USPSTF's recent stance on glaucoma challenged

Arlington, VA-The United States Preventive Services Task Force's (USPSTF) recent decision that there is not enough scientific evidence to support the practice of screening for glaucoma has prompted a daylong conference between the Potomac Institute for Policy Studies and Glaucoma Foundation to examine this issue.

The task force made its decision based on the fact that it couldn't find evidence in federally funded trials conducted between 1980 and 2005. However, Rohit Varma, MD, professor of ophthalmology at the University of Southern California and Eve Higginbotham, MD, dean of Morehouse School of Medicine, presented data, which were not available during the time of the task force meeting, that established a link between early glaucomatous optic nerve loss and loss in visual function.

"The dilemma," according to Jonathan Javitt, MD, senior fellow of the Potomac Institute, professor of ophthalmology at Johns Hopkins University, and one of the working chairs of the conference, "is how do you prove something [i.e., that untreated glaucoma causes blindness] that everyone knows, that is obvious from animal experiments, and that can never be tested in a clinical trial because of the obvious ethical impossibility. Therefore, the conference focused on new evidence that even the earliest signs of glaucoma damage, which were observed in some clinical trials, are associated with meaningful effects on patient quality of life."

The USPSTF findings, according to policymakers, are inconsistent with independent reviews of their own organizations. Medicare for instance, after examining the science of glaucoma screening, supported congressional action that instituted glaucoma screening as one of Medicare's first funded prevention programs.