Which Eye Care Specialist Do You Need?

It’s time to get your eyes checked – do you go to an ophthalmologist, optometrist or optician? Your optometrist sees the beginnings of age-related macular degeneration, but is sending you to see and ophthalmologist, why?

One of the most confusing things about taking care of your eyes can be differentiating between an ophthalmologist, optometrist and optician. Each eye care specialist has a very important part to play in the health of your eyes and here is a quick synopsis of what each does so you can choose the best one for your vision issues and treatment.

Ophthalmologist
These specialists are fully trained medical doctors that have completed the eight years of training beyond a bachelor’s degree. Their training has included a full spectrum of eye care, from prescribing glasses and contact lenses and giving eye injections, to carrying out intricate eye surgeries. Many doctors may also be involved eye research to better understand vision, improve eye disease treatments or potentially find a cure. They are easily identified by the MD following their name.

Optometrist
These medical professionals have completed a four-year program at an accredited school of optometry. They have been trained to prescribe and fit glasses and contact lenses, as well as diagnose and treat various eye diseases. They provide treatments through topical therapeutic agents and oral drugs, and are licensed to perform certain types of laser surgery, such as Lasik. They are easily identified by the OD following their name.

Optician
These eye care professionals are not licensed to perform eye exams, medical tests or treat patients. Their purpose is to take the prescription from the ophthalmologist or optometrist and work with you to determine which glasses or contact lenses work best for you. If you suffer from an eye disease like keratoconus, these specialists can make the difference between a relatively normal life, or one that is dictated short periods of vision because of contact lens pain. These eye care professionals may hold and associate optician degree or have apprenticed fore required number of hours.

While each one of these eye specialists has their own area of expertise, they can form a team whose only concerns are your eye health and the ability to see as clearly as possible.

8/11/15

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Eye Issues For Every Age Recap

Vision is something we take for granted, but when we start to have trouble seeing it is easy to panic. This blog has covered a variety of eye issues for every age, from children through older adults. Here are a few articles from leading doctors and specialists that you may have missed and might be of interest.

Bill Takeshita, OD, FAAO – Visual Aids and Techniques When Traveling

Michelle Moore, CHHC – The Best Nutrition for Older Adults

Arthur B. Epstein, OD, FAAO – Understanding and Treating Corneal Scratches and Abrasions

The National Eye Health Education Program (NEHEP) – Low Vision Awareness
Maintaining Healthy Vision

Sandra Young, OD – GMO and the Nutritional Content of Food

S. Barry Eiden, OD, FAAO – Selecting Your Best Vision Correction Options

Suber S. Huang, MD, MBA – It’s All About ME – What to Know About Macular Edema

Jun Lin, MD, PhD and James Tsai, MD, MBA – The Optic Nerve And Its Visual Link To The Brain

Ronald N. Gaster, MD FACS – Do You Have a Pterygium?

Anthony B. Nesburn, MD, FACS – Three Generations of Saving Vision

Chantal Boisvert, OD, MD – Vision and Special Needs Children

Judith Delgado – Driving and Age-Related Macular Degeneration

David L. Kading OD, FAAO and Charissa Young – Itchy Eyes? It Must Be Allergy Season

Lauren Hauptman – Traveling With Low Or No Vision / Must Love Dogs, Traveling with Guide Dogs / Coping With Retinitis Pigmentosa

Kate Steit – Living Well With Low Vision Online Courses

Bezalel Schendowich, OD – What Are Scleral Contact Lenses?

In addition here are few other topics you might find of interest, including some infographics and delicious recipes.

Pupils Respond to More Than Light

Watery, Red, Itchy Eyes

10 Tips for Healthy Eyes (infographic)

The Need For Medical Research Funding

Protective Eyewear for Home, Garden & Sports

7 Spring Fruits and Vegetables (with some great recipes)

6 Ways Women Can Stop Vision Loss

6 Signs of Eye Disease (infographic)

Do I Need Vision Insurance?

