For most Americans, the New Year gets us thinking about money. We revisit our personal and business budgets with renewed optimism, pledging to make more and save more. As citizens, we have some control over our financial destinies, and for many individuals, increased wealth is within reach. Yet, as a nation, the United States does not have that luxury, at least not with respect to healthcare costsparticularly those resulting from poor vision. Without a very serious look at the way eye care is handled in this country, without a major paradigm change, creating new budgets will be a difficult taskif not an impossible one.

The United States spends more than $50 billion a year on vision problemsand the prevalence and the costs to care for these conditions are rising fast. Currently, more than 38 million Americans age 40 and older are blind, visually impaired or have an age-related eye disease, such as macular degeneration, glaucoma, diabetic retinopathy or cataracts, according to the National Eye Institute, and reported by senior editor John Murphy in this months special news analysis piece, The High Cost of Poor Vision. As life expectancy increases and medicine improves, this number is expected to grow to more than 50 million Americans by the year 2020, he reports. And that means greater expenditures.

While, on the surface, that may sound like good news for the profession, it most certainly is not. First, this level of spending is unprecedented, and our economy may not be able to sustain it, which could leave an enormous segment of the aging population without adequate careor with no care at all. Second, much of the nations current spending is misguided insofar as not enough attention and too few dollars are aimed at preventing age-related disease.

Prevention is truly the key to mitigating and reducing vision problems, and it is a step in the right direction toward saving our economy. The costs of vision loss, both for individuals and for the economy, are simply too great to ignore.