The National Eye Institute reports that the risk of developing glaucoma increases as people age, especially for those over the age of 60. Regular screening and appropriate treatment may prevent or delay loss of vision. Medicare recipients may be eligible for screening and treatment coverage if they meet certain requirements.
Glaucoma damages the eye’s optic nerve, but the exact process for how this damage occurs differs between the various forms of this disease.
Common types of glaucoma in adults:
- Open-angle glaucoma. This is the most common form of the disease. When a shift in the angle of the fluid that cycles within the eye causes it to move too slowly, pressure builds and damage to the optic nerve can occur.
- Secondary glaucoma. Primary medical conditions can also impact how fluid in the eye creates pressure against the optic nerve, such as diabetes, high blood pressure, cataracts, tumors or inflammation. Certain surgeries or medications may also disrupt the normal function of the eye and lead to glaucoma.
- Low-tension glaucoma. In some people, their optic nerve is less tolerant to the pressure, so even a low or normal amount of pressure against the optic nerve causes damage.
- Angle-closure glaucoma. If the iris blocks the flow of fluid within the eye, it causes a sudden build-up of pressure and is considered a medical emergency that requires immediate care.
Symptoms of Glaucoma
Symptoms associated with open-angle glaucoma can include loss of vision that begins at the periphery or blind spots that seem patchy in your central vision. As the disease advances, tunneled vision develops. With this type of glaucoma, pain is uncommon and there may be no detectable vision loss in its early stages. One or both eyes may be impacted.
Other types of glaucoma may develop similarly to open-angle glaucoma. However, symptoms of angle-closure glaucoma are often more severe and progress quickly. There may be pain and blurry vision, halos around light sources, redness in the eyes, nausea, vomiting and extreme headaches. If you suspect you have developed this type of glaucoma, you should seek emergency treatment immediately.
Tests and Treatment for Glaucoma
Your eye doctor may perform a series of tests to determine glaucoma. A dilated eye exam may include a test of how well your vision functions at different distances, through the periphery and how much pressure is present in the eye. The thickness of your eye’s cornea may also be measured. Typically, numbing drops are applied in addition to a dilation medicine.
If glaucoma is diagnosed, the type of glaucoma disease present will determine which treatment you receive. Some types of glaucoma can only be treated by surgery while others respond well to medicated eye drops or prescription medication. A treatment called laser trabeculoplasty may be used to reduce fluid in the eye, but the benefits of this treatment can wear off over a period of time.
Surgery can help reconstruct the chambers of the eye so that fluid is able to cycle normally again, thus preventing vision loss from advanced stages of glaucoma. However, secondary conditions such as cataracts or inflammation may occur.
Medicare Coverage for Glaucoma
Medicare benefits with Part B provides coverage for diagnostic tests and outpatient visits, but these benefits only apply to glaucoma screenings once a year for Medicare recipients deemed to be at high risk of developing glaucoma. This includes recipients with diabetes and anyone with a history of glaucoma in their family. If a recipient is African American and over the age of 50 or Hispanic and over the age of 65, they also qualify as high risk.
Prescription eye drops and medication can be covered when included in the formularies for Medicare Part D prescription drug plans, which are available as stand-alone benefits or bundled with a Medicare Advantage Plan. Medicare benefits under Part A apply to the inpatient surgery used to treat glaucoma.