The Eye Care Industry Focuses On Boomers -- And Millennials

November 30, 2015 | By Neil Howe

This editorial originally appeared in Forbes.

According to mounting research, myopia (nearsightedness) among the young has become a global epidemic. In the United States, myopia rates have roughly doubled over the last generation. A recent study published in JAMA reports that in China (where rates of myopia have skyrocketed to roughly 90% among urban youth), the major cause could be a lack of sun exposure. But young adults aren’t the only ones struggling to see clearly. Older adults are also looking for treatments that address their age-related vision problems. Amid rising demand, the eye care industry is poised to accelerate. It’s already developing new technologies that not only treat, but also prevent (and in some cases eliminate) vision problems.

With increasing demand from every age group, the $36 billion eye care industry has a bright future. The industry, which includes eye care professionals (opticians, optometrists, and ophthalmologists) and products (eye glasses, contact lenses, and corrective surgeries,) posted a steady combined annual growth rate of 3.4% from 2006 to 2012, outpacing the average growth of the economy at large (2.9%) over those years. Forecasters expect this rate to increase to 5.0% from 2014 to 2019.

At the bottom of the age ladder, this growth is being driven by climbing myopia rates. From 1971 to 1972, the prevalence of myopia in the United States was 25%. Between 1999 and 2004, the rate nearly doubled to 42%—with double-digit increases across every age bracket.Today roughly half of young adults in the United States are nearsighted, double the share when their grandparents were the same age.

The costs associated with correcting myopia are substantial. A 25% myopia rate leads to more than $2 billion per year in medical costs and productivity losses. Some patients are opting for new preventative treatments like atropine drops and orthokeratology lenses that keep myopia from worsening. Yet no one expects these preventative measures to slow the overall rise in myopia, which will generate more expensive vision problems down the road—including cataracts, glaucoma, and retinal detachments that can result in blindness.

What’s behind the myopia epidemic? Researchers have long blamed genetics—but it’s become obvious that other factors are at play. In 1969, a study of Eskimos who had recently moved from one town to another showed that while less than 2% of subjects older than 41 years of age had myopic eyes, more than 50% of subjects between 11 and 40 years old had at least one myopic eye—suggesting that vision problems may be environmentally induced.

One popular theory is the “near work” hypothesis, which suggests that activities such as reading and using smartphones strain the eyes, increasing the risk for myopia. This argument is largely backed up by evidence connecting rising education levels with nearsightedness. As children spend more time reading, studying (particularly true in China), and watching screens of all shapes and sizes, it’s not surprising that things are getting blurry.

Another explanation that is rapidly gaining traction points to sun exposure. According to this theory, light stimulates the release of dopamine in the retina. This neurotransmitter in turn blocks the elongation of the eye during development. (In an elongated eye, the lens focuses light before it reaches the retina.) In 2009, German researchers showed that high illumination levels slowed the development of experimentally induced myopia in chicks by 60%.

Yet it’s not just myopia that’s generating new demand in the industry. Boomers are starting to experience age-related vision problems as well. Since 2000, the number of 40+ Americans with vision impairment and blindness, cataracts, and open-angle glaucoma hasincreased approximately 20% per condition. Meanwhile, the same population has seen an 89% rise in diabetic retinopathy, the leading cause of blindness in American adults. By 2032, the number of cases of blindness, low vision, and age-related eye disease is expected to increase by 56% to 64 million cases. While part of this growth is due to Boomers’ sheer size, it’s also the result of their higher rates of obesity and diabetes.

These age-related vision problems will demand innovative solutions from the industry. Some Boomers are already undergoing refractive lens exchange to pre-empt cataract surgery. For more serious conditions like wet macular degeneration, others are forgoing expensive and painful intraocular injections in favor of inexpensive and painless dietary supplements like Longevinex.

And these eyesight solutions aren’t limited to the myopic and the aging. Researchers are in the process of developing bionic lens implants that promise to not only correct vision, but also enhance it to superhuman capacity. Even the blind have the opportunity to see with devices that recognize text and lenses that use other parts of the brain (not the optical cortex) to stimulate sight.

This increase in demand for vision care is generationally driven. The G.I. Generation came of age with the sharpest rise in schooling ever recorded—making them the first generation to be pushed indoors for near work, and also likely the first generation to experience a significant rise in myopia rates. Later, Boomers experienced the advent of air conditioning from first-wave to last, which made the indoors a more comfortable space to spend time. This shift indoors has reached its peak with Millennials and Homelanders. Under the watchful eye of ever-protective Boomer and Xer parents, these kids have increasingly spent more time in the safety of their own homes—often hardly outside at all for days at a time. Researchers and doctors are fighting back against the shift, reminding parents that “sunlight is the best optometrist.”

As all of these generations age, the vision industry will see strong demand from a burgeoning elderly population. Between obesity and diabetes, Boomers will be at the greatest risk for diabetic retinopathy and its subsequent blindness, necessitating expensive technologies and treatments—such as intraocular lenses that can offer clarity three times greater than natural 20/20 vision. While the vision industry will certainly continue to thrive, Millennials and Homelanders will be forced to foot the bill—a number that won’t be easy on the eyes.


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