problem than avoidable blindness. After going on about how blindness costs UK taxpayers millions of pounds a year in rehabilitation and long-term care, the article concludes with the following statement: "But research indicates that 88% of people with cataracts, 86% of people with age related macular degeneration (AMD) and 81% of people with suspected and definite cases of glaucoma are not in touch with eye care services." Most people with these conditions know they're losing their sight. Some avoid seeking medical attention on the mistaken belief that this loss is the inevitable result of aging, but others avoid treatment because they fear blindness, and believe that they can 'retain their independence' for longer by denying the problem. 

While preventing avoidable blindness is a laudable goal, and a money saver (as advocates are quick to point out), the "cost of blindness' can be further ameliorated through better education about the realities of sight loss. As long as organizations devoted to preventing blindness continue to talk about it in derogatory terms - "Many of the same economic and social cost considerations apply to both developed and developing countries, although the developing countries have more limited health and social care services and hence lower overall economic resources, to bear the burden of avoidable blindness." (WHO blindness) - those people who could most benefit from early detection and treatment will continue to stay away from the professionals who can help them. After reading material like this, it's easy to see how someone new to blindness could believe it so crushing a condition that they'd rather pretend they can still see well than admit they can't.

No mention is made in most "prevent blindness" texts of how much rehabilitation can restore productivity, but only of how much blindness can destroy quality of life. By failing to strike a balance between the cost of blindness and the benefit of rehabilitation, those people and organizations hoping to prevent blindness may in fact be missing the forest for the trees.

A. Hopfe

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