The medicare glaucoma screening benefit: A critical program that misses its target

摘要

IN JANUARY 2002, UNITED STATES (US) EYE DOCTORS celebrated what was perceived as a huge victory: Medicare's first-time coverage of a screening benefit for an ocular disease, glaucoma. The benefit covers an annual dilated eye examination with an intraocular pressure measurement and direct ophthalmoscopy or slit-lamp bio-microscopic examination for individuals at high risk of glaucoma. Initially, high-risk individuals were defined as all African Americans aged 50 or older and individuals of any age or race/ethnicity with diabetes or a family history of glaucoma. In 2006, the benefit was expanded to cover Hispanics aged 65 and older. These groups were selected because primary open-angle glaucoma (POAG) is 4-5 times more common in African Americans than in whites, African Americans are far more likely to be blinded by glaucoma, and the prevalence of POAG in older Hispanic populations can be as high as in African Americans.