How to Help a Blind or Visually Impaired Person with Mobility

Your Comprehensive Eye Exam (infographic)

Famous People with Vision Loss – Part I

Famous People with Vision Loss – Part II

Development of Eyeglasses Timeline (infographic)

What eye topics do you want to learn about? Please let us know in the comments section below.

7/21/15

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Driving With Vision Loss

Challenges Faced by Individuals Driving With Vision Loss

Overview
People of all ages often view driving as the key to independence. Individuals with vision loss are no exception. Three groups of people with vision loss who wish to acquire or maintain the privilege of driving include teenagers with a congenital or acquired visual impairment who have never driven, adults with the same who have never driven, and adults with an acquired visual impairment who have driven in the past but may lose their license because of their vision loss. However, vision standards for driving vary from state to state, and this variation persists despite decades of research demonstrating that there is no absolute cutoff criteria in visual acuity or peripheral vision for safe versus unsafe driving. The fact that states have variable standards results in people with visual impairments not being able to be licensed in some states, including perhaps their own, while being able to be licensed in a neighboring state. Clearly, the ability of these individuals to safely operate a motor vehicle does not change when they cross a state line. Yet, to maintain at least some driving privileges, they may find themselves having to move to a different state.

It is well known that many older drivers modify their driving norms to help keep themselves and others safe. For example, many older drivers voluntarily reduce or stop driving at night, in hazardous weather conditions, or on super highways. By limiting their driving, older drivers, particularly those with visual impairments, are able to continue operating their automobiles safely and efficiently in spite of reduced vision. This is important, considering the vast majority of older adults live in the suburbs or in rural areas where automobiles are required for transportation.

Maximizing Visual Capabilities
It is important for all individuals, but particularly for drivers who are visually impaired, to make sure their spectacle correction is up-to-date. Contrast enhancement and glare control with filtering lenses can also be of great benefit. Most drivers have experienced driving into the glare of the sun, while looking through a dirty windshield. Although wearing sunglasses and keeping windshields clean is not mandatory, they certainly help drivers see more easily and feel more comfortable when driving.

Maximizing Visual Attention
Human factors research has found that inattention blindness and the cost of switching contribute to or directly cause automobile mishaps. Inattention blindness refers to when a person’s attention to one activity undermines his or her attention to other activities. For example, when drivers focus on directional signs, their attention is not on what is happening on the road in front of them. The cost of switching refers to the time it takes a person to switch attention between different activities. A common example that causes driving mishaps is when drivers text while driving. When people focus on texting while driving, their response to the traffic around them is delayed.

Useful Field of View testing research has shown that the time it takes a person to process visual information, especially the complicated visual environment experienced each time a person drives, increases with age. With this in mind, decreasing or eliminating the time it takes older drivers or drivers with visual impairments to look for and visually process signage should help them maintain their concentration on the road ahead and the traffic around them.

A simple way to reduce or eliminate the need to look for directional signage is with the use of a Global Positioning System (GPS) device that uses spoken directions. Older drivers and drivers with visual impairments in particular should consider using a GPS device with spoken directions so that they are freed from the distraction of looking for/at road signs and can keep their attention on the traffic around them.

Finally, with the technology, such as adaptive cruise control and lane alert warnings, currently available in cars, it is expected that all drivers will be safer behind the wheel.

Final Considerations
A good driver is someone who has the ability to perceive change in a rapidly changing environment; the mental ability to judge and react to this information quickly and appropriately; and the motor ability to execute these decisions, along with the compensatory skills to compensate for some loss of ability in the other areas. Additionally, a driver’s familiarity with the driving environment and his or her past driving record should be taken into account when considering limiting driving activities or retiring from driving altogether.

For many drivers with vision loss, a limited driver’s license that allows them to drive during daylight hours, within a restricted radius of their home, and at lower rates of speed may be all they desire. However, there are times when an individual will need to retire from driving altogether because of vision loss or a combination of vision and cognitive changes. When this time comes, the individual needs to understand that retiring from driving is for his or her safety and the safety of others.

