No scleral lens just yet

[saralynn143]

Thanks, Jill Marie. In his return message, the doctor said he was going to research the implication of Restatis on nerve damage. At least he will know for the next patient in my situation. I'm sorry to hear about your eye troubles and glad you are better.

Sue, I hope you are able to work with your insurance company for some coverage. I plan to ask as well.

[Dena King]

Hi ladies, sorry I haven't been on much lately.  I'm going to try to address some things I have just read.
1.  Scleral lens.  Mine was about $1200 which included exam I believe which was denied by insurance 2 times.  Then I got very angry and filed an appeal with the commonwealth of Kentucky public protection cabinet, department of insurance, health and life division per advice from my dr.

My ophthalmologist, and lens docs both wrote letters explaining my past, And I also,wrote a letter.
I am pleased to say the state ruled in my favor stating the vision exclusion for contact lens does not apply to my case pursuant to Exposure Keratitis 370.34, Dry Eye Syndrome 375.15, secondary to Facial Paralysis 351.9, due to an acoustic neuroma 225.1,

The Kentucky dept of insurance said pursuant to KRS 304.17A-617(3)(d), HHP must cover scleral
Lens.  My insurance responded to me within a week, however I had not met my $5000 deductible fully and most of it was applied to that. 

I am sure all states have public insurance departments that you all can try.  I sure hope this helps!

I STILL LOVE MY LENS!!!!!

2) I also tried restasis and hated them, made my eye so raw I got a bad infection. It is so wonderful to have my lens so I can enjoy the outside.  I still wear wrap around sunglasses also, patch or goggles at night.

[saralynn143]

So I was looking back in my notes about past appointments. The first time I asked about a scleral lens was September 19, 2008, almost FIVE years ago. I had read an article about the Boston Foundation for Sight work with soldiers and printed it out to show my ophthalmic surgeon at the follow-up for my eyelid implant. I told him I thought it would make a great research project to look at the effectiveness of the lens for facial paralysis patients. He said had been at the hospital where they treat the soldiers to confer with the doctors there. At that time the lens was primarily used in burn wards where the patient has no eyelids. It shows promise in short-term use, but he thinks it is not suitable for mobile patients with other options.

If this works out for me I am definitely making a follow-up appointment to show him otherwise.

[ginsue]

I just heard from my husband's union local yesterday.  Insurance WILL pay.  Now we must find out if the doctor is in-network. 

[saralynn143]

That's fabulous, Sue!