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  • H. Dunbar Hoskins Jr., MDThe H. Dunbar Hoskins Jr., M.D. Center for Quality Eye Care was established as a quality of care and health policy research center that advances the accessibility to and appropriateness of eye care services. The work of the Hoskins Center will help ensure that patients continue to receive high quality, evidence-based eye care within a tightening economic environment that demands increased value for services provided.

  • Corneal Hysteresis for the Diagnosis of Glaucoma and Assessment of Progression Risk OTA - IN PRESS
    from AAO OTAC Glaucoma Panel, Hoskins Center for Quality Eye Care
    Corneal hysteresis measurements appear to complement structural and functional assessments in the diagnosis of glaucoma and the assessment of risk for glaucoma progression.
    Ophthalmic Technology Assessment
    Surgical Treatments to Improve Visual Acuity in Infantile Nystagmus Syndrome OTA - IN PRESS
    from AAO OTAC Pediatric Ophthalmology/Strabismus Panel, Hoskins Center for Quality Eye Care
    Eye muscle surgery in patients with infantile nystagmus syndrome may confer modest improvements in binocular best corrected visual acuity.
    Ophthalmic Technology Assessment
    Management of Pain after Photorefractive Keratectomy OTA
    from AAO OTAC Refractive Management/Intervention Panel, Hoskins Center for Quality Eye Care
    The use of specific therapeutic soft contact lenses, topical and oral NSAIDs, topical anesthetics, postoperative cold patches, and systemic opioid agonists can be effective for reducing postoperative photorefractive keratectomy pain.
    Ophthalmic Technology Assessment
    Effectiveness of Laser Refractive Surgery to Address Anisometropic Amblyogenic Refractive Error in Children
    from AAO OTAC Pediatric Ophthalmology/Strabismus Panel, Hoskins Center for Quality Eye Care
    Laser refractive surgery to address amblyogenic refractive error in children appears to reduce anisometropia effectively; however, higher-quality studies are needed to make conclusive recommendations regarding effectiveness and long-term visual and safety outcomes.
    Ophthalmic Technology Assessment
    Femtosecond Laser-Assisted Cataract Surgery OTA
    from AAO OTAC Refractive Management/Intervention Panel, Hoskins Center for Quality Eye Care
    Femtosecond laser assisted cataract surgery achieves similar refractive and safety outcomes as conventional phacoemulsification cataract surgery.
    Ophthalmic Technology Assessment
    Orbital Radiation for Thyroid Eye Disease OTA
    from AAO OTAC Oculoplastics/Orbit Panel, Hoskins Center for Quality Eye Care
    Orbital radiation appears to modify the active phase of thyroid eye disease. It may help prevent and treat compressive optic neuropathy, improve motility restriction, and decrease clinical activity in thyroid eye disease.
    Ophthalmic Technology Assessment
    Adjustable Sutures in the Treatment of Strabismus OTA
    from AAO OTAC Pediatric Ophthalmology/Strabismus Panel, Hoskins Center for Quality Eye Care
    Adjustable and nonadjustable suture techniques resulted in good surgical outcomes. Most assessed studies reported advantages of adjustable over nonadjustable suture techniques, but the significance and magnitude of these findings are uncertain, and warrant further investigat…
    Ophthalmic Technology Assessment
    Intravitreal Pharmacotherapies for Diabetic Macular Edema OTA
    from AAO OTAC Retina/Vitreous Panel, Hoskins Center for Quality Eye Care
    Intravitreal anti-VEGF and corticosteroid therapeutics are effective for the treatment of diabetic macular edema. Cataract progression and ocular hypertension are potential adverse events related to corticosteroid therapy. The literature does not conclusively assess comparat…
    Ophthalmic Technology Assessment
    Home- and Office-Based Vergence and Accommodative Therapies for Treatment of Convergence Insufficiency in Children and Young Adults OTA
    from AAO OTAC Pediatric Ophthalmology/Strabismus Panel, Hoskins Center for Quality Eye Care
    Office-based vergence and accommodative therapies improve motor outcomes in children with symptomatic CI, although data are inconsistent regarding symptomatic relief. Evidence is insufficient to determine whether home-based therapies are effective.
