YOUR EYE IS COMPOSED OF MORE THAN 2 MILLION WORKING PARTS
Eye care education is something everyone’s entitled to and important that you have access to resources when you need them. The information provided herein is for patients and their families to learn general information about common eye facts. Your eye care professional who has examined either your eyes, or your family member’s eyes, and who is familiar with your medical history is the best person to answer specific questions.
How To Use Eye Drops
Infections, inflammation, glaucoma, and many other eye disorders are treated simply with eye drops. Surprisingly, even the small amount of medication in an eye drop can have significant side effects in other parts of the body. It is important to remember that all medicines have side effects. There are ways to decrease the absorption of the eye drop into the system, and to increase the time the eye drop is on the eye, making the medicine a more safe and effective solution.
Inserting eye drops may seem difficult at first but becomes easier with practice. To put in an eye drop, tilt the head back. Then create a pocket in front of the eye by pulling the lower lid down with an index finger or gently pinch the lower lid outward with the thumb and index finger. Let the drop fall into the pocket without touching your eye or eyelid (to prevent contamination of the bottle).
Immediately after inserting the drop, squeeze the bridge of your nose for two to three minutes with your thumb and forefinger. This prevents most of the drop from traveling down the tear duct to the rest of the body.
Keep your eyes closed for three to five minutes after instilling the drop. Because the volume of a single drop exceeds the capacity of the surface of the eye, it serves no purpose to use two drops at the same time.
Before opening your eyes, dab unabsorbed drops and tears from the closed lids with a tissue.
If you are taking two different types of eye drops, wait at least five minutes before instilling the second drop.
Injections and Lasers
Our Ophthalmologists at the Eye Clinic of Fairbanks currently provide injections and laser procedures for several different eye conditions including diabetes, macular degeneration, glaucoma, retinal tears, and posterior capsule opacification.
Annual Routine Exam vs Medical Exam
All of the exams performed at the Eye Clinic of Fairbanks evaluate the complete health of your eye. When needed, they also involve dilation of the eye so the doctor can get a good look at the back of your eye.
Many commercial insurance plans through employers offer benefits of an annual/biannual eye exam and a vision “rider” that provides for a vision exam. In addition, recent publicity about “free” preventative services at both the state and Federal level has people believing that they can receive a “free” eye exam every year. In this posting we are going to try to explain all of those various exams, the benefits covered and why some patients cannot take advantage of certain benefits because of chronic eye disease.
Benefits under most vision plans are limited to those services, provided by an ophthalmic or optometric provider, needed to evaluate your need for glasses/contact lenses or to adjust the prescription for your eyewear. This exam will be billed to the vision services insurance plan named in the vision service “rider” (such as VSP) to the patient’s health insurance. If you have VSP, please let the Receptionist know at the time of scheduling so that an authorization can be obtained for you ahead of time. Your authorization will outline your benefit provisions including any copays you will need to pay at the time of service or allowances that you may utilize on glasses or contacts.
Some vision insurance plans such as Davis Vision, Blue Vision, United Vision, Humana Vision, or Spectera the Eye Clinic of Fairbanks cannot bill, however, we can provide you as the patient a full receipt and copy of necessary coding so that you can apply for reimbursement from these plans.
If your insurance plan offers you an annual or biannual eye exam as a part of your regular medical benefits without a vision rider such as VSP, that exam will be billed to your insurance plan and you will be responsible for any copays or deductibles at the time of service according to the benefit plan.
Another type of exam is a medical exam being done because of a complaint from the patient about a medical eye problem, or a family history of medical eye problems. With an exam such as this, the patient will pay a copay and deductible at the time of service and the exam will be billed to their regular health insurance. This exam will be as complete as the doctor feels is needed to address the issue that brought the patient to the office in the first place. So it may or may not include dilating the patient's eye. These types of exams are associated with a medical diagnosis and are treated as medical exams according to the benefit plans.
Now the confusion comes when a patient presents at the Eye Clinic of Fairbanks, or any other ophthalmic or optometric office, for their vision plan exam but the patient's concerns and the doctor's findings indicate a medical problem in the course of the exam. Since the vision insurance such as VSP does not accept medical claims, the exam may have to be billed to the patient's regular health insurance. If you have concerns about this type of situation, please speak with our Financial Counselor for insurance and payment options.
Some patients with chronic systemic conditions such as diabetes, which can have serious effects on the eyes, or chronic eye disease, such as glaucoma or macular degeneration, will, once those conditions are diagnosed, will rarely qualify for a vision plan exam because it will be necessary to address their chronic condition at visits with the eye doctor. Their visits to their eye care provider will generally be billed to their medical insurance.
Finally, for patients with Medicare if there is a medical eye problem, the exam will be billed to, and most likely paid by, Medicare. If the patient truly has no medical eye problems but still seeks an eye exam to check for a glasses or contact lens prescription, the patient will have to pay for that exam because Medicare does not cover such exams.
The key here is that the expectations for what services the patient will receive for the different types of eye exams must be understood by the patient. It is important that patients understand the benefits offered by their health insurance plan and the differences between those services. The exams are not interchangeable and the services covered under each type of exam cannot be interchanged as per coding regulation to fit the desires of the patient. If you have questions about your individual coverage, please feel free to speak with our friendly staff and we will make every endeavor to verify your benefits and coverage before your exam. If you have questions about your bill, please give us a call and we will be happy to help navigate that for you as well.
Pediatric Myths and Facts
“Kids don’t need their eyes checked until they go to school.”
