Eye Yi Yi!

I was up much too early this morning because I had an appointment with my ophthamologist. Before we get into that, though, let's discuss our favorite public transit system.

My appointment was for 8:40 am. I got down to Frankford Terminal to catch the El around 8:10, giving me plenty of time to get to Allegheny station and either walk or take another bus to the office. However, when I got up the stairs to the El platform, there was chaos. It was filled with people waiting for a train, and some were getting quite disturbed. I got my phone and logged onto the mobile version of SEPTA's website to see if there were any advisories, and found...nothing. They have a Twitter account as well. I went on Twitter and found...nothing. (Later I checked and saw that their Twitter account hadn't been updated in 3 days until this afternoon, when there was an announcement about a book drive.) Thanks for nothing, SEPTA.

I thought about waiting to see if a train was coming from somewhere, but I saw that one of my fine Twitter peeps, PhilthyBlog (the actual blog is here) posted that he was sitting on a train that was stuck at a station for 15 minutes. So I left the El platform and caught a bus instead, and ended up only a few minutes late.

So, about my eyes...

I've been to the eye doctor's often over the last two-plus years.
I started noticing my vision seemed a little blurry in my left eye. It turns out I had a cataract. This is highly unusual for someone my age. What can I say? I'm special. In October '08 I underwent surgery. This brings back memories for three reasons:

1) It was nine days before the Phillies won the World Series, so I could see everything more clearly. ;-)

2) I remember being really worried about the procedure. Basically, a cataract is a clouding of the lens of your eye. If this happens and it impairs your vision too much, they have to remove your eye lens and replace it (with what's called an intraocular lens). It's an outpatient procedure and obviously they give you anesthesia in the eye so you don't feel anything there, but usually they don't put you under. I was nervous about it, though, in the days before the surgery. I really was afraid that something would go wrong and it would be either uncomfortable or painful and I'd end up moving or twitching or something while the doctor was cutting out my lens. So, for the first time in nearly a year, I was pretty careless about watching my diet. That started the upward trend of the last two years. From November '07 to July '08 I had dropped from 261 lbs. to 209 lbs., and was only a little bit above that in October of that year. Since then, though, I've had a slow but steady climb in the weight department. These days I'm hovering around the 240 mark. I really need to get that turned around.

3) When I was wheeled into the room where the procedure was being done, I was hooked up to an IV, and the woman administering it asked me a question. I started to answer her, and the next thing I remember was the doctor saying "We'll be taking you back into the recovery area in about five minutes." The whole thing happened and I was blissfully unaware!

I had a follow-up exam the next week and got a prescription for new eyeglasses as well. Since then I've been going back every 6 months. They check the new lens to make sure no filming develops on it. This happens sometimes, and if it does they do a laser procedure to correct it. They also check my right eye. I have a tiny cataract in that eye, but it's not affecting my vision. And they check for glaucoma. They've worried about it because my optic nerve looks really weird. I remember years and years ago a different eye doctor had said this, but they did further tests and found nothing actually wrong. It just looks like it. I'm not sure of all the technical jargon.

Anyway, every time I go, they dilate my pupils and run various tests and scans. The new lens in the left eye is fine -- no filming. The cataract in the right eye is still tiny and nothing needs to be done on it yet. And there's no glaucoma and other than that one spot on the optic nerve, everything looks fine.

Which brings me to the actual reason I decided to write about this to begin with. When I checked in at the desk, it was explained to me that my visit was designated as a medical visit, which was covered by my insurance. However, if an exam to check the prescription on my glasses was done, that was a separate issue and if my insurance covered it (which it does, once a year, if I'm not mistaken) I'd have to either pay $20 to have it done that day or make a separate appointment because they can't bill the insurance company for the medical visit and the prescription visit on the same day.

I didn't run across this issue in my previous visits so I don't know if this is something new or what, but to me it's incredibly inefficient and inconvenient. I can't imagine how the insurance company rationalizes this. If anyone knows, feel free to enlighten me. But it seems to me that this is another example of something in our health care system that needs to be fixed.

As it turned out, the doctor looked at my eyes, then looked at my charts for the information from the previous testing that the technician had done first, and said that he thought I needed a new prescription. I kind of laughed. He ended up doing the test shown in this video:



Then he wrote out a prescription for new glasses. I didn't pay $20, either. I don't know whether they're going to try and charge my insurance company for it or just have the $20 deducted from my medical savings account (I have one of those plans where I get a balance each year, and co-pays for doctor's visits, prescriptions and such -- and now, the cost of eyeglasses as well -- get deducted from it).

Anyhoo, if you've read this far, what the heck is wrong with you? And, the good news is, I go back in 6 months and if everything still checks out okay then, I can go back to being checked yearly.