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Do you undergo cataract surgery when it is not vital? Some people do it to improve their eyesight, but it is not without risks

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Judy is an experienced consultant who frequently travels to business meetings. She got here to me because she felt her contact lenses were uncomfortable and wanted to explore other options – especially surgical alternatives.

One option was to replace the lens with an implant. This surgery is similar to cataract surgery, but is offered to patients who do not have the disease. However, it is not without risk.

As an optometrist specializing in touch lenses, dry eye treatment, and pre- and post-operative management of eye surgery, I had the experience required to help Judy.

Dry eyes

I began with Judy’s clinical assessment. When she got here to see me, she was about to turn 53 and had myopia (cannot see far), astigmatism (images stretched to near and much), and presbyopia (low vision at near) due to age.

She hated glasses and didn’t want to wear them in front of clients, so she had undergone laser surgery to correct myopia 15 years earlier.

At the age of 45, when presbyopia developed, Judy had to wear contact lenses again. Around the time of menopause, on the age of 51, she developed dry eye symptoms, which had turn out to be more severe within the months preceding her visit to me.

Changes in lens materials, care products, or wearing style (sooner or later) had little effect. The dry environment (automotive interiors, airplanes, processed office air) to which she was frequently exposed contributed to her symptoms. She also spent a variety of hours in front of the pc screen, so she blinked less often, which in turn increased her visual discomfort.

Clinical examination revealed that she did indeed suffer from dry eyes. She had a reduced amount of tears, side effect of laser surgery. Her cornea was dry and discolored, which we attributed to incomplete closure of the eyelids during sleep, undoubtedly induced by cosmetic eyelid surgery she had undergone three years earlier. And then got here the results of her medications: some antidepressants dry eye effect.

Step by step approach

Judy’s vision problems were compounded by poor eye health.

All dry eyes affect the standard of vision, whatever the correction method used. The very first thing that needed to be done was to restore balance and cure her dry eyes.

The past surgery has left a mark and there is no going back. So what should we do in this example?

As for the eyes, yes first step is to provide intensive lubrication (fully artificial tears, without chemical preservatives). The ointment also needs to be applied at bedtime to protect the cornea while you sleep. For this reason, topical use of cyclosporine must be considered its effect on tear stability.

Additionally, soft contact lenses may worsen dry eyes. Fortunately, there are other alternatives. Scleral lenses these are large, stiff lenses that create a tear reservoir, which helps reduce dry eye symptoms. Despite their large diameter, these lenses are very comfortable because they rest on the white of the attention (sclera) without touching the cornea. Visually, they will compensate for myopia, astigmatism and presbyopia.

I suggested these lenses to Judy. However, I understood from her response that she was searching for a surgical alternative as a substitute.

Scleral lenses are large, stiff lenses that create a reservoir for tears.
(Michaud Oil), Provided by the writer

Lens substitute, clear crystal lenses optional

Laser amplification is out of the query when the cornea becomes too thin.

However, for several years now, surgery has been possible to replace the crystalline lens, the natural lens contained in the eye, with an implant. Similarly to cataract surgery, this procedure is performed within the absence of the sort of pathology, in often younger (50-65 years) and healthy patients. And it’s quite popular today.

The advantage is that this implant can correct most vision defects – unlike Lasik. In Judy’s case, it could be a multifocal lens (for distance and near vision) and a toric lens (astigmatism).

Judy was immediately fascinated about this selection. She assumed that thanks to this operation she could be permanently free from the necessity to wear contact lenses or glasses.

A procedure that carries potential risks

Every surgery carries risks. In the case of a disease or pathology, the ophthalmologist’s decision to operate should theoretically be based on a rigorous assessment of the extent of risk compared to the expected advantages.

When replacing a transparent lens within the absence of any pathology, the risks and advantages have to be weighed in a different way. Basically, we’re talking about non-essential and non-urgent cosmetic surgery. The risks remain, but the advantages are less obvious and more related to personal patient satisfaction, which might vary greatly depending on our own perspective.

Although cataract surgery is considered a protected procedure, the identical cannot all the time be said replacing clear lenses. The younger the patient, the greater the chance of complications. Other patient-specific aspects it can even affect your weight. The patient’s condition must be fastidiously assessed before proceeding.

