Medicare Rules Updated for Intraocular Lenses

Cataract surgery is the most commonly performed medically indicated operation. Millions of cataract surgery patients now have more choices than ever before.

Traditionally, the eye surgeon selected a distance-vision correcting lens implant. Medicare paid for the intraocular lens (IOL). With the introduction of innovative (and much more expensive) IOL designs that simultaneously correct for both distance and near vision, Medicare and private insurers initially balked. Patients were left to pay for the entire IOL.

Relief, some relief, is on the way for folks with astigmatism.

The Centers for Medicare & Medicaid Services (CMS) have added astigmatism-correcting (toric) IOLs to the list of devices available to beneficiaries who are willing to pay out of pocket for materials and services that exceed the agency's customary reimbursement for cataract surgery. This new policy, which was enacted on January 22, 2007 is similar to a May 2005 ruling that granted beneficiaries access to presbyopia-correcting IOLs. 'Access' means the insurer pays the equivalent for the standard IOL and the patient covers the balance.

Although the CMS have not identified which IOLs will be impacted by this ruling, Alcon Laboratories, Inc. (Fort Worth, TX), and STAAR Surgical Company (Monrovia, CA) anticipate that their toric IOLs will be among the eligible lenses.

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• Medicare Premiums to Rise Nearly 6%
• 9 Key Points About Medicare Coverage

Technorati Tags: medicare, cataracts, surgery, medicare coverage

Must See, Must Have: Low-Vision Gadget

Millions of Americans see so poorly that they cannot qualify for a driver's license. These people possess Low Vision. In addition to experiencing a blurry world, low vision patients may also endure blind spots or significant visual field defects. Some have only a small island of vision.

So, what is it like to have low vision? Imagine someone smearing your 52" plasma HD monitor with petroleum jelly and then masking large segments of the screen with pieces of black paper.

Magnifiers and other low vision devices have been around for a long time. Eye doctors refer their low vision patients to a clinical specialist who can assist the individual find the most workable devices.

I rarely endorse commercial products, but this new gadget is worthy of attention. It's called Scribolux - a portable illuminated magnifier that is durable and very easy to use. It runs on 4 'AA' batteries and its LCD lamp never needs replacement.

Other stand magnifiers are available, however, the design of the Scribolux 2.8x magnifying lens is such that the user can enjoy a larger viewing area than similar-looking devices. Instead of reading single, enlarged letters the individual can see an entire word or even a full line of text (depending on text layout).

You probably know someone who has trouble reading. Why not tell them about the Scribolux? Click here to learn more.


DISCLAIMER: Dr. Lloyd has no financial interest in Eschenbach Optik of America, Inc. and received no compensation for comments posted in this blog. Dr. Lloyd thinks the Scribolux is very cool!

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• WebMD Video: Low Vision Aids
• WebMD Video: Retinal Disease Study

Technorati Tags: low vision, gadgets, scribolux

Back from the Future

I just had the opportunity to take a sneak peek at the newly designed WebMD. Most 'redesigned' websites are typically more cosmetic, that is to say, more style than substance. Not so with WebMD. They have dropped the engine and replaced the transmission!

This WebMD overhaul has been in the works for a long time and I know you will be pleased with all of the upcoming improvements.

They won't let me divulge everything but I did spend time at the new WebMD Eye Care Center. It is extremely well-organized and very easy to navigate. One cool feature is a new visual symptom simulator that gives members a realistic feel for the kinds of changes generated by various eye problems: cataract, glaucoma, etc.

There is also a huge directory of all the different kinds of refractive surgery procedures. You know, the alphabet soup (PRK, LASIK, AK, etc.) They are all presented in one location. Soon I will be able to respond to Message Board inquiries with a simple link to that very informative page. In case you were wondering, members can easily enlarge the screen print size with one click. It's something many of you have requested.

I've hardly begun to showcase all of the innovations at the WebMD Eye Care Center. You'll need to see it yourself to appreciate all that will soon be available. Coming soon to a browser near you!

Technorati Tags: webmd preview

Need One More Good Reason to Quit?

1,519,086 people can't be wrong!

That's the number of brand new Medicare enrollees that were randomized to a population study designed to identify factors that lead to the development of macular degeneration. These were everyday people of all types with all kinds of health issues.

Age-related macular degeneration (ARMD) is the leading cause of irreversible vision loss in older adults. It affects millions of Americans but early treatment can preserve eyesight. More and more attention is now being paid to preventing ARMD.

I'll try not to bore you with the numbers (there are plenty of them), but when the health records of these 1,519,086 Seniors were analyzed, ARMD was statistically more common in:

• Females
• Caucasians
• Diabetics
• Heart-attack survivors
• Hypertensives
• Smokers

The statistical connection between heart attacks, smoking, and ARMD was significant. Future studies will be necessary to control for other lifestyle variables, but it is likely that the smoking+ARMD link will only strengthen.