Finally, it is well known that vision loss in general, as well as the loss of driving privileges, can lead to feelings of hopelessness and depression. Fortunately, there are many things that can enhance the functional abilities of individuals with vision loss. To learn about available resources for individuals with vision loss, visit the National Eye Health Education Program low vision program page at www.nei.nih.gov/nehep/programs/lowvision.

7/9/15

Mark Wilkinson, OD
University of Iowa Carver College of Medicine
Chair of the National Eye Health Education Program Low Vision Subcommittee

Scleral Lens Education Society

Scleral Contact Lenses have taken over a century to evolve into one of the best options for managing eye diseases such as keratoconus. This evolution began in the late 1800’s, with blown glass lenses. However, until the advent of highly oxygen permeable plastics, scleral lenses had very limited application. Now, with current technology and materials, scleral lenses have become a mainstream and rapidly growing lens option.

Scleral lenses are becoming more popular due to the exceptional comfort they can provide even to the most unusual eye shape. This comfort is attributable to their large size that allows them to tuck behind the eyelids, their relative lack of movement with eye blinks, and their fluid reservoir that keeps the cornea hydrated and does not actually touch the fragile corneal tissue in individuals with keratoconus.

As utilization of and demand for scleral lenses began to grow last decade, it became apparent that there was a need for more professionals trained in fitting scleral lenses, as well as someone to provide a consensus opinion for the eye care world on what the standard of care should be for these lenses. In addition, a process for providing a credential for those that attained a level of expertise in scleral lens fitting would allow those seeking experts in the field of fitting sclerals to find an experienced professional.

The Scleral Lens Education Society (SLS) was established in 2009 as an organization to help bring professional consensus to the suddenly rapidly growing area of scleral lenses. The mission statement of the SLS reads: “The Scleral Lens Education Society (SLS) is a non-profit organization 501(c)(3) committed to teaching contact lens practitioners the science and art of fitting all designs of scleral contact lenses for the purpose of managing corneal irregularity and ocular surface disease. SLS supports public education that highlights the benefits and availability of scleral contact lenses.”

Beginning with the founding board which included world renown experts in scleral lens fitting such as Greg DeNaeyer, OD, Christine Sindt, OD, and Bruce Baldwin, OD, PhD, the SLS has worked to spread the word about the potential benefits of scleral lens wear to both providers and patients alike. Professional education has included scleral lens webinars, workshops, and lecture series that are always standing room only events.

Currently, the SLS has over 2000 member contact lens practitioners as well as over 50 fellows, or certified scleral lens fitters that have demonstrated their expertise through a peer reviewed process of case reports, publications, and lectures. Many of these members and fellows are international, with SLS fellows from 11 countries, 5 different continents, and 20 different states in the US. Members hail from all 50 states, 6 continents, and over 40 countries.

In addition, the SLS has numerous industry sponsors that support the mission of the society to provide patient access to experienced fitters across the world. The sponsors provide the resources that allow the educational opportunities for practitioners as well as the website and patient resources that are available.

SLS board members are elected to serve in various capacities, including fellowship, public education, and international relations, and are elected to one year terms. The current board consists of:
President, Muriel Schornack, OD, Mayo Clinic, Rochester, MN
Vice President, Melissa Barnett, OD, University of California, Davis
Secretary, Michael Lipson, OD, University of Michigan
Treasurer, Mindy Toabe, OD, Metrohealth, Cleveland, OH
Immediate Past President, Jason Jedlicka, OD, Indiana University
Fellowship Chair, Pam Satjawatcharaphong, OD, University of California, Berkeley
Public Education Chair, Stephanie Woo, OD, Havasu Eye Center, Lake Havasu, AZ
International Chair, Langis Michaud, OD, University of Montreal

For more information about scleral lenses and the Scleral Lens Education Society, please visit the website at www.sclerallens.org. If you or someone you know might benefit from scleral lenses, you can locate a fitter in your area through the website as well. If you are unable to locate a fitter near you on the website, please contact the SLS and we will try to locate options in your local area.

