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October 1994

The Ischemic Optic Neuropathy Decompression Trial

Author Affiliations

Edina, Minn

Arch Ophthalmol. 1994;112(10):1275. doi:10.1001/archopht.1994.01090220025004

I read with interest the editorial by Kelman1 in the December 1993 issue of the Archives regarding the Ischemic Optic Neuropathy Decompression Trial (IONDT), but noticed some misleading information. Kelman stated that the IONDT is a clinical trial funded by the National Eye Institute, Bethesda, Md. The official brochure sent to ophthalmologists around the country states that the National Institutes of Health is the sponsor and that "patient care costs" will be billed to insurance coverage. The patient is responsible for "any other charges beyond what the insurance covers."

We all know that, in a clinical trial, more complete and frequent testing is done compared with the standard of care given in a private office. Who should pay for clinical trials? Dollars are becoming more scarce for research in all fields of medicine. Is it ethical to bill an insurance company for a surgical procedure that has not been