Short of breath and blind in 2027? Quit kidding yourself and take action today! Most insurance plans will pay for smoking cessation treatments. Innovative medical and behavioral therapies can help you permanently end your addiction to nicotine.

SOURCE: Duan Y, Mo J, Klein R: Age-related macular degeneration is associated with incident myocardial infarction among elderly Americans. (in press) Ophthalmology 2007.

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Technorati Tags: ARMD, smoking, smoking cessation

When Doctor's Dad Needs Eye Surgery

Last week my father told me his eye doctor recommended that he undergo cataract surgery. As an ophthalmologist my mind is flooded with many conflicting thoughts.

Should I step-in and organize things?

Should I make a few phone calls so that my father has access to some high-volume surgical superstar?

Should I make discreet inquiries regarding the qualifications and reputation of his local eye surgeon?

Should I just be still and let Dad continue to run his own life as he has for 86 years?

My dad is very active and enjoys good health. He is one of the funniest people I know and definitely the kindest. I want the absolute best for him and I know how to get it.

That's why I will just be still and let him continue to run his own life.

I have learned to fear VIP Medicine. I have witnessed how it actually causes more complications and leads to the kinds of disasters that never befall ordinary folks.

When health care providers begin to bend the rules to accommodate 'someone special' they make dangerous compromises. They typically offer a lower standard of care. How's that for a paradox - important people receiving marginal care!

Dad went for his cataract operation yesterday. He was back home in just a few hours - no problems. Time to plan our next trip together.

I'm glad I chose not to treat him like a VIP. He's the kindest person I've ever known.

Related Topics:

• 6 Signs Your Parents Need Help
• Cataracts and Your Eyes

Technorati Tags: cataracts, surgery, health

Decide NOW to be an Eye Donor

What are the odds?

Over the past two weeks I twice found myself waiting at the Department of Motor Vehicles. One time it was about me (license had nearly expired!), the other visit was for my daughter (newly licensed driver).

Oh, the noise of humanity! The hordes of grumbling motorists, the inconsolable infants, the monotonous public address messages. Above it all, the one sound that I clearly heard was the DMV clerks' inquiry "Do you agree to become an organ donor?"

Do YOU agree to become an organ donor?

As an ophthalmologist this is a very important question. Most folks hear the phrase 'organ donor' and they think of hearts, lungs, and livers. Truth be told, corneal transplantation is far more common and far more successful. And remember, two people benefit when the eyes are donated.

This is no time to be squishy. Check your driver's license. Have you agreed to organ donation in the event of your untimely death? Organ donation is an act of extreme generosity encouraged by all major religious faiths and cultures. Yes, you can decide to donate individual organs or let many recipients benefit from your good legacy. Take my word for it, nobody viewing your open casket will notice anything missing - 'She looks fabulous!'

Finally, if you agree to let others live after your life has ended then be sure to inform others of your decision. It will insure that your organs are harvested expeditiously and it will inspire others to follow your marvelous example.

Related Topics:

• Organ Donors Needed: Transplants Save Lives
• Getting College Students to Become Organ Donors

Technorati Tags: organ donor, cornea transplant

MS Suspected? Vision Tests Helpful

Some clinical diagnoses are remarkably straightforward. For example, sudden pain in the right lower belly with nausea and an elevated white cell count is indicative for acute appendicitis. Yes, there are exceptions but most of the time it's the appendix.

Multiple Sclerosis (MS) is very different. It is a subtle, insidious autoimmune disorder that slowly destroys the myelin in your nervous system. The 'hotspot' on this brain scan illustrates a MS plaque. No two MS patients are the same, nor is their clinical course. It runs the spectrum from mild to wild.

Since no doctor wants to rush to label a patient with a potentially life-threatening demyelinating neurologic disorder, it may take months or years before a diagnosis can be established with confidence. Such a delay can postpone treatment opportunities and therapeutic options.

Did you know that eye symptoms are among the earliest changes that affect MS patients?

Vision specialists at Houston-based MS Eye Care (a collaborative research center) have identified four vision tests that, when combined, offer very useful predictive information regarding the presence of multiple sclerosis.

Families worried about a loved one's prospects for having MS might ask their local doctors about ordering these painless, noninvasive tests:

1. Visual evoked potential
2. Multifocal visual evoked potential
3. Optical coherence tomography
4. Visual fields

These experts suggest that obtaining the complete panel of tests at one time can help to promptly identify (or exclude) possible MS suspects. Should symptoms persist or progress these baseline tests become very valuable in determining if any measurable change in vision function has occurred.

SOURCE: Wall Street Journal, 01/02/2006

Related Topics:

• Arm Yourself Against MS
• MS: Treating the Patient, Not Just the Pain

Technorati Tags: MS, Multiple Sclerosis, MS diagnosis, tomography