False: It is recommended that children have their first eye exam at 6 months of age, or sooner if the parent or pediatrician has concerns. Childhood visual development starts early and many causes of pediatric related vision loss can be cured with appropriate vision care treatment at an early age.
“Wearing the wrong kind of eyeglasses damages your eyes.”
False: Eyeglasses are used to sharpen your vision. While correct eyeglasses or contacts help you see clearly, wearing a pair with the wrong lenses, or not wearing glasses at all, will not physically damage your eyes. However, children under 8, who need eyeglasses, should wear their own prescription to prevent the possibility of developing amblyopia or ‘lazy eye.’
“Sitting close to the television can damage children’s eyes.”
False: Children can focus at close distance without eyestrain better than adults. They often develop the habit of holding reading materials close to their eyes or sitting right in front of the television. There is no evidence that this damages their eyes, and the habit usually diminishes as children grow older. Children with nearsightedness (myopia) sometimes sit close to the television in order to see the images more clearly.
“Children outgrow misaligned eyes.”
False: A child whose eyes are misaligned may develop poor vision in one eye because the brain will “turn off” or ignore the image from the misaligned or ‘lazy eye.’ The unused eye will not develop good vision unless it is forced to work, usually by patching the stronger eye. Children who appear to have misaligned eyes should be examined by an ophthalmologist. In general, the earlier misaligned eyes are treated, the better. Treatment may include patching, eyeglasses, eyedrops, surgery, or a combination of these methods.
“Eating carrots improves your vision.”
False: Carrots are rich in vitamin A, which is essential for sight, but many other foods also contain this vitamin. A well-balanced diet, with or without carrots, provides all the vitamin A necessary for good vision.
“If you cross your eyes, they'll stay that way.”
False: Contrary to the old saying, eyes will not stay that way if you cross them. If your child is crossing one eye constantly, schedule an evaluation by an ophthalmologist.
“If parents have poor eyesight, their kids will inherit that trait.”
True: Unfortunately, this one is sometimes true. If you need glasses for good vision or have developed an eye condition (such as cataracts), your kids might inherit that same trait. Discuss your family's visual history with your doctor.
“Two blue-eyed parents can't produce a child with brown eyes.”
False: Two blue-eyed parents can have a child with brown eyes, although it's very rare. Likewise, two brown-eyed parents can have a child with blue eyes, although this is also uncommon.
“Only boys can be color-blind.”
False: It's estimated that up to 8% of boys have some degree of color blindness, whereas less than 1% of girls do.
“The eye is full size at birth.”
False: The eye is NOT full size at birth but continues to grow with your child. This growth partially accounts for refractive (glasses) changes that occur during childhood.
“Wearing glasses too much will make the eyes "dependent" on them.”
False: Refractive errors (near-sightedness, far-sightedness, or astigmatism) change as kids get older. Many variables come into play, but most of this change is likely due to genetics and continues despite wearing glasses earlier or later or more or less. Wearing glasses does not make the eyes get worse.
Reading in dim light is harmful to your eyes.
It is not harmful to watch a welder or look at the sun if you squint, or look through narrowed eyelids.
If you use your eyes too much, you wear them out.
Wearing poorly-fit glasses damages your eyes.
Wearing poorly-fit contacts does not harm your eyes.
You do not need to have your eyes checked until you are in your 40s or 50s.
Safety goggles are more trouble than they're worth.
It's okay to swim while wearing soft contact lenses.
Children outgrow crossed eyes.
A cataract must be ripe before it can be removed.
Cataracts can be removed with lasers.
Eyes can be transplanted.
All eye care providers are the same.
Fun Facts and Trivia
Although reading in dim light can make your eyes feel tired, it is not harmful.
Even if you squint, ultra-violet light still gets to your eyes, damaging the cornea, lens and retina. Never watch welding without wearing the proper protection. Never look directly at an eclipse.
You can use your eyes as much as you wish—they do not wear out.
Although a good glasses fit is required for good vision, a poor fit does not damage your eyes.
Poorly fit contact lenses can be harmful to your cornea (the window at the front of your eye). Make certain your eyes are checked regularly by your eye doctor if you wear contact lenses.
There are several asymptomatic, yet treatable, eye diseases (most notably glaucoma) that can begin prior to your 40s. Annual or Bi-annual eye examinations should begin at age 3 and continue as directed by your eye care provider.
Safety goggles prevent many potentially blinding injuries every year. Keep goggles handy and use them!
Potentially blinding eye infections can result from swimming or using a hot tub while wearing contact lenses.
Children do not outgrow truly crossed eyes. A child whose eyes are misaligned has strabismus and can develop poor vision in one eye (a condition known as amblyopia) because the brain turns off the misaligned or "lazy" eye. The sooner crossed or misaligned eyes are treated, the less likely the child will have permanently impaired vision.
With modern cataract surgery, a cataract does not have to ripen before it is removed. When a cataract keeps you from doing the things you like or need to do, consider having it removed.
Cataracts cannot be removed with a laser. The cloudy lens must be removed through a surgical incision. However, after cataract surgery, a membrane within the eye may become cloudy. This membrane can be opened with laser surgery.
The eye cannot be transplanted. It is connected to the brain by the optic nerve, which cannot be reconnected once it has been severed. The cornea—the clear front part of the eye—can be transplanted. Surgeons often use plastic intraocular lens implants (IOL's) to replace natural lenses removed during cataract surgery.
Doctors of optometry (ODs) are not medical doctors but are primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye.