Vision loss

If it's on your mind and it has to do with multiple sclerosis in any way, post it here.

Vision loss

Postby scoobyjude » Wed May 06, 2009 7:11 pm

Found this interesting since I have had no visual symptoms yet. I have yearly exams and my optometrist knows I have MS so he does more extensive tests but I wonder if that's enough. I've always had bad eyes but they do seem a little worse over the last few years.


Vision Deteriorates Even Without Sight-Related Symptoms in Patients With MS: Presented at ARVO
By Ed Susman

FORT LAUDERDALE, Fla -- May 5, 2009 -- Researchers suggest that clinicians make a point of checking patients with multiple sclerosis (MS) for diminished vision even when the patients have not experienced any vision-related symptoms such as optic neuritis.

The study was presented here on May 3 at the Association for Research in Vision and Ophthalmology (ARVO) 2009 Annual Meeting.

"Our findings suggest a subclinical axonal loss in the anterior vision pathways of patients with multiple sclerosis that occurs without symptoms," said lead author Esther Bisker, MD, University of Pennsylvania, Philadelphia, Pennsylvania.

More precise studies that can reveal vision loss, such as low-contrast acuity tests, will help identify patients who may have deteriorating sight.

"Our study indicates that these tests should be performed among all patients diagnosed with multiple sclerosis, not just those with a history of vision complications," said Dr. Bisker.

She stated that visual dysfunction and axonal loss commonly occur with MS and that optical coherence tomography has enabled researchers to see the unique correlations between structure and function of the anterior visual pathway in this disease.

The researchers followed 1,011 patients in the MS treatment programs at the University of Pennsylvania; Johns Hopkins University, Baltimore, Maryland; and University of Texas Southwestern Medical School, Dallas, Texas.

High-contrast and low-contrast visual acuity were checked at 6- and 12-month intervals, and optical coherence tomography was used to determine differences in thickness of the retinal nerve fibre layer. The final analysis involved 336 patients.

The patients were separated into 2 study groups -- 1 involving 428 eyes of patients who did not experience optic neuritis and the other involving 220 eyes of patients who did experience optic neuritis. Patients had a mean age of 44 years, and 85% were diagnosed with relapsing-remitting MS.

Worsening of low-contrast acuity was noted in 74 eyes (29%) of people with a history of optic neuritis, whereas similar worsening of low-contrast acuity was seen in 638 eyes (35%) of patients who had no history of optic neuritis.

Dr. Bisker said the difference did not rise to statistical significance but underscored that clinicians need to be aware that visual deterioration is ongoing in MS.

Funding for this study was provided by the National MS Society and the National Eye Institute.


[Presentation title: Clinical and Ocular Imaging Characteristics of Eyes With Visual Loss Over Time in Multiple Sclerosis. Abstract 927-D709]
User avatar
scoobyjude
Family Elder
 
Posts: 516
Joined: Sat Feb 18, 2006 4:00 pm
Location: suburb of Chicago, IL USA

Advertisement

Postby EyeDoc » Tue May 12, 2009 7:52 am

This is why optical coherence tomography (OCT) should be done on all MS patients. Ask your eye doctor if they have this instrument. Get a baseline measurement done, but be aware that a diagnosis of MS is not considered reimbursable for this test by medical insurances yet so you may have to pay for it out of pocket.

In my clinic I do this test on all MS patients. I don't charge them for it...but I am probably a big ol' softy with MS patients :)
User avatar
EyeDoc
Family Elder
 
Posts: 161
Joined: Thu May 11, 2006 3:00 pm
Location: Texas, USA

Postby JenniferF » Tue May 12, 2009 1:24 pm

EyeDoc wrote:This is why optical coherence tomography (OCT) should be done on all MS patients. Ask your eye doctor if they have this instrument. Get a baseline measurement done, but be aware that a diagnosis of MS is not considered reimbursable for this test by medical insurances yet so you may have to pay for it out of pocket.

In my clinic I do this test on all MS patients. I don't charge them for it...but I am probably a big ol' softy with MS patients :)


This is a brand new topic for me. Could you quickly explain what the practical implications of this are? Ie different glasses? Some other treatment?

Thanks!

Jen.
User avatar
JenniferF
Family Member
 
Posts: 83
Joined: Wed Aug 27, 2008 3:00 pm

Postby EyeDoc » Tue May 12, 2009 2:35 pm

JenniferF wrote:
EyeDoc wrote:This is why optical coherence tomography (OCT) should be done on all MS patients. Ask your eye doctor if they have this instrument. Get a baseline measurement done, but be aware that a diagnosis of MS is not considered reimbursable for this test by medical insurances yet so you may have to pay for it out of pocket.

In my clinic I do this test on all MS patients. I don't charge them for it...but I am probably a big ol' softy with MS patients :)


This is a brand new topic for me. Could you quickly explain what the practical implications of this are? Ie different glasses? Some other treatment?

Thanks!





The practical implication is basically just that we can monitor how much the MS is progressing year to year. Prior to this technology the only way to monitor MS progression was through MRI. So theoretically if I see a large change in a patient one year to the next, I could then talk to their neurologist to let them know there was a good bit of progression. Perhaps a neurologist could get more aggressive with this patient's treatment.

The readings from this instrument will not help us with glasses prescriptions.
User avatar
EyeDoc
Family Elder
 
Posts: 161
Joined: Thu May 11, 2006 3:00 pm
Location: Texas, USA

Re: Vision loss

Postby NHE » Tue May 12, 2009 5:26 pm

JenniferF wrote:This is a brand new topic for me. Could you quickly explain what the practical implications of this are? Ie different glasses? Some other treatment?

Optical coherence tomography is a way to track damage to the nerves in the retinal tissue. Here's an article which briefly discusses the technique.

http://www.news-medical.net/news/31252.aspx

NHE
User avatar
NHE
Volunteer Moderator
 
Posts: 3368
Joined: Sat Nov 20, 2004 4:00 pm

Postby Sharon » Tue May 12, 2009 6:34 pm

To All -

My insurance has covered OCT tests for two years. Dr.'s office must be coding it without the MS

Eyedoc wrote:
Ask your eye doctor if they have this instrument. Get a baseline measurement done, but be aware that a diagnosis of MS is not considered reimbursable for this test by medical insurances yet so you may have to pay for it out of pocket.


Sharon
User avatar
Sharon
Family Elder
 
Posts: 1236
Joined: Sun Nov 07, 2004 4:00 pm
Location: Colorado

Postby scoobyjude » Tue May 12, 2009 7:07 pm

Eyedoc or anyone else, do you have any idea how much the OCT might cost if my insurance doesn't cover it?
User avatar
scoobyjude
Family Elder
 
Posts: 516
Joined: Sat Feb 18, 2006 4:00 pm
Location: suburb of Chicago, IL USA

Postby Sharon » Tue May 12, 2009 8:24 pm

Here is a breakdown of my eye doctor bill - this was for the OCT and a complete eye exam. I do not know the codes - maybe "eyedoctor" can help

Ophthal-Comprehensive #92014
Refraction-Post Op #92015

Breakout of bill:
x-ray or lab services 85.00 - ***noted-charges...considered to be experimental or investigational
x-ray or lab services 85.00 **same notation as above
x-ray or lab services 130.00
medical services 25.00
office visit 110.00
total 435.00

I paid $40.00 for my deductible - that is all
I had Aetna insurance at the time
User avatar
Sharon
Family Elder
 
Posts: 1236
Joined: Sun Nov 07, 2004 4:00 pm
Location: Colorado

Postby JenniferF » Thu May 14, 2009 6:54 am

EyeDoc wrote:
The practical implication is basically just that we can monitor how much the MS is progressing year to year. Prior to this technology the only way to monitor MS progression was through MRI. So theoretically if I see a large change in a patient one year to the next, I could then talk to their neurologist to let them know there was a good bit of progression. Perhaps a neurologist could get more aggressive with this patient's treatment.

The readings from this instrument will not help us with glasses prescriptions.


Thanks! Very helpful.
User avatar
JenniferF
Family Member
 
Posts: 83
Joined: Wed Aug 27, 2008 3:00 pm

Postby scoobyjude » Fri May 15, 2009 8:48 pm

Thanks Sharon. I have VSP. I'll have to find out if it is covered.
User avatar
scoobyjude
Family Elder
 
Posts: 516
Joined: Sat Feb 18, 2006 4:00 pm
Location: suburb of Chicago, IL USA

Postby Sharon » Fri May 15, 2009 8:58 pm

Scoobyjude -

Glad I could help - good luck. Oh, be sure to get a copy of your report for your records when you get the tests. I have found that if I ask at the time of testing (whether it be MRI's or whatever), I will not be charged. If I ask later, they charge a "copy" fee. I am a strong advocate to make sure that I have a file with my medical tests - all of them - blood tests, annual exams, MRI's, X-rays, doctor's visits, etc., etc.
User avatar
Sharon
Family Elder
 
Posts: 1236
Joined: Sun Nov 07, 2004 4:00 pm
Location: Colorado

Postby scoobyjude » Fri May 15, 2009 9:04 pm

will do :)
User avatar
scoobyjude
Family Elder
 
Posts: 516
Joined: Sat Feb 18, 2006 4:00 pm
Location: suburb of Chicago, IL USA

Postby EyeDoc » Mon May 18, 2009 11:27 am

Sharon wrote:Here is a breakdown of my eye doctor bill - this was for the OCT and a complete eye exam. I do not know the codes - maybe "eyedoctor" can help

Ophthal-Comprehensive #92014
Refraction-Post Op #92015

Breakout of bill:
x-ray or lab services 85.00 - ***noted-charges...considered to be experimental or investigational
x-ray or lab services 85.00 **same notation as above
x-ray or lab services 130.00
medical services 25.00
office visit 110.00
total 435.00

I paid $40.00 for my deductible - that is all
I had Aetna insurance at the time



There you go...look at the notes that says "considered to be experimental". That is indicative that some insurances will not cover it. Believe me. I have tried to get reimbursed many times and been denied. Perhaps some insurance companies are starting to cover it. That is great.

I believe we charge approx $75.00 per eye for the test.
User avatar
EyeDoc
Family Elder
 
Posts: 161
Joined: Thu May 11, 2006 3:00 pm
Location: Texas, USA


Return to General Discussion

 


  • Related topics
    Replies
    Views
    Last post

Who is online

Users browsing this forum: No registered users


Contact us | Terms of Service