Get your eyes checked

Richard

Richard

Final Approach
Joined
Feb 27, 2005
Messages
9,076
Location
West Coast Resistance
Display Name
Display name:
Ack...city life
Get your eyes checked
This is a medical matter but I'm putting it here for max exposure.

If it's been more than one year you need to schedule a visit with the optometrist. Even if there is no family history, you have uncorrected vision, you're young, you protect your eyes, yada yada.

Let my story be a warning: a recent eye injury brought me back to my optometrist. He removed a fleck of ferrous metal but was greatly concerned about the rust stain. He referred me to a surgeon who removed additional metal and ran some more tests. The surgeon noticed what appeared to be melanoma. A check up OV confirmed this. Surgery is scheduled soon. They're gonna stick a sharp knife in and scrape. I am not looking forward to this.

I have always had great vision but I've spent a lifetime on the water and under a sometimes harsh sun. So I've been outdoors a lot. Even when young I never went for the tan but chose to stay 'bundled up' (hat, dark sunglasses, sunscreen, longsleeve shirt, etc) I figured even though I took precautions I was putting myself at risk so I made annual treks to the dermatologist and optometrist.

Last October was my most recent full on eye exam---and there was no melanoma! The surgeon explained this by saying it 'evolves' very quickly when on the eye. He sees about 10 of these per year. Sure, he probably has a thriving practice but he's one guy in a semi-rural area.

Anyway, doing nothing is a very bad idea. He listed three different ways I could lose the eye within the year if I do nothing. Also, there is the risk to other organs (the melanoma will diffuse across porous bone into areas you don't want to talk about.)

Weird to say, but this recent injury was a blessing in disguise because my eye could very well be too far gone before my next scheduled OV. Also, this surgeon is a pilot so he understands my concerns there and he is NOT a required reporter to the FAA although he coordinates his work with several senior AMEs. He will tailor his report to accompany my next Class 2 exam.

Get your eyes checked.
 
Yup. You don't know what you don't check. Just like the question how much air is in you LMG tire. Maintainence decisions in humans are far more earthshaking.
 
I hate glasses and fuzzy images but this is one of the two reasons I do like being nearsighted. They force you to go to the eye doc at least semi regularly. The other is glasses keep pointy/projectile type objects and hostile liquids out of your eyes.

If you can't remember to go or it's a hassle, use your flight medical as a reason to go at least every other year. Schedule it about 2 months ahead of your medical. (2 months gives you time to adjust to new glasses if needed) Then you walk in and the eye exam is not even on your worry list at all. (Average cost/effort: Approx 1 AMU for approx 1 AMU of flight time) (AMU=aviation monetary unit)

I go to a real eye doc, not lenscrappers or the sort (they're completely incompetent at best IME with them) I go to someone who actually knows what he's doing and looking for and have him do the full interrogation exam. Runs $100 and and takes an hour of your time every year or two. So far so good other than the walking into walls thing.
 
Richard said:
Get your eyes checked.
Click to expand...


Yes. I'd like to add that when you do, get a vision field test also. In my case, I went to the optomitrist (2001) because I was noticing a change in my vision that seem excessive for my age. He correctly diagnosed a tumor that was compressing the optic nerves causing the problems. Confirmation of his diagoses came a week later when an MRI revealed a 3cm tumor. Had surgury 5 weeks after that.

Get your eyes checked and get the vision field test.

PS Annual MRI last month indicated it's returned, and I'm being handed back to the nuerosurgeon. I should know early July if I'll need another surgury. :(
 
My father was diagnosed with eye melanoma 8 years ago.

He was treated in a specialized center with proton therapy.

The proton therapy option is minimally invasive (they only stitch 4 minute metallic markers on the eye for proper aiming of the beam).

My father lost most of his vision in the affected eye - but it apparently had nothing to do wit the therapy (at least that's what I remember).

We should get our eyes regularly checked by a competent physician.
 
ditto the above advice on regular checks - my brother in law's brother lost his eye to melanoma. Prior to that, I had never heard of that as an eye disease. Early detection is the key; Richard, best wishes for the best possible outcome for you!
 
Last edited:
Yep, I'm a diabetic, and I'm at the eye doctor yearly. Nothing wrong with them except for slight astigmatism.
 
Guys, my surgery was a success back in 2005. I brought this post back from the archives to serve as a reminder to the reader....
 
Richard

Glad it was a success - are you 20/20? I've heard of people having their eye excised because of melanoma.

Yes, eye exams are very important!
 
I happy to report I still have good vision. I wish I could say it's as perfect as it once was. My last AME exam revealed my right eye needs slight correction for distance; I have to wear glasses while flying.

For the first time in my life I am required to have corrective lenses. But I turned 50 this yr so I guess I'm doing pretty good. I want to get the opinion of my eye doc about my prescription for flying.

The only lingering effect from the surgery is a black fuzzy just off center. It's permanent in position but the eye doc said he can't see it. It's like a dust particle always in the same spot. It's about the size of a C-172 at 1 mile.:wink2:
 
Time for this reminder.

BTW: In February I went to the eye doc (new practice, $25 for full exam to build patient base :)). He pronounced my vision 20/15 uncorrected and produced a letter which I took to my AME. I don't need to wear glasses while flying anymore! I do carry a copy of that letter with me with AME signature when acting as required flight crew.

Get your eyes checked.
 
Just went yesterday, after a long hiatus. I go to the University Optometrist School. They did a very, very thorough checkup (took half the day). They had a cool gizmo that could take a photo of my retina. Very, very cool.

Don't really need bifocals, and probably never will. For whatever reason my presbyopia is not that bad, and I don't need reading glasses, though I do have to remove my specs for fine work. Cool by me, bifocals are expensive!
 
Glad to hear that you had a successful outcome. Ocular melanoma is one of the few things in the eye that can come out and kill you :eek: .Luckily, it's a rather uncommon disease.

What is more important from a screening perspective is to get checked for glaucoma (increased pressure in the eye and nerve damage). It is quite insidious in that in its chronic form it doesn't hurt and by the time it affects vision for the patient to notice, very little can be done. According to national eye institute stats, about 1/50 folks over 40 have glaucoma and many of those are not aware that they have it (if you are african american, your odds are a lot higher).
 
It's been implied in this thread but not explicitly stated: Getting an eye exam is important for more than just eye health. There are diseases/conditions that present symptoms detectable during an eye exam that would otherwise not be noticed until a more advanced stage. Diabetes is perhaps the most significant example.

Anyone who avoids getting regular eye exams because "my vision is fine!" is missing an opportunity for early detection of some serious situations that affect far more than vision.
 
Jim_R said:
It's been implied in this thread but not explicitly stated: Getting an eye exam is important for more than just eye health. There are diseases/conditions that present symptoms detectable during an eye exam that would otherwise not be noticed until a more advanced stage. Diabetes is perhaps the most significant example.

Anyone who avoids getting regular eye exams because "my vision is fine!" is missing an opportunity for early detection of some serious situations that affect far more than vision.
Click to expand...

To explain further, the retina of the eye is the one place you can look directly at the capillary blood vessels and see the effects of end organ damage from hypertension and diabetes.
 
I lost my right eye about twenty years ago. When I started flying I also had a cataract in my left eye. My first year of flying was pretty interesting in that I could not see much beyond the control panel and the big fan out front.

I could function just fine at my job, but I was not driving at the time. I decided I wanted to fly so darn bad, that I subjected myself to cataract surgery. That is where they take out your old natural lens and replace it with, I guess, plastic or glass. This is a very scary procedure when they are cutting into the only eye you have left.

The results were downright astonishing. It was like being a kid again, everything is very bright and crystal clear. I now have (corrected) 20-15 vision.

I was required to do a full SODA ( statement of demonstrated ability ) flight with an FAA examiner. I aced it after over an hour in the air with the guy. He ran me through absolutely everything that would be vision related, including emergency lost engine procedures and landings.

The point of all this is that you can indeed survive as a pilot with having only one eye, and if you are ever told you need cataract surgery, jump at the opportunity, the results are almost unbelievable. Well worth any risk you might think is involved.

I guess, as we age, our natural lens ages as well. For older pilots, I would recommend that procedure even if you didn't have cataracts, if you could afford it or could convince your insurance to pay for it.

John
 
John Baker said:
The point of all this is that you can indeed survive as a pilot with having only one eye, and if you are ever told you need cataract surgery, jump at the opportunity, the results are almost unbelievable. Well worth any risk you might think is involved.
Click to expand...

Hear, hear !

I guess, as we age, our natural lens ages as well. For older pilots, I would recommend that procedure even if you didn't have cataracts, if you could afford it or could convince your insurance to pay for it.
Click to expand...

As cataract is a medical condition, most if not all health insurances will cover it (it is not part of 'vision' coverage in that sense).
If anyone has a commercial insurance plan that requires pre-certification, make sure to have a long lists of 'activities of daily living' that are impaired by the decreased vision. Driving, golf, grandkids, finding the dog etc. The key is to document that it is a medical issue that affects 'ADLs'.
 
steingar said:
Just went yesterday, after a long hiatus. I go to the University Optometrist School. They did a very, very thorough checkup (took half the day). They had a cool gizmo that could take a photo of my retina. Very, very cool.
Click to expand...

My doc also bought/leased/whatever one of those. Spinning mirrors that sound like a jet engine winding up are very cool.

We know him well outside of his normal job, so we were chit-chatting a bit about it. He showed me some photos of the amount of the retina that he can see with the traditional methods and what the machine gives him, and it's significantly more. The green laser is a uncomfortably bright, but only lasts a very short time.

He also shared that since the machine produces a digital photo on his computer in the exam rooms, he can very easily e-mail that photo to another doc for a second, third, fourth, or fifth opinion on difficult cases -- whereas with the old system, he'd look at you, then tell you to pack across town to the second opinion, and there probably wouldn't be a third, fourth, or fifth.

He also showed that the software allows post-processing (looked a lot like photoshop-style filters to me) that allow him to see "depth" and other changes in the retina easier.

I was glad I scheduled on one of his slower days so he could take the extra time to show me the geek toys.

The downside... insurance companies won't pay completely for this machine/test (yet). So he has to have patients sign a waiver that they understand that he's going to use it, and they'll have to pay an additional $35 that very few insurance companies will cover. (You can, however, count it as a medial cost against a "Cafeteria Plan" if you have one of those with bucks in it, and pay it back to yourself that way.)

In this economy, some people really do balk at the $35 and opt-out. After seeing how much more of my retina he can examine with it and how good the pictures are, I'd always pay the $35 unless I was dead broke. It's a significant technical improvement for the eye docs.

I can't remember what they did, but the glaucoma eye pressure test was totally non-invasive this time too. No puff of air that I remember decades ago, and no blue ring of light actually being pressed against the eye.

I can't remember what new gizmo he had for that, but I do remember them saying, "Your eye pressure looks good." And me remarking, "But you didn't do anything?"

Very cool technology.

I specifically go to this guy because my last prescription had a weird "flattening" effect to everything. My depth perception was a bit wacked. Everything was sharp and clear, but for some reason the world was "flat". I explained this as best I could in layman's terms to the Doc we know, and he spent an extra 10-15 minutes using his ancient but still workable lens set and frames that hold these temporary lenses trying some things to figure it out.

He explained that not only had I been slightly over-corrected previously (by measuring the old lenses in my glasses) but that they'd also goofed the astigmatism correction just slightly, and the two together could create the effect I was seeing.

That little bit of extra time has yielded the best prescription I've had in years.

I also learned another lesson the hard way... if the glasses aren't right, go get 'em fixed. Find a doc who'll do it right, if it doesn't look right to you.

When I was changing jobs recently I realized that that same aforementioned pre-paid "Cafeteria Plan" had some bucks still in it that the IRS was going to get to keep free of charge if I didn't spent it. So I treated myself to a pair of Sheyden dual-RX flip-up prescription + sunglasses.

The folks at Sheyden send their stuff out to what is apparently a GREAT lab. They nailed the prescription mentioned above, and the optics on the Sheydens are by far the best optics I've ever had in a pair of sunglasses, even prescription ones.

I don't know how they did it. I've had really nice "clip-ons" made by other manufacturers where there's both the clear lens and the sunglasses lens clipped in front, and I've always had problems in the airplane with those having "between the lenses glare" at high sun angles.

I can't get the Sheydens to do it. Something about their design is different.

I absolutely love the quality of the frames, and the ability to go from having sunglasses on -- to clear -- with the flip of a finger while flying is wicked awesome. Now if Sheyden only made foggles. (GRIN!)

Yeah, they make you look like a total dork, but they're the best set of sunglasses I've ever owned.

Being a cheapskate has its disadvantages... but they're easily made up for once in a while when you "splurge" on something really high quality and realize what you were missing. Be it a better eye doc, or a nice high-quality pair of shades...
 
denverpilot said:
The downside... insurance companies won't pay completely for this machine/test (yet). So he has to have patients sign a waiver that they understand that he's going to use it, and they'll have to pay an additional $35 that very few insurance companies will cover.
Click to expand...
My eye doctor has this machine too and I never even considered NOT spending the extra $35, or whatever it is she charges. In fact even the normal part of my eye exam is not completely covered as it is.
 
weilke said:
As cataract is a medical condition, most if not all health insurances will cover it (it is not part of 'vision' coverage in that sense).
Click to expand...

