A guide to further factors that determine if insurance covers eyelid surgery, and cosmetic financing options.

In part one of our checklist used in deciding if insurance covers eyelid surgery, we discovered determining factors within photos taken at time of consultation. The final component insurance companies look for is the Humphrey Visual Field test.

The Humphrey Visual Field, or HVF, is a unique automated procedure used to perform

perimetry. Perimetry is a test that measures the entire area of a patient’s peripheral vision that can be seen while the eye is focused on a central point. During this test, lights of varying intensities appear in different parts of the visual field while the patient’s eye is focused on a certain spot.

HVF testing is effective in diagnosing many possible ocular conditions, like glaucoma. Using this test from a cosmetic standpoint to see if insurance covers eyelid surgery, it is an invaluable tool to illustrate the visual obstruction associated with ptosis repair and/ or Blepharoplasty. This procedure is completely pain-free and is performed quickly and easily in about 30 minutes, and is effective in diagnosing the functional (or medical) necessity of surgery.

An HVF test used to determine functional necessity will be conducted twice. The first time, a patient’s eyelids will be in normal position. Prior to the second test, the patient’s eyelids will be elevated from their natural position, usually secured with medical tape, and placed in a manner that the eyelids would be after surgery.  Generally, this compare and contrast is often severe. If insurance covers eyelid surgery, testing will show that more than 30% of a patient’s visual field is lost due to droopy eyelids.

test used to determine if insurance covers eyelid surgery

Results of an untaped (left) and taped (right) Humphrey Visual Field test used to determine medical necessity.

 

Above are the results of both tests of a patient whose insurance covers eyelid surgery. The results on the left are normal (or untaped) position, and the results on the right are the elevated (or taped) position.  The small circles represent the different lights that are flashed throughout the test, and the black squares represent how many of these lights were recorded as being seen by the patient. Through these results, it is extremely clear to see how the patient would functionally benefit from corrective eyelid surgery.

 

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