    Ophthalmic Technology Assessment
    Botulinum Toxin Injection for the Treatment of Strabismus
    from AAO OTAC Pediatric Ophthalmology/Strabismus Panel, Hoskins Center for Quality Eye Care
    Extraocular muscle injection of botulinum toxin type A (BXTA) for horizontal strabismus achieves high rates of successful motor alignment comparable to eye muscle surgery. Limited data are available on comparative sensory outcomes in children for these 2 treatments for strab…
    Ophthalmic Technology Assessment
    Multifocal and Accommodating Intraocular Lenses for the Treatment of Presbyopia OTA
    from AAO OTAC Refractive Management/Intervention Panel, Hoskins Center for Quality Eye Care
    The evidence reviewed shows no superiority of any single IOL implantation technique in the absence of zonular support. Various techniques provide equivalent outcomes but each technique has its own profile of inherent risk of postoperative complications.
    Ophthalmic Technology Assessment
    OCT Angiography for the Diagnosis of Glaucoma OTA
    from AAO OTAC Glaucoma Panel, Hoskins Center for Quality Eye Care
    Vessel density loss associated with glaucoma can be detected by OCTA. Peripapillary, macular, and choroidal vessel density parameters may complement visual field and structural OCT measurements in the diagnosis of glaucoma.
    Ophthalmic Technology Assessment
    Homeopathic Agents or Vitamins in Reducing Ecchymosis after Oculofacial Surgery OTA - IN PRESS
    from AAO OTAC Oculoplastics and Orbit Panel, Hoskins Center for Quality Eye Care
    The current literature does not support the use of topical Arnica montana, vitamin K oxide, R. tomentosum, or Melilotus extract for reducing ecchymosis after oculofacial surgery or pulsed dye laser surgery.
    Ophthalmic Technology Assessment
    Office- or Facility-Based Probing for Congenital Nasolacrimal Duct Obstruction OTA
    from AAO OTAC Pediatric Ophthalmology/Strabismus Panel, Hoskins Center for Quality Eye Care
    Evidence supports the efficacy and safety of both in-office and facility-based surgery for congenital NLDO. However, treating bilateral NLDO in a facility setting may be better. Because a significant percentage of children achieved resolution spontaneously before 12 months o…
    Ophthalmic Technology Assessment
    Intraocular Lens Power Calculation in Eyes with Previous Excimer Laser Surgery for Myopia OTA
    from AAO OTAC Refractive Management/Intervention Panel and Hoskins Center for Quality Eye Care
    Calculation methods requiring both prerefractive surgery keratometry and manifest refraction are no longer considered the gold standard. Refractive outcomes of cataract surgery in eyes that had previous excimer laser surgery are less accurate than in eyes that did not.
    Ophthalmic Technology Assessment
    Interventions for Indirect Traumatic Optic Neuropathy OTA
    from AAO OTAC Oculoplastics and Orbit Panel, Hoskins Center for Quality Eye Care
    Despite reports of visual improvement with corticosteroids, optic canal decompression, and medical therapy for indirect TON, the weight of published evidence does not demonstrate a consistent benefit for any of these interventions. In summary, no consensus exists from studie…
    Ophthalmic Technology Assessment
    Intense Pulsed Light for Meibomian Gland Disease OTA
    from AAO OTAC Oculoplastics and Orbit Panel, Hoskins Center for Quality Eye Care
    Although methodological limitations and potential conflicts of interest in some studies raised concern, the existing body of literature demonstrates improvements in the signs and symptoms of MGD after IPL therapy.
    Ophthalmic Technology Assessment
    Intraocular Lens Implantation in the Absence of Zonular Support: An Outcomes and Safety Update OTA
    from AAO OTAC Cornea and Anterior Segment Disorders Panel, Hoskins Center for Quality Eye Care
    The evidence reviewed shows no superiority of any single IOL implantation technique in the absence of zonular support. The various techniques seem to have equivalent visual acuity outcomes and safety profiles. Each technique has its own profile of inherent risk of postoperat…
    Ophthalmic Technology Assessment
    Sentinel Lymph Node Biopsy for Eyelid and Conjunctival Malignancy OTA
    from AAO OTAC Oculoplastics and Orbit Panel, Hoskins Center for Quality Eye Care
    Sentinel lymph node biopsy is a promising procedure in patients with eyelid and conjunctival malignancy, and it is useful in identifying sentinel lymph nodes. However, at present, insufficient evidence exists showing that SLNB improves patient outcomes and survival. Recognit…
    Ophthalmic Technology Assessment
    Imaging Methods for Differentiating Pediatric Papilledema from Pseudopapilledema OTA
    from AAO OTAC Pediatric Ophthalmology/Strabismus Panel, Hoskins Center for Quality Eye Care
    Although several imaging methods demonstrated high positive and negative percent agreement with clinical diagnosis, no ophthalmic imaging method conclusively differentiated papilledema from pseudopapilledema in children because of the lack of high-quality evidence.
    Ophthalmic Technology Assessment