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National task force joins AOA recommendations in urging comprehensive eye exams, not glaucoma screenings

August 20, 2013

Anyone at risk for glaucoma should have regular comprehensive dilated eye examinations, according to a new report by the U.S. Preventive Services Task Force (USPSTF). Screening is not sufficient to spot the disease, particularly in its early stages when prompt care can help limit vision loss.

In line with AOA recommendations, the government task force noted most people with glaucoma do not have symptoms, and comprehensive, dilated eye examinations are recommended every one to two years for those at higher risk for glaucoma, including blacks and Hispanics age 40 and older, all those older than 60 and those with a family history of glaucoma.

“This is another advocacy win by optometry, and further recognition of our profession’s leadership role in safeguarding the health and well-being of the American people,” said Mitchell T. Munson, O.D., AOA president.

Screening programs, commonly offered as a means of detecting glaucoma in the general population, check for only one sign that might not always be associated with the sight-threatening eye disease: elevated intraocular pressure (IOP), the USPSTF report noted.

Because of individual differences in normal eye pressure and the various forms of the disease, screening by itself is not sufficient for accurately detecting glaucoma, the task force emphasized.

“In contrast, a comprehensive dilated exam looks at the back of the eye to detect subtle changes of the optic nerve in patients without any visual symptoms, thereby potentially leading to early detection of the disease,” the report stated.

Early treatment for glaucoma is effective in keeping visual field defects from getting worse and this is very important for preserving vision, the report found.

“The USPSTF recommendation regarding glaucoma screening for asymptomatic Americans in the primary care setting reaffirms the clear message that AOA doctors have been delivering to policymakers and the medical community for many years,” Dr. Munson said. “Whether it’s identifying glaucoma in adults or refractive error and other amblyogenic factors in children, comprehensive dilated eye examinations provided by an optometrist or ophthalmologist are the only way to reliably and consistently identify specific diseases in both symptomatic and asymptomatic patients. More importantly, though, regular comprehensive eye exams offer so much more to patients of all ages. Unlike many screenings which typically target a specific disease or visual condition – and tend to do so rather poorly, comprehensive dilated eye examinations are instead designed to diagnose a more complete spectrum of eye diseases and vision conditions and have been shown to do so nearly 100 percent of the time.”

The USPSTF report is the latest in a series of actions taken by government entities in supporting the concept of a comprehensive dilated eye examination as an essential preventive step aimed at ensuring optimal health for all.

Earlier this year, the AOA helped convince Congress and federal agency officials to make an annual comprehensive eye exam through age 18 the foundation of eye health care for America’s children and a required element of coverage under new health plans created under the Affordable Care Act beginning in 2014.

According to AOA analysis of health plans to be offered under the 2010 health care law, nearly all states will feature a pediatric vision care benefit based on an annual comprehensive eye exam provided by an eye doctor and is embedded with other benefits as part of the overall health insurance plan.

The analysis also indicates that asymptomatic adult eye exams may be covered in health plans offered through state marketplaces at no additional cost to consumers – and roughly 27 states have included an adult eye health benefit in their benchmark plan. It is unclear at this point how widespread this adult coverage may be as the state-based marketplaces come online.

For more information, visit www.nei.nih.gov/glaucoma.

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