Eye doctors took one on the chin last month, right there in USA Today, on ABC News on your drive-time radio, following the release of a study by Sean P. Donahue, MD, an associate professor of ophthalmology, pediatrics and neurology at Vanderbilt University.

 His study* assessed the eye exam results of more than 100,000 Tennessee children screened from 1997 to 2003. Dr. Donahue determined that of the 3,640 children referred for follow-up exams, 890 were false-positives who actually had satisfactory vision. Yet almost 20 percent of these children were prescribed eyeglasses. Extrapolating the overall cost for unnecessary spectacles nationally, Dr. Donahue estimated that at $150 per pair, the annual cost nationally of prescribing unnecessary glasses could exceed $200 million.
This study is fated to become another scrap tossed into the sausage grinder that is the debate over eye exams versus screening for the nation's children. Is it cost-effective to devote dwindling health-care dollars to improve the identification of children with vision problems? In this argument, apples are regularly compared to oranges and oranges to mangoes, because the studies that would directly address the issues either can't be devised or haven't been funded.

Dr. Donahue's study never set out to resolve that question, but it highlights a serious need for a better understanding of why so many cases were misdiagnosed: 11.7 percent of the children prescribed glasses unnecessarily were seen by general ophthalmologists; 35.1 percent were evaluated by optometrists. True, no one's going blind, but both numbers are far too high and make for media coverage that eye doctors don't need.

I'd like to see the lens and frame makers step up on this one. Maybe fund a study to find out why this happens and how to fix it. It could come from the buckets of money they pour into programs such as the disingenuously tagged "Check Yearly, See Clearly" p.r. campaign by the Vision Council of America. (VCA spokesmen insist this program does not promote yearly exams, which they admit are unnecessary in the vast majority of cases. But unless there's some form of at-home self-exam to detect refractive changes that I'm not aware of, "check yearly" means see your eye doctor every year. Clearly.)
I would think these are the very people who would be most interested in seeing this situation righted. I don't  know much about marketing but I'm pretty sure "Get a Second Opinion When Your Doctor Prescribes Glasses for Your Child" isn't going to move much merchandise.


* "How Often Are Spectacles Prescribed in Normal Preschool Children?" in the June issue of the Journal of the American Association for Pediatric Ophthalmology and Strabismus.