7/2/15

Jason Jedlicka, OD
Clinical Associate Professor, Chief of Cornea and Contact Lens Service
Indiana University, School of Optometry

Vision Recap Of Previous Articles of Interest

Besides the comments that we get, one of the best parts of putting together this blog is the wonderful group of guests who share their expertise and personal stories. I want to thank all of the eye care professionals and friends that have contributed to make this blog a success.

Here is a quick vision recap of some of the articles we had in the past that you may have missed.

Jullia A. Rosdahl, MD, PhD – Coffee and Glaucoma and Taking Control of Glaucoma

David Liao, MD, PhD – What Are A Macular Pucker and Macular Hole?

Kooshay Malek – Being A Blind Artist

Dan Roberts – 15 Things Doctors Might Like Us To Know

Jennifer Villeneuve – Living With KC Isn’t Easy

Daniel D. Esmaili, MD – Posterior Vitreous Detachment

Donna Cole – Living With Dry Age-Related Macular Degeneration

Pouya N. Dayani, MD – Diabetes And The Potential For Diabetic Retinopathy

Robin Heinz Bratslavsky – Adjustments Can Help With Depression

Judith Delgado – Drugs to Treat Dry AMD and Inflammation

Kate Streit – Hadley’s Online Education for the Blind and Visually Impaired

Catherine Warren, RN – Can Keratoconus Progression Be Predicted?

Richard H. Roe, MD, MHS – Uveitis Explained

Sumit (Sam) Garg, MD – Cataract Surgery and Keratoconus

Howard J. Kaplan, MD – Spotlight Text – A New Way to Read

Gerry Trickle – Imagination and KC

In addition to the topics above, here are few more articles that cover a variety of vision issues:

If you have any topics that you would like to read about, please let us know in the comments section below.

6/23/15

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

What Are Scleral Contact Lenses?

In the beginning…of contact lenses…there were scleral lenses…only.

In the year 1887 a great gift was given to the world of sufferers of distorted vision resulting from corneal tissue that was irregular in shape from disease or trauma.

The contact lens was invented nearly simultaneously by physicians working separately in Germany and in France. Working from drawings of Leonardo da Vinci (1508) and ideas of the British astronomer Sir John Herschel (1828), August Müller and separately Adolph Fick and Eugene Kalt blew glass shells to fit the outer eye and to some extent remedy their visual difficulties. These lenses rested on the conjunctiva of the eye above the sclera or white of the eye and were thus the first scleral contact lenses — the first contact lenses of any sort.

What are Scleral Contact Lenses?

The design and manufacture of scleral lenses has been a story of technological development significant for improvement in comfort, material, and affinity for the ocular surface.

For many years the lenses were partially molded and partially ground from the material of which hard contact lenses are made: PMMA (poly-methyl methacrylate) known as Plexiglas or Perspex. To form these lenses, like tooth implants, a plaster cast is made from a negative mold prepared from dental impression putty. The plastic would be heated and given the shape of the fitting surface of the lens from the plaster cast and then the power and edge curves would be ground onto the outside surface of the lens. Later came preformed trial sets not unfamiliar to those which we use today.

The current generation of scleral lens fitting began sometime in the last fifteen years with the mating of advanced corneal topography measurements, computer driven lathes and the observations of some very clever contact lens scientists. Proprietary designs of scleral lenses offering a variety of diameters, fitting philosophies, and multiple parameters are filling the gaps contact lens specialists have been wrestling with using smaller corneal contact lens designs for decades with less than optimal results. Most recently a firm has begun manufacturing lenses with a 3-D printer from an image generated from the eye. One eye…one lens, the lens is meant to fit like a fingerprint.

When discussing contact lens treatment, experts are experts because they agree that, any sort, size, or design of lens will have both positive and negative effects on the eyes and the tissues surrounding them. While it is true that many of the fitting and comfort issues confronted with corneal lenses of any size and design can be managed well with scleral designs, the scleral lens can also be difficult for some patients; for some eyes; for some conditions.

