Author Archive for: ‘Ian McLeish’

Use your PRSI entitlement in 2017??

If you do not avail of the new PRSI treatment benefit scheme in 2017, you have lost out?

There has been a significant change to the rules of entitlement to the PRSI scheme – it has been changed from “once every 24 months” to “every second calendar year”. This made no difference in my mind, at all – but Sandra pointed out that if you were to claim in 2017, you would be re-entitled in 2019. If you do not use your entitlement until 2018, you will then need to wait until 2020. Sandra is quite correct that if you need something – glasses or contact lenses, you should arrange to get them before the end of the year, otherwise your 2017 entitlement is gone! It is all about this new rule arriving so late in a calendar year.

Remember that most self employed people are now also entitled to eye tests and help towards glasses or contact lenses, for the first time.

The difference between 24 months and every second calendar year will make little difference in the longer term, but in the short term, you could use your entitlement in December 2017 and January 2019 – that is a claim in the second calendar year. Wait till January (18), and you will need to wait until January 2020.

You can use your entitlement once every second calendar year, but not necessarily at the same time – you can use the glasses/contacts claim in 2017, and still have an eye test in 2018, if you wish, or need one, but you would have no help towards spectacles, or contact lenses at that visit, which is fair I reckon?

This post would probably be of most interest to people who have recently damaged their glasses, or need to reorder their contact lenses for the Holiday Season.

But! We need to know that you want to use it in 2017 – if you call in 2018 to say you should have/ wished you had used it – it will be too late – claims cannot be submitted before the authorisation date! If you do not use the facility in 2017, your next but one claim will be 2020 at the earliest..

Clients who have a Medical Card, but also PRSI entitlement – “Dual Qualification”, can chose to use either entitlement – we would recommend the PRSI route as it is faster – no need to wait 8 weeks for a HSE authorisation. But you are not entitled to use BOTH, apparently – I have asked the Department about the client who used their Medical Card last year, and now wants to use their PRSI, but as yet I have had no response. We are not, never were allowed to “dual claim”, so it is “either or” as we understand, unless or unless that is clarified.

Call us for more information or to book an appointment.

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Saline is not suitable to store contact lenses!

I had a young lady in on Saturday, looking for a contact lens case. She is a student and was home for the weekend, but forgot her case. She had purchased her usual contact lens solution in a nearby pharmacy, but they did not have any contact lens cases.

The solution she had purchased was LensPlus – a bottle of Saline – suitable for rinsing all types of contact lenses. But it is not suitable for storing contact lenses – it has no antimicrobial activity, at all. It is salty water, with a tiny amount of Hydrogen Peroxide, to prevent the solution itself becoming contaminated, but the Peroxide concentration is such that it will not kill bugs on a contact lens, and breaks down rapidly when exposed to light! I advised her that the solution was a bad choice, and that she should return to request a refund, but then she admitted that she had been using that one for ages with her lenses.

I gave her a trial pack of Optifree Puremoist, which has a bottle of correct solution in it, and a case. She was very grateful as “her eyes were killing her”, as she had slept in her lenses.

Daily contact lenses are supplied (Sterile) in salty water, but they are sterile until opened, and (should) only be used once! This student was wearing monthly lenses, which are also sterile until opened. After that first day, they need to be disinfected. Poor advice when she was taught about how to look after her lenses, I guess?

I cannot think of any disinfecting solutions which are supplied without a case these days, so please be aware – if the solution does not come with a new contact lens case in the box, it is likely because the solution is not suitable for storing/disinfecting your contact lenses!

You should probably be using a “multipurpose solution” – suitable to clean, rinse and store (disinfect) the lenses. Her solution was suitable for rinsing only.

Unless you were recommended a different care scheme, such as Hydrogen Peroxide based, which often requires a separate cleaner, and neutralisation before wearing the lenses, either with a different solution in the morning, an added tablet in the evening, or a platinum catalyst in the base of the barrel case, but these are less common these days – I would only recommend these types to people with very “allergic” or sensitive eyes. These solutions often have a red tipped bottle nozzle, to indicate it cannot go into your eyes. I’ve been there, and it SMARTS, more than a little!

Contact lens solutions can be bought in the pharmacy and in the supermarket, but READ THE LABEL, and if you are in any doubt, consult your contact lens specialist?

Best advice I reckon is do not change brands until you check with the optician – the number of people I see who do not know what they are using – “it is a white and blue bottle”, it has a yellow label, it is a square bottle……

More government funded eye tests (more “free” eye examinations!)

Good news and less good news.

As a one year “austerity measure”, the government removed most optical and dental benefits from those paying PRSI as a PAYE employee. This one year measure lasted rather longer than one year! I am not sure if this was taken away in 2008 or 2009?

At the Optometrist, entitled clients were still allowed a funded eye exam, but there was no help towards the cost of spectacles.

In the 2016 Budget, the government announced a broadening of the scheme, to include a contribution towards spectacles or contact lenses (about time!), also they increased the coverage to include those who were paying a Class S self employed stamp, and their dependent spouses for the first time.

