Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or diabetics with no diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or in the 12 months prior to the measurement period.
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Individual Clinician
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Group/Practice
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Health Plan
Measure Info
ACP supports “Diabetes: Eye Exam” for application at the health plan level. There are two different time intervals to meet the measure based on whether the patient has a history of retinopathy: 1) people with diabetes with routine eye exams screened every two years and 2) patients with documented retinopathy screened annually. The measure is more feasible at the health plan level as health plans have access to previous patient exam data. ACP does not support this measure for application at the individual physician level because of uncertain validity. Many physicians may not be able to determine if their diabetic patient has prior documentation of retinopathy and will order annual screening exams for all people with diabetes, which would be overuse. The developers should consider a definition in the denominator to clarify “documented retinopathy.” ACP does not support the measure at the group practice level because there is no testing data.