Eyeglasses Prescription Changing Every Eye Doctor Visit Causing Worries Your Eyes Will Go Blind?

Texas Eye And Laser Center - Eyeglasses Prescription Changing Every Eye Doctor Visit Causing Worries Your Eyes Will Go Blind?

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A commonly heard question in my optometrist eye care center is will my eyeglasses prescription keep changing? Followed frequently by will I go blind? The latter is a common misperception based very slightly on fact. People due lose eyesight and suffer loss of vision from degenerative myopia or nearsightedness. There is a significant increase in the percentage of people who get retinal detachments in the nearsighted population. However, even though this is a significant increase, relatively speaking it is extremely rare.

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A very small segment of the population do have degenerative nearsightedness. This is a pathological state of the eye where it progressively gets worse at a rapid rate and causes a number of serious vision problems including retinal detachments, glaucoma, cataracts and retinal degeneration that can cause blindness. This condition is evident in adolescence and if you have to ask you don't have it. Degenerative myopia has a reported incidence of 2% in the United States, and is the seventh leading cause of blindness. It is more common in Chinese, Jewish, Japanese and Arab populations, and women. In my patient population the incidence is much lower, probably less than .02%. It probably has some dependence on how pathological myopia is defined, if it is not sight threatening or decreasing vision I don't categorize it as pathological nearsightedness.

Progressive myopia is associated with some systemic diseases like Marfan's syndrome (probably what Abraham Lincoln had), retinopathy of prematurity, Ehler's-Danlos syndrome, and albinism. You would probably know if you had any of these conditions. The prescriptions in degenerative myopia are typically so high at an early age that they are probably 5-10x worse than what you currently experience. All that being said, when will your eyes quit changing? Personally I believe all of the studies are outdated. Years ago when a child reached adolescence the eyeglass prescription stabilized. The periods of rapid body growth seemed to correlate fairly well with eye growth. The period of change has gradually extended out in time. First you have to define what stable means. To some, it means a change of 4 steps which in optical terminology is one diopter. Past studies have indicated myopia develops in about 20% of people over the age of 20 who go back to school (or live in restricted near environments like submarines). If you decide 3 steps is change instead of 4 then this number goes up to over 40%. Define it as 2 steps or less in a year (0.50 diopters) and the numbers go even higher.

The one thing that is indisputable today is that blurred vision is a stimulus for change in your glasses prescription. What is not clear (pardon the pun), is what this really means. Under focusing, over focusing, fluctuations in focusing may all cause blurred vision. It may take seconds or hours to start the process. Current research indicates it is not central vision but peripheral blurred vision that may cause visual changes. From the studies of changes in vision in older students it is clear to me that there are genetic and environmental factors at work. Authors of some studies do not think the research substantiates an environmental factor, only the age of onset of myopia-I disagree. What I believe is our world is exponentially changing into a near centered environment (i.e. we all live on the internet where you are now). This is not a normal visual environment and probably not the healthiest for the eyes (computer vision syndrome is on the upswing). The alternative is rapidly becoming unemployment in our computer dependent work environments so it's really not an option. Maybe when you gaze at the computer for three hours then look up a focusing spasm occurs for 30 seconds and the blurred image causes your visual system to try and adapt (focus for the right distance). This mal-adaptation would cause myopia. Then again you could habitually focus to close or too far (normal is a little behind the object viewed). Probably it is something altogether different. Focusing on a flat plane when we are designed to focus in a 3D world could push the eye into changing. The tear film layer of the eye is crucial for clear vision and dry eyes could cause blurred vision. Working on a computer causes a decrease in blink rate and subsequent drying of the eye and degradation of the tear film layer. A poor tear film equals blurry vision and possibly Dry Eye Syndrome ( DES).

