Every morning, my drive-time entertainment is provided courtesy of a tiny radio station whose signal, depending on the prevailing winds, manages to sail beyond the campus of the small university that operates it. Obviously fulfilling its FCC duty, the station occasionally runs a public-service spot from the Foundation Fighting Blindness in which an elderly man speaks of his encroaching AMD and why early detection is so important. Somehow, I suspect, the message falls mainly on the deaf ears of otherwise-occupied 18-year-olds on campus.

It's generally accepted that sight is the most precious of human senses. Not as well-established is why so many people at risk for sight-threatening diseases fail to avail themselves of the advantages of regular eye exams. Duke University's Paul Lee, MD, JD, took a stab at that issue with a nine-year study of Medicare beneficiaries in this month's Ophthalmology.

What's disturbing about Dr. Lee's study was the poor rate of compliance with recommended eye exams even among patients already diagnosed with AMD, glaucoma or diabetes. The worst performance was among patients with diabetes. The authors propose the latter is generally diagnosed by a primary-care physician, while AMD and glaucoma are diagnosed more often by eye doctors. An established relationship with an eye doctor may benefit these patients in terms of their understanding of the value of regular follow-up. Among the proposed solutions is better education of both the public and community physicians about the consequences of non-compliance.

But when does the public hear that message outside of an eye doctor's office?
Instead of blanket programs that lose their meaning by encouraging yearly eye exams for everyone, when most of us don't need them, what is needed is a more focused message targeted directly at the middle-aged and older patient population moving into prime territory for AMD, glaucoma and diabetes.

Maybe some of the dollars thrown at promoting refractive surgery procedures could be better directed at getting the simple message out that if you're over 65, see your eye doctor every year. If you're over 40 and have symptoms or are at risk for systemic disease like diabetes, don't skip your eye exam. We can get to the finer points in time. Right now, the signal is weak and the message is not getting through.

—Chris Glenn, Editor in Chief