Keeping your vision healthy

Introduction

Vision changes can feel scary, frustrating, and isolating. You are not alone. Vision loss is common with aging and with certain medical conditions, but many causes are treatable and many people do very well with the right care, tools, and support. This article explains what vision loss is, common causes, symptoms and urgent warning signs, how diagnosis and treatment work, and practical steps you can take today. You will also find a simple overview of what Medicare may cover for eye care, closely aligned with the video included with this article. Throughout, you will see where an Understood Care advocate can help you coordinate care, lower stress, and stay on track.

What vision loss means

Vision loss ranges from mild difficulty seeing clearly to severe loss of sight. It can affect one or both eyes and may involve blurry central vision, loss of side vision, poor night vision, sensitivity to light, or trouble focusing. Some changes are part of normal aging, such as the need for reading glasses. Others signal an eye disease or another health issue that needs medical attention.

Common causes of vision loss

Cataracts

Cataracts are a clouding of the eye lens. They are very common with aging. Early on, you may notice glare, faded colors, or blurry vision. Surgery can remove the cloudy lens and replace it with a clear artificial lens placed inside the eye.

Glaucoma

Glaucoma is a group of diseases that damage the optic nerve. It often starts without symptoms. Over time it can reduce side vision and, if untreated, can lead to serious vision loss. Early detection through a comprehensive dilated eye exam is important because treatment can slow or prevent further damage.

Age related macular degeneration

Age related macular degeneration, often called AMD, damages the macula which is the part of the retina responsible for sharp central vision. Dry AMD progresses over time. Wet AMD involves leaking or abnormal blood vessels and can cause faster central vision loss. Treatments exist for certain forms of AMD.

Diabetic retinopathy and diabetic macular edema

High blood sugar over time can damage the tiny blood vessels in the retina. This can cause diabetic retinopathy and fluid buildup called diabetic macular edema. Good diabetes management is essential. Treatments include eye injections, laser therapy, and sometimes surgery.

Other causes

Other conditions can affect vision, including retinal detachment, corneal disease, inherited retinal disorders, stroke, head injury, and severe dry eye. Any sudden change in vision should be treated as urgent.

Symptoms you should not ignore

Seek same day care or emergency care if you have any of the following

• Sudden loss of vision in one eye or both eyes
• A dark curtain or shadow over part of your vision
• Flashes of light or a sudden increase in floaters
• Eye pain, headache, and nausea together with blurred vision
• Sudden double vision or loss of side vision
• New blind spots, distortion, or a rapid change in central vision

How eye doctors find the cause

History and exam

Your eye care professional will ask about your symptoms, medical conditions, medicines, and family history. A comprehensive dilated eye exam lets the doctor look at the retina, macula, optic nerve, and lens.

Tests you may have

• Visual acuity and refraction to check clarity and any need for glasses
• Tonometry to measure eye pressure
• Visual field testing to check side vision
• Optical coherence tomography to look at the macula and retinal layers
• Retinal photos and angiography for blood vessel changes in conditions such as diabetes
  Your doctor will explain which tests you need and why.

Treatment options

Treatment depends on the cause and stage of disease. Your care plan may include one or more of the following

• Eyeglasses or contacts when appropriate
• Prescription eye drops for glaucoma and other conditions
• Anti VEGF eye injections for wet AMD or diabetic macular edema
• Laser treatment for leaking blood vessels or retinal tears
• Cataract surgery to restore clarity
• Vitrectomy surgery for certain retinal problems
• Low vision rehabilitation to help you make the most of the vision you have

Your doctor may also recommend healthy lifestyle steps such as blood sugar and blood pressure control, smoking cessation, regular physical activity, and a diet rich in leafy greens and fish.

Daily living with vision loss

Make your home safer and easier to navigate

Increase lighting in hallways, stairs, and kitchens. Use contrasting colors for edges. Remove clutter and secure loose rugs to reduce falls. Organize medications and use large print labels.

Use low vision tools

Magnifiers, better task lighting, large print clocks and phones, screen readers, and electronic magnification can make daily tasks easier. Your eye care team can refer you to low vision specialists and occupational therapy for training.

Plan your day for comfort and safety

Group appointments and errands to reduce fatigue. Ask for accessible formats for written instructions. Bring a trusted person to visits to help take notes.

Medicare coverage in plain language

The video included with this article highlights a few key points that match Medicare rules

• Routine vision services are typically not covered by Original Medicare. Routine means a standard vision test for glasses or contacts when no medical condition is present.
• Some Medicare Advantage plans include routine vision benefits. These can include an annual routine exam and an allowance for glasses or contacts. Benefits vary by plan.
• Original Medicare covers certain services when a medical condition is involved. Examples include
  • Yearly eye exams for people with diabetes to check for diabetic retinopathy
  • Glaucoma screening once every twelve months for people at high risk
  • Certain tests and treatments for age related macular degeneration
  • Cataract surgery when medically necessary. After surgery with a lens implant, Medicare Part B covers one pair of standard eyeglasses or one set of contact lenses
    Coverage details and costs depend on your specific plan, deductibles, and copays. An advocate can help you confirm your benefits and expected costs before you schedule care.

