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Overview

Glaucoma is the second most common cause of blindness in the U.S., affecting nearly 3 million Americans. Glaucoma represents a family of eye diseases commonly associated with optic nerve damage and visual field changes (a narrowing of the eyes' usual scope of vision). Because the disease often progresses silently, with no warning or symptoms, it is estimated that up to one-half of the approximately 3 million Americans with the disease don't even know they have it.

Glaucoma occurs when high fluid pressure in the eye presses against the optic nerve, causing damage. The damage to optic nerve fibers can cause blind spots to develop. These blind spots usually go undetected until the optic nerve is significantly damaged. If the optic nerve is destroyed, blindness results.

While anyone can get glaucoma, certain groups of people are at higher risk for the disease. These include African Americans and Hispanics, and people with diabetes, who are nearly twice as likely to develop glaucoma as adults without diabetes.

Glaucoma screening can lead to early detection and treatment, which can prevent, slow, or stop vision loss from the disease. Medicare covers annual glaucoma screening for people at high risk for the disease; this section describes this benefit and provides information and resources for health care professionals and organizations to support the delivery and promotion of this benefit for appropriate Medicare beneficiaries.

What Medicare covers:

Medicare covers annual glaucoma screening for the following persons considered to be at high risk for this disease:

  • Individuals with diabetes;
  • Individuals with a family history of glaucoma;
  • African Americans over the age of 50; and
  • Hispanics 65 and older (new addition to the benefit in 2006).

Medicare will pay for glaucoma screening examinations when they are furnished by or under the direct supervision in the office setting of an opthalmologist or optometrist, legally authorized to perform these services under State law. The beneficiary will pay 20% as the copayment or coinsurance after meeting the yearly Part B deductible.

A glaucoma screening examination includes the following:

  • A dilated eye examination with an intraocular pressure measurement; and
  • A direct opthalmoscopy examination, or a slit-lamp biomicroscopic examination.

Other helpful information:

Medical advances have made it easier to diagnose and treat glaucoma before even moderate vision loss occurs. Because glaucoma progesses with little or no warning signs or symptoms, and vision loss from glaucoma is irreversible, it is very important that people at high risk for the disease receive annual screening, and that those who have it are treated and monitored routinely.

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Related Links Inside CMS

Medicare.gov Information for Beneficiaries

Prevention - General Information
Related Links Outside CMSExternal Linking Policy
National Eye Institute's Glaucoma Information

Glaucoma Research Foundation
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