The retina of each myopic person is susceptible to tearing. This is a possible complication of cataract and lens surgery this could not be taken flippantly. The highly myopic retina is also stretched and may worsen after 60like a movie screen that breaks. Vision mechanically deteriorates.

A multifocal implant requires an ideal retina to provide good vision. Because Judy was very nearsighted, her lifelong vision could not be guaranteed after clear lens substitute.

Not to mention that, like her mother and grandmother, she could sooner or later develop macular degeneration. Also on this case the vision of the multifocal implant will likely be significantly impaired.

Multifocal implants are sometimes related to the perception of halos and glare, especially within the evening. Although most patients tolerate these unintended effects after surgery, they will turn out to be very concerning in the long run persist over time. Dry eyes may be the worst. Moreover, the procedure is not completely reversible – removing the implants could have serious consequences.

So replacing Judy’s lens didn’t seem to be the perfect option, a minimum of for now. In the meantime, she decided to consider scleral lenses and optimize her dry eye treatment.

She left satisfied after exploring her options with the one who knew her eyes best – her optometrist!

This article was originally published on : theconversation.com
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Health and Wellness

Nene Leakes misses her husband Gregg very much

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alum Nene Leakes spoke to fans on Instagram Live about how much she misses her late husband, Gregg Leakes. During the live broadcast, the truth star, 56, responded to a fan who asked if she misses Gregg. Leakes began by saying that she misses Gregg “a lot.”

“There’s an old saying that you don’t miss a good thing until the shit’s gone, like the shit’s real,” she began. “I didn’t even realize how valuable Gregg was to my life or to us until he was gone. Because there were so many times I wanted to say, ‘Oh, Gregg would have liked that,’ you know? And then I had to remind myself that Gregg wasn’t here.”

It’s been over three years since Gregg’s death – he died of cancer on September 1, 2021 on the age of 66. He was diagnosed with cancer in 2018.

Leakes continued during her Instagram Live: “I miss Gregg so much, so much it doesn’t make sense, I really miss him, he was amazing. He did so much to push my career and support me,” she said. “It’s hard for anyone to step into his shoes, Gregg is that kind of guy. I feel like I was lucky and blessed by God to have such a wonderful husband for so many years.”

The Leakes have been married twice during their relationship, which some say is proof of their love. They first tied the knot in 1997 after which divorced in 2011. The former couple remarried in 2013 and remained married until Gregg’s death in 2021.

Since his death, the Glee star has been in relationship with dressmaker Nyonisela Sioh. The pair began dating the identical 12 months Gregg died, but their relationship appears to have been rocky. That includes multiple breakups and a lawsuit Leakes filed by Sioh’s ex-wife, who accused the TV star of breaking up marriages.

The last time we reported on the state of their relationship was in March 2024, once they appeared to be on good terms as all of them went all out for a festive event together.

Still, we may not know what is going on on between the pair, as Leakes has announced that she’ll be more reserved about her relationships in the longer term.

“My next relationship is going to be absolutely private. I think it’s the most public relationship I’ve ever had — it’s more public than Gregg. And I just feel like it’s best to be private,” she said during an interview on the Reality with the King podcast with Carlos King.

This article was originally published on : www.essence.com
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Health and Wellness

Providing end-of-life support through home care is essential, but it can come with its own challenges

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Earlier this month, the Government announced significant changes to aged care in Australia, including an A$4.3 billion investment in home care.

In addition to the changes to the home care packages, the home support programme will include a very important addition – the tip of life path for older Australians.

This path offers you access to higher level home care services for older people to assist Australians stay at home as they approach the tip of their life. Specifically, it will provide a further A$25,000 for palliative support where an individual has three months or less to live.

This is a positive change. But there could also be some challenges in implementing it.

Why is this essential?

Older people have clearly expressed their wish to stay of their homes as they age. most individualshome is where they wish to be within the last months of their lives. The space is personal, familiar, and comforting.

However, the information from Australian Bureau of Statistics shows that the majority individuals who die between the ages of 65 and 84 die in hospital, while most individuals aged 85 and over die in residential care homes.

This apparent gap may reflect a scarcity of appropriate services. Both palliative care services and family doctors play a very important role in providing medical care to people living at home with terminal illness. However, the chance die at home is based on the supply of ongoing support, including direct care and assistance with each day living.