How Understood Care advocates help

Set up the right appointments and prepare for visits

If you need an ophthalmology visit, a retina specialist, glaucoma follow up, or post surgery care, we can help you book the right visit at the right time and in the right network. We also help you prepare questions and gather records so you get clear answers

Make communication with your care team simple and clear

Vision care often involves several clinicians. Your advocate can help draft messages, share updates between offices with your permission, and confirm next steps so nothing is missed

Arrange reliable transportation

Safe transportation is essential when bright light, dilation, or surgery affects your ability to drive. We help arrange accessible rides that fit your needs and budget, and we plan for pick up after procedures that require a driver

Check coverage, lower bills, and find the most affordable options

We can review what your plan covers, estimate out of pocket costs, find in network providers, and look for the most affordable options for glasses after cataract surgery, medicines, and procedures. We can also help correct billing errors and set up payment plans when needed

Support second opinions when decisions are complex

If you want another expert to review your diagnosis or treatment options for cataract surgery, glaucoma, AMD, or diabetic retinopathy, we help you collect records and schedule a second opinion so you can decide with confidence

Coordinate helpful services at home

After eye surgery or when living with low vision, support at home can make recovery and daily life easier. We can help you explore home care options and coordinate services

Practical tips you can use today

Prepare for your next eye exam

Bring a list of changes you have noticed, a medication list, and your questions. Ask about your diagnosis, stage of disease, treatment options, expected benefits, risks, and what to watch for between visits.

Protect your eyes every day

Wear sunglasses that block ultraviolet light. Use protective eyewear during yard work and hobbies. Manage blood sugar, blood pressure, and cholesterol. Do not smoke. Stay physically active and eat a nutrient rich diet that includes leafy greens and fish.

Know when to call

Call your eye doctor promptly for new flashes or floaters, a dark curtain in your vision, eye pain, sudden blur, double vision, or a rapid change in central vision.

Next step

If you are ready for support, we would be honored to help you connect with an advocate, set up appointments, review coverage, and make a clear plan that fits your life.

Frequently asked questions

How often should I get an eye exam

If you have diabetes, Medicare covers a yearly exam for diabetic retinopathy. If you are at high risk for glaucoma, Medicare covers a screening every twelve months. Your eye care professional may recommend more frequent visits based on your condition.

Will Original Medicare pay for glasses

Original Medicare does not cover routine glasses or contacts. After cataract surgery with a lens implant, Part B covers one pair of standard eyeglasses or one set of contact lenses. Some Medicare Advantage plans may offer an allowance for glasses or contacts beyond that.

What is low vision rehabilitation

Low vision rehabilitation helps you use the vision you have with training, tools, and home strategies. Services are often provided by low vision specialists and occupational therapists. Many people find that this support restores independence and safety with reading, cooking, mobility, and personal care.

How can an advocate help me decide about cataract surgery or glaucoma treatment

Your advocate can help you gather second opinions, compare benefits and risks, confirm costs, schedule surgery, arrange a driver, and set reminders for follow up and medicines. We also help you communicate with your doctors and make sure your questions are answered in plain language.

References

Medicare coverage overview for routine eye exams
https://www.medicare.gov/coverage/eye-exams-routine Medicare

Medicare coverage for eye exams if you have diabetes
https://www.medicare.gov/coverage/eye-exams-for-diabetes Medicare

Medicare coverage for glaucoma screenings
https://www.medicare.gov/coverage/glaucoma-screenings Medicare

Medicare coverage for macular degeneration tests and treatment
https://www.medicare.gov/coverage/macular-degeneration-tests-treatment Medicare

Medicare coverage for cataract surgery and post surgery eyewear
https://www.medicare.gov/coverage/cataract-surgery Medicare

Medicare coverage for eyeglasses and contacts after cataract surgery
https://www.medicare.gov/coverage/eyeglasses-contact-lenses Medicare+1

National Eye Institute overview of glaucoma
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma National Eye Institute

National Eye Institute overview of cataracts
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cataracts National Eye Institute

National Eye Institute overview of age related macular degeneration
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/age-related-macular-degeneration National Eye Institute

National Eye Institute overview of diabetic retinopathy and diabetic macular edema
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/diabetic-retinopathy National Eye Institute

CDC Vision Health facts and prevention
https://www.cdc.gov/vision-health/index.html CDC

CDC Vision loss facts and data
https://www.cdc.gov/vision-health/data-research/vision-loss-facts/index.html CDC

CDC Preventing vision loss and healthy habits
https://www.cdc.gov/vision-health/prevention/index.html CDC

National Institute on Aging overview of aging and eyes
https://www.nia.nih.gov/health/vision-and-vision-loss/aging-and-your-eyes National Institute on Aging

USPSTF recommendation on screening for impaired visual acuity in older adults
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/impaired-visual-acuity-screening-older-adults USPSTF

NEI Vision rehabilitation resources and fact sheets
https://www.nei.nih.gov/learn-about-eye-health/outreach-resources/vision-rehabilitation-resources National Eye Institute

Cleveland Clinic overview of low vision and rehabilitation
https://my.clevelandclinic.org/health/diseases/8585-low-vision Cleveland Clinic

NEI Vision and aging resource hub
https://www.nei.nih.gov/learn-about-eye-health/outreach-resources/vision-and-aging-resources National Eye Institute

CDC Vision impairment and falls in older adults
https://www.cdc.gov/vision-health/prevention/older-adult-falls.html CDC

CMS Medicare Learning Network Vision Services fact sheet
https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/visionservices_factsheet_icn907165.pdf Centers for Medicare & Medicaid Services‍