Visual impairment among community-dwelling East Harlem older adults: Implications for diabetes prevention and management

Racial/ethnic disparities exist in diabetes prevalence and complications, including visual impairment. Emphasis on health literacy overlooks that some patients cannot see well enough to read food and medication labels, monitor glucose, draw up insulin and be physically active.

Communities IMPACT Diabetes Center assessed visual impairment prevalence and the vision-related physical environment in East Harlem, NY. A structured tool assessed built environment characteristics, including eye care facilities and sidewalk conditions, in two census tracts. Additionally, IMPACT partnered with a vision rehabilitation agency on a survey. Domains included the Functional Vision Screening Questionnaire, receipt of eye care within the past year and demographics.

The environmental assessment revealed 53% of sidewalks were “in good condition” and 30% had some obstruction. No eye care facilities were identified. For the survey, 555 predominantly older, Hispanic and African American adults participated. Half had not had an eye exam within the past year, 26% met low vision criteria and 30% self-reported diabetes; 52% stated their vision makes it difficult to do things they would like to do, 58% reported difficulty recognizing family and friends' faces, 44% reading regular size print and 49% reading medicine labels, small print and prices when shopping.

Greater public and primary care provider awareness of vision health is needed not only because visual impairment is a consequence of diabetes and other chronic diseases, but also because effective strategies to prevent and control these conditions require adequate vision. Clinicians should routinely ask patients if they experience difficulty seeing and refer them for eye care.