Steadfast Care Planning
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Steadfast Care Planning
A Clearer Path to Aging Well: The Overlooked Role of Eye Health with Dr. Ravi Goel
šļø Thereās more to an eye exam than meets the eye...
What if one simple exam could reveal far more than just how well you see? I sat down with Dr. Ravi Goel to explore a topic that touches every one of usābut rarely gets talked about.
We covered far more than vision care. This conversation opened my eyes (literally!) to some surprising connections between eye health, aging, and long-term planning. Whether youāre caring for yourself or someone you love, this is something youāll want to hear.
We also touched on a couple of resources that could be game-changers for families navigating care decisions.
š§ Take a listenāyou might never look at a routine eye exam the same way again.
#EyeCare #VisionHealth #HealthyAging #SteadfastCarePlanning #SeniorWellness #CarePlanning #AgingWell #Cataracts #Glaucoma #PreventiveCare #Podcast
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Steadfast Care Planning podcast is made possible by Steadfast Insurance LLC,
Certification in Long Term Care, and AMADA Senior Care.
Come back next time for more helpful guidance!
Kelly Augspurger [00:00:02]:
Hey, everyone. Welcome to Steadfast Care Planning, where we plan for care to live well. I'm Kelly Augspurger, long-term care insurance specialist and your guide. With me today is Dr. Goel, cataract surgeon and comprehensive ophthalmologist with the Regional Eye Associates in Cherry Hill, New Jersey, as well as a clinical spokesperson for the American Academy of Ophthalmology. Dr. Goel, thanks so much for being here.
Dr. Ravi Goel [00:00:25]:
Thanks for having me.
Kelly Augspurger [00:00:26]:
Today we are going to be talking about how people can see well as they grow older. So can we jump right in?
Dr. Ravi Goel [00:00:32]:
Sure. I think that my goal in life is to protect sight and to help patients lead healthy lives. And the academy's mission is protecting sight and empowering lives. I finished residency back in 2001, and I'm a cataract surgeon and a comprehensive ophthalmologist right in my hometown where my family's lived for 50 years. And I think that ophthalmology and fellow ophthalmologists, we have that mission to help our community members, help our neighbors lead healthy, productive lives. And especially as we see the population getting older, we see the potential for vision loss or, visual demands, but the potential for vision loss to increase as the decades go on. A lot of our efforts are to help manage our patients and help to treat them and to give them the goals and the steps to help to lead healthier lives.
Kelly Augspurger [00:01:20]:
Thank you, Dr. Goel. How often should this older adult population get eye exams?
Dr. Ravi Goel [00:01:26]:
So the mantra always is that by the age of 40, you should have an eye exam, comprehensive eye exam with an ophthalmologist. Ophthalmologists are physicians and surgeons. We go to 4 years of college, 4 years of medical school, 4 years of residency, maybe 1 to 3 years of fellowship. But I think that at the age of 40, you should get an eye exam. Once you get older, if you have risk factors, you should have eye exams more frequently. Certainly when you're at the age of 65, which I think many of your audience are, they should have an eye exam at least once a year. And if there are other additional risk factors, every year or two, and sometimes more frequently, depending on what their clinical findings are.
Kelly Augspurger [00:02:01]:
Gotcha. And then what's the difference between an optometrist and an ophthalmologist? Because I think most people probably don't know the difference.
Dr. Ravi Goel [00:02:09]:
Oh, that's great. So there are the 3 O's, ophthalmologists, optometrists, opticians. That's what we talk about the traditional 3 O's in eye care. We're all part of an eye care team. So as I mentioned, ophthalmologists are physicians and surgeons. We go to 4 years of college, 4 years of medical school, we generally have an MD, medical doctor, or a DO doctor of osteopathy. So MD/DO's, then we do 4 years of residency, hospital based residencies. Then typically we may do 1 or 2, maybe 3 years of fellowship.
Dr. Ravi Goel [00:02:42]:
And then we come out, we join a clinical practice, or a faculty, or private equity, whatever, and then we go through board certification. Optometrists go to 4 years of college, 4 years of optometry school.
Kelly Augspurger [00:02:54]:
Mm.
