When my vision started to decline, my world got smaller. I was 13 or 14 years old when I realized I needed to sit closer to the front of the classroom. I had a headache most days from squinting.
The solution to my problem was easy — corrective lenses are some of the oldest medical interventions available — but it also wasn’t easy. Because in the U.S., glasses are hard to get.
An astounding number of people live with myopia, or nearsightedness. As many as 40 percent of the population requires corrective lenses to read street signs or bus schedules — and the number is growing. A research paper in the journal Ophthalmology predicts that by 2050, half the population will need vision correction.
Any visual challenge can be an impediment, and many of our own neighbors struggle with full or partial vision loss. But unlike vision loss, myopia isn’t considered a disability if it’s not caused by macular degeneration. And while Social Security may help defer the costs — a medical-vocational allowance might mean that prescription lenses are covered if it helps keep someone on the job — in general, glasses and contacts are an extra expense.
The need for affordable vision care is substantial, in part because it’s viewed as something extra. Many health care plans, like Apple Health (Medicaid), don’t cover glasses. Instead, patients have to purchase a separate health plan through a third-party provider, or buy their glasses at a discounted rate, which is frequently still out of reach. And because prescriptions for glasses and contact lenses expire, the patients must keep coming back to for another costly visit to the doctor.
That means that a lot of folks are struggling to see with little to no access to the tools they need to fix it. They are left to tough it out, potentially unable to find work or get around safely.
This was clear at the Seattle-King County Clinic in 2018, when 1,221 patients received visual care. More than 1,080 left with prescription lenses. But, according to the final report, “29% of patients indicated they had never sought professional eye care, could not remember when they last received care, or it had been more than 5 years.” Just 17 percent said the same thing about visiting the dentist.
Vision services are treated in our modern American medical system like something that’s nice to have, but not required. But if health care doesn’t cover the ability to see, it’s hard to imagine what’s considered necessary at all.
Hanna Brooks Olsen is a writer and policy consultant. Her work has appeared in the Atlantic, the Nation, GOOD, Bust Magazine, KNKX, and a handful of others. She’s currently writing a book about Lou Graham, the great Seattle madame.
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