Intraocular Injection Treatments for (Wet) Macular Degeneration

The newest treatment being used for macular degeneration involves use of drugs called anti-vascular endothelial growth factor (anti-VEGF) medications. These drugs help stop new choroidal neovascular membranes (CNV) from growing by blocking the effects of a growth factor these blood vessels need to thrive. Anti-VEGF medications are injected directly into your eye. After the injection, most patients experience scratchiness and tearing within the first 24 hours and may also temporarily see a large shadow in their vision.  Although the thought of receiving an injection directly into the eye may seem scary, it is virtually painless.
Some anti-VEGF agents that have been approved for use or are currently being investigated for treating macular degeneration include:

Macugen. Pegaptanib (Macugen) is approved for the treatment of wet macular degeneration. This drug is given as a series of injections into the vitreous fluid in the eye. It helps to prevent further vision loss by stopping the formation of new blood vessels and decreasing leakage from existing blood vessels.  The average cost per injection is about $1000.00 and can be administered every 6 weeks if necessary.

Lucentis like Macugen, ranibizumab (Lucentis) is an anti-VEGF drug used to treat wet macular degeneration. It also impedes new growth of abnormal blood vessels and helps dry up leaking vessels. However, ranibizumab may be able to reverse some of the effects of macular degeneration, not just prevent further vision loss.  The average cost per injection is about $2000.00 and can be administered monthly if necessary.

Bevacizumab (Avastin). Most doctors are prescribing this drug, which is closely related to ranibizumab. Bevacizumab hasn't been approved by the Food and Drug Administration (FDA) as a treatment for macular degeneration, but it has been approved as a treatment for colon and rectal cancer. That means that the use of this medication to treat macular degeneration is currently considered an off-label use of the drug (off-label use is the practice of prescribing drugs for a purpose outside the scope of the drug’s approved label, most often concerning the drug’s indication).

The average cost per injection is about $100.00 and can be administered every 4 weeks if necessary.

The charges are for medication only, excluding the exam fee, injection fee and are subject to change at any time.

*Reference material obtained through (www.mayoclinic.com)

Fashionably Healthy Eyes

Sunglasses are more than just a fashion statement.  They serve an important purpose in protecting your eyes from harmful UV rays produced by the sun.  These rays can also be reflected from the ground, water, snow, sand and other bright surfaces. Ultraviolet (UV) radiation from the sun consists of three bands:  UVA, UVB and UVC.

UVA - These rays may be harmful to your central vision. They can damage the macula, a part of the retina at the back of the eye.  UVB - These rays will not only cause a sunburn on your skin, but also on your eye (photokeratitis). UVC - These rays are absorbed by the upper atmosphere and do not reach the earth’s surface.

Scientific studies and research from the U.S. space program have shown that long-term exposure to UV radiation may cause serious damage to the eye.   This long-term exposure may increase your risk of developing cataracts, macular degeneration, pterygium and skin cancer around the eyelids.   

Wearing sunglasses will help in two important ways.  They filter light and protect your eyes from UV rays. When purchasing sunglasses make sure they filter out at least 98% of the UVA and UVB rays.

Common Billing Questions

I came in for a routine eye exam.  Why did you file to my medical insurance?
Insurance companies define a routine eye exam as one with a diagnosis of myopia, hyperopia, astigmatism or presbyopia.  Glasses or contact lenses can enable the patient with one or more of these conditions to see clearer.  Before seeing you, the doctor cannot know whether or not you have a medical condition.  Medical conditions include but are not limited to eye infections, dry eyes, glaucoma and cataracts.  If the doctor diagnoses a medical condition, your routine vision plan will not pay the claim and it will be filed to your medical insurance.

I have Medicare and a supplement.  Why did I still receive a bill?
Medicare and many Medicare supplements require the patient to pay a deductible.  Many supplements do not cover the Medicare deductible.  Also, some do not cover the entire co-insurance left by Medicare and may exclude coverage for some diagnostic tests.  Your insurance company should be able to explain the coverage and exclusions of your plan to you.

According to my insurance company, I do not owe anything.  Why did you send me a bill?
Medicare and commercial insurance companies often pay only part of your claim and we have to re-file for the remainder.  Our computer system is not smart enough to realize that and sends you a bill for the remainder.  Rest assured that a real live person looks at your account before any drastic collection measures are taken.

Why did my eye exam cost so much?
Our doctors have between four and 13 years of additional training after college.  When you see one of them for a medical eye condition, he or she may order one or more diagnostic tests in order to properly diagnose and treat your condition.  As is the case when you see any doctor, there is a charge for each test.