ADA's Dr. Robert Gabbay Discusses Patient, System Challenges to Eyecare

Third of four parts

Less than half of Americans with diabetes get annual eye exams, says Robert Gabbay, M.D.,Ph.D., FACP, who became chief scientific and medical officer for the American Diabetes Association this summer.

“We need to do better,” said Gabbay in a video interview with Managed Healthcare Executive® this week. Retinopathy from diabetes is the leading cause of blindness among working age adults, said Gabbay, “and it is largely preventable.”

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The diabetes association has launched a public health campaign to encourage people with diabetes to get eye exams. The association’s partners in the campaign are VSP Vision Care, a vision care insurance company, and Regeneron.

Both optometrists and ophthalmologists can do routine eye exams, and Gabbay noted that 80% of eye exams are done by optometrists. “I think the key is getting screened and then based on what disease might be present seeing an ophthalmologist who can treat that disease.”

Gabbay and the campaign are focused on exams of the retina to detect retinopathy that usually entail getting the eyes dilated. He said some people mistakenly believe that the routine eye exams for glasses or contactlenses that involve reading an eye chart are sufficient. “Well,” he said, “they don’t count.”

Retinal cameras at primary care offices could help so more people could get screened “right then and there,” Gabbay said. “Otherwise it is one more appointment with one more healthcare professional, located elsewhere.”

People’s uncertainty about their health insurance can be another factor in people not getting these exams, Gabbay said. “It is not simple and it is not always clear to the individual with diabetes that this will be covered.” Gabbay noted that high-deductible health plans can expose people to the cost of services like eye exams. “The net result is for the person living with diabetes, yes, there could be a cost barrier.”