Scleral Lens Update

[Jill Marie]

Hi to all that have a scleral lens, to those thinking about getting one and to anyone that is experiencing dry eyes because of the AN surgery.

I've had a scleral lens for 2 years now and can't imagine life without it.  Twice the lens has broken after taking it out of my eye and I've had to wait about 4 days to get a new one.  By the time I got my replacement lens my eye was already hurting and took about a week to heal.  Each time the lens broke I hated the thought of not having it for a few days because life is so much better with it.  I now have a replacement lens so if I break another one or loose it I don't have to wait for a new lens. 

My lens is a bit smaller then some of the others that have the lens so it costs me $300 where as others on this board have paid more.  My replacement lens is exactly the same as my regular lens but only cost me $70 because I ordered it right after I got my other lens.  My insurance company covers the lens but it is put towards my $500 deductible, hopefully one day they will cover all of it.  At first they wouldn't cover it at all, thanks to my doctor and those in insurance billing they fought to get it covered.  For now I have to appeal the claim once a year to get it approved but they are working on it so I won't have to do that anymore as long as I have the same insurance company.  I will keep working towards more doctors and insurance companies realizing how much these lenses help those with dry eyes so more people can get the relief I have from the lens and not have to pay a lot to get one.

If you have questions about the lens please feel free to ask and also check out other posts about the lens.  Jill

[ANGuy]

I'm glad it works so well.  Is there a downside to these?  I see topics where people are asking if they should get one, I can't see why they shouldn't other than the cost.  But, I have no experience with them and have no eye issues.

[Jill Marie]

Hi ANGuy,

For me there is no downside, not even the cost!  Despite the corneal abrasion I got the first year I had the lens and the eye allergy I developed last summer, both attributed to the lens, that was nothing compared to the pain and cost I went through before the lens.  I was to the point where I was seriously considering having my eye removed or going on disability because work was becoming to hard to get through.  I was spending $4000.00 a year on eye ointment. 

To someone that has to use eye drops now and then and ointment at night it might not be something they want to do.  Each person needs to evaluate there situation to see if it's worth it for them.  One of the reasons I mentioned the cost of my lens is because I think more people would give the lens a try if it didn't cost them so much. 

I didn't have to have a special fitting unlike some of the others on the board, got my lens at the first appointment.  I still have to use eye ointment 24/7 most others don't.  One gentlemen found the lens didn't work for him because it blurred his vision and he couldn't do his job, for me it saved my job. 

Putting the lens in and taking it out took a bit of learning but it's second nature now.  I have special cleaning supplies which cost a bit and take some time but still way cheaper than what I use to do.  Everyone's costs and cleaning needs will vary depending on how dry there eye is and perhaps how long they have had the dry eye.  I've been dealing with this for 23 years come June. 

I honestly don't know how I survived all the years without the lens, guess it was because I didn't have a choice! 

Thanks for posting!  Jill

[ANGuy]

Thanks for the informative, first-hand, response.

[Mimispree]

After reading everyone's Scleral Lens posts, I would love to get one.  I am going to start with the eyelid weight  and then wait a year to see if my facial nerve heals.  My surgeons have a great statistics on facial nerve healing.

In the meantime, I looked up Scleral Lens manufacturers and emailed them to please lobby to have the lens covered by insurance companies for patients with AN's or other vestibular tumors that traumatize the facial nerve.

I will post their names and emails in an upcoming post in case others just want to communicate to them encouraging them to lobby the insurance companies.  After all, it's their profit margin and our eyes that will benefit.

I'd do it today, but I'm struggling to get a brief report written.  Why is just working at my desk so tiring??    The new normal is so different I often wonder if I'll ever get used to it.  Anyway, I'll do it as soon as possible.

Thank you everyone!

[Jill Marie]

Mimispree

I sure hope you don't need the lens but if you find you do we are here to help you get use to using it and will help with any other questions you have.  Don't get me wrong, the lens is great if you need it, just hope you don't need it. 

WOW! What a great idea to email the Scleral Lens manufacturers and ask them to lobby to have the lens covered by insurance companies for patients with AN's or other vestibular tumors.  When you can please post the names and email addresses so we can help you. 

My Insurance company is treating me really well right now, got a call back telling me that lens is covered but of course only on my deductible.  She wanted to let me know that they are still working on getting the approval for the lens with out an appeal and they're trying to figure out how to override the computer so it won't kick my claim out every time.  Making progress so will continue to work on it.  Jill

[Anasazi42]

Hi all, I posted this info in another topic about "post op paralysis dry eye". But I have a Prose device scleral lens. It WAS covered by my insurance (Aetna) because it is considered a prosthetic. My opthalmologist sent all of my medical notes to the facility, closest to where I live. After an initial consultation, and approval by my insurance company, I began the fitting process. You can find the information about the Prose Device at the Boston Foundation for Sight.
 
http://www.bostonsight.org/PROSE-treatment/About-PROSE

I should add that this was without a fight or appeals or anything like that. The eye institute that fits the Prose Device will take care of the insurance approval for you. After my initial consultation, where they fit a sample scleral lens to be sure you can tolerate it and are a good candidate, the eye institute starts the insurance approval process. I didn't have to do anything. They notified me that everything was a go, and they scheduled the first fitting. The only out-of-pocket expense for us was transportation and hotels, because unfortunately the centers that fit this Prose Device are not too numerous. We were lucky enough to have one in our state, but it was still a 4 hour drive away.