Eyeglasses overprescribed for children, study asserts

Children with “satisfactory vision” are often prescribed unnecessary eyeglasses following vision screenings, according to a large retrospective study of school-aged children in Tennessee.

Sean P. Donahue, MD, reviewed eye examination results of more than 100,000 children screened in Tennessee from 1997 to 2003. Of the 3,640 children referred for follow-up exams, 890 were found to have satisfactory vision and thus were considered false-positives, he reported in the June issue of the Journal of the American Association of Pediatric Ophthalmology and Strabismus.

Of the false-positives, he said, almost 20% were prescribed eyeglasses. Extrapolating the data from Tennessee to the whole United States, Dr. Donahue said that at a rate of $150 per pair of glasses, the annual cost of prescribing unnecessary glasses could exceed $200 million.

Dr. Donahue also found that the rate of unnecessary glasses prescriptions was 35.1% when the child was evaluated by an optometrist, 11.7% when evaluated by a comprehensive ophthalmologist and 1.8% when examined by a pediatric ophthalmologist.

According to a press release issued by the journal, Dr. Donahue’s research adds to the growing controversy about pediatric vision screening. An editorial in the same issue noted that, in Kentucky, the state paid for many of the unnecessary glasses, thus diverting limited Medicaid funds away from other potential uses.

Dr. Donahue’s research “is an alert about proper use of the dwindling medical dollar and the real cost of mandatory eye screening in children when the system is abused,” the editorial said.