Guideline Group, Eye Doctors Disagree On Vision Tests For Seniors
By MICHELLE ANDREWS
Some doctors and a key group of preventive care experts aren’t seeing eye to eye on seniors’ need for vision screening during primary care visits.
There’s not enough evidence to know whether giving seniors a vision test when they visit their primary care doctor will lead to earlier detection and treatment of cataracts, age-related macular degeneration or refractive problems that could require corrective glasses or contacts, according to guidelines published March 1 by the U.S. Preventive Services Task Force in JAMA, the Journal of the American Medical Association.
The task force, an independent group of medical experts, evaluates the scientific evidence related to preventive services for patients that don’t have symptoms or signs of medical problems. Under the health law, services that the task force assigns a grade of A or B based on the strength of the evidence must generally be covered by health plans, including Medicare, without charging consumers anything out of pocket.
In this instance — screening for impaired visual acuity in people age 65 and older — the task force assigned an I grade, saying the evidence was insufficient to assess the balance of benefits and harms of screening, the same grade it assigned screening in 2009 when it last reviewed the evidence.
An organization of eye doctors and surgeons criticized the task force recommendation. In an editorial published in JAMA Ophthalmology, Dr. David Parke II, chief executive officer of the American Academy of Ophthalmology, argued that the task force didn’t give enough weight to supporting evidence about the health and quality of life benefits of identifying and addressing visual problems early.
There’s a misperception that seniors get an eye exam every year, Parke said in an interview, but many don’t. “This is simply an issue of whether it makes sense, when a senior is in a primary care situation, to look at an eye chart and see if they can see well,” said Parke. “For a substantial percentage of seniors it may uncover a treatable disease.”….
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