Dr. Ravi Goel [00:02:55]:
And then they may have 1 or 2 years of a residency that can be anywhere from like a Walmart, or a Kmart, or like through a mentorship. Some of the institutes in the country have residency programs, but they're not trained to do cataract surgery. They're not trained to do intensive surgery. In only 10 states are they allowed to do laser surgery. So that's a big scope of practice battle we have with optometry currently. And up until the late 90s, they weren't allowed to prescribe drops in the state of New Jersey. So that could be a state-by-state issue. So really, in terms of patient safety, you need to know who the person wearing the white coat is in front of you.
Dr. Ravi Goel [00:03:32]:
Are they an ophthalmologist? Are they optometrist? Are they optician? Opticians are those who fit you for glasses. Generally optometrists, they do routine care. Optometrists throughout the spectrum, they do general eye exams, contact lens fittings, low vision, etc. But in terms of medicine and surgery of the eye, that's ophthalmologists.
Kelly Augspurger [00:03:51]:
Okay, thanks for clarifying that. I learned something new today. Just to say thank you for that. And then what kinds of things can eye exams catch before the person may even know that they have a health issue? What do you tend to see?
Dr. Ravi Goel [00:04:03]:
I can count a number of patients who I'm doing a routine eye exam on them. I sit back and say, "Oh, how long have you had diabetes?" And they say, "I don't have diabetes." I'm like, "Oh..." then I know that's going to be a longer eye exam because I have diagnosed their diabetes.
Kelly Augspurger [00:04:17]:
Oh my goodness.
Dr. Ravi Goel [00:04:18]:
I remember being a resident looking at a routine eye exam. I did my residency down in Baltimore and every employee in the hospital got a free routine eye exam through the eye clinic. So all the residents did routine eye exams, and this patient's eye, I can still see it, this patient's optic nerve was swollen. Came in for routine eye exam. I was like, "What is going on?" I called my senior resident. We sent him down to the ER and he was in kidney failure.
Dr. Ravi Goel [00:04:41]:
So he was an African American gentleman in his 40s. He had other risk factors, but you can have diabetes, high blood pressure. You can diagnose cancer in the eye. You can diagnose primary cancer in an eye exam. Or, unfortunately, you can diagnose metastatic cancer, where you have a primary cancer somewhere else in the body and it goes to the eye. You know, common diseases such as MS, multiple sclerosis or, sarcoidosis. A bunch of diseases will have clinical signs that are in the eye. High cholesterol, high blood pressure.
Dr. Ravi Goel [00:05:12]:
I'll look at a patient, I'll be like, "Hey, your blood vessels look very tenuous." They look like they're being pulled, or whatever. So you can have patients who have signs of stroke. Your audience is going to know about TIA well, patients will come in and say, "I've been losing my vision for, like, 15 minutes a day. And then it goes, fine. A curtain comes over my vision." I'll look at the patient, say, "Ma' am, you're having a stroke or you're at high risk of a stroke. We need to call 911 and send you to the emergency department."
Dr. Ravi Goel [00:05:39]:
Sometimes when I lift a patient's lid and it's really soft, it was really easy for me to lift. I'll sit back, I'll say, "Do you have sleep apnea?" And the patients will jump back. They'll be like, "How did you know I have sleep apnea?" I say, "Well, because there's something called floppy eyelid syndrome, where we can literally just move a lid. And just when you've looked at thousands of lids, you're like, oh, it looks like something called a floppy eyelid. And that could be a risk factor for sleep apnea." So at that point, we say, "Look, you could have sleep apnea, but I'm not gonna say you do, so we're gonna send you over to our MD colleagues, primary care physicians, et cetera." But I've diagnosed brain tumors. I've diagnosed aneurysms indirectly.
Dr. Ravi Goel [00:06:17]:
I saw a patient. I don't want to be too specific, but they were going on vacation a few days later. And I looked in for a routine eye exam. And I looked in the eye, and the optic nerve was a little swollen on both sides. I said, "Something's going on." And I added tests that day. I extended their visit. I set my clinic back.
Dr. Ravi Goel [00:06:34]:
I said, "I gotta send you the ER." She called and said, "Thank you. Because of you I was diagnosed, not because of me, but you found my brain process." You could have thyroid eye disease. Some patients whose eyes are sort of bulging out, proptosis. So there are all sorts of things that you can find on routine eye exam.
