Articles about Eye Health and Disease 2003
 

Rates of Annual Eye Examination in Persons with Diabetes and Chronic Eye Diseases

(From Lee PP, Feldman ZW, Ostermann J, et al. Ophthalmol 2003;110(10):1952-9.)

Annual eye examinations for persons diagnosed with diabetes, glaucoma, and age-related macular degeneration (AMD) are important for detecting potentially treatable vision loss among those already diagnosed with these conditions. According to this study involving an analysis of Medicare claims data by Duke University, NC, actual rates of eye examinations for persons diagnosed with these conditions currently fall far short of recommended rates.

Researchers gathered a random sample of Medicare beneficiaries aged 65 or older and followed between 1991 and 1999, unless mortality or enrollment in a health maintenance organization for greater than six months in a given 12-month period intervened. They analyzed all claims data (both physician and facility) during this time for the presence of diagnosis codes consistent with one of the three study conditions (diabetes, glaucoma, AMD) and the performance of eye examinations. Optometrists, ophthalmologists or other providers of eye care submitted claims. Rates were calculated on the basis of a 15-month time window for annual examinations rather than for 12 months, to allow for less than full compliance with the guidelines for various reasons (e.g., inclement weather preventing an examination).

• Among those with diabetes in this population, 50 to 60 percent had annual eye examinations in a 15-month period. Of those followed for at least 75 months after diagnosis, about 75 percent had one or more 15-month gaps between visits.

• For subjects diagnosed with glaucoma, most visit rates were in the 70 to 90 percent range per 15-month period. The percentage of subjects with at least one 15-month period with no visits was considerably lower than for diabetes.

• The patterns for those with AMD were in between those for diabetes and glaucoma.

• Over a nine-year period, only slightly more than 50 percent of those studied who had a least one of the three conditions complied with practice guidelines.

The authors suggest that approaches to enhancing long-term and consistent follow-up of those already in the eye care system are necessary.

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