Insurers should emphasize preventive care, AAO says

San Francisco-The American Academy of Ophthalmology (AAO) is calling for Medicare and other insurers to emphasize preventive care after a study recently published in the AAO journal Ophthalmology (2007;114:238-245) found that poor vision is costing Medicare more than $2 billion annually in non-eye-related maladies and health-care needs.

The study, looking at a 5% sampling (approximately 1.5 million people) of Medicare beneficiaries continuously enrolled from 1999 to 2003, concluded that those with moderate, severe, and total vision loss experienced increases in depression, injuries, and the need for nursing-home facilities. The study also showed that Medicare beneficiaries with coded diagnoses of vision loss incurred significantly higher costs than those with normal vision, and approximately 90% of those costs were non-eye related.

More than half of the cases were due to age-related macular degeneration (AMD) and glaucoma, and a sizable number of cases of vision loss were due to cataracts that had not been surgically removed.

“These are all treatable conditions. If identified early, the adverse effects of glaucoma and AMD can be minimized, and cataracts can easily be treated,” said H. Dunbar Hoskins Jr., MD, AAO executive vice president.

Jonathan C. Javitt, MD, MPH, was the lead researcher on the study, which was conducted by researchers affiliated with the Potomac Institute for Policy Studies, the Wilmer Eye Institute at Johns Hopkins University School of Medicine, and Pfizer Inc.

The academy and Dr. Javitt said the study is a chance for the Centers for Medicare and Medicaid Services to build on the Medicare Glaucoma Detection Act of 2001, which covers an annual glaucoma screening for patients at risk, as well as its coverage of eye exams for those with diabetes, available since 1998. Awareness of these benefits is low, however; the academy noted that fewer than 45% of patients on Medicare with diabetes have had an eye exam.