Dr. Ravi Goel [00:06:53]:
You have to have that clinical suspicion. You do always what's in the best interest of the patient. But back in the 90s when they were talking about primary care, we would present ourselves as being primary care of the eye. OB guys were primary care for women, pediatricians, internal medicine, et cetera. We're like, "Hey, we're the primary care of the eye." Our colleagues outside of ophthalmology, they're seeing patients for high blood pressure, cholesterol, et cetera. They don't want to manage the eye stuff and they don't have the equipment to either. So those are just some of the things you can find on routine eye exam.
Kelly Augspurger [00:07:20]:
That is fascinating. I've heard of some of those things that you talked about, but others not. Really just makes me think that the eye is like a window into a really good picture of your health. So if there's an issue...
Dr. Ravi Goel [00:07:31]:
I'll tell you, the eye is the only place in the human body that I know of in which you can look at a blood vessel without cutting into tissue. We can look at a lens or take a photo. We can look at arterioles, arteries and veins. The only place you can look at that in the human body without cutting tissue, you can look right out in the back of the retina. That's actually really nice. That's cool.
Kelly Augspurger [00:07:54]:
That is so fascinating.
Kelly Augspurger [00:07:56]:
The Steadfast Care Planning podcast is sponsored by AMADA Senior Care. AMADA provides complimentary consultation with a senior care advisor to find the right care from in-home caregiving to community care, as well as long-term care insurance claim advocacy and unique support partnerships for financial advisors to address family transitions and generational retention. To learn more, visit www.SteadfastWithAmada.com.
Kelly Augspurger [00:08:27]:
What types of eye diseases or complications do you tend to see in older adults?
Dr. Ravi Goel [00:08:31]:
The typical ones, cataracts, glaucoma, macular degeneration. Those are the three leading causes of vision loss as you get older. Your diabetes, diabetic retinopathy. Those are the main causes of vision loss. I mean, if you think about. There's this old study in the 80s or 90s called the Baltimore Eye Survey. And the Baltimore Eye Survey was done at Johns Hopkins Hospital. They hypothesized what's the most common cause of vision loss in Baltimore. And the punchline is that a mile or two from Johns Hopkins Hospital, for many years the #1 eye hospital in the world, the number one cause of vision loss in Baltimore, Maryland at the time was cataracts.
Dr. Ravi Goel [00:09:10]:
Garden variety cataracts, where patients didn't have access to seeing an ophthalmologist, not even knowing that they had a cataract. So I think that cataracts, glaucoma. Glaucoma is the thing that you lose sleep over as an ophthalmologist because it's a silent disease. People don't know that they have glaucoma. So, for example, somebody who has glaucoma typically could be over the age of 60, has a family history, ethnicity, Asian Americans, African Americans, Hispanic Americans, history of high eye pressure, also a history of diabetes, high blood pressure, or if they're on long-term steroid use, you could be on steroids for whatever condition that your other colleagues want to put you on. And that can cause high pressure in the eye and that can cause, in this case, a secondary glaucoma. But glaucoma is one of those silent diseases. We talk about cataracts and...
Kelly Augspurger [00:09:59]:
Can you describe, Dr. Goel, can you explain to us what the differences are between glaucoma, cataracts, and maybe age-related macular degeneration? What do those look like? Because I don't think most people really understand what they are and what the differences are between them.
Dr. Ravi Goel [00:10:12]:
Sure. So basically you can imagine a camera system. If you're taking a photo of something, remember those old photo systems you had to...you got the film, you had to mail it out to a lab and get it processed. Well, it's the same thing. If you have a camera, you have the lens, okay. Imagine that lens being clear, and as you get older, the lens will get cloudy. So imagine the natural lens of the eye. So when light comes into your eye, the first thing it hits is a tear film.
Dr. Ravi Goel [00:10:39]:
And then it hits the cornea, which is sort of that dome in front of the eye. Then it goes through something called the anterior chamber. Somebody has blue eyes, or brown eyes, that's called the iris and the opening is called a pupil. Almost like a student. The history of the word pupil came from the teacher, and the student was upside down. When you look right at somebody.