Family members and friends often provide this support, but it is not all the time possible. Even when it is possible, caregivers can lack of self-confidence and skills provide the crucial care and should lack sufficient support and respite from their carer role.

Palliative care funding offered by Support at Home should help an older person to stay at home and die at home in the event that they wish.

Unless someone dies suddenly, care needs are prone to increase towards the tip of an individual’s life. Support at home may include assistance with showering and toileting, assessing and treating symptoms, developing care plans, managing medications, dressing wounds, home tasks, preparing meals, and communicating with the person’s family.

Occupational therapists and physical therapists can help select equipment and suggest at-home modifications.

End-of-life support may additionally include explaining goals of care, contacting services corresponding to pharmacists to acquire medications or equipment, liaising with organisations on financial matters, respite care or funeral planning, in addition to accepting grief and offering spiritual care.

However, we don’t yet know what exact services this amount shall be allocated to.

What will we learn about this program thus far?

The in-home support program, including an end-of-life pathway, is scheduled to start on July 1, 2025.

We know that funding is linked to a survival prognosis of three months or less, which shall be determined by a physician.

Further information indicates that the elderly person could also be referred to high priority assessment to access the end-of-life pathway. We don’t know what which means yet, but they don’t need to be current Support at Home participants to be eligible.

The latest path will allow the funds for use over a 16-week period, which is prone to provide some margin of safety with a three-month timeline.

Although an increasing number of details are coming to light, some issues still remain unclear.

Home care providers will want detailed details about what could also be covered by this funding and the way they may work with primary care providers and community health settings.

Older people and their families will need to know what the procedures are for applying for this funding and the way long it will take to process applications.

Everyone will need to know what happens if an individual doesn’t die inside three months.

We are waiting for specific details about this latest path.
Ground Photo/Shutterstock

Some challenges

The willingness to access appropriate supports and services shall be crucial for older people using this pathway. Home care providers will due to this fact need to evaluate how the end-of-life pathway suits into their operations and the way they can construct the crucial skills and capabilities.

The demand for nurses with palliative care skills and allied medical examiners is prone to increase. Providing end-of-life care can be particularly burdensome It will due to this fact be crucial to develop strategies to stop worker burnout and encourage them to take care of themselves.

It shall be crucial to watch how pathways are implemented in rural and distant areas and across different cultural and social groups to make sure they profit all older people.

Effective coordination and communication between home care, primary care and specialist palliative care providers shall be key. Digital health systems that connect sectors can help. Family involvement may also be very essential.

Escalation and referral pathways must be established to enable appropriate response to emergencies, unexpected deterioration or family distress.

At last, specifying exactly when someone dies can be difficult. Knowing when the last three months of life begin can be difficult, especially when frailty, cognitive issues, and multiple health problems could also be present.

This may mean that some people aren’t perceived as ready for this path. Others will not be willing to just accept this prognosis. The older person may additionally be expected to live with a terminal illness for a lot of months or years. Their palliative care needs won’t be met by this path.

Despite these challenges, the announcement of the Home Care End of Life Pathway is timely and welcome. As a population, we reside longer and dying older. More detail will help us higher prepare for the implementation of this program.

This article was originally published on : theconversation.com
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Health and Wellness

Why Dental Care Isn’t Covered by Medicare? It’s Time to Change That—Here’s How

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When the forerunner of Medicare was established within the Nineteen Seventies, dental care was ignored. Australians are still suffering the results half a century later.

Patients pay significantly more for dental care than for other kinds of care.

More Australians are more likely than their peers in most wealthy countries to delay or forgo dental treatment due to the price.

And as our oral health deteriorates, fees proceed to rise.

Health care by funding source.
Grattan Institute

Over the many years, there have been quite a few reports and inquiries calling for the introduction of universal dental insurance to address these problems.

Now with the Greens proposing That and rank-and-file Labour MPs supporting Is it finally time to join Medicare?

What’s stopping us?

Australian Dental Association says The idea is just too ambitious and too expensive, declaring that it will require significantly more dental staff. They say the federal government should start small, specializing in essentially the most vulnerable populations, initially seniors.

Starting small is sensible, but ending small could be a mistake.

