Legislation is needed to increase detection and treatment
Too many African Americans are losing their sight to a preventable disease. Glaucoma is the leading cause of irreversible vision loss among African Americans, but the danger isn’t well known even among those who are most at risk.
One of my dear friends is an African asylum seeker named Deborah. In the fall of 2018, the two of us went on a shopping date to America’s Best. The eyeglasses business was offering a two-for-one sale that included a complimentary eye exam, and Deborah took advantage of it to update her glasses prescription and get some cute new frames.
During the exam, the optometrist on staff, who was a person of color, recommended that Deborah get a glaucoma screening based on her race and age. Deborah had no pain in her eyes, nothing that would cause her concern. But she listened to the expert and got the screening.
In mere minutes our fun shopping trip turned into a medical shock: Deborah was developing glaucoma. If she didn’t start treating it immediately, she could go blind.
Glaucoma is vision cell death caused by too high inner-eye pressure. People who are 40 years or older, have high blood pressure, or have diabetes are at risk for glaucoma.Beyond these general risk factors, Black Americans have far higher rates of glaucoma than Whites due to genetics, structural racism, and access barriers.
If detected early, prescription eye drops can stop glaucoma from developing, but without treatment it causes permanent vision loss. In the critical early stage there is no warning pain, so the only way to detect it soon enough is through medical assessment. Though Deborah felt completely well, she was actually developing a debilitating disease.
Thanks to that optometrist from America’s Best, Deborah immediately started daily prescription eye drops. Now her inner-eye pressure is back to healthy levels, and the drops keep it that way. But if it weren’t for a series of chance circumstances, Deborah could have gone blind.
Beyond the pain of losing her vision, glaucoma has serious economic costs. People with glaucoma spend an average $2,903 in health costs per year. It’s also harder to find employment when you have a visual disability, and in Minnesota 20% of people with a visual disability are in poverty with another 23% qualified as low income.
It would have broken my heart to see Deborah—or anyone else—go through that. Our African American neighbors shouldn’t lose their sight from a preventable disease.
An estimated 1,566 African Americans are at risk for developing glaucoma in Hennepin County alone, and most of them are probably unaware of the danger. Going blind can’t be left to chance. We need public health policy to address glaucoma for Black Minnesotans.
To address this, the Minnesotan legislature should adopt the Philadelphia Glaucoma Detection and Treatment Project as a model for preventative public health policy. The Philadelphia Project combined community-focused educational outreach, targeted glaucoma screening, and wellness follow-through for at-risk African Americans in the community.
It increased glaucoma detection rates by 39%, allowing medical treatment to stop the progression of this debilitating disease. These results confirm what experts have insisted for over a decade: Routine screenings for glaucoma among at-risk groups is a cost-effective intervention, with investments paid for in the long run through decreases in healthcare spending, disability services, and employment services.
With the historic electoral triumphs of African American politicians in recent years, the stage is set in Minnesota for anti-racist health legislation. It is time for Minnesota legislators to create policy that will prevent glaucoma among African Americans.
Keelia Silvis is a master of public health student at the University of Minnesota.