Regardless, the result I believe, (with no real evidence to back it up other than what I see day to day and year to year), is that very few people totally stabilize today at any age. Most show a very marked reduction in changes in their twenties, especially when they get out of school. A lot of optometrists refer "stable" as eyeglass correction changes 2 steps or less in a year. A few patients I see start to get better for no apparent reason. I have asked all the questions I can think of about lifestyle etc. and the only common factor I have ever found is invariably they are wearing their full distance correction, not under corrected like some Eye Doctors believe is beneficial. Please note that only a small subgroup of people wearing their full RX improve year to year. The eye has a built in self correcting mechanism called emmetropization which I believe starts working again in some people at a later age for unknown reasons. If we didn't have that process there would really be a lot of very, very thick lenses! Also I see much less dramatic differences in prescriptions between the eyes when people wear their glasses full time. Occasionally people have the same prescription in both eyes and ask if it will stay that way-probably not but wearing the correct lens prescription will keep them much closer to each other. Statistically nearsightedness decreases a little in your 40's due to changes in the lens in the eye. Later in life, the lens changes again as cataracts start to develop and nearsightedness increases. This is really nice for people that are farsighted since they notice improvements (at least for a while). People who are diabetic with poorly controlled blood sugar have prescription changes all over the board.

Last but not least, patients ask if they can do anything to prevent their eyes from changing. The answer is: Maybe-maybe not-or definitely yes in the future. A prescription drug due out in the next few years may slow changes in childrens eyes. Orhtokeratology (also called corneal molding in some formats) may slow changes but this involves wearing rigid gas permeable lenses and sometimes comfort issues. One soft contact lens which is less "elastic" than others may slow changes. Aspheric soft contact lenses may have some potential in my opinion but there is no basis for this currently that I am aware of. One small study indicated bifocal soft contact lenses may also have some effect, again my guess is due to an aspheric effect on peripheral vision correction.

We always recommend good ergonomics if only for the relief of eyestrain they offer: Look up every 15 minutes or so at something far away then close and back and alternate 10 times to break any focusing spasms. Get up every hour even if you only walk around the computer-this breaks the physical and visual posture. Use anti reflection coatings on your glasses prescription and have a separate computer lens prescription if you are presbyopic (need bifocals). An unpreserved artificial tear used 3-4x per day when doing a lot of near work could be helpful. Children who are esophoric (eyes that don't turn in but have the tendency to turn in at near) may benefit from a multifocal prescription. I would think the same is true of adults but again I am not aware of any research. It probably will change again at some point in the future. Nutritional advice varies all over the place and probably has an effect- eat a healthy diet with lots of fruits and vegetable and little sugar is about as far as I can say at this time. And rest assured, your chances of going blind even though your vision seems to change every year is very, very low-and seeing your eye doctor every year for a dilated eye exam is great preventative care.

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Medicare & Medicaid Doctor Directory - How to Find Doctors Who Accept Medicare and Medicaid

Texas Eye Care Associates - Medicare & Medicaid Doctor Directory - How to Find Doctors Who Accept Medicare and Medicaid

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If you are receiving Medicare and/or Medicaid, it can often be difficult to find a doctor, be it a general practitioner or specialist, who will accept your insurance. Unfortunately the payment schedules set up by the government have resulted in many doctors opting out of the system because they simply cannot afford the substantially lower payments for Medicaid/Medicare services as well as afford to pay for the substantially greater paperwork involved in taking such patients.

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Sadly, government has had a tendency to reduce reimbursement payments, not increase them, and do not seem to be interested in covering the actual cost of providing services.

Not only that, but private insurers are not longer willing to "subsidize" public patients by paying higher rates, so doctors cannot shift the ever-increasing costs to them.

As a result, at a time when more and more doctors are opting out of the system, those doctors who still take Medicare and Medicaid patients generally limit the number they will serve, so finding a doctor who will take your Medicare or Medicaid insurance is not as easy as simply opening the phone book and making a phone call. Indeed, it probably will take some real time and effort on your part.