From the outset the larger size of the today’s scleral lens provides comfort on par with soft contact lenses for exactly the same reason: their size. Also, like soft contact lenses the scleral will not move around on the surface of the eye allowing the wearer a much more relaxed contact lens experience — there is no necessity to balance small corneal lenses between tense eyelids – vision can be enjoyed in any direction of gaze. The lenses will not fall off the eye and the increased size is a clear plus in finding a dropped contact lens.

On the other hand the quality of vision gained with scleral lenses specifically in cases of distorted corneae is far more comparable to that achievable with corneal GP lenses than with soft contact lenses in most cases.

Over the years my keratoconus patients have benefited from a series of contact lens breakthroughs that have variously improved the quality of their vision, their comfort with contact lenses, or in some other way the health of their eyes. Some years ago I “re-invented” the piggy-back system of contact lens wear which I summarized in 2008 in an article published in the Contact Lens Spectrum. Piggy-backers would place their vision restoring firm contact lens on top of a disposable daily wear lens of minimal focusing power. The soft lens would reduce the sensation of the firm lens while in many cases preventing the contact lens from abrading the cornea. More recently I have been successfully moving patients to scleral lenses because there is certainly less bother (only one lens per eye) and far less worry over corneal abrasions as the lens rests on the conjunctiva over the sclera and maintains a fluid cushion over the cornea itself.

Scleral lenses are finding their place in the world of contact lens fitting primarily to remedy vision problems from very irregular or otherwise damaged corneae both those caused by developing disease and trauma through injury or surgery. More and more, these lenses are requested by patients with normal eyes who want to enjoy the benefits provided by these lenses while participating in sports or other activities.

Scleral lenses are renowned for their greater comfort. In many cases a correctly fitted lens can be worn for many waking hours. Many patients have found that they benefit from exchanging the fluid from the reservoir from time to time throughout the day. The fluid that fills the lens-cornea space is sterile, non-preserved normal saline or in some cases saline with a non-preserved tear substitute added when needed for improved comfort.

A proper care regimen for scleral lenses is not different from that for any other contact lens manufactured from a firm oxygen permeable material. The lenses require cleaning upon removal, soaking in a recommended solution appropriate to the material of the lens and a periodic treatment to remove protein deposits. Of course, the exact care specifications will vary from patient to patient according to the evaluation of their contact lens specialist.

Just like any lens modality, the fitting requires expertise. Many who fit and dispense contact lenses rely on boxed soft lenses for their patients. When corneae become distorted those lenses will hardly fill the need. Greater expertise is required to fit rigid corneal lenses needed for these more problematic surfaces. The decision of the corneal lens expert to move on to the world of larger lenses is not of the same magnitude as that from boxes to corneal GP lenses. The investment is more a matter of time spent in discussion with the manufacturer’s fitting consultants, some reading, a webinar or two and keeping up to date with the lens designs that are available.

I was not among the first to use the current generation of scleral lenses, but when the opportunity knocked some years ago, I realized the importance of this form of contact lens and I believe I have positively influenced the quality of life of many of my patients.

5/28/15

Bezalel Schendowich, OD
Medical Advisory Board of the National Keratoconus Foundation
Fellow of the International Association of Contact Lens Educators
Clinical Supervisor & Specialty Contact Lens Fitter, Sha’are Zedek Medical Center, Jerusalem, Israel

Traveling With Low Or No Vision

What Good is Sitting Alone in Your Room?

Traveling with low or no vision

There is a whole world out there to discover — regardless of whether you can see it all with your eyes. No one will tell you traveling with low or no vision does not present challenges, but there are precious few that cannot be overcome with planning, creativity and patience.

A plethora of for-profit and nonprofit companies exist to help you navigate the complexities of traveling with a vision disability — from technology and websites, to travel agents and tour operators. And don’t overlook helpful — and free! — resources such as your friends and family, assistance pets and even complete strangers.