And once having had the procedure, all vision tests and procedures from then on are covered as a medical condition by your medical insurance -- no more need for vision insurance
 
oldShar said:
And once having had the procedure, all vision tests and procedures from then on are covered as a medical condition by your medical insurance -- no more need for vision insurance
Click to expand...

Yes and no. All vision tests related to the surgery are covered, after a while typically the medical carriers start to deny it again claiming that it's vision.
 
My Dad has Macular Degeneration. The doc said that long term exposure to bright sunlight was a possible cause. Well, my Dad spent years on the water. But he always wore dark glasses. Doc countered with: Your Dad is now 94. Were the glasses just dark, or UV protected as well? It is really quite recently that it has become almost impossible to buy a pair of dark glasses that are not UV protected. So, yes see your Eye Doc. But wear UV Dark Glasses, too.....

-Skip
 
weilke said:
Yes and no. All vision tests related to the surgery are covered, after a while typically the medical carriers start to deny it again claiming that it's vision.
Click to expand...

Nope. As long as the ophthalmologist (NOT optometrist) codes the procedure as post-op follow-up it passes -- at least it has for me for the past 12 years.

((There is always the possibility of remission -- especially if the carrier sack wasn't perforated during the lens replacement))
 
oldShar said:
Nope. As long as the ophthalmologist (NOT optometrist) codes the procedure as post-op follow-up it passes -- at least it has for me for the past 12 years.

((There is always the possibility of remission -- especially if the carrier sack wasn't perforated during the lens replacement))
Click to expand...
Believe me, Weilke knows what he is writing about. In general, specific diagnosis codes allow billing for various tests and procedures. Different insurance companies have different rules. Also, some providers do a good job of listing the correct codes and others are less capable. Some providers have also been known to "game the system" to get what they want for the patient or themselves.
 
For the three OVs with two eye docs for my original eye injury, I paid a $25 co-pay each OV. For the two OVs plus surgery (including anetheologist) + 7 follow-up OVs (1 x per week) I paid $2,000. I would dearly pay that amount again if required.

I say this to redirect the discussion to the fact that your health is far more important than coding. This is as Mari and others had mentioned when they said they would gladly pay the extra $35.

Again, no matter your age, health, no previous conditions, or type of ins you have, or don't have, GET YOU EYES CHECKED.
 
Insurance billing rules do not always make sense. Some companies will not cover a cardiac CT but will pay for invasive heart cath that costs about 4 times as much and has higher risk. Many people refuse to pay anything out of pocket if it is not covered by insurance even if they have money to blow on all sorts of other stuff. Your health should be worth something.
 
Gary F said:
some providers do a good job of listing the correct codes and others are less capable. Some providers have also been known to "game the system" to get what they want for themselves.
Click to expand...

OK, I will concur with that after being billed $4000 for a normal 10-year colonoscopy that was supposed to be a standard part of an annual physical, and $300 for a standard mammogram. The providers get a bigger chunk of the change that way, since the insurance company washes their hands of price control when they refuse to pay the procedure (by being coded as diagnostic instead of preventive.)
 
fgcason said:
I hate glasses and fuzzy images but this is one of the two reasons I do like being nearsighted. They force you to go to the eye doc at least semi regularly. The other is glasses keep pointy/projectile type objects and hostile liquids out of your eyes.
Click to expand...

I know this is an old post but third reason is that you have UV filters over your eyes almost 100 percent of the time where those with good vision are exposed much of the time unless they are wearing quality sunglasses or are in a vehicle etc. with UV filtering glass.

An acquaintance of mine is an avid skier and mountaineer with uncorrected vision who always said she "hated wearing" sunglasses. In her forties she has already dealt with eye problems.
 
oldShar said:
OK, I will concur with that after being billed $4000 for a normal 10-year colonoscopy that was supposed to be a standard part of an annual physical, and $300 for a standard mammogram. The providers get a bigger chunk of the change that way, since the insurance company washes their hands of price control when they refuse to pay the procedure (by being coded as diagnostic instead of preventive.)
Click to expand...
The medical system could use a good dose of competition. Four grand seems high for a colonoscopy. Some insurance policies cover it periodically over age 50 for health maintenance while others require findings such as abnormal hemocult cards. Three hundred for a mammogram seems reasonable.
 
Gary F said:
The medical system could use a good dose of competition. Four grand seems high for a colonoscopy. Some insurance policies cover it periodically over age 50 for health maintenance while others require findings such as abnormal hemocult cards. Three hundred for a mammogram seems reasonable.
Click to expand...

