JustCare

Tag: Vision

  • Lasik surgery may permanently harm your eyes

    Lasik surgery may permanently harm your eyes

    Before deciding to spend your money on Lasik surgery (laser eye surgery) to correct your vision, you should understand the potentially harmful side effects. Roni Caryn Rabin reports for The New York Times that Lasik surgery may permanently harm your eyes. Blurry vision and dry eye are two common side effects of Lasik surgery, which can last a lifetime.

    Lasik surgery is a fairly common procedure. Since it was first approved, nearly 10 million Americans have gotten Lasik surgery to correct their vision. Yet, many of them appear not to appreciate the potential side effects.

    The side effects of Lasik surgery range in number and severity. Some people experience irreversible damage to their eyes, with serious trouble seeing and agonizing eye pain after Lasik surgery. One person featured in Rabin’s story reported seeing in triplicate, extreme sensitivity to light, light rings around bright objects, dry eye, a burning sensation in his eyes, and poor night vision.

    The FDA lists several side effects of Lasik surgery on its web site, but reports that “most patients are very pleased with the results.” Results of a recent clinical trial of Lasik surgery patients published in January 2017 in JAMA Ophthalmology suggest that the FDA may be overstating people’s satisfaction with the results. “Many participants without visual symptoms at baseline developed symptoms following the procedure,” according to the JAMA study.

    Almost half of people who had healthy eyes and received Lasik surgery developed visual aberrations afterwards. Almost one in three people suffered dry eye pain after Lasik surgery. In a 2008 FDA hearing, people who received Lasik surgery testified to the chronic pain they experienced after surgery, as well as job loss, depression and suicidal feelings.

    No doubt, many people appear happy with Lasik surgery. And, some people who receive laser eye surgery experience harmful side effects that go away after a few months. But, the risks of blurry vision, chronic eye pain, light sensitivity, and poor night vision are real and should not be taken lightly.

    Here’s more from Just Care:

  • Protect your eyesight: Free and low-cost vision care

    Protect your eyesight: Free and low-cost vision care

    Your ability to see well is precious. But, your vision is likely to deteriorate as you age. Some people develop eye diseases that have no early warning signs, including age-related macular degeneration, glaucoma, dry eye and diabetes eye disease. They require treatment to help preserve vision. In some cases, if you do not get treatment, you could lose your vision. So, you want to get your eyes checked regularly. While Medicare does not cover routine eye care or eyeglasses generally, here are some options for free or low-cost vision care.
    • Medicare pays for procedures to treat a chronic eye condition like a cataract, as well as glasses you need post cataract surgery.
    • Medicare pays for annual eye exams if you have diabetes or are at high risk for glaucoma.
    • Medicaid generally pays for eye care. For information about Medicaid coverage in your state visit the Kaiser Family Foundation.
    • PACE (Program of All-Inclusive Care for the Elderly). PACE programs generally provide vision care to program participants, along with an array of other important services. For more information, click here.
    • Federally Qualified Health Centers (FQHC). Across the country, thousands of FQHCs, sometimes called Community Health Centers or CHCs,  offer a wide range of free or low-cost health care services, including vision care. To find a health center near you, click here.
    • If you’re a Vet, the VA may cover your eye exam and glasses.
    • EyeCare America offers no-cost eye examinations through the Foundation of the American Academy of Ophthalmology,
    • Lions’ Club may assist older adults needing vision care. Contact your local Lions’ Club chapter through this online Lions’ Club Directory.
    • For information about free or low-cost eye care in your community, visit Eldercare.gov. Also, The National Federation of the Blind provides a range of online resources for older adults.
    Here are three ways you can protect your eyesight:
    1. Get an annual eye exam: According to the National Institute on Aging, if you’re over 65 you should have your eyes checked regularly.  Dilating your eyes allows the doctor to detect diseases, which need treating—such as cataracts, glaucoma, corneal diseases, retinal disorders and dry eye–but which may not show any symptoms. Early detection can help preserve your vision.
    2. See the eye doctor right away if you have vision problems such as swelling around your eyes, double vision, light flashes, eye pain or blurriness.
    3. Take care of your eyes: Wear sunglasses in bright light to protect against ultraviolet radiation, wear a broad-rimmed hat, eat healthy, and keep your weight in check.

