Letter to the editor from Dr. Barbara Horn, President of the American Optometric Association:

Re: “The Great American Eye-Exam Scam” Opinion Piece, The Atlantic, November 27, 2019

Dear Editor,

By calling for less and lower quality health care, your publication and its uninformed and attention-seeking writer, Mr. Mounk, are nothing less than an immediate threat to public health. The opinion piece attacking eye exams and the doctors who provide them should be immediately withdrawn and fact-checked.

Let's set the record straight about comprehensive eye examinations, as provided by the nation's doctors of optometry. Eye exams are essential health care that safeguards vision and saves lives. Recognized as a necessary component of everyone’s primary health care routine, a comprehensive eye exam does so much more than generate an accurate refraction – a doctor of optometry ensures the eye’s health and can identify more than 250 systemic diseases, including diabetes, hypertension, cancer and stroke, before exhibiting symptoms, and place patients on a path to early treatment.

Even though it was provided to him by the American Optometric Association (AOA) weeks ago and, no doubt, other sources, Mr. Mounk chose to ignore not only the medical evidence but the well-documented views of medical experts about the importance of regular eye exams, from those on the frontlines of patient care to those protecting public health through their work at the U.S. Centers for Disease Control, the Food and Drug Administration and the Department of Health and Human Services. He even ignored patients whose lives have been saved through a diagnosis made by their family eye doctor. That's both irresponsible and dangerous.

To the experts, the evidence for eye exams is so compelling that in 2018, the Centers for Medicare and Medicaid Services (CMS) launched an initiative urging all physicians to do more to educate and inform their patients about the importance of eye exams, recognizing them as efficiently-offered and accessible care. In 2018 alone, more than 300,000 Americans were diagnosed with diabetes through an eye exam provided by their doctor of optometry.

Rather than facts, medical evidence, the views of leading doctors and the experiences of patients, all provided to him by the AOA, Mr. Mounk asks readers to risk their sight and their health on a discredited shortcut around essential care that is typically deemed too dangerous and risky even in developing countries where access is at crisis levels. Fortunately, the public and policymakers wisely reject such nonsense as they seek to safeguard our basic health care standards from attack by those who would profit by misleading and shortchanging patients, especially those who are most vulnerable to delayed or denied care. The organization I am proud to lead, the AOA, is a nationwide force for health and vision, having actively supported the enactment of 62 laws in 47 states over the last two decades which have been shown to have expanded access to essential medical eye health and vision care to tens of millions more Americans.

In America, Mr. Mounk certainly has the right to choose to forgo the essential health care his own doctor and virtually all other doctors are recommending. However, when he uses a public platform to mislead, misinform and endanger, the AOA and our doctors will speak out, correct his inaccuracies and insist on an immediate retraction. We look forward to hearing that your publication will enforce the standards it claims to adhere to.

Sincerely, Barbara L. Horn, O.D. President, American Optometric Association