Resources for Eye Care, Exams, and Glasses: How to See More and Pay Less

By Marie Tetsu and Kira Wang

Cost can sometimes be a barrier to proper eye care, but a variety of programs offer free or low-cost eye exams and other resources. Are you eligible? 

Most people rely on their sight every day, making eye care essential to our health. For people with diabetes, annual dilated eye exams are especially necessary to catch early signs of eye disease. But eye care can be expensive: adults with diabetes report that associated cost or a lack of insurance are some of the main reasons for not receiving eye care in the past year. While cost may prohibit people with diabetes from getting vital care, there are many programs that offer free or low-cost eye exams and glasses. Given the added financial burdens that so many people are facing as a result of COVID-19, we’ve built a list of resources designed to help people with diabetes and support those experiencing vision loss.

Note: to qualify for many of these resources, you or your family will need to meet certain criteria. Each organization has different requirements – which we’ve done our best to lay out – but be sure to check each website!

1. EyeCare America

EyeCare America offers medical eye exams to qualifying people in the United States, often with no out-of-pocket cost. Two main programs are included in EyeCare America: the Seniors Program and the Glaucoma Program.

  • The Seniors Program connects people over the age of 65 with volunteer ophthalmologists in their area who provide free eye exams, and it offers up to one year of follow-up care for any diagnosed conditions. To qualify, you must:
    • Be a US citizen or legal resident
    • Not belong to a health maintenance organization (HMO) insurance plan or have Veterans Affairs (VA) eye care benefits
    • Not have received an eye exam by an ophthalmologist in the last three years
  • The Glaucoma Program provides a free glaucoma exam to qualifying people who are uninsured. If you have insurance you may still request an appointment through the program but will be responsible for any co-payments. To qualify, you must:
    • Be a US citizen or legal resident
    • Neither belong to an HMO nor have VA eye care benefits
    • Not have had an eye exam in the last 12 months
    • Be at an increased risk for glaucoma, which is true if you have diabetes, have a family history of glaucoma, are African American and over the age of 50, or are Hispanic and over the age of 65

Regardless of insurance coverage or income level, anyone can use the EyeCare America Drug Discount Card in English or Spanish. Unfortunately, EyeCare America does not cover eyeglasses or services such as surgical operations.

2. Lions Club International

Lions Club International provides access to eye care and assistance with purchasing glasses for people who are considered low income. The non-profit also offers classes and services for those who are blind or have limited vision. Lions Club presents many of these vision programs through OneSight eye care centers located across the US and around the world. Lions Club International also provides a limited number of vouchers for free glasses, and offers mobile eye care services to children. You can find your local Lions Club here.

3. VSP Eyes of Hope

Eyes of Hope through VSP Global provides eye care and gift certificates for eyeglasses to children, adults, and people affected by disaster. Unfortunately, because of COVID-19, the distribution of new certificates is currently paused.

  • For children: Sight for Students gift certificates provide free eye care and prescription glasses from a local optometrist to people under the age of 19. To qualify, children must have a family income at or below twice the Federal Poverty Level for their family size, and cannot have received care through VSP in the last 12 months. To acquire a gift certificate, parents can find a local partner here.
  • For adults: Adults who make less than twice the Federal Poverty Level and have not received care from a VSP program in the past year are eligible for vouchers. Mobile Eye Care Clinics are also available to people but are suspended until 2021 due to COVID-19.
  • For people affected by disaster: If you have been affected by a natural disaster (like fire, hurricane, tornado, or flooding), are in need of eyeglasses or eye care, and do not have vision insurance, you can qualify for a VSP gift certificate. Contact your local American Red Cross chapter.

4. Medicare

Medicare Part B covers an annual dilated eye exam for people over the age of 65 with diabetes. Dilated eye exams are extremely important for monitoring vision in people with diabetes. Medicare does not provide free routine eye exams or eyeglasses. Under Medicare, you’ll pay 20% of the Medicare-approved amount and the Part B deductible. If you are receiving care in a hospital outpatient setting, a co-payment is also required.

