Ophthalmologists Consider Five Tests and Treatments

The American Academy of Ophthalmology today announced it is participating in the Choosing Wisely campaign, a national initiative of the American Board of Internal Medicine Foundation to encourage conversations between patients and their doctors about treatment options and efficient use of health care dollars. The Academy is one of 17 organizations joining Choosing Wisely today – representing more than 350,000 physicians, nurses, pathologists, radiologists and other health care professionals – to release lists of commonly performed tests, procedures and treatments that patients and physicians should discuss.

The United States spends more on health care than many other industrialized nations, yet often does not achieve better health outcomes. This may be explained in part by an overuse of unnecessary and duplicative medical tests. Choosing Wisely, which promotes best practices and better management of health care resources, complements physicians' efforts to use evidence-based medicine to meet patients' needs.

To ensure that the best care options are considered for ophthalmic patients, the Academy has identified five common tests and treatments that ophthalmologists and patients should discuss:

Preoperative Medical Tests: Don't perform preoperative medical tests – such as an electrocardiogram or blood glucose test – prior to eye surgery unless there are specific signs indicating a need for them.

Imaging Tests: Don't routinely order imaging tests when there are no symptoms or signs of significant eye disease.

Antibiotics for Pink Eye: Don't prescribe antibiotics for pink eye that is caused by an adenovirus.

Antibiotics for Eye Injections: Don't routinely provide antibiotics before or after injections into the vitreous cavity of the eye.

Punctal Plugs for Dry Eye: Don't treat dry eye by inserting punctual plugs before attempting other options, such as medical treatments with artificial tears, lubricants and compresses.

"Some experts estimate that up to 30 percent of health care delivered in the US may be unnecessary or duplicative," said David W. Parke II, MD, CEO of the American Academy of Ophthalmology. "Not only does this represent significant waste, but it also underscores patients' unnecessary exposure to risks associated with any test or procedure. The American Academy of Ophthalmology is participating in Choosing Wisely as a way to support evidence-based medicine and promote greater patient involvement in their eye care. By increasing conversations between ophthalmologists and those they treat, we can better guarantee that patients receive the right eye care at the right time."

The Academy's health policy committee led the development of the list of five tests and treatments with input from members and ophthalmic subspecialty societies. Numerous recommendations and supporting evidence were researched and reviewed under the leadership of William L. Rich III, MD, the Academy's medical director of health policy.

"In medicine, more isn't necessarily better," said Dr. Rich. "Conversations around the five tests and treatments identified by the American Academy of Ophthalmology can reduce the potential for over-treating our patients. We will continue our work to identify treatments that could benefit from better conversations between ophthalmologists and their patients."

To date, twenty-five specialty societies have released lists through Choosing Wisely. The lists released today will be promoted nationwide through the Choosing Wisely campaign's consumer partners, including Consumer Reports, AARP, Wikipedia and the National Business Coalition on Health.

To learn more about Choosing Wisely and to view the complete lists and details about the recommendations, visit ChoosingWisely.org. To learn how patients can start conversations about the five ophthalmic tests and treatments above, visit geteyesmart.org.