Reframing Aging and Blindness/ Low Vision  

older person smiling and a younger person embracing them

As we approach Older Americans Month and Healthy Vision Month in May, let’s reflect on the progress in achieving the desired long-term outcomes in the Theory of Change (TOC), adopted by the Aging and Vision Loss National Coalition (AVLNC) in 2019. 

When first established through VisionServe Alliance (VSA), the Coalition sought to lay out the most critical issues related to acknowledging and delivering services to older people with age-related vision loss. 

Theory of Change (TOC) Problem Statement 

As stated in the problem statement of the TOC, “Age-related eye diseases significantly impair the sight of 12 million plus Americans 60 years of age and older.” The statement goes on to reflect that without intervention, the ability to function independently and the physical and mental health of these individuals will be adversely affected. The overall cost of vision-related problems, including falls, was over $145 billion annually in 2014 and is expected to reach $376 billion by 2050 (Vision Loss Impact – Research to Prevent Blindness (

Critical Long-term Outcome 

In the TOC, AVLNC laid out an ambitious but critical long-term outcome. “Ideally, older people with vision loss will successfully age in place, engage in meaningful activities, and access resources, professional vision rehabilitation services, independent living tools, and employment when desired.” 

Since 2019, the Coalition has worked on four primary goals to achieve this outcome:  

  • awareness,  
  • policy and funding,  
  • data and research, and  
  • access to services. 

The Big Data Project Reports 

As a result of this work, we now have Big Data reports that show the prevalence of low vision and blindness nationwide, in many states, and down to the county level. The reports highlight stunning facts about the low socioeconomic levels, poor quality of life, and a large number of co-morbidities experienced by older people who are blind or have low vision (see Big Data reports). Some counties in the US have a prevalence rate of over 21%! 

This country’s vision rehabilitation system reaches less than 3% of older people needing services. Additionally, the funding for these services has remained stagnant for over a decade. 

Infographic for the Aging and Vision Loss National Coalition (AVLNC) Theory of Change. The graphic is divided into four main sections with arrows indicating flow from left to right, suggesting a progression from 'Process & Activities' to 'Desired Outcomes' and ultimately to 'Long Term Outcomes.' On the top right, there's a 'Problem Statement' indicating that age-related eye diseases impair the sight of 12+ million Americans over 60 years old, with a projected increase and significant economic cost.
'Process & Activities' includes bullet points such as 'Awareness,' 'Policy & Funding,' 'Data & Research,' and 'Access,' detailing strategies like national awareness campaigns and advocacy for vision issue inclusion in legislation.
These activities lead to 'Desired Outcomes' including 'Education & Understanding' about the causes of eye disease and the impact of professional vision rehabilitation, and 'Policy & Funding' for professional vision rehabilitation and training, as well as 'Data & Research' and 'Access' to high-quality vision rehabilitation and resources.
The central theme of 'Education & Understanding,' 'Data & Research,' and 'Access' is encapsulated in yellow circles with plus signs, emphasizing their interconnectedness.
The culmination is the 'Long Term Outcomes' section, which envisions older adults with vision loss being able to age in place and engage in meaningful activities due to increased awareness of and access to resources, professional services, and independent living tools. The bottom of the graphic features a progression of silhouetted figures walking, ranging from a young child to an older adult with a cane, symbolizing the journey through life stages.

Funding and Policy 

Through the Funding and Policy Committee, advocates have recommended changes to the Older Americans Act (OAA) that would recognize and include vision rehabilitation services for older people who are blind or low vision. Read A 21st-Century Vision for an Age-Old Problem ( to learn more about these advocacy efforts. Work is underway to find ways to obtain Medicare coverage for these services.  

Establishing Vision Rehabilitation Week 

We continue spreading public awareness about the need for vision rehabilitation services in various ways. VisionServe Alliance, its members, AVLNC, and national vision and aging partners are working together to establish Vision Rehabilitation Week. The global holiday will commemorate and provide vital awareness and education about all life-changing Vision Rehabilitation services. Vision Rehabilitation Week will confirm how vital Vision Rehabilitation is in the Continuum of Care for vision. Additionally, it will celebrate the importance and benefits of careers in the field. Stay tuned for more information! 


Larry Johnson, at 90, is a fierce activist on behalf of services for older people who are blind or have low vision, sums up the need for advocacy. The following quote comes from Larry Johnon’s article, “Aging and Vision Loss, When the Golden Years Behin to Lose Their Luster.” 

“What happens as we get older? Well, we can’t do a lot of things we used to do. If you have had a knee or hip replacement, have arthritis, high blood pressure, or COPD, you definitely recognize and accept the fact that you have to slow down. But when your vision, hearing, or balance begins to fail, you are much less willing to admit it. You postpone handing over your car keys to your daughter. You put off looking into being tested for a hearing aid or getting a support cane to help you walk. It’s embarrassing, and it’s painful to admit the truth. You don’t see so well, hear so well, or aren’t as steady on your feet as you once were. When, finally, you’re ready to acknowledge that you have a visual or hearing impairment, what do you do? Where do you turn for help, and what kind of services will you need?

Typically, if you are experiencing vision loss, you are going to need special magnifiers, perhaps a talking clock, someone to teach you how to use your microwave, your washing machine and how to safely cook a meal with little or no vision, and how to travel to your doctor’s office and lots more. But now you are faced with another stark reality–the lack of available services, resources, and trained professionals to help you adjust to your new life of vision loss and make it possible for you to continue to “age in place” and live independently and not have to move into a nursing home.” (Resources | Alliance on Aging and Vision Loss ( 


Let’s come together to change the reality! Join AVLNC’s efforts. Email us at  [email protected]

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