Vision PM

Failing eyesight can quickly sideline your business. If you take care of your eyes, they’ll stay on the lookout a lot longer.

Your profession requires being able to see a great deal clearly: map details, distant road signs and peripheral activity in adjacent lanes. Every two years, you must pass your medical, which includes a vision exam. It’s easy to take good insight for granted, but for those approaching middle age, the days of perfect vision may be numbered.

Owner-operator Ron Snell says he realized his vision was getting worse when it became more difficult for him to read exit signs from far away. “I’d have to get up too close and not have time to react properly.” He then realized that he couldn’t read license plates in front of him and that he experienced some blurriness while driving at night. He has been wearing glasses ever since.

“As we get older, the ability of the eye to focus up close is slower and less efficient, and that is manifested as difficulty with reading,” says Dr. Janine Smith, deputy clinical director for the National Eye Institute. For example, you might have trouble trying to read the fine print in an atlas.

This condition, presbyopia, tends to show up between ages 40 and 50, Smith says. “A lot of people buy over-the-counter drugstore reading glasses,” Smith says. “This is fine as long as they see an eye care provider first and have their eyes examined to make sure that is what’s going on, because it could be something else.”

Reading glasses are simply magnifiers and are often adequate to treat presbyopia, says Dr. Daniel Coden, an ophthalmologist in La Jolla, Calif. Presbyopia worsens with age, so an exam every year or so is useful and often indicates that a prescription should be upgraded.

People who have more serious refractive errors – half of all Americans – will need prescription glasses, Coden says. Refractive errors include myopia, or nearsightedness; hyperopia, or farsightedness; and astigmatism, an irregularly shaped cornea that prevents light from focusing correctly on the retina.

Truckers who need something more than reading glasses should consider progressive lenses, which provide a gradual transition between different visual distances, suggests Dr. Alan Margolis of MargolisVision, a private practice in the Denver metro area. “Truck drivers have to see well from far away because they are moving fast, and they have a limited time to stop,” Margolis says. “So you want an eyeglass lens with good distance capability. But they might also need to read a map without taking the glasses on and off. That’s why they need a progressive lens.”

Truck drivers also want their lenses to be “contrast sensitive,” meaning they can be enhanced through tinting and be more effective in fog, snowstorms and other conditions of poor visibility.

Contact lenses are another option. However, because these can require some compromise on depth perception or distance vision, they often are not ideal for truckers.

There are also several surgical options, though these can be pricey. Conductive keratoplasty, or CK, is a nonlaser way to treat someone who is only slightly farsighted or who doesn’t need glasses for distance, Margolis says. In this procedure, the doctor typically treats only one eye with a radio frequency probe that shapes the cornea to bring the near world into better focus, Coden says.

The procedure is quite effective and takes only five minutes, Margolis says. It typically costs $1,500 to $1,800 per eye, however, and it is meant only to “turn back the clock,” not ward off future deterioration, so people may need to have the surgery repeated.

Laser vision correction, or Lasik, is becoming increasingly safe and easy thanks to advancements in technology, Margolis says. Studies have shown that Lasik seems to improve nighttime vision, Coden says.

However, laser vision correction is considered cosmetic or elective surgery, so insurance companies rarely cover the cost, often $3,300 to $4,500 for both eyes.

A cataract, or a clouding of the lens, is the most common manifestation of aging in the eye, Smith says. It is curable, however, because the cloudy lens can be removed and replaced.

In glaucoma, the pressure within the eye gets too high, damaging the optic nerve and resulting in the loss of peripheral vision and, later, central vision.

“If you have a problem with peripheral vision, you may not notice it.” Smith says. “If you have difficulty changing lanes, you may need to get your eyes checked.”

Coden says glaucoma isn’t curable, but many treatments are available. The most common is eye drops that lower the eye pressure, Smith says.

Around age 60 or 70, age-related macular degeneration, which affects central vision, becomes a major concern. While the leading cause of blindness in black Americans is glaucoma, the leading cause of blindness in white Americans is macular degeneration, Smith says.

Macular degeneration can slowly degrade the vision and make drivers susceptible to glare and low light conditions, Margolis says. “These things come on very slowly, so often people are not aware of the presence of the problem.”

