VARIATION IN OPHTHALMIC TESTING BEFORE CATARACT-SURGERY - RESULTS OF A NATIONAL SURVEY OF OPHTHALMOLOGISTS

Little information is available either for the clinical value of many ophthalmic tests performed preoperatively in the evaluation of patient s for cataract surgery of for variation in ophthalmologists use of suc h tests. To assess variation in ophthalmologists' use of ophthalmic te sts, we conducted a national survey of American Academy of Ophthalmolo gy members. Thirty-three percent, 17%, 37% and 19% of the respondents reported that they ''frequently'' or ''always'' perform glare testing, contrast sensitivity testing, potential acuity measurement, and specu lar microscopy, respectively, in patients being considered for catarac t surgery who have no history of eye disease other than cataract. In c ontrast, 27%, 54%, 24%, and 48% of respondents reported that they neve r perform each of these four tests in such patients. Two ophthalmologi st characteristics-a surgical volume of greater than 200 cataract extr actions per year and performance of surgery in an ambulatory surgical center or private office (as opposed to a hospital)-were independently associated with an increased probability of performing each of these four tests frequently or always. Ten percent of less of the respondent s reported that they frequently or always perform electroretinography, visual evoked response testing, photography of fundus or anterior seg ment, B-scan ultrasonagraphy, formal color vision testing, and formal visual field testing in such patients. Thus, there is considerable var iation in ophthalmologists' use of glare testing, contrast sensitivity testing, potential acuity measurement, and specular microscopy. A sma ll percentage of ophthalmologists may be overusing several other tests in the evaluation of patients being considered for cataract surgery.