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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.

  • Effectiveness of Conventional Digital Fundus Photography-Based Teleretinal Screening for Diabetic Retinopathy and Diabetic Macular Edema - IN PRESS
    from AAO OTAC Retina/Vitreous Panel, Hoskins Center for Quality Eye Care
    Compared with traditional surveillance methods, teleretinal screening for diabetic retinopathy is accurate and cost-effective in detecting referable-level disease and may also improve overall screening compliance rates via improved care access and patient preference.
    Ophthalmic Technology Assessment
    Toric Monofocal Intraocular Lenses for the Correction of Astigmatism during Cataract Surgery
    from AAO OTAC Refractive Management/Intervention Panel, Hoskins Center for Quality Eye Care
    In eyes with clinically significant keratometric astigmatism, toric monofocal intraocular lens implantation at the time of cataract surgery results in excellent uncorrected distance visual acuity and good rotational stability postoperatively.
    Ophthalmic Technology Assessment
    Aqueous Shunts with Extraocular Reservoir for Open-Angle Adult Glaucoma
    from AAO OTAC Glaucoma Panel, Hoskins Center for Quality Eye Care
    Implantation of aqueous shunts with extraocular reservoir can lower intraocular pressure effectively with low risk of long-term complications in the management of open-angle glaucoma but is more effective as the primary procedure in eyes with higher baseline intraocular pres…
    Ophthalmic Technology Assessment
    Central Visual Field Testing in Early Glaucoma
    from AAO OTAC Glaucoma Panel, Hoskins Center for Quality Eye Care
    The 10-2 visual field test provides a useful complement to the standard 24-2 visual field test in some persons with early glaucoma.
    Ophthalmic Technology Assessment
    Trabecular Procedures Combined with Cataract Surgery for Open-Angle Glaucoma
    from AAO OTAC Glaucoma Panel, Hoskins Center for Quality Eye Care
    When performed concurrently with cataract surgery, trabecular procedures reduce intraocular pressure an additional 1.6 to 2.3 mmHg (3.8%–8.9%) over cataract surgery alone in subjects with hypertensive, mild to moderate open-angle glaucoma. Patient-specific considerations can…
    Ophthalmic Technology Assessment
    Advanced Corneal Imaging in Keratoconus
    from AAO OTAC Cornea and Anterior Segment Disorders Panel, Hoskins Center for Quality Eye Care
    Modern tomographic corneal imaging builds on topography to help clinicians detect keratoconus. Detection of keratoconus suspects remains more difficult than diagnosing frank keratoconus.
    Ophthalmic Technology Assessment
    Selective Laser Trabeculoplasty for the Treatment of Glaucoma
    from AAO OTAC Glaucoma Panel, Hoskins Center for Quality Eye Care
    Selective laser trabeculoplasty is an effective long-term option for the treatment of open-angle glaucoma. It can be used as either a primary intervention, a replacement for medication, or an additional therapy with glaucoma medications.
    Ophthalmic Technology Assessment
    Use of Mitomycin C in Dacryocystorhinostomy
    from AAO OTAC Oculoplastics/Orbit Panel, Hoskins Center for Quality Eye Care
    Intraoperative use of mitomycin-C (MMC) in external and endoscopic dacryocystorhinostomy (DCR) in adults has been shown to improve outcomes in some settings, but there is no agreement on the recommended concentration or application time for MMC.
    Ophthalmic Technology Assessment
    Levodopa/Carbidopa to Augment the Treatment of Amblyopia
    from AAO OTAC Pediatric Ophthalmology/Strabismus Panel, Hoskins Center for Quality Eye Care
    Augmentation of amblyopia therapy with the oral administration of levodopa/carbidopa has not demonstrated lasting improvements in vision, and the potential for long-term adverse effects limits prolonged use of these medications.
    Ophthalmic Technology Assessment
    Thermal Pulsation in the Management of Meibomian Gland Dysfunction and Dry Eye
    from AAO OTAC Oculoplastics/Orbit Panel, Hoskins Center for Quality Eye Care
    Although the current literature is potentially affected by industry bias, it suggests that thermal pulsation is safe and may be as effective as warm compress therapy and eyelid hygiene for meibomian gland dysfunction and dry eye.
    Ophthalmic Technology Assessment
    Corneal Hysteresis for the Diagnosis of Glaucoma and Assessment of Progression Risk OTA
    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
    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