Eye-care chain vendors:
LensCrafters
www.lenscrafters.com

Pearle Vision
www.pearlevision.com

Target Optical
www.target.com

Wal-Mart Vision Center
www.walmart.com

Financial assistance:
Macular Degeneration Support
www.mdsupport.org, Search for “financial assistance.”

National Eye Institute
www.nei.nih.gov, Search for “financial aid.”

Unite for Sight
www.uniteforsight.org


THE PRICE OF VISION
Almost as scary as eye disease is the cost of vision care. “A big rip-off,” says Mike Garvey, who wears trifocals and is a company driver for D&B Transport of Muskegon, Mich. “Just like doctors or anybody else, the more they can bleed out of you, they will.”

“I think a lot of truck companies should pay for it, since your eyes are very important out here,” says Daniel Gray, a 32-year-old owner-operator from Jacksonville, Fla., who wears contact lenses for his slight nearsightedness. “Or they should at least have someone come in and do eye checks every six months.”

While both Gray and Garvey have vision insurance to reduce their out-of-pocket expenses, many owner-operators don’t and face much bigger costs to maintain good vision.

An eye exam costs approximately $90, says Sean Cooley, a spokes-man for VSP, a vision care insurer. An eye exam and prescription glasses can cost more than $300. Choose plastic progressive lenses and a stylish frame, and that can easily rise to $500 or $600.

Laura Center, an optician at a Pearle Vision store in Oklahoma City, says her starting price for single vision plastic lenses is $119. Bifocals and trifocals cost $159 and $199, respectively, while plastic progressive lenses start at $229. Lenses can be treated with scratch-resistant coatings or tints, all of which add to the price.

Online vendors such as www.eyeglasses.com and www.39dollarglasses.com often sell eyewear at discounted prices, but sales might be limited to certain frames or lenses. When shopping online, moreover, you don’t get to try on frames before buying.

Frank Davis, 48, an owner-operator from St. Charles, Mo., wears glasses with transitional lenses for his astigmatism. Davis has vision insurance through the Owner-Operator Independent Drivers Association but also relies on sales that are common among national chains such as Pearle Vision and Target Optical.

Other cost-saving options include state or national programs that offer free eye exams and related services to eligible people.

For example, EyeCare America, a public service of the American Academy of Ophthalmology, offers free eye exams for qualified people, such as those 65 or older and uninsured people at increased risk for glaucoma. EyeCare America does not pay for medication, glasses or surgery, but often a doctor will help the patient minimize costs.


HOW TO PROTECT YOUR SIGHT
Eyes are sensitive, delicate organs, and over-the-road trucking presents more threats than most occupations.

USE SUNGLASSES. This is the most important thing truckers can do to protect their eyesight, says Dr. Janine Smith of the National Eye Institute. Ultraviolet radiation not only tires the eye but also can damage it and cause cataracts to form prematurely. Most sunglasses today have UV protection. Better sunglasses have polarized lenses, which reduce glare.

WEAR PROTECTIVE GLASSES. Smith also suggests keeping a pair of goggles in the glove compartment for maintenance tasks: “If you are changing a tire or doing any kind of mechanical work, you need to wear eye protection.” Dr. Alan Margolis says he is a fan of wraparound sunglasses because they can keep dust and debris out of the eyes.

HAVE A HEALTHY LIFESTYLE. Eat a variety of foods, especially fruits and vegetables, and exercise regularly. “Your general medical health is closely related to eye health,” says Smith. Studies have shown multivitamins can slow the development of macular degeneration. On the other hand, smoking increases one’s risk of getting the disease.

SEE A SPECIALIST. The key protective step, says Dr. Daniel Coden, is preventive maintenance. “Anyone over 40 should see a ophthalmologist at least yearly to check for glaucoma and macular degeneration.”


FOCAL POINTS
Those who need something better than ordinary reading glasses have several types of lenses to choose from, says Dr. Alan Margolis:

BIFOCALS. The lens has one component in the top for seeing things at a distance and another component at the bottom for near or reading vision. A line separates the parts.

TRIFOCALS. The lens has a third component for viewing an intermediate zone, such as a computer screen.

PROGRESSIVE OR BLENDED LENSES. The lens has a graded transition from distant to near, eliminating the lines between focal lengths that can cause visual discontinuity.

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