Ophthalmology groups propose national fundus screening to presidential candidates

With three major blinding diseases -- macular degeneration, diabetic retinopathy, and glaucoma -- on the rise due to population aging, the Korean Ophthalmological Society (KOS) and the Korean Retina Society (KRS) have proposed the “National Eye Reassurance Project” to presidential candidates.

The idea is to prevent visual impairment by introducing fundus examinations to national health checkups.

The KOS and the KRS said Wednesday that they held a “21st Presidential Election Policy Field Meeting to Improve the People’s Eye Health” with Rep. Kim Yoon of the Democratic Party of Korea (deputy head of the DPK’s Central Electoral Commission), according to the two organizations.

The meeting was attended by Rep. Kim and leading experts in the field of ophthalmology and retina, including Choi Kyung-sik, director of legislation at the KOS, Ahn Ji-yoon, deputy secretary-general, and Park Woon-cheol, secretary-general of the KRS, to diagnose the current state of eye health in Korea and discuss the need for effective policies to prevent blindness by, for instance, introducing a national health checkup for fundus examination.

80-90% of 'preventable blindness' is due to macular degeneration, diabetic retinopathy, and glaucoma

According to the two eye-related groups, the incidence of severe eye diseases, including the three major blinding diseases of macular degeneration, diabetic retinopathy, and glaucoma, is increasing rapidly as Korea enters an ultra-elderly society and the prevalence of chronic diseases, including diabetes and hypertension increases.

The number of patients treated for the three major blinding diseases increased by 33.1 percent from 1.5 million in 2019 to 2.1 million in 2023, with those aged 50 and older accounting for more than 80 percent of the total. For macular degeneration, the leading cause of blindness, the number of patients increased more than 2.5 times, from about 200,000 in 2019 to about 510,000 in 2024.

Blindness imposes a significant burden on society as a whole, not only in terms of reduced quality of life for individuals but also in terms of family care burden and lost productivity.

According to the Korean Medical Association's Disability Evaluation Standards, bilateral blindness has a 92-96 percent loss of labor capacity, which is higher than that of double arm amputation (89-95 percent). The annual socioeconomic cost of macular degeneration is estimated to be 694.3 billion won ($504.1 million), of which formal medical expenses are about 410.2 billion won, informal medical expenses are 90.7 billion won, caregiving expenses are 40.1 billion won, and productivity losses are about 132.5 billion won.

While 80- 90 percent of visual impairment can be prevented or cured with early diagnosis and management, early diagnosis through regular screening is essential because when people realize they have visual impairment, it is often too late for treatment. Therefore, the World Health Organization (WHO) recommends preventing blinding diseases through fundus examinations.

WHO-recommended 'fundus examination' requires national screening for high-risk groups

Fundus examination is a noninvasive test that can detect abnormalities in the retina and optic nerve in about five minutes. It can diagnose the three major blinding diseases and various diseases, including hypertension, diabetic retinopathy, and hereditary eye diseases, early. The test is also affordable, costing less than 10,000 won per person.

In Singapore, for instance, a fundus examination-based diabetic retinopathy screening program is in operation. In the United Kingdom, fundus examination-based screening is performed annually for diabetic patients to help prevent blindness by detecting and treating diabetic retinopathy before vision changes.

In Korea, on the other hand, fundus examinations are only included in examinations at university hospitals and some private screening centers. They are not included in the national health examination.

According to the KOS, one in four Koreans has never had an eye examination in their lifetime. In particular, diabetic patients who are at high risk of blindness are recommended to have a fundus examination immediately after diagnosis. There is also an annual eye examination, but only 23.5 percent of diabetic patients actually undergo a fundus examination.

To prevent the direct and indirect costs and loss of social productivity due to blinding diseases, the two associations suggested that fundus examinations should be proactively introduced during national health checkups for people aged 60 and older who have a high incidence of severe eye diseases and for people at high risk of blinding diseases, such as diabetics and smokers, and gradually expanded.

“It was meaningful to have in-depth discussions with ophthalmology experts leading the way to protect people's precious eyesight,” Rep. Kim said. “Based on the discussions, the DPK will continue to pay attention and strive to come up with effective policies to prevent blindness.”

KOS President Kim Chan-yun said, “As Korea is one of the fastest-aging countries in the world, itmust respond to severe eye diseases with a high risk of blindness." “I hope that policies for the eye health of the people will be prepared as soon as possible, as blindness not only reduces the quality of life of individuals but also causes a great burden on the national society through labor productivity loss and care burden.”

KRS President Park Kyu-hyung said, “Retinal diseases that cause blindness, such as macular degeneration and diabetic retinopathy, are often difficult to recover from if the golden time for treatment is missed. If relevant tests are included in the national health checkup system so that they can be diagnosed and managed early through regular fundus examinations, it will help protect people's precious daily lives and contribute to securing national vision.”