Ask Our Expert, Edwin Marshall, O.D., M.S., M.P.H.


Dr. Marshall





Edwin Marshall, O.D., M.s., M.P.H.

Why is it important to raise awareness about eye diseases and conditions among African Americans?

Dr. Marshall: African Americans have some of the highest rates of vision impairment and blindness due to eye disease, particularly people over the age of 40 and those with a family history of eye disease. Unfortunately, too many African Americans do not get regular, comprehensive dilated eye exams that could help save their sight. The prevalence of eye disease among this population is high and is projected to grow even more in the next decade.

 What are the most common eye diseases and conditions African American should know about?

Dr. Marshall: The most common eye diseases and conditions affecting African Americans include cataractdiabetic eye diseaseglaucoma, and low vision. Here is how these diseases and conditions affect vision:

  • Cataract: Cataract is a clouding of the normally clear lens inside the eye. The clouding interferes with our ability to see clearly. Most cataracts are related to aging, and are very common in older people. The symptoms include cloudy or blurry vision, colors seem faded, poor night vision, double vision or multiple images in one eye, and frequent prescription changes in your eyeglasses or contact lenses.
  • Diabetic eye disease: Diabetic retinopathy is the most common diabetic eye disease and a leading cause of vision loss and blindness in American adults. It is caused by changes in the blood vessels of the retina. Approximately 828,000 African Americans have diabetic retinopathy, and this number may exceed 1 million by 2030. The early stages of diabetic retinopathy usually have no symptoms. The disease often progresses unnoticed until it affects vision. Bleeding from abnormal retinal blood vessels can cause the appearance of “floating” spots. These spots sometimes clear on their own. But without prompt treatment, bleeding often recurs, increasing the risk of permanent vision loss.
  • Glaucoma: Glaucoma is a group of eye diseases that can damage the optic nerve. Glaucoma affects side, or peripheral, vision first. More than 520,000 African Americans have glaucoma, and this number may exceed 860,000 by 2030. Without treatment, people with glaucoma will slowly lose their peripheral vision so that they see as if they are looking through a tunnel. Over time, straight-ahead (central) vision may decrease until no vision remains.
  • Low vision: Low vision means that even with regular glasses, contact lenses, medicine, or surgery, people find everyday tasks difficult to do. Reading the mail, shopping, cooking, seeing the TV, and writing can seem challenging. Approximately 188,000 African Americans have low vision, and this number may reach 366,000 by 2030. Signs of low vision include difficulty recognizing familiar faces, reading, cooking, picking out and matching the color of your clothes, and reading street signs.

Can these eye diseases and conditions be prevented or managed?

Dr. Marshall: Many of these diseases and conditions do not have noticeable symptoms in their early stages, but they can be detected through a comprehensive dilated eye exam. The earlier the disease or condition is detected, the earlier the treatment can began. Here are some lifestyle tips to help you focus on your vision:

  1. Get regular comprehensive dilated eye exams.
  2. Know your family’s eye health history.
  3. Eat a nutritious diet.
  4. Wear protective eyewear.
  5. Maintain a healthy weight.
  6. Quit smoking or never start.
  7. Control your diabetes.
  8. Wear sunglasses when outside.


Dr. Marshall, a National Eye Health Education Program spokesperson, is professor emeritus of optometry and public health at Indiana University. He served as chair of the National Commission on Vision and Health, the Executive Board of the American Public Health Association, and The Nation’s Health Editorial Advisory Committee. He is a past president of the National Optometric Association.