5. OneSight

OneSight is an independent non-profit that provides eye exams and glasses to people, and establishes permanent vision centers around the US. People can take a free online vision exam here. While this online exam does not replace an in-person visit with an eye care professional, it can provide useful information about your sight.

6. New Eyes

New Eyes offers prescription eyeglasses to children and adults who are at or below 2.5 times the Federal Poverty guidelines. You can sign up with the help of a clinician or social worker and use vouchers on the New Eyes website.To qualify, you’ll need to meet the financial requirements, have had an eye exam within the last two years, and not have received other charitable or government resources to pay for eyeglasses. People financially affected by COVID-19 can apply directly here (without the help of a social worker or other health advocate).

7. Mission Cataract

Mission Cataract USA offers free cataract surgeries one day a year to people of all ages who have no insurance and don’t qualify for Medicare, Medicaid, or other forms of government support. Cataracts cause the lens in your eye tobecome cloudy, and your vision may become blurred or less vibrant. Aging is the most common cause of cataracts, however, people with diabetes have a higher risk of developing cataracts.

8. Operation Sight

Operation Sight is another group that provides free cataract surgery to US citizens and permanent residents. To qualify, you must be at or below twice the Federal Poverty Level, and uninsured or underinsured (this would indicate that your insurance does not cover cataract surgery). If you receive Medicare Part B you will not be eligible. You must also have a formal cataract diagnosis. Fill out this form to find out if you qualify.

9. Support Groups for Vision Loss

If your vision, or that of a family member’s, has been harmed by diabetes-related eye disease or other causes, you might consider joining a vision loss support group. VisionAware helps adults adjust to life with vision loss. Whether in-person or online, support groups can offer a space to share your stories and concerns, and it is a space to learn from others with similar experiences. Check out VisionAware’s featured support groups here and find your local chapter.

Learn more about the risks diabetes poses to eye health in our recent article, “Seeking Healthy Vision: Eight Strategies For Caring for Eyes.” If you meet the qualifications of any of the programs we’ve listed, make sure to inquire and apply. Prioritize your vision and keep your eyes as healthy as possible for a long lifetime of use!

About Marie
Marie Tetsu is a rising senior at the College Preparatory School in Oakland, California. She is an eye-care enthusiast, and has been wearing prescription eyeglasses for the past ten years. In college, Marie plans to double major in English and Biochemistry on the pre-med track.  

About Kira

Kira Wang graduated summa cum laude and Phi Beta Kappa from Duke University with a degree in psychology and minors in biology and chemistry. At Duke, she wrote a senior thesis on the coping strategies of parents and youths with chronic illness and spent over two and a half years researching retinal imaging techniques in the Duke Eye Center. She’s currently taking a gap year and plans to go to medical school.

Source: diabetesdaily.com

Your Eye Health During COVID-19 — What You Should Know

This content originally appeared on diaTribe. Republished with permission.

By Kira Wang

While the global pandemic has interrupted many healthcare services, eye care is still essential and available under certain circumstances

Diabetes can lead to changes or problems in your vision, making annual eye appointments a necessity for every person with diabetes. One can prevent complications with vision for many years, even many decades, with some luck – it’s about glucose management as well as genes. For people who already have eye complications, treatment may be required as often as every few months in order to keep eyesight as strong as possible. But COVID-19 has disrupted many aspects of our daily lives, including the ability to visit eye care professionals for regular appointments. Although providers may not be able to see you in person at this time, there are still ways for you to access the care you need and keep your eyes as healthy as possible.

Can I still see my eye care provider in person?

We reached out to diaTribe’s network of healthcare professionals and learned that eye care providers are still treating emergencies and people with advanced cases of diabetes-related retinopathy and diabetes-related macular edema. Emergencies might include cases of trauma, infection, or sudden changes in vision (e.g., flashing lights, floaters, blurriness) – if you have experienced any of these situations, talk to your healthcare team right away.

If you have been diagnosed with diabetes-related retinopathy or diabetes-related macular edema, delaying treatment can risk worsening vision, and you may need to receive in-person care. If your treatment has been rescheduled, double-check with your healthcare team to make sure your vision is not at risk. For more mild cases of diabetes-related retinopathy or diabetes-related macular edema, your healthcare professional may consider the risks of exposure to COVID-19 versus how your vision will be affected without scheduled treatment.

