Medical Eye Conditions

The following are examples of eye problems that can be evaluated and billed to your medical insurance.  The same insurance you use when you see your primary care doctor or any medical specialist.   Examples include, eye pain, redness, sudden light sensitivity, dry/scratchy/itchy eyes, floaters, flashes of light, lid bumps, eye scratches, removing foreign objects and sudden vision loss.  If you have been told you have glaucoma, cataracts, macular degeneration, and dry eye, you can use your medical  insurance for the evaluation.

Vision insurance plans cover a wellness exam and glasses or contact lenses.  However, many eye problems are considered medical and are covered by your standard health insurance plans such as UnitedHealthCare,  Aetna, Blue Cross Blue Shield, Humana, Medicare and Cigna.

Dry Eye Syndrome

What is it?

Dry eye syndrome is a chronic lack of sufficient lubrication and moisture in the eye. Persistent dryness, scratching, burning, and redness in your eyes are signs of dry eye syndrome. Some people also experience a “foreign body sensation,” the feeling like there’s something in the eye. And, it may seem odd, but sometimes watery eyes can result from dry eye syndrome, because the excessive dryness works to over stimulate the watery component of your eye’s tears.

What Causes Dry Eyes?

In dry eye syndrome, the eye doesn’t produce enough tears, or the tears have a chemical composition that causes them to evaporate too quickly.  Dry eye syndrome has several causes such as the following:

• Part of the natural aging process, especially during menopause
• A side effect of many medications, such as antihistamines (allergy pills), antidepressants, certain blood pressure medicines, Parkinson’s medications, and birth control pills
• Environmental
  • A dry, dusty or windy climate.
  • Air conditioning or a dry heating system at work, home, or in the car
  • Insufficient blinking, such as when you’re staring at a computer screen all day.
• Symptom of systemic diseases such as lupus, rheumatoid arthritis, rosacea or Sjogren’s syndrome (a triad of dry eyes, dry mouth, and rheumatoid arthritis or lupus).
• Long-term contact lens wear is another cause; in fact, dry eyes are the most common complaint among contact lens wearers.

Treatment

Dry eye syndrome is an ongoing condition that may not be cured (depends on the cause), but the accompanying dryness, scratching and burning can be managed.

Today there are many treatment options for dry eye suffers.

• Artificial tears, which are lubricating eye drops that may alleviate the dry, scratching feeling.  Not all lubricating eye drops are the same.  Dr. Armitage will recommend the one for you. Prescription eye drops such as Restasis (www.restasis.com); they help your eyes to increase tear production instead of temporarily lubricating them
• Temporary or permanent silicone plugs in the lacrimal (tear) ducts keep tears in your eye from draining away as quickly. Called lacrimal plugs or punctal plugs, they can be inserted painlessly while you’re in the eye doctor’s office and are normally not felt once inserted.
• Nutritional supplements for dry eyes such as Omega Type 3 fatty acids. Studies have found that supplements containing certain essential fatty acids can decrease dry eye symptoms.  Dr. Armitage recommends Omega Max which is manufactured by Amerisciences and is the Omega 3 used by NASA for the astronauts,  The gel tablets are made from cold water fish such as cod, mackerel, and salmon.  The fish oil is very high quality free of any heavy metal contaminants.  Plus the capsule is designed to dissolve in your intestine instead of the stomach which avoids the “fishy burps”.  It takes about 2 -3 months of treatment before any improvement is noted.
• For contact lens wearers there are new lenses that can reduce end of day dryness and irritation compared to other lenses.

“Pink Eye”

What is it?

This is the common name given when an eye is pink or red.  This color is due to inflammation and the eye may also be uncomfortable.  The eye may itch, scratch, burn, be sensitive to sunlight, tear and have a discharge.

A pink eye may be due to a virus, bacteria, or allergy.  If you wear you contact lenses too many consecutive nights, replace them infrequently, clean them improperly, or use the incorrect solutions, may also cause inflammation.

Treatment

Many of these conditions require prescription eye drop medication to resolve the problem.  A thorough evaluation by the doctor is required prior to initiating treatment.

The use of Visine or other over the counter drops to get the “red out” are not recommended since this only makes the eye temporarily whiter but does nothing to affect the underlying cause. There are prescription eye drops such as antibiotics, antihistamine/mast cell stabilizers, and steroids that can be used to more effectively treat your “pink eye” than over the counter drops.  Oral medications are usually not effective as prescription eye drops to treat “pink eye” conditions.