    Here’s more from Just Care:

  • What Medicare covers

    What Medicare covers

    In order to plan for your care as you get older, it is good to know what Medicare covers and what it does not cover. You can then budget for your out-of-pocket costs. Because Medicare generally does not provide full coverage and does not cover some high-cost services, annual out-of-pocket health care costs with Medicare average $5,500. And, if you need to pay for long-term care services, unless you have Medicaid as well as Medicare, your costs will likely be much higher.

    Services Medicare covers: Medicare Part A–which is generally premium-free if you or your spouse paid Medicare taxes–covers hospital, skilled nursing facility, skilled rehabilitation facility, hospice and other inpatient services. Medicare Part B–which has a standard monthly premium of about $134, though people with higher incomes pay more–covers medical services from doctors, therapists and other Medicare-certified health care providers, along with medical equipment and supplies. (To be enrolled in traditional Medicare or a commercial Medicare Advantage plan, you need Medicare Parts A and B.) Medicare Part D–which has a monthly premium that varies depending upon the plan you choose–covers prescription drugs and is optional.

    Note: People who enroll in a commercial Medicare Advantage plan also have Medicare Part C.

    Click on the links below to learn more about Medicare’s benefits and the services it does not cover.

    Keep in mind that some costly services are expressly excluded from Medicare coverage.

    Services Medicare does not cover:

    If you qualify for Medicaid as well as Medicare, Medicaid may cover some of these services.

    Here’s more from Just Care:

  • Medicare should cover dental, vision and hearing services

    Medicare should cover dental, vision and hearing services

    A new paper in JAMA, by Amber Willink, Cathy Schoen and Karen Davis, explains why Medicare should cover dental, vision and hearing services. Right now, these three services, along with long-term care, are the biggest gaps in Medicare coverage. Lack of coverage for these services may lead to unnecessary hospitalizations and can push older adults into bankruptcy. Expanding Medicare to cover these services would benefit older adults, people with disabilities, health professionals and the Medicare program.

    A survey of people with Medicare in 2012 reveals that most people with Medicare end up going without needed vision, dental and hearing care. Three-quarters of people surveyed reported hearing difficulties and more than four out of five of them (84 percent) did not have a hearing aid.

    About 11 million people with Medicare (about 20 percent) said that they had trouble eating because of problems with their teeth, but seven in ten of them had not seen a dentist in the last year. (Here are some tips for getting free or low-cost dental care if you have Medicare.)

    Another 20.5 million people with Medicare reported problems with their eyesight, yet more than half of them (57 percent) had not had an eye exam in the past year. (Here are four things to do to protect your eyesight.)

    Cost is the primary reason people do not get these services. Hearing aids alone typically cost $4,700 for both ears. (That said, low-cost hearing aids may be available soon.) On average, people who received services spent $927 for dental services, $715 for vision services, and $1338 for hearing services.

    Not surprisingly, people with incomes under 100 percent of the federal poverty level were far less likely to get these critical services than people with incomes over 400 percent of the federal poverty level.  In most states, Medicaid does not pay for much if any vision, hearing or dental care.

    People who forego this care are far more likely to be hospitalized or to need emergency care than people who receive treatment for their vision, hearing and dental needs. There are currently two bills in Congress that would cover these services, but for now they appear to be going nowhere.

    Here’s more from Just Care:

  • Can you see clearly now?

    Can you see clearly now?

    Medicare does not cover vision care, and most studies of people with chronic conditions overlook the burden of not being able to see clearly. A 2015 JAMA report looks at the handicap of visual impairment relative to other chronic diseases. The researchers find that vision is important to quality of life, and vision impairment is a public health burden that warrants more consideration in public health policies.

    To assess the burden of vision impairment the researchers surveyed individuals to get a measure of quality-adjusted life years rather than mortality or disability. Survey results showed that after osteoarthritis/rheumatoid arthritis and stroke, vision impairment presented the greatest burden to people. Vision impairment affects people’s health-related quality of life a lot more than other chronic diseases. Its burden is substantial.