Planning ahead is important, and every person is different – ask your doctor in advance about what specific plan works for you. If you do visit your eye care provider in person, remember to wear a face covering—this will help keep you and your healthcare team safe!

Telemedicine and eye care: when can I talk to my healthcare professional virtually? 

For problems with the outside of your eye, video visits can help you connect with your provider right from your home. Issues outside your eye might include redness, discharge, or swollenness. Explaining your symptoms to your provider over video can help them determine whether you’ll need to be seen in person.

What should I know about scheduling eye appointments in the midst of COVID-19?

For those who already have regularly scheduled eye appointments, your check-ups may be delayed during these times. If your visit is delayed, you should still pay attention to any changes in your vision. You can do this by giving yourself an at-home eye test.  If you don’t already have annual visits with an eye care professional, try to set up an appointment as soon as eye care clinics are back up and running.

Remember: keeping your blood sugar levels in range is central to maintaining healthy eyes.

In these challenging times, we are impressed by the use of telemedicine, for eye care and beyond. For more information on telemedicine during COVID-19, check out these nine tips by longtime diaTribe advisor Dr. Francine Kaufman. To the many healthcare professionals out there, we are grateful for your service and support. Mark your calendars—July is Healthy Vision Month, and we’ll have more articles on eyes coming your way soon!

About Kira

Kira Wang graduated from Duke University summa cum laude with a degree in psychology and minors in biology and chemistry. She wrote a senior thesis on the transactional coping strategies of parents and youths with chronic illness and spent time researching eye imaging techniques in the Duke Eye Center.

Source: diabetesdaily.com

Diabetes Eye Screenings: Why They Are Important and Challenging

This content originally appeared on diaTribe. Republished with permission.

By Renza Scibilia and Chris ‘Grumpy Pumper’ Aldred

Regular eye screenings are important for people with diabetes. Learn more about diabetes-related retinopathy screenings from diabetes advocates Renza and Grumpy

What Causes Diabetes-Related Retinopathy?

Diabetes-related retinopathy occurs when many years of high blood sugar levels cause damage to blood vessels in the eye. This damage triggers your body to make more blood vessels – but these new vessels are fragile and easily damaged, which can result in bleeding or scarring in the eye that worsens vision. Fortunately, there are medications available that can improve symptoms. For more background on diabetes-related retinopathy, see here.

There is more to developing a diabetes-related eye condition than just A1C. Time in range also plays a role, as seen by recent research – diaTribe will be updating readers on this in the coming months!  Blood pressure also plays an important role in our risk, as can rapid fluctuations in glucose levels. Family history of eye conditions, such as glaucoma and age-related macular degeneration (AMD), may increase the risk of diabetes-related eye issues, so knowing and sharing your family history is important when discussing your eyes at screening appointments.

The importance of eye screenings

In diaTribe’s past interview with ophthalmologist (eye doctor) Dr. Ivan Suñer of Memorial Hospital of Tampa, we learned that people with retinopathy often have no noticeable symptoms until they are at high risk for losing their vision. Early detection of diabetes-related retinopathy is crucial to prevent vision loss. Thus, his number one piece of advice was to see a doctor regularly for eye screenings. The American Diabetes Association (ADA) recommends that people with diabetes get a comprehensive eye exam every two years if there is no evidence of retinopathy. For those with retinopathy, the ADA recommends an eye exam every year.

Given the importance of eye screenings, Renza and Grumpy – within a few days of each other – both recently tweeted about our upcoming eye screening checks. (Renza has annual visits to her private ophthalmologist as suggested by Australian guidelines; Grumps receives a screening every three to four months to monitor some damage in his left eye.)

Both of us (Renza and Grumpy) are fortunate that we live in countries with national eye screening programs for people with diabetes. (Australia’s program was launched just this year; the UK program has been around for a number of years now.)

