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Chapter 11

PublicInformation

About Eye Care

• Principle 6. Public awareness and dissemination oj eye careinjormation are needed to reduce the prevalence oj preventable,undiagnosed, and untreated eye i,yury and disease.

Significanceof the Principle

Public awareness and wide dissemination of eye care information areimportant means of reducing the risk of eye and visual system injuryand disease. promoting knowledgeable decisions regarding utiliza­tion of eye care services. and encouraging individual. family. andgroup responsibility for eye care. Prevention of eye injury and diseaseas well as early diagnosis and treatment resulting from timely eyecare promote vision for Americans. Additionally. self-testing ofvision.vision screening of children. and full compliance with recommendedeye care are among the benefits related to strong individual. family.and group responsibility for eye care. In aggregate. potential benefitsof public awareness and wide dissemination of appropriate. accurateeye care information are of such great magnitude that this principleis a core feature in a national eye care plan.

Major Issues andRelated Principles

Major issues related to public awareness include the subject of publicinformation regarding overall health care and the appropriate roles ofgovernment. schools. employers. and other representatives of societyin disseminating health care information. An additional major issueis the role of the news media in distributing timely. accurate. andresponsible health care information.

Equally important as issues related to public information abouteye care are national policies pertaining to quality of eye care. accessto eye care. and affordability of eye care. Manifestly. public informa­tion and increasing public awareness of the need for eye care must becoupled with a national health care system that provides quality eyecare that is accessible and affordable.

The principle of public awareness and dissemination of eye careinformation relates most closely to:

• Principle 1. Eye care is an integral component ojhealth care.• Principle 2. Quality eye care is needed to attain. preserve. and

restore best possible visionjor every American.• Principle 3. Access to quality eye care includes direct and ref­

erral access to ophthalmologistsjor all Americans.• Principle 4. Quality eye care must be affordable to all Ameri­

cans.

Public Information About Eye Care

EvaluationPublic awareness and dissemination of information regarding eyecare are needed to reduce the risk of eye injury and disease. to pro­mote knowledgeable decisions by Americans regarding eye care byophthalmologists and other eye care professionals. and to encourageindividual. family. and group responsibility for eye care. Evaluation ofthis principle warrants consideration of public awareness of eye care.public information regarding utilization of eye care services. andindividual. family. and group responsibility for eye care.

Public Awarenessof Eye Care

Americans fear blindness more than any other health problem exceptcancer. However. public understanding of the prevention. diagnosis.and treatment of eye disease. and the relative qualifications andscope of services of ophthalmologists and other eye care professionalsare quite deflctentt.

In 1979. a Gallup poll of 3.000 adults in the United Statesshowed that only 5% of those queried knew the difference between anophthalmologist and an optometrtsts, In 1982. surveys conductedbefore and after intensive media campaigns in three cities focused onthe ophthalmologist's role in diagnosing and treating glaucomaBefore the intensive media campaign. queries to 1.200 personsrevealed that 66% identified ophthalmologists as able to examineeyes. 74% identified ophthalmologists as able to diagnose eye disease.69% identified ophthalmologists as able to treat eye disease. and 72%identified ophthalmologists as being able to prescribe medications.After the intense media campaign. the consumers' knowledge of theophthalmologist's role in these areas increased by 4-10%.

Data regarding the public's awareness of the symptoms andsigns of eye disease are limited. It is generally believed. however. thatpublic recognition of the signs and symptoms of eye disease such asamblyopia. diabetic retinopathy. and macular degeneration is poor.Even if the public's awareness of eye disease and of major signs andsymptoms were good. the lack of understanding regarding the compe­tence and scope of services provided by ophthalmologists and othereye care professionals would greatly impede knowledgeable decisionsregarding timely eye care by ophthalmologists and other eye careprofessionals.

There is little likelihood that the public's recognition of individ­ual. family. and group responsibility for eye care is more than rudi­mentary. Deficiencies in self-testing of vision. vision screening ofchildren. and compliance with long-term treatment regimens indicatethat responsibility for eye care is not widely identified by individuals.families. and groups.

Recognizing these limitations in public awareness regarding eyecare and the lack of reliable information in this field. studies by oph­thalmologic organizations. other eye and health care organizations.and government agencies are recommended to determine the extentof public knowledge regarding care of the eyes and visual system andidentification of issues on which it is most important to focus publicinformation activities. Thereafter. effective programs to increase pub­lic awareness of eye care merit high priority.

85

Principle

6Public awareness and dtssem­inatic,>n ofeye care iriformation

are needed to reduce theprevalence ofpreventable.

undiagnosed, and untreatedeye injury and disease.

86

The public's lack ofunderstanding

regarding the servicesprovided by eye careprofessionals greatly

impedes knowledgeabledecisions regardingtimely eye care by

ophthalmologists andother eye careprofessionals.

Eye Care for the American People

Public InformationRegarding Utilizationof Eye Care Services

Substantial eye care and health care information is being transmit­ted to the American public through the news media. schools. employ­ers. government. and other means. These activities are fragmentedhowever. and not designed to promote systematic awareness concern­ing major aspects of eye care and the appropriate utilization of eyecare services.

Recognizing the lack of systematic. prioritized information dis­seminated to the general public. ophthalmologists and other eye careprofessionals should establish the most important information tocommunicate to the public and convey this by use of all availablenews media and other avenues for communication with the Americanpublic.

Professional judgment and studies of public awareness shoulddetermine relative importance of and need for public informationregarding:

• Prevention of eye injuries in the home. in recreation settings. inthe workplace. and elsewhere.