Travel Tools
Everyday tools become even more essential when you are traveling in unfamiliar surroundings. A mobility cane (consider a small travel version) will let you find your way more easily — and notify others of your vision issues. This is especially helpful for two reasons: Strangers are less likely to get in your way and more likely to help if you ask for it. In a recent DEF blog post (“Visual Aids and Techniques When Traveling”

Linda Becker, who has retinitis pigmentosa (RP) and travels primarily with her guide dog, is planning her next trip to Australia and New Zealand with Mind’s Eye Travel, a company that specializes in creating tours especially for people who are blind or visually impaired, as well as providing sighted guides. There are many such companies that will assist you with all facets of travel, from immigration documents to reservations to tour guides. Traveleyes offers discounts to sighted travelers in exchange for helping guide non-sighted travelers during group vacations around the world. DisabledTravelers.com is a good resource for companies that specialize in travel for people with accessibility issues. It includes reviews and recommendations on everything from airlines and cruises, to travel agents and hotels.

Plan, Prep, Pack
Ask any experienced low-vision traveler, and they will tell you planning, planning and more planning is the key to successful travel. Not only will it make your trip go more smoothly, it will give you peace of mind, as well as the ability to relax and enjoy yourself. The fewer surprises, the more confident and comfortable you will feel. And if something does goes awry, it is easier “go with the flow,” because everything else has been planned.

Right at the top of the list with planning is, well, making a list. Prepare a list of all the items you will need, then double it. That means if you wear contact lenses, pack at least one extra pair, as well as cleaning solutions. Same goes for glasses and sunglasses. Make sure you have plenty of the medications and other supplies you use on a day-to-day basis. Most seasoned travelers suggest you have multiples of all these stashed in different bags: your carry-on, your suitcase and a handbag of some kind that never leaves your side. This way, if one bag gets lost, you still have another one or two. Sample sizes may become your best friend!

Carolyn Hammett, an accomplished photographer and world traveler who has keratoconus (KC), advises: “Be prepared; having backups makes you more comfortable. Be ready to change contact lenses in public restroom if you need to. Have one of everything you need, vision-wise, with you at all times.” To learn more about Hammett and see what she packs for a two-week trip, see “Through a Lens with One Eye Blind,” a story from our recent e-newsletter focused on travel experiences and tips.

“Leave extra time, notify airlines or others in advance that you may need assistance, and don’t be afraid to ask for help,” says Adam Lawrence, who also has RP and travels regularly with his guide dog. (Read more about traveling with guide dogs in “Traveling Tails”, from an article in our recent e-newsletter.

Speaking of help, don’t forget the helper sitting next to you right now, whether it’s a spouse, a friend or a guide dog. Traveling alone can be vexing for people with full vision, so it’s natural for those with low vision to feel even more anxiety.

Dame Judi Dench, who has age-related macular degeneration (AMD), recently told Radio Times she no longer travels alone. “I need someone to say, ‘Look out, there’s a step here!’ or else I fall all over the place like a mad, drunk lady,” she said.

“Don’t travel by yourself the first time — go with someone you trust, and let them know how much help you want,” Hammett says. “I’ve gotten to the point where I tell my husband, ‘Don’t tell me anything until I screw up.’”

With planning, preparation and practice, you may get to a point where you feel comfortable traveling alone. You will only know your limitations if you try to stretch them.

“Just try,” Hammett says. “Do it once to find out if you can.”

Additional Resources

Access-Able Travel Source’s “Travel Tips for People Who are Blind or Visually Impaired”

Society for Accessible Travel & Hospitality

Transportation Security Administration’s “Passengers Who Are Blind or Have Low Vision”

5/14/15

Lauren Hauptman
Lauren Hauptman INK

Itchy Eyes? It Must Be Allergy Season

Spring is in the air, which also means it’s the season for allergies (i.e. Itchy, watery, red and generally unhappy eyes). People with keratoconus need to be particularly careful around allergy season, because rubbing your eyes can exacerbate both your allergies and keratoconus. Among the general keratoconus population, we see a significant incidence of allergic eye disease, which causes itchy eyes. In addition to this, there is a high correlation of keratoconus patients who rub their eyes. If you are one of these, STOP. When you rub your itchy eyes, it damages the mast cells within the eye tissue, causing histamine to release from these cells. More histamine around your eyes will increase itching and your urge to rub, which in turn can cause keratoconus to get worse. So even if rubbing makes your itchy eyes feel good, stop: the potential long term damage outweighs the short-term relief.