In Australia, KeepSight operates as a “recall and reminder” system. People with diabetes register with the program and are sent prompts to make appointments. The frequency of these reminders is individually tailored, determined by how frequently screening checks are required.

In the UK, the Diabetic Eye Screening Program (time for a rename and some #LanguageMatters attention!) is overseen by the National Health Service (NHS). Screening appointments are made for people with diabetes, and follow up letters are sent with the results.

National screening programs work because they offer a coordinated and consistent approach that has the potential to reach a wide number of people. In an ideal world, they capture all people living with diabetes, ensuring screening occurs at the right time, changes to the eyes are identified early, and appropriate treatment is started immediately.

When implemented properly, the results of screening programs can be staggering. Before the UK program was established, diabetes-related eye conditions were the leading cause of preventable blindness in the UK. That is no longer the case.

The challenges of eye screenings

Not many people with diabetes look forward to their eye screenings. And many of us will look for any excuse to put off making or going to our screening appointment. There are a number of reasons for that.

While it may be one of the least invasive checks on our screening list, it can be one of the most disruptive. If pupil dilating drops are required, the rest of the day is often a write-off. Even when the blurred vision goes, we are often left feeling tired or with a headache from the bright light and eye strain caused by the drops.

On top of organizing time off work or school for ourselves, we may need to involve a friend or family member to take us to the appointment. All of these things can make coordination of our appointment difficult and become a reason that we postpone or cancel.

But logistics are only one reason we may decide to put off our appointment. Many of us are anxious about results from screening checks. Diabetes-related complications are often presented to us in such a scary and threatening way that we are frightened to organize and attend appointments. (Renza recently wrote this piece, “Why Scare Tactics Don’t Work in Diabetes” for diaTribe about how her introduction to diabetes-related complications when she was diagnosed with diabetes scared her so much that she was simply unable to face the thought of diabetes screenings.)

And those of us who have missed an appointment or two, or have never been screened before, become worried that we will be “told off” when we do eventually gather the courage to attend.

What works and how can we do better?

  • Making the process of actually having a diabetes eye check as easy and smooth as possible will always mean more uptake. Bringing screening to the people, rather than expecting people to travel long distances, will reduce a significant barrier to keeping up-to-date with screening checks. There are a number of different initiatives that are working toward making screening checks more convenient.
  • Pharmacies are being used in some areas to provide initial screening checks (using a retinal scanning camera), with any necessary follow-up being conducted by specialist eye health care professionals. This works well because it means the initial screening check – which will pick up any changes – is done somewhere convenient and familiar, and without the need for dilating drops. Hopefully this will reduce some of the nervousness people may feel about going to a clinic or hospital setting.
  • Coordinated reminder systems are great! Anything that helps ease the weight of “diabetes administration” is welcome to help with the daily tasks demanded by diabetes.
  • Counselling around the visit would also be helpful for some!

Having any sort of diabetes-related complications screening is never just about the process of attending and completing the screening. Just the thought of, and planning for, the appointment can be distressing for people, especially for those who have had complications presented to them in a scary or threatening manner. Offering counselling before and/or after screening is a great idea to help address some of those anxieties, and provide people with practical tips for coping.

Screening checks are part of the process of managing diabetes-related complications

We’d urge healthcare professionals to acknowledge just how difficult it can be for someone to simply show up for a screening appointment, and commend those that do. A little word of understanding can go a very long way!

As ever, peer support can be hugely beneficial. Whether it be sharing stories about how people manage to navigate anxieties and nervousness about eye screening checks, or how people have dealt with a diagnosis, speaking with others who have walked a similar path can be useful and can help reduce the isolation many people feel.

And finally, most people with diabetes do know the importance of regular complications screening, and that early detection and treatment will likely result in better outcomes. (In Grumps’ case, this early detection has meant that the issues have not progressed for several years and that, to date, no treatments have been required.) But that is not enough. We need to follow messages and campaigns that highlight the importance of screening with advice on how to make the process easier and more comfortable for people with diabetes, while recognizing how difficult it can be. Humanizing the experience of screening, and giving results and follow- up, is all an important part of the story.

Source: diabetesdaily.com

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