Dr. Ravi Goel [00:10:56]:
So that's what I'm told, anyway.
Kelly Augspurger [00:10:58]:
Okay.
Dr. Ravi Goel [00:10:59]:
So you have the tear film, the cornea, the anterior chamber. Then you have the pupil right behind there sits the natural lens of the eye, and I typically tell patients that, think about a peanut M&M. A peanut M&M has a peanut, the chocolate and the shell.
Kelly Augspurger [00:11:15]:
Yeah.
Dr. Ravi Goel [00:11:15]:
Okay. That's the classic peanut M&M. And imagine that being a lens in which the lens has a clear peanut, a clear chocolate, and a clear shell.
Kelly Augspurger [00:11:25]:
Okay.
Dr. Ravi Goel [00:11:26]:
You can get cloudiness in any of those layers. Like lens proteins, it's called. Lens proteins will change so that that lens gets cloudy. So it's almost like driving along the highway. And it starts to snow. And you haven't turned on the windshield wipers so you're gradually getting snow.
Dr. Ravi Goel [00:11:43]:
You can sometimes see through it, a couple flakes. But as the flakes get more. And as it gets thicker, you're gonna have more trouble seeing through the lens. Okay, so then light is traveling. Light travels from the tear film to the cornea, through the anterior chamber, through the pupil, hits the lens. That's where you can get a cataract. After that, it hits something called the jelly of the eye, the vitreous gel, almost like a thing being like Jell-O. That's a clear substance that helps you sort of process light.
Dr. Ravi Goel [00:12:08]:
And then it hits the retina. The retina is sort of that dome in the back, and that has nine layers to it. It's a little more detailed, but that retina layer is sort of a conduit to the brain that has nerve fiber layers, etc. But that processes information. That's the film. And the film then it processes, goes to the optic nerve, sends information to the optic nerve, the optic nerve, sends it off to the brain, et cetera, for processing. So when it hits the retina, that's where you can have a lot of diseases.
Dr. Ravi Goel [00:12:38]:
You can have macular degeneration, you can have diabetic retinopathy. You can have those blood vessels I mentioned which were high blood pressure. Or you can have those soft signs of something called embolus. Somebody's having a stroke from the heart, something called a Hollenhorst plaque. You throw off a plaque from the heart, goes to the eye, hits the retina, stops at the retina, hopefully. And then the optic nerve sends information to the brain, and that's where you can get glaucoma. The optic nerve.
Dr. Ravi Goel [00:13:09]:
The way to think about optic nerve, think about. You have an ice cream bucket. You have a bucket of ice cream. You take a scoop of ice cream from the center. If that bucket is 10 across, you take a scoop in the center, about two or three across. That's the typical size of the optic nerve. There's no average sort of in a podcast, but you know, like two or three or four. You take a scoop of ice cream, you know, the diameter of the scoop is three or four.
Dr. Ravi Goel [00:13:29]:
The radius, you know, the buckets, 10, you know, distance across. And there are disease processes that can cause damage to the optic nerve over life, over time. Glaucoma is one word, but it has many sub diagnoses under that. You know, this glaucoma, that glaucoma, you know, open angle, closed angle, long term, short term, fast, slow, whatever. So, okay, you know, secondary to other diseases. But the only thing we know how to modify is the pressure in the eye. So when we treat glaucoma, the only thing that we can really try to, you know, treat, to manage is the intraocular pressure. So that's why we'll do.
Dr. Ravi Goel [00:14:07]:
Laser is now becoming the standard care for glaucoma surgery or drops or surgery. So those are the three things you can do.
Kelly Augspurger [00:14:14]:
Okay.
Dr. Ravi Goel [00:14:15]:
Certainly the one modifiable risk factor for everything in my mind is smoking. So if you're a smoker, you're at increased risk for cataracts. For sure. I'll see a smoker's cataract. You should avoid smoking for glaucoma. You got to stop smoking because as I said, light comes in, passes through everything, hits the retina. The retina is composed of 9 plus layers, and those layers regenerate. And what macular degeneration is.
