Medicare and Cataracts: What You Should Know
According to Health Grades, there are about 3 million cataract surgeries performed in the United States each year. That's because about one in five adults over 65 has a cataract, and if you're 75 or older, you have a 50% chance of developing one.
If you've noticed your vision is getting blurry or hazy and you don't have any eye pain, it might be cataracts.
Anyone can develop cataracts, but it's interesting to note that according to a study done by the National Eye Institute, cataracts tend to be more prevalent in women than men.
Let's take a look at what cataracts are, what causes them, their symptoms, risks, prevention, and what Medicare covers.
What are Cataracts?
A cataract is a cloudy area in the lens of your eye that causes blurry vision.
Your eye's lens is just behind the iris, or the colored part of your eye. The lens focuses the light as it comes in and goes to the retina, which sends signals to your brain. Your brain turns those signals into what you see.
When you develop cataracts, the naturally clear lens gets cloudy or discolored in spots interfering with your vision.
Cataracts develop over time, and you'll begin to notice that it's harder to read in dim light, distinguish between colors, or even drive comfortably at night.
Types of Cataracts and the Causes
Most cataracts are age-related, but other things can cause them.
The five main types of cataracts are:
1. Age-related cataracts:
The lens in your eye is mostly protein and water, and when they're in good shape, they're clear. As you age, this protein begins to clump together and causes cloudy spots, which are cataracts.
2. Traumatic cataracts:
Serious eye injuries can damage the lens of your eye, which can cause a cataract. Vision Aware says that some of these injuries are:
- Hard blow or hit
- Cut or puncture
- Chemical burn
- Electric shock
An injury can cause a cataract to form immediately, or it could form over time.
3. Radiation cataracts:
Certain types of radiation can cause cataracts, such as the radiation you receive from cancer treatments, or even the ultraviolet (UV) rays from the sun.
4. Pediatric cataracts:
When children get cataracts, it's usually genetic, but they can also get them for the same reasons as adults, complications of pregnancy, childhood illnesses, or tumors in the eyes.
Cataracts in children should be treated as soon as they being impairing vision, so they don't lead to other problems.
5. Secondary cataract:
Sometimes called after-cataract or posterior capsule opacification, a secondary cataract is caused by scar tissue forming after cataract surgery. It causes blurry vision, but it's an easy fix with a laser treatment right in your eye doctor's office.
Symptoms of Cataracts
Most symptoms of age-related cataracts take a while to show up, even years. According to NVision Centers, most people who develop cataracts receive their diagnosis after age 40 but don't need treatment until they're at least 60 years old.
However, cataracts caused by trauma, illness, or radiation exposure might require treatment within a few years rather than decades.
Symptoms to look for include:
- Cloudy or blurry vision
- Colors look faded
- You can't see well at night
- Lamps, sunlight, or headlights seem too bright
- You see a halo around lights
- You experience double-vision
- The prescription for your glasses changes often
Once you begin noticing any of these problems, it's time to talk to your eye doctor. These are the most common symptoms of cataracts, but they can also be signs of other eye problems.
Risks of Cataracts
Your risk for developing cataracts goes up as you get older, but some other factors heighten your risk, including (Mayo Clinic):
- Increasing age
- Excessive exposure to sunlight
- High blood pressure
- Previous eye injury or inflammation
- Previous eye surgery
- Prolonged use of corticosteroid medications
- Drinking excessive amounts of alcohol
Related reading: Aging is Real: 10 Ways Your Body Changes After 60
Since most cataracts are caused merely through the aging process; prevention might not be possible. However, you might be able to reduce your chances of developing cataracts by taking a few precautions, such as:
- Having regular eye exams: regular exams help your doctor diagnose cataracts or any eye problems at their earliest stages when they're easiest to treat.
- Not smoking: ask your doctor about ways to quit smoking.
- Limiting alcohol consumption: for optimal health, you shouldn't have more than two alcoholic beverages per day, and excessive alcohol use contributes to cataract development.
- Protecting your eyes: Wear a wide-brimmed hat and sunglasses that block ultraviolet rays from the sun when outdoors.
- Eating a balanced diet: a healthy diet rich in fruits and green leafy vegetables will help you get the vitamins, minerals, and antioxidants essential for your eyes.
- Limiting steroid use: cataracts can be a side effect of steroid use, restrict their use when possible.
When Should You See Your Doctor?
