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February 27, 1995

Optometric Care and Undetected Eye Disease: A Case of Berkson's Bias?

Author Affiliations

Denver, Colo

Berkeley, Calif

Arch Intern Med. 1995;155(4):427-429. doi:10.1001/archinte.1995.00430040103016

In the August 22,1994, issue of the Archives, Wang et al1 reported on risk factors associated with patients' awareness of their own eye disease, such as cataract, glaucoma, diabetic retinopathy, and age-related macular degeneration. Among other factors such as age, general health, history of diabetes, and having insurance for eye care, the authors identified a 7.25-fold increase in the risk of unawareness of eye disease on the part of the patient if the previous eye care practitioner was an optometrist. It is unfortunate that the authors could not resist the pejorative comment, "the prevalence of eye disease in optometrists' offices and the effectiveness of the tests conducted by optometrists to identify eye disease requires further investigation."1 Such over-extension of the results from this study is a cause for continuing divisiveness between two professions and serves no patients well.

The fact that this conclusion is not in any way