Fewer Eye Exams for Diabetics?
But what really concerns Olansky, professor of medicine at the University of Oklahoma Health Science Center, is that HMOs will use the new study as an excuse to reduce needed benefits. "The real difficulty is I can imagine an HMO saying it only needs to be done every two years, and you are going to have patients who are going to need it more often," she says.
Olansky suggests that all diabetes patients should have dilated eye exams at least two years in a row. Unless there are findings of heightened risk of retinopathy, she would leave the question of whether less frequent examinations are needed up to the ophthalmologist.
Vijan and Olansky both worry about patients who are not getting screened at all. Currently, half of the 5.3 million non-insulin-dependent diabetes patients in the U.S. don't get annual eye exams. "A lot of people aren't getting screened," Vijan says. "A certain group is coming in every year, and a certain group is not coming in at all. I'm really worried about getting to that latter group. The best way to do that is open for debate; it is something we need to study more."