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There are two types of coverage that people often have that cover different eye care needs. “Vision plans” cover routine eye checkups, which often lead to an eyeglasses and/or contact lens prescription. Vision insurance does NOT cover medically-related eye problems, such as: • Red or painful eyes • Loss of vision • Diabetic eye disease • Glaucoma • Eye injury • Cataracts • Flashes of light • Macular degeneration These types of problems are covered under your standard medical insurance. Vision plans are usually an option above and beyond what is generally referred to as medical insurance, and they only cover completely routine eye exams. For example, if you have diabetes, you should have a dilated medical eye examination annually. Your medical insurance should cover this visit. However, if you also want to get new glasses or if you have a vision plan, you will need to schedule another appointment for a different date to have an eyeglasses-oriented, vision-related visit, or pay out-of-pocket for the non-medically covered eyeglasses/contact lens prescription. Note that some offices only accept medical insurance, and do not accept vision plans or vice-versa. You should contact your eye doctor’s office to determine this. Vision plans usually cover routine care visits once every year or two, whereas medical insurance can be used any time you encounter a medical eye problem. The text to the right is intended for patients. Please feel free to photocopy and use in your practice with our compliments. REVIEW OF OPTOMETRY JUNE 15, 2020 17 This 31-year-old man was packing for an anticipated vacation when the bungee cord snapped and struck his eye. As can be seen in this series of photographs taken over a two-week period, he initially had soft tissue ecchymosis and hyphema. We cyclopleged the eye with 5% homatropine and prescribed Lotemax SM (Bausch + Lomb) to be used every two hours for two days, and then QID for one week. The bulk of therapy was, however, “time,” while our medical intervention hastened recovery. After about 10 days (Figure 5), iridodialysis can be seen from 4 o’clock to 6 o’clock, and the iris sphincter inferiorly developed traumatic iridoplegia. (For bothersome photophobia, or cosmetic concerns, opaquely tinted soft contact lenses can be employed.) After a month, we performed gonioscopy to assess the ciliary body face tear, and explained to the patient his long-term risk of increased intraocular pressure, and the need for annual monitoring. Case Report: Bungee Cord Injury A NEW HIGH FOR PORTABLE REFRACTION The technology of automated refraction continues to evolve and become more portable. We even envision the day your iPhone or laptop camera device can be configured to perform self-refraction. When an automated refractor was needed for a medical mission to Uganda and Kenya, the humanitarian leadership at Plenoptika graciously loaned us one of their portable “Quicksee” autorefractor units. The instrument performed exactly as we hoped, and ultimately, vision was enhanced for several needy people in these underserved communities.
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