Is the examination for the early detection of the green star medical rip-off?

Many ophthalmologists offer a screening for the early detection of glaucoma and recommend it as a regular measure at intervals of 2-3 years from the age of 40 years. The glaucoma examination has become one of the most common IGeL services in German practices. IGeL stands for Individual Health Care and means that you have to pay for the medical offer yourself.

Health insurance pays only in case of suspected illness

From the statutory health insurance, the investigation is only paid if a specific suspected glaucoma is present. This is justified by the fact that it is not clear whether the benefit of this early detection measure actually outweighs the possible damage. Apart from unpleasant sensations and a possible risk of infection in the eye examination, it is mainly about wrong diagnoses. In principle, these can be expected in every early detection measure, for example in the notorious mammography screening for breast cancer.

Possible misdiagnosis: false positive and false negative

Two types of wrong diagnoses are possible: false-positive diagnosis mistakenly assumes glaucoma, although none at all. Unnecessary further diagnostic and possibly even therapeutic steps, which can always have side effects and risks, are the result. In a false negative diagnosis, however, an existing Green Star is overlooked and the person weighs in false security.

Overriding benefits likely, but not proven

Whenever a green star is detected with a screening test, it has paid off according to medical and ethical standards. The same applies if the eye health has been reliably confirmed. Both should overall outnumber the misdiagnosis numerically. Whether it is then also the not always transparent, often financially dominated interests of the health insurance companies is served, may be another matter.

Therefore, a proper glaucoma examination, which must include more than the mere measurement of the intraocular pressure, one can speak badly of rip-off. Alone, scientific studies are still lacking that substantiate this assumption.

Author: Dr. Hubertus Glaser