There is not, and never has been, any requirement that doctors treat patients insured by Medicare or Medicaid. Therefore, people with Medicare or Medicaid are increasingly turning to federally funded clinics, or even to emergency rooms that cannot, by law, turn them away. Sadly, using emergency rooms for non-emergency health care is unbelievably expensive, making the lower reimbursement Medicare/Medicaid rates not financially wise in the long run.

So, how do you find a doctor that will take new Medicare/Medicaid patients?

Well, first of all, do not expect to find a doctor or, should you find one or a clinic taking Medicare/Medicaid patients, do not plan on getting an appointment quickly. Sadly, that will not happen very often. Indeed, if you need quick care, the emergency room is likely to be your only recourse.

To track down Medicare/Medicaid providers, you can contact your local health department or social service agencies to find out more information and there are a number of Medicare and Medicaid doctor directories online. While they cannot guarantee you an appointment, they do have access to information about current providers.

You can also go to the Medicare website at Medicare.gov or call them at 800-633-4227 (TTY 877-486-2048) to find Medicare providers in your area, although there is no guarantee they will be accepting new patients. It is worth a try, though.

Also, managed care is probably a better bet than private practice. HMOs organized by private insurers have a practical interest in having HMO doctors taking government-insured patients, while Prepaid Health Plans (PHPs) are generally run by hospitals or medical schools, and often only accept Medicaid patients.

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Toenail Fungus Laser Treatment - Is it Worth?

Texas Eye And Laser Center Fort Worth - Toenail Fungus Laser Treatment - Is it Worth?

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Toenail fungus a very ugly fungi that affects almost 25 million persons around America. The toenail fungus causes the toenail to be very hard and thick and turn yellow. If you've a fungus infection and you are thinking about different treatments, there are a few things to consider.

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There's no flawless fix for toenail fungus. There are some oral medicines for toenail infection, like Lamisil, and these are said to treat the infection about 10 percent of the time. A new recent treatment for this fungus is the use of lasers. So far there were a few studies that show very promising conclusions. These lasers work from killing the fungus but also leaving the nail and other foot tissues un-damaged. Many big companies are looking to get in on the action.

How exactly do the lasers work? These lasers are aimed at the fungus in the toenail that basically vaporizes it while leaving your skin unharmed.

Does it work? Around first clinic studies earlier this year, almost 90 percent of the patients were able to grow out a regular appearing nail after just one laser treatment. After that treatment, the toenail should grow usually in one year if there's a healthy bed to do so. The success rate here is similar to the oral fungal pill.

Is the laser treatment Agonizing? Is it Safe? The laser has absolutely no affect on regular and healthy skin tissue, there's no pain. The studies taken so far show absolutely no side effects from taking the laser treatment to get rid of the fungus.

How long will it take? Only ten minutes are needed for treatment, per toe.

So... how safe is it? There are absolutely no health or age restrictions. In recent clinical studies there were no bad reactions, harm, ailments or side effects. As you might know, the ability to use the medication accessible today for treatment carries with it the possibility of kidney failure, lasers don't.

Will my insurance cover it? The laser treatment of for toenail fungus isn't covered by most insurance companies or plans as it's thought of as aesthetic. The cost can be anywhere from 0 to 0.

It's credited to your operation fee if you want to go forward with treatment. The treatment is usually a fee of . If your infection is resistant or if it is not responding to regular toenail growth, the nails might need the next laser treatment therapy. This sometimes happens when all of your toenails are extremely infected. You may need additional treatments in this case.

If the toenail lasers, which did recently finish small clinical trials really work, they will show a recent way to cure toenail infections by killing the fungi while keeping the toe whole and healthy.

Currently, there's no sure fix. The fungus are so smart that popular fungus pills, which move the risk of liver cause injury to, are totally successful under 50 percent of the time. And medications that you physically put on your toes work less than 10 percent of the time.

Drug companies like Schering-Plough are working on recent pills and ointments and lotions to fight the toenail fungus.

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