I am all for competition. I am also for a requirement that providers have a posted schedule of charges in the waiting area and that they have to provide and estimate prior to any procedures. This system would also require every patient at the end of a visit to sign a delivery slip for the full-fare price, payable 'net 30' and a credit card to hold.

This will never happen. The hospitals would hate if people found out that ambulatory surgery centers and independent outpatient imaging centers routinely under-bid them by 50%.
 
Have the office call for pre-approval from the insurance company before you have an elective procedure. If insurance does not cover the cost ask what you will be charged or find out what other options you have.
 
Gary F said:
Have the office call for pre-approval from the insurance company before you have an elective procedure. If insurance does not cover the cost ask what you will be charged or find out what other options you have.
Click to expand...

Again, that may or may not work.

The lying weasels at united at times will not issue a pre-cert for a procedure 'because it is not needed' yet deny the charges later on 'because no pre-cert was obtained' ;) . There is a reason they have 102mil/year to pay as salary to their CEO.
 
I went to some place in town that gave me a glasses / contact prescription in like 5 minutes. The goal was to correct my distance vision some. Never had problems up close.

The contacts really screwed up my up close vision. Text on a computer monitor or my laptop was slightly blurry and annoying. I complained to the eye doc and he said they were fine. I eventually gave up on the contacts...I still wonder why they caused that effect...
 
weilke said:
Again, that may or may not work.

The lying weasels at united at times will not issue a pre-cert for a procedure 'because it is not needed' yet deny the charges later on 'because no pre-cert was obtained' ;) . There is a reason they have 102mil/year to pay as salary to their CEO.
Click to expand...
The response "certification not needed" should be legally equivalent to an approval. If you have adequate documentation of this response it should be possible to dispute the bill. It is important for the doctor's office to record the billing code provided and get the name of the person at the insurance company. The billing (diagnosis) code used to inquire for the pre-approval must match the one submitted by the provider that performed the test or procedure, if not you may have a problem. This might simply be a clerical mistake which can be corrected or somebody in your doctor's office or the insurance company may have screwed up.
 
jesse said:
I went to some place in town that gave me a glasses / contact prescription in like 5 minutes. The goal was to correct my distance vision some. Never had problems up close.

The contacts really screwed up my up close vision. Text on a computer monitor or my laptop was slightly blurry and annoying. I complained to the eye doc and he said they were fine. I eventually gave up on the contacts...I still wonder why they caused that effect...
Click to expand...

The contacts readjusted the focal length of your eyes, extending it outward. Because it was extended outward, you couldn't see up close. Only way around that is two different contacts, one close and one far. I'm told people do that for LASK. Eeuuch.

My glasses do that to me now. In my case it is called presbyopia, and happens to guys my age. The good thing is I really don't need bifocals (good, because they are bloody expensive). And because I wear glasses (I've never been able to wear contact lenses) I can just take them off, which I do. The optometrist I saw the other day told me I may never need bifocals, which is kinda cool. Hey, at my age you take what you can get.
 
steingar said:
The contacts readjusted the focal length of your eyes, extending it outward. Because it was extended outward, you couldn't see up close. Only way around that is two different contacts, one close and one far. I'm told people do that for LASK. Eeuuch.
Click to expand...
I'm pretty sure that two different contact lenses, one for each eye, is not an approved item on FAA medicals. If Jesse was 20 years older I would say it was age. I have the same effect with contacts which I wear because I am quite nearsighted. I can still see well enough close up to pass the medical with contacts but without reading glasses but that day is coming. When I am wearing glasses I can just take them off to see something up close.
 
Everskyward said:
I'm pretty sure that two different contact lenses, one for each eye, is not an approved item on FAA medicals. If Jesse was 20 years older I would say it was age. I have the same effect with contacts which I wear because I am quite nearsighted. I can still see well enough close up to pass the medical with contacts but without reading glasses but that day is coming. When I am wearing glasses I can just take them off to see something up close.
Click to expand...
I passed my second class medical without contacts or glasses so my vision is still pretty decent. I just discovered that it could be "even better". I opted for prescription sunglasses, glasses, and contacts.

The prescription sunglasses and glasses work perfectly and my vision thru all distance ranges is amazing. The contacts screw up my near vision but slightly enhance my distance vision.
 
Everskyward said:
I'm pretty sure that two different contact lenses, one for each eye, is not an approved item on FAA medicals.
Click to expand...

They've approved LASIK, and that is exactly what they do. If someone has had LASIK and they don't need reading glasses, the focal lengths of their two eyes are different.
 
You must log in or register to reply here.
Back
Top