Glasses Are Being Overprescribed for Young U. S. Children, Leading Pediatric Ophthalmology Journal Asserts.

TORRANCE, Calif. -- Journal of AAPOS Publishes Landmark Article on the Cost to the Nation of "Unnecessary" Glasses for Children

The annual cost of prescribing "unnecessary" glasses to pre-school aged children could add up to hundreds of millions of dollars according to an article being published in the June issue of the Journal of AAPOS(1), the leading peer-reviewed journal dedicated to pediatric ophthalmology. Sean P. Donahue, MD, Associate Professor of Ophthalmology, Pediatrics and Neurology of Vanderbilt University authored the article, which looks at eye examination results of more than 100,000 children screened in Tennessee from 1997 to 2003. Dr. Donahue determined that of the 3,640 children referred for follow-up exams, 890 were found to have satisfactory vision and thus were considered false-positives. Yet almost 20 percent of the children were still prescribed eyeglasses. Dr. Donahue, in an effort to determine the overall cost for these "unnecessary" spectacles, applied the data to the entire nation. He concluded that at a rate of $150 per pair, the annual cost to the country of prescribing "unnecessary" glasses could potentially exceed $200 million.

"With Dr. Donahue's article, pediatric ophthalmologists now have concrete data to back up what had long been only anecdotally supported," said Dr. Sherwin J. Isenberg, Editor-in-Chief of Journal of the American Association of Pediatric Ophthalmology and Strabismus (JAAPOS). "This study illustrates the importance of disseminating information and informing the medical community and the public about groundbreaking research."

Dr. Donahue further found that the rate of prescribing these "unnecessary" glasses was 35.1 percent when the child was evaluated by an optometrist and 11.7 percent when evaluated by a comprehensive ophthalmologist. The rate fell to just 1.8 percent when the child was examined by a pediatric ophthalmologist.

Donahue's research can be seen as relevant to the current controversy about the value of vision screening in children and the pending legislation in many states mandating such screening. According to Dr. Sherwin J. Isenberg, M.D., editor-in-chief of the Journal of AAPOS, much of this legislation is supported by optical trade organizations.

An editorial in the same issue by Steven J. Lichtenstein, MD, who practices pediatric ophthalmology in Kentucky (currently the only state with mandatory screening of all children prior to kindergarten by an optometrist or ophthalmologist), asserts that of the many children in Kentucky who had received "unnecessary" glasses, many had their glasses paid for by the state. In the editorial, Dr. Lichtenstein comments that he regrets that those funds were not used for the more than 1,400 Kentuckians in nursing homes who have been denied Medicaid benefits or the 198 denied admission to nursing homes because of a shortfall in Medicaid funding between April and July 2003. Dr. Lichtenstein holds that Dr. Donahue's research is "an alert about proper use of the dwindling medical dollar and the real cost of mandatory eye screening in children when the system is abused."

The American Association for Pediatric Ophthalmology and Strabismus, the society associated with the Journal of AAPOS, says that it supports the concept of vision screening, but recommends that screening by conducted by pediatricians and family practitioners as well as eye professionals.

The study is reported in the article, "How Often Are Spectacles Prescribed in Normal Preschool Children?" in the June issue of Journal of AAPOS, official journal of the American Association for Pediatric Ophthalmology and Strabismus, which is published by Elsevier.

About The American Association for Pediatric Ophthalmology and Strabismus

The mission of AAPOS is to provide ethical leadership for comprehensive medical and surgical eye care of children and adults with strabismus. It strives to accomplish this through education of present and future members, other health care providers and the public, and by encouraging research. Visit AAPOS at www.aapos.org.

Journal of AAPOS is the leading peer-reviewed journal dedicated to pediatric ophthalmology. Visit the journal at www.mosby.com/jaapos.

About Elsevier

Elsevier is a world-leading science and medical publisher. Working in partnership with the global science and health communities, the company publishes more than 1,800 journals and 2,200 new books per year. It also offers a suite of innovative electronic products such as ScienceDirect and MD Consult, bibliographic databases, online reference works and subject-specific portals. Visit Elsevier at www.elsevier.com.

(1) JAAPOS 2004; 8: 224-229.