• Importance of eye and visual system examinations in infantsand children. in adults and the elderly. and in specific circum­stances at other times.

• Signs or symptoms suggesting the need for medical eye care byan ophthalmologist.

• Eye disease risk associated with glaucoma or other family his­tory of eye disease.

• Eye disease risk associated with systemic diseases such as dia­betes mellitus.

• Medications that require eye and visual system monitoring suchas topical and systemic corticosteroids.

• Detection of Vision-threatening eye disease by individual self­assessment of visual acuity. visual field. and binocular vision.

• Family and group responsibility for eye and visual system care ofinfants. children. elderly adults. and others who may be unableto practice effective self-testing and self-care.

• Need for compliance with eye disease treatment regimens suchas the regular use of medications for glaucoma.

• Availability of low-vision aids and rehabilitative services forAmericans who have impaired vision or are blind.With priorities of public information established on the basis of

systematic studies. effective public information activities may beplanned and carried out. News media in the United States playa sig­nificant role in providing public information on health issues.Research has demonstrated that media campaigns are effective inimproving the public's awareness of eye disease. the need for earlydiagnosis of eye disease. and the scope of services provided by oph­thalmologists and other eye care professtonalss, Public informationmay also be disseminated by government. schools. employers. healthinsurance companies. eye care and health care professionals. andhealth-related organizations. Written materials. audio presentations.and video programs are among the forms of communication that maybe used for public education.

The American Academy of Ophthalmology has included print

Public Information About Eye Care

news releases and electronic information dissemination on a varietyof topics affecting the eye and visual system in public informationprojects and programs. Additionally. public service projects such asthe American Academy of Ophthalmology National Eye Care Project(Chapter 9. Affordable Eye Care) and the Worker's Eye Health Projectare useful in providing eye care information.

The National Society to Prevent Blindness (NSPB). Research toPrevent Blindness (RPB). RP Foundation Fighting Blindness. LionsInternational. and other eye and health-related organizations have alsoconducted effective programs to prevent eye injury. establish eye safetystandards in theworkplace, and generally increase public awareness ofeye care.

Ophthalmologists and other eye or health care professionalsmay greatly enhance the effectiveness of public information programsby coordinating with health-related voluntary organizations. by work­ing with groups composed of individuals who have similar age and/orinterests. and by participating in community programs. radio present­ations. and video programs. Furthermore. on a regular ongoing basiseye care professionals may present public information to patientsand families receiving eye care.

Individual. Family.and Group Responsibility

for Eye CareA desired outcome of public information is increased individual. fam­ily. and group responsibility for eye care. The individual is responsi­ble for noting symptoms or signs of vision-threatening eye disease.for self-testing of visual acuity. visual field. and binocular vision atappropriate intervals. for obtaining eye examinations and visionscreening procedures at appropriate intervals. and for complyingwith eye disease treatment recommendations.

Family responsibility for eye care is increasingly important asthe significance of early diagnosis and treatment of eye disease ininfants and children as well as the elderly and other dependent adultsis documented in scientific studies. Additionally. group responsibilityis important for individuals who have no family group on which torely. Dependent children who are wards of society. and elderly Ameri­cans who have survived longer than other family members are amongthose who must rely on other groups for support in obtaining eyeexaminations on a timely and appropriate basis and for aid in coop­erating with treatment recommendations..

To enhance quality and decrease cost. optimal eye care requiresincreased responsibility on the part of individuals. families. and othergroups.

ConclusionPublic information regarding eye care is required to decrease theoccurrence of preventable injury and disease. to promote knowledge­able decisions by Americans regarding utilization of eye care services.and to bring about enhanced individual. family. and group responsi­bility for eye care. Public information must stem from professionaljudgment of ophthalmologists and other eye care professionals. accu­rate information regarding public awareness of eye care, well designedpublic eye care information programs. and activities to strengthenindividual. family. and group responsibility for eye care.

87

Principle

6Public awareness and dissem­ination ojeye care information

are needed to reduce theprevalence ojpreventable.

undiagnosed, and untreatedeye injury and disease.

88

Public information isrequired to decrease

the occurrence ofpreventable injury and

disease, to promoteknowledgeable

decisions regardingutilization of eye careservices, and to bring

about enhancedindividual, family, and

group responsibility foreye care.

Eye Carefor the American People

Recommendations1. Ophthalmologic organizations, other organizations, and govern­ment agencies should conduct studies to determine the extent ofpublic knowledge regarding eye care and to identify the subjects onwhich to focus public information activities.2. Ophthalmologic organizations, other eye and health care organi­zations, schools, employers. and government agencies should dissem­inate public information to prevent eye injury and disease, to pro­mote early diagnosis and treatment of eye disease, to gutde decisionsby Americans regarding utilization of eye care services, and toencourage individual, family, and group responsibility for eye care.3. Public information activities related to eye care should utilizenews media and be coordinated with eye and health care organiza­tions. eye and health care professionals. schools, employers, healthinsurance companies, government, and community services.

References 1. Survey '84: A study of attitudes toward blindness and blindnessprevention. Sightsaving 1984-85: 53(3):14

2, Reinecke RD, Steinberg T. Manpower studies for the United States,Part II: Demand for eye care, a public opinion poll based on aGallup poll survey, Ophthalmology 1981: 88:34A-47A.

3, American Academy of Ophthalmology. Glaucoma Media ProjectSan Francisco: American Academy of Ophthalmology, 1981.