Dr. Ravi Goel [00:14:38]:
The macular degeneration is the 9 layers are regenerating and they're leaving stuff behind. They're leaving these particles behind that the retina is not able to process, not able to clean up. They're not able to sweep the floor after a big event so that debris stays behind. And then you can get different types of macular degeneration, dry and wet. But basically, dry macular degeneration is when you have something called drusen, little think about calcium, little yellow particles. Really, you could think about it in the retina.
Kelly Augspurger [00:15:05]:
Okay.
Dr. Ravi Goel [00:15:06]:
But then as those 9 layers, the 9 layers have some blood vessels in some of the deeper layers. And if there's enough disruption, those blood vessels become weak and they can leak or you can get new blood vessels form is what happens. So you have new blood vessels form, then you can go from something called dry macular degeneration to something called wet macular degeneration. And at least for the last 15, 20 years, the wet macular degeneration we would treat with medicine. Now, in the last few years, there are some types of dry macular degeneration with something called geographic atrophy, where you can also get medicine delivered to the eye to help manage, your macular degeneration going forward. But for dry, I would definitely tell you, talk to your ophthalmologist, talk to your retina specialist, talk to your primary care doctors, because there are vitamin supplements that, put a plug in from the National Eye Institute. The National Eye Institute is this amazing organization which is part of the National Institutes of Health. But the National Eye Institute has given us so many great breakthroughs and discoveries that have helped everyone to sort of lead healthier lives.
Dr. Ravi Goel [00:16:12]:
And also, I should mention green leafy vegetables, and antioxidants, omega fish with omega 3s and nuts, that sort of thing. But, my point is that you have dry macular degeneration, wet macular degeneration. And for dry, you want to do, you know, healthy diet, sunglasses, green leafy vegetables, salmon, omega 3s and areds 2 supplements, both of them. You should see a retina specialist at some point, but the wet one, generally you may be getting injections in the eye to help treat those diseases.
Kelly Augspurger [00:16:40]:
Okay, so you talked about risk factors, smoking being one of them. When we're talking about glaucoma, cataracts, and then AMD, age-related macular degeneration. Any other risk factors? Like what about alcohol or bad, I'm assuming bad diet because we were talking about good diet. Is that in line with what you tend to recommend, or what else do you see?
Dr. Ravi Goel [00:16:59]:
Excessive alcohol use, I think is the risk factor for cataracts. Yeah, that's all I'd say there. If you're taking excessive alcohol, you may most likely have other risk factors also.
Kelly Augspurger [00:17:08]:
So. Okay, but smoking is the biggest risk factor for this thing?
Dr. Ravi Goel [00:17:12]:
Yes, smoking is the biggest, not the biggest, but smoking is a significant risk factor for certainly for cataracts, certainly for macular degeneration. Macular degeneration, excuse me. And also for glaucoma.
Kelly Augspurger [00:17:23]:
Okay. Any other big risk factors that we should know about?
Dr. Ravi Goel [00:17:26]:
I think that there can be the innocent things. I think that, like you're on steroids, you don't even know why and that can be a risk factor for glaucoma and for cataracts. So I think that could be a risk factor for both. So I think that you generally want to avoid prolonged UV exposure for cataracts and also for macular degenerations. So you don't want to be sungazing, you want to have there's something called UV 400 or 100% UVA/UVB protection in your sunglasses.
Kelly Augspurger [00:17:53]:
Really? Okay.
Dr. Ravi Goel [00:17:54]:
You want to protect your eyes from bright sunlight.
Kelly Augspurger [00:17:56]:
Do you find that light eyed people are more susceptible to glaucoma, cataracts, macular degeneration than darker eyed people?
Dr. Ravi Goel [00:18:03]:
That's a great question. So I think that lighter eyed folks probably are more susceptible to macular degeneration. I have to get a date on that. Quite honestly. I probably would not quote me on that one, but...
Kelly Augspurger [00:18:13]:
No, that's okay. I just wonder, my daughter has, both my kids have blue eyes. I have darker kind of hazel eyes and I think they're more sensitive to light because of having lighter eyes. And so I've been told. And so I just wondered if that makes them and other people more susceptible to eye issues as they age.
