AOA president to IOM: Comprehensive eye exams essential to prevention and public health

AOA President David A. Cockrell, O.D., ensured optometry's clinical experience, public health expertise, and insight into effective prevention will be incorporated into a new study on visual impairment and eye health in the United States.

"The only preventive public health intervention that will accomplish these goals is regular comprehensive eye examination."

Addressing the Institute of Medicine (IOM) Committee on Public Health Approaches to Reduce Vision Impairment and Promote Eye Health on May 19, Dr. Cockrell reiterated AOA's decision to sponsor the new consensus study to provide a vital, common-sense perspective that has been missing in previous public health studies in these areas.

"The AOA hopes the consensus study will have a meaningful, positive impact on public policy, resulting in high-quality, safe and accessible eye health and vision care for all Americans for decades to come," Dr. Cockrell told members of the committee.

The year-long IOM consensus study that seeks to examine the core principles and public health strategies to meet their aforementioned goals has just commenced, and will focus on the following topics:

• Public health burden on eye disease and vision loss.
• Prevention and care of eye disease and impaired vision.
• Evidence-based health promotion interventions for vision loss.
• Collaborative strategies to promote vision and eye health as a public health priority.

Key to AOA sponsoring the study is reinforcing and standing firm on the position that the most effective and efficient preventive public health intervention for the wide range of vision care needs facing Americans remains regular comprehensive eye examination, performed in person by an eye doctor.

Studies and reports released by the IOM are widely read on Capitol Hill and within federal agencies and, often, impact policies for a decade or more, according to AOA Washington office staff.

4 areas of prioritization

In addressing the committee, Dr. Cockrell pledged AOA's support as a trusted resource and charged the committee members with considering four areas of prioritization to realize their goal, namely:

1. Regular comprehensive eye examination provided in person by an eye doctor remains key in the eye and vision health of Americans of all ages, and through the Affordable Care Act's essential health benefit, Medicare, Medicaid, the Children's Health Insurance Program, and a growing number of private health plans, more Americans now have coverage for routine eye exams than ever before.
2. Eye health and vision care needs of Americans of all ages must be accurately identified and efficiently addressed without overlooking the disparities on vulnerable populations, and the IOM should focus on eye disease prevention, as well.
3. The language regarding eye health and vision care must be precise so the public understands the benefits, differences and drawbacks, and so policymakers understand the data—e.g., a “vision screening” should not be used interchangeably with “eye examination.”
4. The IOM must distinguish between what's difficult and what's illogical; access to care and delivering care can be challenging, but they can be achieved with effort, innovation and teamwork, whereas an inherently flawed approach does not get better with repetition.

"The AOA celebrates and embraces many scientific advances in eye health and vision care, but cautions the IOM not to simply equate 'innovative' with 'better,'" Dr. Cockrell told the committee. The growing application of telehealth, for instance, brings with it great potential and plenty of concerns.

"As you embark on this important work, we urge this committee to, first and foremost, keep in mind that the only preventive public health intervention that will accomplish the goals of the consensus study is regular comprehensive eye examination provided in person by an eye doctor."