You’ve been diagnosed with a cataract and you’ve been told you should have cataract surgery. The surgeon is also telling you that you should consider paying extra out of pocket it for it.

Where did this come from? Why should you have to pay out of pocket for cataract surgery? Shouldn’t your health insurance just cover it?

In trying to answer those questions, you will first need a little history of both cataract and refractive (correcting errors of refraction such as nearsightedness, farsightedness and astigmatism) surgery.

Radial keratotomy (RK) was the first widely used refractive surgery for nearsightedness. It was invented in 1974 by Russian ophthalmologist Svyatoslav Fyodorov, and it was the primary refractive procedure done until the mid-1990s. Then it was surpassed by the laser procedure called PRK and then, eventually, LASIK; they are still the predominately pure refractive surgeries done today.

Cataract surgery has its origins all the way back to at least 800 BC in a procedure called couching. In this procedure, the cataract was pushed into the back of the eye with […]

As an eye doctor, diagnosing a red eye can be challenging. Are we dealing with an infection, allergy, inflammation or dryness?

One of the most common questions I get is, “Doc, my eyes are red, burning, itchy, and tearing. Is this dry eye or from allergies?” The short answer is it could be one, both or neither. I’ll outline various ways these conditions present clinically and the treatments for them.

The hallmark symptom of allergy – meaning if you have this symptom you almost definitely have the condition – is itching. Red, watery, ITCHY eyes are almost invariably due to an allergen, whether environmental or medicinal. It is one of the most common ocular conditions we, as eye doctors, treat – especially when plants are filling the air with pollen as they bloom in the spring and then die off in the fall.

The itching occurs because an immune cell called a Mast cell releases histamine, causing the itching sensation. It can be quite unbearable for the sufferer, causing them to rub their eyes constantly, which […]

Do you have floaters in your vision?

Floaters are caused by thick areas in the gel-like fluid that fills the back cavity of your eye, called the vitreous.

Many people, especially highly near-sighted people, often see some degree of floaters for a good portion of their lives. Often, these floaters are in the periphery of your vision and may only be visible in certain lighting conditions. The most frequent conditions are when you are in bright sunlight and are looking toward the clear blue sky. This I know from personal experience as I have a floater in my left eye that I most often see when swimming outdoors. Every time I turn my head to the left to breathe I see this floater moving in my peripheral vision.

This is totally harmless other than when I’m swimming in the ocean and swear that sudden object in my peripheral vision is a shark bearing down on me. Some people who have floaters are not as lucky and the floater can be very central and almost constantly annoying, […]

There are several different variations of Glaucoma, but in this article we will mainly focus on Primary Open Angle Glaucoma. This means that there is no specific underlying cause for the Glaucoma like inflammation, trauma or a severe cataract. It also means that the drainage angle where fluid is drained from the inside of the eye into the bloodstream is not narrow or closed.

Closed or Narrow Angle Glaucoma, which will be discussed in another article, is treated differently from Open Angle Glaucoma

In the U.S., Primary Open Angle Glaucoma (POAG) is by far the most common type of Glaucoma we treat.

Glaucoma is a disease where the Optic Nerve in the back of the eye deteriorates over time, and that deterioration has a relationship to the Intraocular Pressure (IOP).  Most – but not all – people diagnosed with Glaucoma have an elevated IOP.  Some people have fairly normal IOP’s but show the characteristic deterioration in the Optic Nerve. Regardless of whether or not the pressure was high initially, our primary treatment is to lower the […]

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Despite requests that patients bring their current glasses to their office visit, many show up without them.

Sometimes it’s an oversight: “I was rushing to get here and forgot them”; “I left them in the car”; “I picked up my wife’s glasses instead of mine by mistake.” Doctors have heard them all.

Sometimes it is unavoidable: “I lost them”; “They were stolen”; “I ran them over with the car”; “I left them on the roof of the car and drove away and now they are gone.”

Frequently, however, it’s intentional. There is a perception by some people that if they don’t like their current glasses or feel like they are not working well for them that they are better off having their eye doctor start from scratch. “Why would I want the doctor to utilize a pair of glasses I’m not happy with as a basis or starting point for my next pair of glasses?”

But bringing your glasses to an appointment is important.

There are two main reasons for eye care professionals to know what […]

The 2017 National Coffee Drinking Trends report showed that 62 percent of more than 3,000 people who participated in the online survey said they had drunk coffee the previous day, which is interpreted as daily consumption. This was up from 57 percent in 2016, said the report, which was released at the coffee association's conference in Austin, Texas.

Even though the U.S. population is drinking more coffee than ever it still only ranks 22nd overall in per capita consumption. The people of Finland average 3 times as much coffee consumption as in the U.S.

So what does all this caffeine intake do to our eyes?

The research is rather sparse and the results are mixed.

Here are the major eye topics that have been investigated:

Glaucoma

One study, published in the journal Investigative Ophthalmology and Visual Science, showed that coffee consumption of more than 3 cups per day compared to abstinence from coffee drinking led to an increased risk for a specific type of Glaucoma called Pseudoexfoliation Glaucoma.

Another analysis of several existing studies […]

A refraction is a test done by your eye doctor to determine if glasses will make you see better.

The charges for a refraction are covered by some insurances but not all.

For example, Medicare does not cover refractions because they consider it part of a “routine” exam and Medicare doesn’t cover most “routine” procedures – only health-related procedures.

So if you have a medical eye problem like cataracts, dry eyes or glaucoma then Medicare and most other health insurances will cover the medical portion of the eye exam but not the refraction.

Some people have both health insurance, which covers medical eye problems, and vision insurance, which covers “routine” eye care (no medical problems) such as refractions and eyeglasses.

If you come in for a routine exam with no medical eye problems or complaints and you have a vision plan then the refraction is usually covered by your vision insurance.

Article contributed by Dr. Brian Wnorowski, M.D.

This blog provides general information and discussion about eye health and related subjects. The words […]

Mark your Calendars!!! On Monday, Aug. 21, 2017, a solar eclipse will be visible across the entire continental United States.

A solar eclipse occurs when the moon blocks any part of the sun, and with this one, all of North America will experience at least a partial eclipse lasting 2 to 3 hours.

A lucky few million people along a 70-mile-wide path from Oregon to South Carolina will experience a brief total eclipse when the moon completely blocks the sun for up to 2 minutes. For that 2 minutes or so it will look like nighttime along that path.

This total eclipse will make the solar corona visible, and stars and the planets may also be visible during this time.

But looking directly at the sun before it is covered is unsafe. Although there is a limited chance of eye damage if you are in the proper area during the total eclipse it is not worth the risk of retinal damage to even take a quick look at the eclipse if it is not “total”.

A […]

With the legalization of medical marijuana in 29 states as of April 2017, the question of whether marijuana is a good treatment for glaucoma has resurfaced.

Glaucoma is a common eye disease that affects the optic nerve and results in loss of peripheral vision. The treatment for glaucoma is to lower the pressure – intraocular pressure – inside the eye. This can be accomplished by laser, eye drops, or surgery.

The idea that marijuana can be used to treat glaucoma dates back to the 1970s. Smoking marijuana does lower intraocular pressure but the effect lasts only 3-4 hours. In order for marijuana to be an effective treatment, a person would have to smoke marijuana every 3 hours. Since marijuana also has psychoactive effects, consistently smoking it could prevent a person from performing at maximum mental capacity, and frequent use can cause problems with short-term memory.

Marijuana not only lowers intraocular pressure but also blood pressure and blood flow throughout the body. There is, however, evidence that decreased blood flow to the optic nerve may cause further […]