Testimony to the Assembly Task Force on People with Disabilities, Assembly Committee on Health, Assembly Committee on Children and Families, Assembly Committee on Education
September 25, 2007

Presented by Dr. Tara Cortes, President and CEO, Lighthouse International

Good Morning. My name is Tara Cortes and I am the President and CEO of Lighthouse International. I would like to thank Assemblymembers Titus, Gottfried, Scarborough and Nolan for convening this hearing. It is important to ensure that individuals experiencing vision loss receive the proper care and services they require to maintain their independence.

We are very concerned about the rapid growth of the population over the age of 65 as well as the spread of diabetes as it relates to the increasingly problematic epidemic of vision impairment in New York State and across the country. A national survey conducted by Lighthouse International found that 21% of the population over the age of 65 self-reports having moderate or severe vision loss, while 1 in 4 Americans over the age of 75 actually do.i As the Baby Boomer generation ages, the number of individuals with vision impairments will dramatically increase. It is estimated that more than 820,000 New Yorkers over the age of 65 will have impaired vision by 2030.ii Meanwhile, the Center for Disease Control and Prevention reports that 20.8 million Americans are living with diabetes, which is more than double the number of cases reported in 1980. These two factors are heavily contributing to the substantial increase in the number of Americans experiencing vision loss.

Vision loss is primarily caused by various diseases and, therefore, is a health care issue and should be repositioned within the health care arena for reimbursement of rehabilitation services. The current New York system does not go far enough to address the health aspects of visual impairments that occur across the entire continuum of vision loss.

Typically, an older adult experiencing vision impairment may be diagnosed with numerous other co-morbidities. Experienced care providers, from a multidisciplinary team with a health and rehabilitation background, are needed to enhance the efficiency rehabilitative services to older adults with vision impairments.

Vision impairments are often the result of frequent age-related disorders, such as a stroke or diabetes. With the rising levels of obesity in America, diabetes is quickly reaching epidemic proportions. The management of this disease is critical to minimize the spread of diabetic retinopathy, a vision impairment that affects nearly half of those diagnosed with diabetes. The vision rehabilitation team needs to work closely with other health professionals to seek and to provide vision rehabilitation to the individuals who experience vision loss as a result of diabetes.

It is also imperative not to overlook infants born prematurely who frequently have vision problems and often have various other health conditions. These infants and preschoolers require a comprehensive approach that assists in their development. This age group also benefits from the myriad of health care professionals who work with the teachers of the visually impaired.

Additionally, Lighthouse International has observed that the 7-14 year old age group is not getting access to adequate vision rehabilitation. These resources are currently only available through the Commission for the Blind and Visually Handicapped for a once per month program that operates only from October to June. These children, most of who are mainstreamed into the public schools system, need improved opportunities to undertake vision rehabilitation services that are incorporated into the recreational modality but on a more frequent basis.

Less than 10% of the population who are visually impaired are blind or have no useable sight. The other 90% have some useable vision which is referred to as low vision or partial sight. The New York system leans heavily on the less than 10% who have no useable sight. Even the name for the proposed Office for the Blind does not reflect the vast majority of New Yorkers who experience vision impairment. Additionally, the Commission for the Blind and Visually Handicapped uses a very narrow definition of legal blindness to determine who is eligible for funded services. For example, the current concentration on visual acuity, of 20/200 or worse, disqualifies a significant number of individuals who are functionally impaired by their vision loss.

New York State should adopt a functional definition of vision impairment that traverses the entire spectrum of vision loss. The goal should be on restoration of function to anyone who is experiencing any degree of vision loss. Many individuals still need services to remain independent, even if they do not meet the strict definition of legal blindness, as defined by the State of New York.

I am honored to present this testimony on behalf of Lighthouse International, a leading non-profit organization dedicated to preserving vision and to providing critically needed health care services to help people of all ages overcome the challenges of vision loss. Through services, education, research and advocacy, the Lighthouse enables people with low vision and blindness to enjoy safe, independent and productive lives.

As a recently appointed member of the new Executive Board of the New York State Commission for the Blind and Visually Handicapped, I look forward to the opportunity to address the issues and recommendations I have highlighted.

i Moderate or severe vision loss was defined as vision loss beyond the scope of best corrected vision through prescribed glasses or lens.

ii Estimates based on the 2006 US Census projected population for New York State in 2030 and the Lighthouse International National Survey on the rate of vision loss.



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