• 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.

  • 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
    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
    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
    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
    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
    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
    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
    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
    from AAO OTAC Pediatric Ophthalmology/Strabismus Panel, Hoskins Center for Quality Eye Care
    Cycloplegic autorefraction is appropriate to use in pediatric population-based studies. Cycloplegic retinoscopy can be valuable in individual clinical cases to confirm the accuracy of cycloplegic autorefraction, particularly when corrected visual acuity is worse than expecte…
    Ophthalmic Technology Assessment
    from AAO OTAC Oculoplastics and Orbit Panel, Hoskins Center for Quality Eye Care
    The current literature suggests that BADM grafts represent an implantation option for lower eyelid retraction repair. Short-term results are favorable, and the materials used may fill an important gap in care for patients for whom no acceptable alternatives exist.
    Ophthalmic Technology Assessment
    from AAO OTAC Pediatric Ophthalmology/Strabismus Panel, Hoskins Center for Quality Eye Care
    No level I evidence supports the use of binocular treatment as a substitute for current therapies for amblyopia (including patching and optical treatment). Two large randomized controlled trials showed inferior performance compared with standard patching treatment.
    Ophthalmic Technology Assessment
    from AAO OTAC Cornea and Anterior Segment Disorders Panel, Hoskins Center for Quality Eye Care
    Conclusions are limited owing to the absence of controlled trials. The literature suggest that autologous serum-based tears is a reasonable option in refractory cases of dry eyes or nonhealing epithelial defects.
    Ophthalmic Technology Assessment
    from AAO OTAC Pediatric Ophthalmology/Strabismus Panel, Hoskins Center for Quality Eye Care
    Intraocular lens implantation is not recommended for children 6 months of age or younger because there is a higher incidence of visual axis opacities with this treatment compared with aphakia. Implantation can be done safely with acceptable side effects in older children.
    Ophthalmic Technology Assessment
    from AAO OTAC Glaucoma Panel, Hoskins Center for Quality Eye Care
    Imaging using SS-OCT has demonstrated that the lamina cribrosa is likely biomechanically active and that significant changes occur in glaucoma. Standardized nomenclature, automated measurements, and longitudinal studies with larger and more diverse sample sizes are needed.
    Ophthalmic Technology Assessment
    from AAO OTAC Pediatric Ophthalmology/Strabismus Panel, Hoskins Center for Quality Eye Care
    Orthokeratology may be effective in slowing myopic progression for children and adolescents, with a potentially greater effect when initiated at an early age (6–8 years). Safety remains a concern because of the risk of potentially blinding microbial keratitis.
    Ophthalmic Technology Assessment
    from AAO OTAC Glaucoma Panel, Hoskins Center for Quality Eye Care
    Intravitreal injection of anti-VEGF agents results in an immediate and transient increase in IOP. A long-term increase in IOP also may be seen. Further studies are needed to determine at-risk populations and to determine the impact on glaucoma progression.
    Ophthalmic Technology Assessment
    from AAO OTAC Pediatric Ophthalmology/Strabismus Panel, Hoskins Center for Quality Eye Care
    There is limited evidence to support the safety and efficacy of β-blockers to promote regression of periocular hemangiomas. Additional research may confirm the best dosage and route of administration to maximize efficacy while minimizing side effects.
    Ophthalmic Technology Assessment
    from AAO OTAC Retina/Vitreous Panel, Hoskins Center for Quality Eye Care
    Review of the literature indicates that intravitreal injection of anti-VEGF therapy is safe and effective for neovascular AMD over 2 years. Further research is needed to evaluate long-term safety and comparative efficacy of these agents.
    Ophthalmic Technology Assessment
    from AAO OTAC Glaucoma Panel, Hoskins Center for Quality Eye Care
    Structural glaucomatous damage can be detected by SD OCT. Optic nerve, RNFL, and macular parameters can help the clinician distinguish the anatomic changes that are associated with patients with glaucoma when compared with normal subjects.
    Ophthalmic Technology Assessment
    from AAO OTAC Glaucoma Panel, Hoskins Center for Quality Eye Care
    LPI increases angle width in all stages of PAC and has a good safety profile. Most PACS eyes do not receive further intervention, whereas many PAC and APAC eyes, and most PACG eyes, receive further treatment.
    Ophthalmic Technology Assessment