Enhancing and Modernizing the US Vision and Eye Health Surveillance System

Visual acuity loss and blindness are significant public health problems, affecting more than 7 million people in the United States. Visual acuity loss is associated with a higher prevalence of comorbid conditions such as diabetes, cardiovascular disease, falls, injuries, depression, and premature mortality. Visual acuity loss, which can be prevented through early detection and timely treatment of common eye diseases, costs the nation more than $130 billion annually. The most common eye diseases that may cause irreversible vision loss include age-related macular degeneration, diabetic retinopathy, and glaucoma. Other treatable forms of vision loss, such as cataract and refractive errors, affect millions of Americans. These conditions are common and expected to increase over the next 30 years due to changing demographics in the U.S. population and an increase in risk factors such as diabetes. Eye diseases also contribute to health disparities in the population. Glaucoma, which affects more than 2.7 million individuals in the U.S., is the leading cause of irreversible blindness among African Americans. In addition, important social determinants of health contribute to these disparities in vision health. National and state data suggest that only about a half of those at high risk for serious vision loss had visited an eye doctor in the past year. Surveillance of eye diseases and related topics is essential to track the magnitude of disease, associated risk factors, and social determinants of health, identify priority populations for intervention, set and monitor national objectives, and inform the development, implementation, and evaluation of public health strategies to support vision health. The purpose of this project is to maintain, enhance, and modernize CDC's Vision and Eye Health Surveillance System (VEHSS), using valid and reliable data from a variety of sources, in order to assess U.S. national, state, and county-level prevalence of the major eye diseases, vision impairment, utilization of eye care services, and related risk factors and social determinants of health.The VEHSS is the only interactive, comprehensive collection of vision and eye health data in the United States. Currently, the VEHSS includes data from a variety of sources including national surveys, administrative claims databases, an electronic health record registry, and published examination studies. Surveillance indicators within four topic areas (eye health conditions, visual function, service utilization, and medical payments and costs) are displayed on the VEHSS website using data visualization tools.This NOFO will focus on maintaining, enhancing, and modernizing the VEHSS. An important task will be to streamline the system, identify data gaps, and prioritize existing and new data sources and related indicators that have the greatest value for the purposes of public health surveillance and practice. Streamlining the system will ensure alignment with priorities of CDC's Data Modernization Initiative, such as improving data analysis and sharing, accelerating data into action, and supporting and extending partnerships. The project will include assessing indicators at regular intervals to determine their ongoing relevance and impact and subsequently providing recommendations for removal of low priority data sources or indicators as necessary. The NOFO will integrate state- and county-level data on social determinants of health. This project will also enhance the visualization and presentation of the data on the website, including through alignment with other relevant CDC surveillance systems and by providing technical assistance to application developers and supporting any necessary transitions. Lastly, this project will focus on outreach and dissemination of the surveillance system to key stakeholders, researchers, scientists, public health practitioners, and policy makers.