Whether your eyes are watery, itchy, or red around this time, you’ll find the best relief beyond your neighborhood drug store’s allergy aisle. While there are over-the-counter medications that help allergies, they may not be the best option for you. Oral medications for allergies tend to dry out the body in general (which is why they make a runny nose stop running), which includes the eyes. When it comes to eye drop options for allergy relief, the results are often unpredictable and short-lived.

Some surprisingly simple changes to your home can help. Keeping the windows and doors closed to keep the allergens out is helpful. Take your shoes off before coming into the house, consider taking a shower before bedtime, or frequently wash your pillowcases, which may remove enough of the allergen to improve your symptoms. If you have a pet that goes outside, consider bathing them twice a week to remove allergens they track in. For direct, immediate relief, place a cold wash cloth on the surface of your eyes to calm the symptoms.

The next step to relief includes personalized recommendations from your eye care provider (ECP). A common medication your ECP may prescribe is an antihistamine-mast cell stabilizer, such as Pataday or Lastacaft. These combination drugs use an antihistamine for immediate comfort and a mast cell stabilizer to carry out the benefits long term. Often these medications are so effective that they may be the only ones you need. When your allergies are severe and this combination drug is not enough, your ECP may add a topical steroid ointment to complete your treatment.

Be extremely diligent in rubbing and rinsing your lenses with fresh solution prior to storing them overnight. This will help to remove the allergens that have accumulated on them during the day.

Even if your annual eye exam doesn’t happen around allergy season, remember to visit your eye care provider if you have allergy symptoms. It may require a combination of prescription medications and environmental changes tailored to your specific symptoms to prepare your eyes now and for allergy seasons to come.

5/7/15

David L. Kading OD, FAAO
Specialty Eyecare Group
Offices in Kirkland, WA and Seatte, WA

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Charissa Young
Optometric Extern
Eye Care Group of Southern Oregon, PC

Do I Need Vision Insurance?

With the rising costs of health insurance, many people are looking for ways to reduce their costs. Since not all insurance packages include vision insurance, many people wonder, do I need vision insurance?

Standard Vision Insurance

Vision insurance is a type of health insurance that entitles you to specific eye care benefits such as routine eye exams and other procedures, as well as a specified dollar mount or discount for the purchase of eyeglasses and contact lenses. It only supplements regular health insurance and is designed to help reduce your costs for routine preventative eye care and eyewear.

You can get vision insurance as part of a group, such as your employer, an association, etc., through a government program such as Medicare or Medicaid, or as an individual. It is often a benefit linked to your regular HMO (health maintenance organization) or PPO (preferred provider organization) health insurance.

There are two primary vision insurance plans available:

Vision Benefits Package – provides free eye care services and eyewear within a fixed dollar amount for which you pay an annual premium or membership fee and a small co-pay. It may also include a deductible.
Discount Vision Plan – provides eye care and eyewear at a discounted rate after you pay an annual premium or membership fee.

Both insurance plans generally include:

Annual eye exams
Eyeglass frames (usually once every 24 months)
Eyeglass lenses (usually once every 24 months)
Contact lenses (usually once every 24 months)
Discounted rates for LASIK and PRK

Here is where you can check for a list of some vision insurance providers.

Medicare and Medicaid

Different kinds of vision care are included in the US government programs, Medicare and Medicaid. These programs are for qualifying American age 65 and older, individuals with specific disabilities and people with low income.

The Types of Medicare For Vision:

Medicare Part A (Hospital Insurance) –Medical eye problems that require a hospital emergency room attention, but routine eye exams are NOT covered.
Medicare Part B (Medical Insurance) – Visits to an eye doctor that are related to an eye disease, but routine eye exams are NOT covered.
Medicare Part D (Prescription Drug Coverage) – Will help pay for prescription medications for eye diseases.