    If we are to prioritize the expenditure of health care resources, we need to understand which chronic diseases impose the greatest burdens. Today, there are about one million blind people and another 3.2 million people with visual impairments.

    With the population aging, the National Eye Institute (NEI), a division of the National Institutes of Health, projects that about seven million people will be visually impaired by 2030. People 80 and older are most likely to be affected by visual impairment or blindness.

    “Early detection and intervention — possibly as simple as prescribing corrective lenses — could go a long way toward preventing a significant proportion of avoidable vision loss,” according to NEI Director Paul A. Sieving, M.D., Ph.D.

    Here’s more from Just Care:

  • Cool tech for the older set

    Cool tech for the older set

    Earlier this year, Tech50plus.com issued its annual Boomie awards for the coolest technology products that came to market for the older set, people over 50.  There were awards for smart phones, tablets, laptops, smart watches and cameras, though I’m not clear why they are any better for older adults than anyone else.  But, here are three technology items that struck me as particularly intriguing, meeting a range of needs, including needs of people aging in place:

    Home security device: For $200, “Ring” let’s you see and speak with anyone who rings your doorbell, whether you’re at home or miles away.  And, sensors let you know about anything going on around your front door.  The promotional material suggests it’s easy to connect to your wifi system. To learn more, visit Ring.com.

    Assistive health technology for the visually impaired: OrCam, MyEye uses a tiny camera that clips onto eyeglasses to help people with limited or no vision “see.” A tiny computer that fits in your pocket connects with an earpiece, which enables the device to help you read and recognize whatever it is you point to.  And, through facial recognition, artificial intelligence and other smart technology, the device remembers what you teach it. The $3500 cost is steep; it includes training. And, no wifi connection is needed.  That said, the Be My Eyes app, bemyeyes.org, uses volunteers to help people see, by “lending” their eyes to the blind.

    Smart wear for bikers: A bright yellow biking jacket with LEDs and motion-activated turn signals on the arms could be what you need to stay safe on the road. It also features 23 other integrated LEDs in white and red to make sure others see you.  Also available in black. Made in England, it retails for $159. To learn more, visit Visijax.com.

    Here’s more from Just Care on 21st century tech:

  • Five ways to ease your fear of falling

    Five ways to ease your fear of falling

    Editor’s note: According to the National Institutes of Health, more than one in three older adults falls each year and the likelihood of falling increases with age. More than 1.6 million of them end up in the emergency room, with bone fractures and other serious injuries. Dianne Lange of Senior Planet offers this advice to help prevent falls:
    Having a fear of falling is a slippery slope. It turns out that being afraid you’re going to fall increases the risk that you will take a tumble, even when you’ve never fallen before. Whether your fear of falling is due to physical or medical issues, or you’re just anxious, there are things you can do to help yourself stay upright:

    1. Do exercises for balance and strength. You want to make your legs stronger, improve your balance and raise your confidence level.

    • Tai Chi is a good example of a practice that does all three.
    • Yoga is strengthening and has many poses that improve balance, some of which you can do seated.
    • There are also balance exercises that you can do almost any where — including while you’re standing in line at the grocery store.

    2. If you’re taking medications, have your health care provider or pharmacist review them so you’ll know if any cause dizziness, make you sleepy or might cause you fall for any other reason.

    3. Have your vision checked.

    4. At home, put away anything you could trip over on stairs and paths that you often walk, so you won’t have to worry. You can find tips on making your home safe on the CDC website.

    5. Check out your shoes. The American Podiatric Association has a 1-2-3 test that can help you evaluate whether your shoes are optimal for balance.

    This post is excerpted from “5 Ways to Ease Your Fear of Falling” on Senior Planet. To read the entire article, click here.

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    Here’s more from Just Care:

  • Don’t let your doctor intimidate you: A personal story

    Don’t let your doctor intimidate you: A personal story

    It was a balmy fall day last year, when I walked through the surprisingly creaky door of a well-respected ophthalmologist, who shall remain nameless. Let us call him, Dr. G.