Dr. Ravi Goel [00:18:30]:
Yeah, I mean, I think that lighter eyed conceptually would make sense to me for macular degeneration, for cataracts. You know, it's just, it's interesting because I think that lighter eyed patients generally, I find they dilate more. So you might, you're probably getting more light into the eye versus brown eyes. Sometimes they don't dilate as well. It might be a little protective in that sense, but I can't be definitive on iris color in that sense.
Kelly Augspurger [00:18:51]:
Okay, that's okay. Just made me maybe think of that as you're talking about it.
Kelly Augspurger [00:18:55]:
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Kelly Augspurger [00:19:21]:
Let's transition to fall prevention. I know that as older adults age, falls are quite common and really one of the biggest things that tend to lead to needing assistance or other issues, you know, hips, legs, knees, that sort of thing. And so we really want to prevent falls as much as possible for good health. So how can cataract surgery help with this?
Dr. Ravi Goel [00:19:43]:
As you mentioned, falls are a significant public health problem.
Kelly Augspurger [00:19:47]:
Yeah.
Dr. Ravi Goel [00:19:47]:
Among older people worldwide, they represent the second cause of death by non intentional injuries. And I found in one study that showed it was like, 646,000 deaths by falls occurring annually. So when I see a patient who is hesitant on cataract surgery, but they use a wheelchair, they use a cane, having trouble walking, I will say, "Hey, you might want to think about cataract surgery because it should help to decrease your risk of falling." And I did find one study in 2021 in the journal Ophthalmology that found evidence that first eye cataract surgery can reduce the risk of falls in older Americans. But second eye cataract surgery may not have additional significant impact. But the risk of falling includes, older age, visual impairment, a history of falling whether or not they have cataracts. And then also you get into this thing called, gait and balance, how well their gait is. But falling risk is a big deal because I remember an old data point when I was in medical school when the attending said to me, "Hey, once the patient has the hip fracture, the risk of death in the neck the next two years goes up exponentially."
Dr. Ravi Goel [00:20:50]:
It's really hip fractures. This is going back 25 years. But one of the biggest risks of falling is actually in your home. So there are modifiable risks that occupational health folks can sort of help you with, like, pearls and other things for transferring in your own home whether it's on the first floor and the second floor.
Kelly Augspurger [00:21:06]:
Yeah.
Dr. Ravi Goel [00:21:06]:
But certainly it makes intuitive sense to us, right, that if you have cataracts and also there are gradations of cataracts. So what I find also fascinating is as a patient gets cataracts, their mood changes, their risk of depression changes. You know Monet, if you trace his paintings over time, they change in color because of his cataracts.
Kelly Augspurger [00:21:25]:
Oh, no kidding?
Dr. Ravi Goel [00:21:26]:
And actually, totally off subject, but Renoir had bad rheumatoid arthritis. Renoir used to have a pen, and he would paint like this.
Dr. Ravi Goel [00:21:35]:
And then he put the paintbrush in his mouth, and then he'd have to go touch it like that and put it back in his mouth because he had terrible rheumatoid arthritis. That's off subject with cataracts. But, you can sort of go with like, it's interesting to follow artists over time certainly in terms of like long-term care. One of the biggest risk factors I find for Alzheimer's, one of the greatest opportunities we have as ophthalmologists to help patients lead healthier lives is to consider patients who have early Alzheimer's, middle Alzheimer's. They can be depressed, or families may say, we don't want to do surgery because they already have Alzheimer's. But they can't see their food, they can't watch the TV.
Kelly Augspurger [00:22:11]:
Yeah.
Dr. Ravi Goel [00:22:11]:
If they can't do what they're enjoying doing, that can lead to increased signs of depression. I have anecdotally had great response with cataract surgery where patients are able to lead healthier lives. And I think that that's been the great joy of being an ophthalmologist.
Kelly Augspurger [00:22:25]:
Oh, I believe that, yeah. If you're not seeing life, if you're not being able to experience what you typically have been able to experience right in the decade before now, you're probably not going to be as happy and content. So we want to improve that as much as possible. Not just physically, but for the people's mental health, as well. So thanks for sharing that. Talk to us about programs like what kind of programs are available for older adults through EyeCare America? What are eligible patients able to receive and how can people find out more information about that?
