• Reading (books, newspaper, magazines, bank statements, receipts, menus, etc.)
  
• Enjoying hobbies
  
• Performing tasks as work
  
• Seeing television
  
• Writing letters or checks
  
• Seeing product and price labels
  
• Operating household appliances or
  
• See the roadway and outdoor signs.

2) Basics information to share with patients:
Please let your patients know that a low vision evaluation will take two to three hours.

Also, the low vision exam is very different from other vision exams they have experienced. Dr. Metzger will thoroughly evaluate the patient's remaining vision and help the patient use that vision to their best ability to meet their goals.

3) Is a low vision examination covered by health insurance, Medicaid, or Medicare?
Policies vary by state, but generally Medicare will cover low vision examinations performed by eye care professionals. Private health insurance usually does not cover low vision examinations, but should check with the insurance carrier to be sure.

4) How much does a low vision evaluation cost?
While costs vary, typically a low vision evaluation costs between $150 and $375, for a two to three hour evaluation.

The patient is responsible for the out-of-pocket cost of the refraction, which determines the need for an eyeglass prescription as this is NOT covered by Medicare. The fee depends on the time and complexity of the refraction. Medicare has never paid for this part of an examination, nor does a Medicare insurance supplement. Again, the refraction fee is an out-of-pocket expense and may range from $75 to $175, while $150 is a common amount.

The refraction is performed with different equipment during a low vision exam. The doctor carefully leads the patient through this specialized refraction, which may take most of the
examination time.

5) How to schedule an appointment:
Please call Dr. Metzger's office at 913-469-8686 and speak with Caroline. You may also submit our online referral form. We will follow up with you to confirm your request.

6) Resources for patients and caregivers
We have two pieces of literature to educate the patient and caregiver about low vision and what to expect from their examination. Please tell your patients and their caregiver to call our office for a packet of information to be mailed to them.

7) Who is a candidate for a low vision examination?

• Literally, any patient with unresolved visual complaints.
  
• Any patient with a permanent loss of acuity from 20/50 or worse.
  
• Patients with 20/20- acuity to 20/40 who report difficulties with reading as comfortably as they are used to. ("The print looks distorted" is common report.)
  
• The patient is in your office for the third time complaining about the Rx, especially the bifocal.
  
• Patients who complain of photophobia and glare problems.
  
• Any patients suffering post stroke, post head-injury, or other neuro event.
  
• Patients reporting diplopia or ghost images.
  
• Patients reporting vision flashing “on and off,” or “things” jump into their field of view when walking.
  
• Patients noted to have unusual head and neck postures when trying to see.
  
• Patients with known visual field loss.
  
• Legally blind patients, even at 20/800, can be provided some care.
  
• Newly diagnosed person with no functional sight – refer so we can get them involved with proper Blind Rehabilitation programs.
  
• Children with a visual impairment – we can make sure they are receiving all appropriate education services the child has a right to receive.
  
• Suspected malingering – emotional or intentional.