The good news is that cataracts are treatable, and the surgery is almost always successful, but if they're left untreated, they can eventually cause you to lose your eyesight.
Once you start noticing any of the symptoms we discussed earlier, it's crucial to see your eye doctor.
What to Expect During an Exam
If you're experiencing any symptoms of cataracts, your eye doctor will probably do a dilated eye exam.
A dilated eye exam is painless and straightforward. Your doctor will give you some eye drops that'll dilate, or widen, your pupils so he can look for any eye diseases.
During a dilated eye exam, your doctor will perform (NEI):
- A visual acuity test to check how clearly you see. Your doctor will ask you to read letters that are up close and far away.
- A visual field test to check your peripheral (side) vision. Your doctor will test how well you can see objects off to the sides of your vision without moving your eyes.
- An eye muscle function test to check for problems with the muscles around your eyeballs. Your doctor will move an object around and ask you to follow it with your eyes.
- A pupil response test to check how light enters your eyes. Your doctor will shine a small flashlight into your eyes and check how your pupils react to it.
- A tonometry test to measure the pressure in your eyes. Your doctor will use a machine to blow a quick puff of air onto your eye, or gently touch your eye with a special tool. Don't worry — it doesn't hurt!
- Dilation to check for problems with the inner parts of your eye. Your doctor will give you some eye drops to dilate (widen) your pupil, helping him see inside your eye.
Depending on your needs, your doctor may include other tests, too. Ask your doctor if you have any questions.
Your vision will blur for a few hours after a dilation exam, so you'll want to ask someone to drive you to and from the visit for safety.
How Often Should You Get a Dilated Exam?
How often you should get a dilated eye exam depends on your risk factors. Talking with your eye doctor is the best way to find out precisely what is right for you.
The doctor will look at things such as your age, medical history, and your family history. Most people over 60 require a dilated eye exam every one to two years.
What if You Need Cataract Surgery?
Once your cataracts begin interfering with your daily activities, like watching TV, reading, or driving, your doctor may decide it's time to have them surgically removed.
According to the NEI, cataract surgery is very safe, and 9 out of 10 people who get it can see better afterward.
The day before surgery, you'll probably need to use some special drops in your eye that your doctor will prescribe, and you won't be able to eat anything after a specific time.
On the day of the surgery, someone will need to take you since you won't be able to drive yourself home.
Typically, patients are awake during cataract surgery. Your doctor will (NEI):
- Put numbing drops into your eye to keep you from feeling anything
- Use tiny tools to cut into your eye, break up the lens, and take it out
- Place the new artificial lens in your eye
Then, you'll rest in recovery for a little while to ensure you don't have any problems before they let you go home.
After you get home, you'll have eye drops to put in your eyes, and you may need to wear a special eye shield or glasses. You'll also have to avoid touching your eye, bending over, and lifting heavy objects for a few weeks.
You should start to feel better after a couple of days and be entirely healed after about eight weeks.
With your improved vision, you'll notice that colors are brighter and how much easier everyday tasks seem.
If you need cataract surgery in both eyes, they will only do one eye at a time.
Medicare and Cataracts
Medicare doesn't cover routine eye exams, but it does cover exams to diagnose potential eye problems. So, if you're receiving a dilated eye exam because you've noticed cataract symptoms, Medicare may cover it.
Medicare covers cataract surgery since it's considered medically necessary. Typically, Medicare Part B will cover 80% of the total surgical costs, including:
- preoperative exams
- removal of the cataract
- implantation of the lens
- postoperative exams
- one pair of prescription eyeglasses after the surgery
You'll be responsible for the remaining 20% plus the $198 Part B deductible. If you have a Medicare Supplement, those out-of-pocket costs will be low or even $0 (your coverage varies slightly depending on your plan type).
If you have a Medicare Advantage plan, you are guaranteed to get at least the same coverage Medicare provides. Some plans offer additional vision coverage, so check with your plan to see what your out-of-pocket costs would be.
There are some things you just have to deal with as you get older, but limited vision due to cataracts isn't one of them.
If you notice it's getting hard to read or drive, then it's time to get something done.
No surgery is fun, but cataract surgery is simple and routine. The recovery is manageable, and it could cost you nothing if you have the right coverage.
Why not take the step to improve your vision? You have tons of things to do and see in your future. Look at it all through new lenses, that way you'll never wonder what you are missing.
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