Dental treatment costs should not just an issue for essentially the most vulnerable or the elderly. More than two million Australians avoid dental care due to its cost.

Above 4 out of ten Adults typically wait over a yr before seeing a dentist.

Care missed or delayed due to cost, by type
Care missed or delayed due to cost, by type.
Grattan Institute

Bringing dental services into Medicare would require many hundreds of recent dental staff. But that might be possible if this system is introduced in stages over ten years.

The real reason dentistry hasn’t been added to Medicare is because it will cost billions of dollars. The federal government doesn’t have that type of money lying around.

Australia has a structural budget problem. Government spending is growing faster than revenue because we’re relatively a rustic with low taxes and high expectations regarding services.

Rising health care costs are a significant factor, with hospital and medical costs among the many six fastest-growing major expenses.

The structural gap is just it is probably going to increase without major changes in policy.

Expected increase in spending
Projected expenditure growth.
Grattan Institute

So can we afford health look after all? We can. But we must always do it by making smart decisions about dental care and hard decisions to increase revenues and reduce spending elsewhere.

Smart decisions about your recent dental program

The first step is to avoid repeating Medicare’s mistakes.

Medicare payments to private firms have failed to bring them to lots of the communities that need them most. Many rural and underserved areas are mass-payment deserts with too few family doctors.

The poorest areas have greater than twice psychological problems of the wealthiest areas, but they receive about half of Medicare-funded mental health services.

As a result, government money doesn’t go where it may bring the best profit.

It’s about 80,000 hospital visits every year due to dental problems that might have been avoided with dental care. If there is just too little care in disadvantaged and rural communities where oral health is worst, this figure will remain high.

Therefore, a big proportion of recent investment ought to be allocated to public dental services, and these services ought to be directed to areas where individuals are deprived of access to care.

Another problem with Medicare is that its payments often bear little relation to the price of care or the impact that care has on a patient’s health.

To reduce costs, Medicare funding for dental care should exclude cosmetic procedures and orthodontics. It ought to be based on efficient workforce models through which dental assistants and therapists use all their skills—you don’t all the time have to go to the dentist.

Dental therapist educates patient
Sometimes you possibly can go to the dentist as a substitute.
Gustavo Fring/Pexels

Financing model should take note of the patient’s needs, reward him for providing him with constant care and have Hat on per patient expenditure.

Oral health should be measured and documented to ensure patients and taxpayers are getting results.

Tough decisions to balance the budget

These steps would scale back the prices of the Greens’ plan, that are difficult to estimate but could amount to greater than 20 billion dollars yr after introduction. Instead, the price would drop to about 7 billion dollars yr.

It could be investment. But in the event you’re fearful about where the cash will come from, there are good ways to pay for it.

Many reforms could reduce government health care budgets without harming patients.

There is a waste of cash in government funding pathology tests and less profitable medicines.

In some hospitals there are excessive costs and potentially harmful low value care.

In the long run, investments in prevention can reduce the necessity for healthcare. A tax on sweetened beveragesfor instance, it will improve health while saving tons of of thousands and thousands of dollars a yr.

Such measures would help the federal government pay for more dental care. But demand for health care will increase because the population ages and becomes dearer. recent methods of treatment come.

This means a broader strategy is required to accomplish three goals: balance the budget, meet growing demand for health care, and include dental care within the Medicare program.

A dentist works on a patient
Adding dental coverage to Medicare would involve some compromises.
Lafayett Zapata Montero/Unsplash

There aren’t any easy solutions, but there are numerous ways to reduce spending and increase revenues without harming economic growth.

A choice of Australia’s infrastructure and defence megaprojects smarter could save several billion dollars a yr.

Revocation of Western Australia’s GST Special Financing Arrangement – Described by economist Saul Eslake as “the worst Australian public policy decision of the 21st century so far” – it will have saved one other 5 billion dollars yr.

Reducing tax relief and tax minimisation options – including capping superannuation relief, reducing capital gains relief, limiting negative gearing and setting a minimum tax on trust distributions – could deliver greater than 20 billion dollars yr.

Such a serious tax reform offers economic advantages while also creating space for higher services, akin to universal dental insurance.

No one likes spending cuts and tax increases, but in the end they might be needed regardless. Dental insurance could also be just what taxpayers need to accept.

This article was originally published on : theconversation.com
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