Joshua Ehrlich, MD, MPH Assistant Professor of Ophthalmology and Visual Sciences University of Michigan

Primary Care Providers Can Encourage Patients To Focus on Vision Health Interview with:

Joshua Ehrlich, MD, MPH Assistant Professor of Ophthalmology and Visual Sciences University of Michigan

Dr. Ehrlich

Joshua Ehrlich, MD, MPH
Assistant Professor of Ophthalmology and Visual Sciences
University of Michigan –Describe the “important role” that primary care providers play in promoting eye health?

Response: Primary care is the entryway into the health system for many individuals. The poll suggests that when primary care providers discuss vision with their patients, they are more likely to get eye exams. It also suggests that primary care providers are having these conversations most often with those who have certain risk factors for eye disease, such as diabetes or a family history of vision problems, as well as those with fewer economic resources. Promoting these kinds of conversations could bolster this trend, increasing the number of diabetics and other high risk individuals who get appropriate eye care. What should readers take away from your report?

Response: We know that the public places a great deal of importance on eye health and vision. We also know that vision loss is associated with falls, social isolation, decreased independence, and cognitive decline. Since most vision loss can be prevented or treated, appropriate eye care is an important part of maintaining health and well-being, especially in later life when many eye diseases become more common.

Primary care providers have many considerations when it comes to maintaining the health of older patients but various studies have shown that maintaining good vision is a priority of patients. With everything that is asked of primary care physicians and only limited appointment windows, where should eye health rank? Why?

Response: The public tends to place a very high value on vision. In a nationally-representative survey from 2016 (Scott et al. Public Attitudes about Eye and Vision Health. JAMA Ophthalmol. 2016;134(10)) respondents rated losing their eyesight as worse than loosing memory, a limb, hearing, or speech. Eye care represents an opportunity to have a large impact on quality of life that is highly valued by patients. Are there any conversations you can recommend family physicians and primary care physicians have with their patients, in light of these findings? What are those conversations?

Response: Patients and primary care providers should be aware of the recommendations for who ought to receive regular eye care. Patients should be asked if they have noticed any changes to their vision or are having any problems with their eyes. Some eye diseases may not have symptoms in their early stages, so identifying those with risk factors is important. Primary care providers can ensure that those who are known to be at high risk or who have a diagnosed eye condition are getting routine eye care.  As adults age, eye diseases like glaucoma, macular degeneration, and cataracts become much more common, so it is important to revisit these themes. How can a primary care physician help patients see the importance of eye health?

Response: The public places a high value on vision, even as compared to other aspects of health (see study cited above). However, especially among those with poor health literacy and health efficacy, it is important to have someone who is part of their health care team pointing patients in the right direction.


Choi S, Stagg BC, Ehrlich JR. Disparities in Low-Vision Device Use Among Older US Medicare Recipients. JAMA Ophthalmol. Published online September 06, 2018. doi:10.1001/jamaophthalmol.2018.3892

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Last Updated on September 11, 2018 by Marie Benz MD FAAD