Do Medical Aids Cover Glaucoma Treatment?

Glaucoma is a Prescribed Minimum Benefit (PMB) as laid down by the South African Council of Medical Schemes. This means that by law your medical aid must cover you fully for all types of glaucoma, most of which are curable.

Your medical aid must pay for diagnosis, treatment and care, no matter which type of glaucoma affects you. This includes medical and surgical management, laser surgery and even iridectomy, if it should be necessary for the iris to be removed.

You should find out which tests your medical aid covers before going for tests, in case your scheme has a test limit per year. If you are over the limit then you get your doctor to write a motivation to your medical aid company motivating the test.

What is Glaucoma?

Glaucoma is not the same at cataracts, although glaucoma is also a condition that affects the eyes. It is Medical Schemes and Glaucoma Treatmentsecond only to cataracts in causing blindness.  In glaucoma the optic nerve, which connects the eye to the brain, gets damaged, leading to reduced vision and a possibility of blindness.

Causes of Glaucoma

There is a clear fluid in the front chamber of the human. In healthy humans small amounts of the fluid are released so as to reduce pressure in the eye. If this release mechanism is blocked or reduced, pressure builds in the eye causing optic nerve damage.

Symptoms of the Four Kinds of Glaucoma

  1. The most common type is chronic, or open-angle, glaucoma which occurs gradually over time. There is generally no pain and visible symptoms until the condition is in an advanced stage
  2. Then there is angle-closure which is a sudden blockage, which can be caused by various medications or by eye inflammation.  Symptoms include pain, nausea, vomiting and headaches.
  3. Secondary glaucoma is any kind of glaucoma that is clearly caused by medicines, eye inflammation, disease or trauma. Symptoms are the same as for angle-closure glaucoma.
  4. A small percentage of babies are born with glaucoma and this can be hereditary. Symptoms include light sensitivity, streaming eyes and twitching of the eyes.

Diagnostic Tests for Glaucoma

There are several quick and effective tests available to the medical profession to diagnose glaucoma. You will probably be given eye drops before the tests are carried out. Tests include

  • A visual acuity test (similar to tests you do when testing for glasses)
  • A visual field test to test for missing areas of vision
  • A pressure test
  • Ophthalmic investigation where the specialist uses an ophthalmoscope
  • A gonioscopy where the outer edge of the eye is examined
  • An examination of the optic nerve to check for damage

How Common is Glaucoma?

It is estimated that four percent of adults over forty in Africa suffer from this condition. For South Africa the figure is slightly higher at 5.3%with nearly one quarter of all cases of blindness attributable to glaucoma.