Foreign Body Removal

At times foreign bodies such as small metal shavings, yard debris, and gravel can become lodged in the eye.  Superficial foreign bodies will cause discomfort, pain, and light sensitivity.  If they are not removed promptly and treated with prescription medication they can cause bad eye infections and affect your vision permanently.

Superficial foreign bodies can be removed at the doctor’s office with eye drops that numb the eye prior to removal.  Prescription eye drops are usually prescribed to help the eye heal and reduce the chance of infection.

Glaucoma

What is it?

Glaucoma, a leading cause of blindness in the U.S., affects between 3 and 4 million Americans. This includes an estimated 1.5 to 2 million people who do not even know that they have glaucoma!   The disease is caused by a build-up of fluid in the eye as a result of it not draining properly. This increase in pressure can damage the optic nerve and cause vision to fade. With the most common type of glaucoma, you do not have any pain and vision is not affected in the early stages.  However, over time the disease will progress and if not treated, vision loss will occur that can not be restored or improved with glasses.   Vision loss begins with your side (peripheral) vision and can progress to affect your central vision.It most often occurs in people over age 40. If you’re African American, have a family history of glaucoma, are very nearsighted or diabetic, you are at higher risk of developing the disease.

While glaucoma is not preventable or curable, it can be slowed. The earlier glaucoma is detected, the less damage it can cause and the longer you will have your vision.

Treatment

Glaucoma can be treated with medication (usually given in eye drops), surgery, or, in some cases, both. These treatments work by helping to drain excess fluid from the eye and/or decreasing the amount of fluid the eye produces.

Cataracts

What is it?

A cataract is a clouding of all or part of the normally clear lens within your eye located just behind the pupil or the center black spot in your eye.  Cataracts are usually found in people over age 55, but occasionally younger people can get them.

People with cataracts report cloudy or blurry vision, colors that seem faded, and poor night vision.

Treatment

When cataracts are small, you can often improve your vision by changing the power of your eyeglasses or using magnifying lenses and stronger lighting.  If the cataract becomes advanced and significantly reduces your vision, it needs to be surgically removed.  However, it does not need to be removed unless your vision loss interferes with everyday activities, such as driving, reading, or watching TV.  You and your eye care professional can make that decision together.  During surgery the cloudy lens is removed and is replaced with an artificial lens.  Glasses are usually required after surgery.

Diabetic Retinopathy

What is it?

Diabetes can damage the blood vessels in your eyes and may lead to diabetic retinopathy. In fact, the longer someone has diabetes, the more likely he or she will have retinopathy.

In the early stages the retina (back of eye) blood vessels will start to leak blood.  The patient will not experience any eye discomfort and vision may not be affected.  In later stages, the disease may lead to new blood vessel growth over the retina. The new blood vessels can cause scar tissue to develop, which can pull the retina away from the back of the eye. This is known as retinal detachment, and it can lead to blindness if untreated. In addition, abnormal blood vessels can grow on the iris, which can lead to glaucoma. People with diabetes are 25 times more likely to lose vision than those who are not diabetic, according to the American Academy of Ophthalmology.

Treatment

According to the American Academy of Ophthalmology, 95% of those with significant diabetic retinopathy can avoid substantial vision loss if they are treated in time.  Early detection is important and diabetics should have a dilated eye exam at least yearly.

Diabetic retinopathy can be treated with laser surgery to seal the leaky blood vessels.  It is a painless surgery since the retina does not have nerve endings. You can significantly reduce your risk of developing diabetic retinopathy by keeping your blood sugar under good control and following your medical doctor instructions.

Macular Degeneration

What is it?

Age-related macular degeneration (AMD) is the leading cause of legal blindness in America. It is most common in older people ages 75-80. It results from changes to the macula, (a portion of the retina at the back of the eye), which is responsible for clear, sharp central vision.

Patients report the following:

• a gradual loss of the ability to see objects clearly
• distorted vision
• a gradual loss of color vision
• dark or empty areas appearing in the center of vision

Treatment

Successful laser surgery may prevent central vision loss from becoming worse, even though normal vision may not be restored.   There are new drug treatments available to treat this condition.   For loss of vision low vision devices such as telescopic and microscopic lenses can be prescribed to make the most out of remaining vision.