America is aging rapidly. Within the next 30 years, those over 65 years of age will grow to form 17% of the population of the United States; the number of people over 85 will more than double. Currently, the rates of eye disease such as cataract, macular degeneration, diabetic retinopathy, and glaucoma are highest in the older group. The risk of blindness is ten times greater for those over age 65 than for younger individuals. This combination of high rates of disease in the fastest growing segment of the population means that the demand for eye care services will increase dramatically. Undoubtedly, new approaches will appear to deal with the epidemiologic reality.