Welcome, Medicare Nation! My guest today is Dr. Steven Loomis, an optometrist in Littleton, CO. Dr. Loomis is also the president of the American Optometric Association. Did you know that June is Cataract Awareness Month? It’s important to know what cataracts are, how they develop, and how to treat them. Dr. Loomis is here to discuss those topics and others related to general eye health. Join us!
- Many people don’t understand the difference between an optometrist and ophthalmologist. Can you explain?
- Think of an optometrist “like a family doctor for your eyes.” These are medical doctors with four years of undergraduate education and four years of specialization. They deal with eye issues such as blurred vision, diabetes, and glaucoma. Optometrists actually diagnosed 240,000 cases of diabetes in 2014! An ophthalmologist is an eye surgeon who works in conjunction with a patient’s optometrist.
- We know we need comprehensive eye exams, but how often should we get them, and what is included in that exam?
- An annual exam is recommended unless there is a condition that warrants more frequent care. Specific tests are included, such as visual acuity, auto refraction, an image of the inside of the eye, visual field, blood pressure, and a check of the pupils. The doctor will also ask questions about medical family history.
- What exactly does “20/20 vision” mean?
- Vision is based on the Snellen Acuity Chart, which was invented by Dr. Snellen over 100 years ago. It is the basic eye chart we are all familiar with that has a series of letters or shapes of certain sizes. The “20 foot” standard has been established, meaning that you see what you should see at a distance of 20 feet. A vision of 20/30 or 20/40 means that you see at 20 ft. what the normal eye sees at 30 or 40 ft. Some people see better than normal, like 20/15. It’s interesting how they measure the 20 feet distance, when most exam rooms are not 20 ft. long. The chart might be 12 ft. away from the patient on the wall, and a mirror is placed 8 ft. behind the patient, to make up the 20 ft. distance.
- As we age, does 20/20 vision decrease?
- Yes, unfortunately. It’s completely normal because our eyes age as do other parts of our bodies. As your lens ages, cataracts may form and the retina and cornea lose some functionality.
- What are “floaters,” and can they clear up?
- Floaters are very common. They can be seen during an eye exam with dilated eyes. What happens is that the vitreous fluid in the eye, which should be firm, solid, and gelatinous, begins to liquefy as we age. This more liquid substance has fibers in it that appear in our vision as floaters. The good news is that they can clear up; they can shrink, sink, and then we THINK they are gone. If floaters increase or change, then see your optometrist to be checked.
- What is glaucoma?
- In short, it occurs when the pressure inside the eye damages the optic nerve. Risk factors include family history, racial characteristics, age, and medications. The first symptom is often vision loss.
- If glaucoma is indicated, what is the treatment?
- Medications can control the pressure. Usually eye drops are prescribed once daily and can safely manage the disease.
- What are cataracts and how are they treated?
- Cataracts are very, very common and usually show up around age 60. The lens becomes not as clear as it used to be as it loses its clarity and transparency. Exposure to UV rays can cause them, as well as steroids, diabetes, radiation treatments, eye trauma, and eye surgery. The #1 cause? Too many birthdays! There is no treatment needed for early cataracts, but they can worsen to cause hazy vision and nighttime glare. Surgery is the only cure, where the natural lens is removed and an artificial lens is implanted. The good news is that your lens prescription can be incorporated into the artificial lens so your vision is improved on multiple layers. (Tune in to hear a fascinating account of cataract surgery details! Did you know it only takes 5-8 minutes to complete?)
- How do Medicare benefits factor into cataract surgery?
- Medicare will pay for a monofocal artificial lens, but the patient can pay for an upgraded lens if desired. Medicare, depending on your plan, will pay a portion of glasses or contacts needed for after surgery.
- Final words from Dr. Loomis: Keep up with your annual eye exams and discuss options with your doctor when issues arise. Visit www.aoa.org for more information and for their “doctor locator” tool.
- Question from Eileen in PA: Does Medicare cover eyeglasses? The answer is no, except for what is needed after cataract surgery, and then a portion may be covered under your plan.
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