If you have Medicare Parts A & B you are generally eligible for the following vision coverage, however, there is a deductible before Medicare will start to pay, at which point you will still be paying a percentage of the remaining costs.

Cataract surgery – covers many of the cost including a standard intraocular lens (IOL). If you chose a premium IOL to correct your eyesight and reduce your need for glasses, you must pay for this added cost out-of-pocket.
Eyewear after cataract surgery – one pair of standard eyeglasses OR contact lenses.
Glaucoma screening – an annual screening for people at high risk for glaucoma, including people with diabetes or a family history, and African-Americans whom are 50 or older.
Ocular prostheses – costs related to the replacement and maintenance of an artificial eye.

There is also Medicare Supplement Insurance (Medigap) which is sold by private insurance companies to supplement only Medicare Parts A & B. It is intended to cover your share of the costs of Medicare-covered services including coinsurance, co-payments and deductibles. For more details about Medicare plans and coverage check their website or call 800-633-4227.

Medicaid is the US health program that gives medical benefits to low-income people who may have no or inadequate medical insurance. A person eligible for Medicaid may be asked to make a co-payment at the time medical service is provided. Vision benefits for children under the age of 21 include eye exams, eyeglass frames and lenses. Each state determines how often these services are provided and some states offer similar vision services to adults. To learn more about Medicaid eligibility requirements and vision benefits call your state’s Medicaid agency or visit their website.

Defined Contribution Health Plans

A way to lower your vison care costs is to take part in a defined contribution health plan (DCHP). You are given a menu of health care benefits to choose from where a portion of the fees you receive for health coverage come from money that is deducted from our paycheck before federal, state and social security taxes are calculated. Four types of DCHP are:

Cafeteria Plans – your employer takes a portion of your salary and deposits it into a non-taxable account for health care spending. The amount taken depends on the number and costs of the benefits you select.

Flexible Spending Accounts (FSA) – your employer takes a predetermined portion of your pre-tax salary and deposits it into health care account for you to pay medical expenses. But generally preventative care such as routine eye exams and are not reimbursable. Nor are eyeglasses and contact lenses reimbursable. You would need to verify with your employer. If you do not use all the money at the end of a 12 month period, the money goes back to your employer.

Health Reimbursement Arrangement (HRA) – this is similar to an FSA except you can use it for preventative care like eye exams and you do not lose the money if it isn’t spent within a certain time period as it can be carried from year to year.

Health Savings Account (HSA) – it can be employer-sponsored of you can set up one independently; however you must purchase a high-deductible health insurance plan to open an HSA and you cannot exceed the annual deductible of your health insurance plan. You cannot be enrolled in Medicare of be a depended on someone else’s tax return. You can use it for preventive care such as eye exams. You can learn more about HSAs by visiting the US Treasury’s website.

There are a variety of options when it comes to vision insurance. You just need to determine your needs and ask providers the correct questions.

4/14/15

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Medical Research Funding Needs Individual Donors

The Need for Medical Research Funding

About 1.75 million U.S. residents currently have advanced age-related macular degeneration with associated vision loss, with that number expected to grow to almost 3 million by the year 2020.

About 8.4 million individuals worldwide are blind from primary open-angle glaucoma, with that number expected to grow to almost 11 million by the year 2020.

About 22 million Americans have cataracts affecting their vision, with that number expected to grow to more than 30 million by the year 2020.

The economic impact of this increase of people with vision loss will be tremendous. But right now scientist are working on ways to treat and eventually cure many eye diseases. The only problem is the funding necessary to support this sight-saving research. Here is a look at the decline of medical research funding in the US and what you can do to help.

3/17/15

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

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Challenges Faced by Individuals Driving With Vision Loss

What are Scleral Contact Lenses?

What Good is Sitting Alone in Your Room?

Standard Vision Insurance

Medicare and Medicaid

Defined Contribution Health Plans

The Need for Medical Research Funding

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