I have also had confirmation that people who “dual qualify” – those who hold a medical card, but are also working, can choose which service they wish to use – if the Treatment Benefit authorises, we would suggest going that route every time – authorisation for a medical card sight test can take many weeks! That is the good news on the Treatment Benefit side.

Less good is the fact that we can no longer check your entitlement with verbal consent – we used to be able to get a person’s name and PPSn number over the phone and enquire to the Department if they would be allowed an eye exam. We now require your written and signed consent to ask this information, because of the upcoming European GDPR rules. (General Data Protection Regulations).

To confirm eligibility, all we need is your PPS number and your date of birth, but we do need to have signed and dated consent to do this.

We can also no longer enquire about any eligibility as a dependant spouse – we used to just require your and your spouse’s PPS numbers, but now you will need to send off a form, with your spouse’s signed consent to access this information.

Overall this is good news as many more people are now going to be entitled to a “Free” Eye Examination. It is not free, but it IS at no charge to you.

Most people should have their eyes checked every two years – don’t be fooled that just because you think you are seeing fine, that everything is OK. Seeing well is a great start, but Glaucoma is not called the “Thief of Sight” for nothing! Eye diseases are rare in young adults and children, but I could easily fill a good few posts about unexpected significant problems I have encountered in a routine, “no worries” eye exam!

Neither PRSI  nor Medical Cards  are supposed to be used for eye examinations in connection with employer VDU usage or employer Safety spectacles requirements. This is to ensure that the employee is not obliged to use their entitlement at any particular Optometrist.

 

 

An Amsler Grid used to detect macular distortion and losses

Keep a check on your own sight!

 

Every year there is a national (AMD) week of attempting to raise awareness of the eye condition AMD (Age related Macular Degeneration).

There are two types of AMD. Neither form is curable at this time, but the vision in Dry AMD will slowly deteriorate over a number of years, and there is much evidence that eye health multivitamin supplements are very effective at slowing this condition down.

The more dramatic form of AMD is the exudative (Wet) form. This type of macular degeneration is caused by new blood vessels which grow underneath the retina. These vessels are leaky and prone to bursting. The leaking causes retinal swelling and visual distortion. The rupture of one of these blood vessels – a haemorrhage, causes the retina to be damaged into a scar which does not function. This means that the central straight ahead vision is irreparably damaged. This is the vision you require to read, drive, see the television and recognise a face, so it is a great loss to those who do not have it.

If Wet AMD is detected early enough it can be treated with intra-ocular injections of a drug which causes these abnormal vessels to “wither away”, and reduce their “leakiness”. This is likely to be an ongoing management, probably indefinitely, but it does significantly help control this condition. There are other possible treatments also, but this type is the most commonly used at the moment, as it is the most effective.

But here is the thing – A National Week of AMD awareness is not sufficient to deal with this devastating eye condition.

Neither is a regular sight test!!

Most eye conditions will be detected during a routine test, but Wet AMD can come on so rapidly that we would really need to be checking everyone every 3 weeks to exclude this possibility – obviously not possible. So you really do need to do this for yourself!

I am aware of many people who come in for a test, as they “need better glasses”, but it only becomes apparent to them (and me) that there has been a significant deterioration in their sight in one eye only. As they see as a pair, they were completely unaware of this significant drop in one – though we do not see twice as good with two eyes – 2 eyes are about 1.44 times better than one. But why really does it need the Optometrist to compare your eyes individually?

A particular gent I recall was very aware of Wet AMD as it is common in his family. He booked in not long (a couple of months) after he had had an eye test, as he had noticed that one of his eyes had changed – he noticed that a horizontal line had a very small kink in it in one eye. He was referred to see a specialist in Dublin, where the condition was unfortunately diagnosed in that eye. He had a round of three injections, and at his next scan, the specialist advised that the eye which was treated had responded well, but the condition was now also in the other eye. – It comes on that quickly!

So what to do?

Just compare your eyes! Ideally put an Amsler grid on the fridge door, but failing that, just compare the vision in the two eyes. If you can’t wink / close one at a time, use your hand to alternately cover the right and left eyes to compare them. If there is a difference between them, but there always was, (maybe you have a weaker eye), get to know what is normal for you? This way you should be able to detect the very earliest possible signs of this problematic disease, and the sooner it is detected, the sooner it can be treated, which is of the essence.

Once a week, be it the Sky guide, the Saorview guide, the newspaper or an Amsler grid, compare your eyes. I would also advise clients that they should come in if they are unsure if they have an issue – please do not wait until you are sure – this problem could be more advanced if you wait until you are sure!!

If you want to you can download an Amsler Grid Here.

 

 

Happy Halloween

Bank Holiday Weekend

Happy HalloweenPlease remember that because it is a Bank Holiday on Monday, as ever we will be closed on the Saturday before, to give us all a bit of a break.

Well, the staff might get a bit of a break, maybe, but I personally seem to be running a taxi delivery service for my kids over the weekend!

Back to work as usual on Tuesday.

We hope you all have a great weekend.

Ian

 

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