    Why was I there? I needed to have cataracts removed from both my eyes. Dr. G was highly recommended by my usual ophthalmologist, a wise, older man who long ago gave up doing surgery.

    A word about cataracts: When you’re older and have blurry vision, it’s generally caused by something called a cataract. Older adults often have the cataracts or clouded lenses of their eyes surgically removed and replaced with an artificial lens. This surgery requires no hospitalization. The operation itself lasts about ten minutes. Recovery is generally less than half-an-hour. It’s a very quick and common procedure. And, Medicare pays for it.

    My vision was actually quite good and the doctor found nothing wrong with it. I could see long distances. And, I could see close up with reading glasses. But, he recommended I see Dr. G. because I had suddenly begun to hate driving at night; the oncoming lights blurred my vision and bothered me. So I made an appointment.

    Dr. G’s waiting room was packed to capacity. Even though I couldn’t find a seat, I was impressed. After a long wait, two assistants examined me superficially but well enough to hand Dr. G some needed information. He pointed out to me a machine he liked to use that Medicare did not cover.

    “Medicare,” Dr. G said, “doesn’t care how well I do my job, but I care. This machine costs three hundred dollars, per eye, but it provides important information. I’m using it if it’s okay with you.”

    What should I have said, “no, it’s not okay with me?” Should I have revealed that I’m a piker, that I couldn’t afford six hundred bucks? I said, meekly, “okay.”

    He proceeded with the examination. He told me something my doctor had never mentioned: that I had astigmatism in one eye.

    “Really?” said I, “I never knew that.”
”Well, you know it now,” said Dr. G.
Astigmatism has to do with how the eye focuses light. Apparently, my left eye doesn’t do light very well. Dr. G went on to explain that the astigmatism will require a tomic lens.

    “What’s that? I asked.

    “It’s a more sophisticated lens used to treat astigmatism,” Dr. G explained. “You need it. But it’s not fully covered by insurance. Should we go ahead with it? Say, yes.”

    When it was all over it took awhile for my eyes to adjust. Friends who had the same surgery said they could see amazingly clearer right away. I could not. I saw distances the same way I saw them before the operation. Reading was a problem; I needed a new prescription for reading glasses.

    A few weeks passed before Dr. G’s office barraged me with bills, some of which I paid until it got to be ridiculous, and I stopped paying.

    Moral of the story: Ask questions, don’t be intimidated by doctors, and don’t be so quick in allowing them to do whatever they want to do. There are great doctors out there, as we all know, doctors who are honest and who care, doctors who take Medicare as payment in full. But every once in awhile you come across a doctor like Dr. G. G for gonif.

    Here are some tips on how to choose a doctor and four questions to ask yourself about your primary care doctor to understand whether the doctor is meeting your needs. As for your eyes, here are four things to do to protect your eyesight and what to do if you think you may have glaucoma.

  • Glaucoma: See a doctor if you experience loss of vision or have a family history

    Glaucoma: See a doctor if you experience loss of vision or have a family history

    Almost one in 50 people over 40 are diagnosed with glaucoma. Glaucoma is a disease that hurts the eye’s optic nerve, leading to loss of vision or blindness. Early treatment, however, generally can prevent significant vision loss.

    You should see a doctor if you think you may have glaucoma. People over 60 are at highest risk for glaucoma. African Americans over 40 are at risk as well, along with diabetics and people with a family history of glaucoma.

    Although Medicare does not pay for standard vision tests, it does cover glaucoma screenings in some instances. Traditional Medicare covers 80 percent of the cost of a glaucoma test annually if you are at high-risk. Supplemental insurance, including Medicaid, should cover the remainder. In order to have coverage, you must visit a Medicare approved eye doctor. Medicare Advantage plans also cover the test if you see a network provider.

    Your eye doctor can detect glaucoma through a comprehensive dilated eye exam. And, if you have glaucoma, it usually can be treated with medications, laser surgery or standard surgery. Unfortunately, lost vision cannot be restored.

    You can read about other preventive services Medicare covers and that you might want to discuss with your doctor on Just Care.

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