Dr. Ravi Goel [00:22:55]:
If patients go to AAO.org EyeCare America they can just type in EyeCare America in Google, they'll get there. EyeCare America is sort of our white hat program through the American Academy of Ophthalmology. I lobby on Capitol Hill every year for patients and for the profession. For the last 20 plus years we always give the offices a print ready flyer for EyeCare America. But there are patients who, if you don't have an ophthalmologist, if you don't have anybody in your community, you can call EyeCare America and they can set you up with an ophthalmologist. Also, if you have Medicare and you have EyeCare America, you can call EyeCare America and if you're approved through the program, et cetera, there can be a decrease in cost for the first year when you see an ophthalmologist. I would have patients contact EyeCare America for more information about that.
Dr. Ravi Goel [00:23:43]:
But yeah, so some of those co-pays and deductibles can be waived through a program that EyeCare America has approved with the government, with HHS. So that may change in months, or years ahead, but the ophthalmologist that you're seeing, it's all volunteer. We're volunteers, so we will agree to waive the deductibles co-pays for a year. So if, for example, you saw somebody on January 1st and you were signed up through EyeCare America, you can't do retroactive. You call EyeCare America, you do their intake, and they set you up with an ophthalmologist, and then the ophthalmologist is informed that you're an EyeCare America patient. You come there, they'll still bill Medicare, but it may help with your deductible. It can be significant for the first year anyway, not permanent, but...
Kelly Augspurger [00:24:22]:
Absolutely, I know that medical expenses are a big concern for many older adults. And so how do we minimize that but still be able to get the quality of care that we need? So that's a great program. So if you know someone that needs some eye care, check out EyeCare America to see if that might be applicable to you, or someone that you know. And then, Dr. Goel, any final advice on what people can do, or how they can plan for care to live well?
Dr. Ravi Goel [00:24:45]:
The American Academy of Ophthalmology has hundreds of articles on something called EyeSmart. They just type in EyeSmart. It's patient friendly, they have videos. The content is vetted by committees of ophthalmologists, or our staff that, that writes them with ophthalmology colleagues. So, if you have dry eye, glaucoma, macular degeneration, if you want like early patient friendly information on those diseases, there are hundreds of topics. That's where I go to, sometimes if I want to point a patient to, I'll go to that page. I'll print out a page, I'll give it to the patient, or I'll discuss it.
Dr. Ravi Goel [00:25:20]:
That's a great starting point.
Kelly Augspurger [00:25:21]:
And say that website one more time.
Dr. Ravi Goel [00:25:23]:
And you just go to AAO.org which is the American Academy of Ophthalmology. AAO.org And then you just make sure it's EyeSmart.
Kelly Augspurger [00:25:32]:
Yeah.
Dr. Ravi Goel [00:25:32]:
Yes. If you go to AAO.org EyeSmart E-Y-E-S-M-A-R-T @ A-A-O.org. EyeSmart. We have an Eye Health A-to-Z so you can sort of search for topics. A little pearl on Google, if you just type in "Cataracts", space, "aao.org" and it'll search the academy site, or any site, really, depending on what you're looking for. That's a little Google search term pearl. You just go to the Google and just type in your term and type in AAO.org, it'll search that site preferentially.
Kelly Augspurger [00:26:01]:
Great. Well, thank you for that golden nugget.
Dr. Ravi Goel [00:26:03]:
Thanks.
Kelly Augspurger [00:26:04]:
Well, Dr. Goel, anything else before we leave? What about if people want to contact you, or to learn more information about you?
Dr. Ravi Goel [00:26:09]:
So I have my practice website you can find online where you just type in ProtectingSight.com, or just my first name, last name, MD.com you'll get to my webpages and I own the site LearnAboutCataracts.com which points to my Protecting Sight page. So I try to make it easy. So, LearnAboutCataracts.com points to Protecting Sight, so you can learn about cataracts there.
Kelly Augspurger [00:26:30]:
Wonderful. Well, thank you so much for your time and your expertise today. I think people probably learned a lot and hopefully are able to take care of themselves and offer some advice to their loved ones on how they can best protect their eye health as they age. So thank you so much and have a wonderful day.
Dr. Ravi Goel [00:26:46]:
Thank you for your time. Thank you.
