RANCHO CORDOVA, Calif.—VSP Vision Care has released its Eye Health Index, featuring the top 10 eye-healthy cities in the U.S. Reno, Nevada, tops the 2016 Index as the nation’s most eye-healthy city. New this year, VSP also unveiled the 10 U.S. cities where the importance of an annual eye exam is not always top of mind. According to the research, Cleveland, Ohio, ranked as the nation’s least eye-healthy city.

The Eye Health Index, now in its fourth year, reviews tens of millions of VSP claims from more than 100 U.S. metropolitan areas to identify which cities are the most focused on maintaining their eye health by getting annual eye exams. The 2016 index rankings were determined by looking at the percentage of VSP members who received an eye exam in 2015 in cities with at least 100,000 VSP members. VSP provides vision benefits to 1 in 5 Americans, the company said.

“An annual eye exam should be a part of everyone’s overall health care routine, not only to keep their vision healthy, but also to leverage its proven preventative health benefits,” said VSP Vision Care president Kate Renwick-Espinosa. “Your eye doctor is often the first to spot signs of chronic conditions, including diabetes, high blood pressure, and high cholesterol. It’s critical that you visit your eye doctor annually to ensure the health of your eyes as well as your wellness overall.”

The top 10 eye-healthy cities in 2016 according to the Eye Health Index are:

1. Reno, Nevada

2. Boise, Idaho

3. Oklahoma City, Oklahoma

4. Des Moines, Iowa

5. Raleigh, North Carolina

6. Redding, California

7. Colorado Springs, Colorado

8. Fayetteville, Arkansas

9. Denver, Colorado

10. Tulsa, Oklahoma

The 10 least eye-healthy cities in 2016 according to the Eye Health Index are:

1. Cleveland, Ohio

2. Bakersfield, California

3. Merced, California

4. Akron, Ohio

5. Albuquerque, New Mexico

6. Detroit, Michigan

7. Stockton, California

8. Santa Rosa, California

9. Bridgeport, Connecticut

10. Salinas, California

Other key findings from the 2016 Eye Health Index include:

• Youth eye health is trending up in some of the least eye-healthy cities. While Bakersfield, Merced, Stockton, Albuquerque and Salinas are some of the least eye-healthy overall, they rank among the cities where the highest percentage of residents under 17 are receiving eye exams.

• There is a gender eye health gap. In general, women are more diligent about their eye health than men. In all of the cities surveyed, more women visited their eye doctors annually than men. Some 58 percent of eye exams were received by women compared to 42 percent for men.