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Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7821
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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what testing is routine for catarac surgery?

Resolved Question:

what testing is routine for catarac surgery?
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. Rick replied 2 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

Well, first of all, a complete eye exam by your surgeon. This includes a eye and medical history, glasses check, refraction, eye pressure check, external eye and adnexa evaluation, slit lamp exam and dilated fundus examination. Rarely would specialized testing be need such as gonioscopy, visual field testing, OCT, or angiography

Customer:

what about refractory tests not covered by insurance? also hoe does macular degeneration figure into lens selection?

Dr. Rick :

To select the correct power of lens for your eye biometry will be done. This involves measuring the curve of your cornea (K readings) and the length of your eyeball (A scan). A formula is then used to pick the best lens for you.

Dr. Rick :

Macular degeneration does not figure into the calculations or the lens selection very much, but it does figure into what you can expect as far as post op vision.

Dr. Rick :

Every insurance is different so I really don't know what would be and wouldn't be covered. I see you are 75 and I can tell you that medicare will cover all testing involved with your surgery, up to their usual 80%

Dr. Rick :

Does this make sense to you?

Dr. Rick :

Of course, medicare, in their infinite wisdom, doesn't cover eyeglass refraction.....so, as this is a very important and necessary part of every complete eye exam, you will have to pay this small charge out of your pocket. Thank your congressman/woman for this little fact.

Customer:

yes but this surgeon wants 265.00 for testing he says is necessary and not covered by insurane..payable upfront.

Dr. Rick :

Did he say what this testing was?

Customer:

yes he lists 4 tests that all or some may be done 1.ophthonix wavefront refraction 2.corneal topography 3.pachymetry 4. post op refractions 5. astigmatism reduction proceedure

Dr. Rick :

ok. not sure why he is doing #1. Are you going with the fancy lens (ReStor, ReZOOM) etc?

Dr. Rick :

#2 is like a fancy way to take K readings...it also give a lot more information about your eye and is necessary to do #5

Dr. Rick :

Pachymetry is not needed in normal cases

Customer:

don't know doctor hasn't said which would be better

Dr. Rick :

4 should be included in your free 90 day post op period

Dr. Rick :

Of course, in the doctors defense, when you last hired a lawyer to assist you, how much (usually non refundable) cash did they demand up front? Doctors are being squeezed by medicare, medicaid, insurance and everyone else. Did you know that payment for cataracts surgery done in 1994 is less then 25% of what doctors get paid for the same -- actually an improved and safer -- surgery today? I paid the vet more to get my dogs broken leg fixed then the orthopod made to fix my 11 year old daughters arm -- about 4 times more to be exact.

Dr. Rick :

Sorry to get on my soapbox......

Dr. Rick :

There are doctors out there who do excellent surgery and do not charge you extra for any of those. Actually I've done number 5 and not charged at all....

Customer:

ok about the soapbox i understand about the medical field but i'm just concerned about getting the right surgeon.

Dr. Rick :

I understand completely......the best way to pick the best surgeon is to ask friends, past patients ect....

Dr. Rick :

Cataract surgery is something that every general ophthalmologist does and does well as a general rule.

Customer:

i've had mixed reviews about this dr. how can i be sure ?

Dr. Rick :

You can't be sure. But in my opinion it seems a little fishy that he is demanding payment for post op refractions as this is contracted as a covered at no cost to the patient item.....

Dr. Rick :

the other charges, I can see some rationale but it's still kinda fishy. Perhaps find another doc.

Customer:

ok and i agree thank you for your time

Dr. Rick :

My pleasure. Best of luck with your upcoming surgery.

Dr. Rick :

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Expert:  Dr. Rick replied 2 years ago.
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Expert:  Dr. Rick replied 2 years ago.
Let me know if there is anything else you would like to discuss pertaining to this issue.
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7821
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you

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