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The Department of Health and Human Services (HHS) released a bulletin on Dec. 16 outlining proposed policies that will give states more flexibility and freedom to implement the Affordable Care Act, including how pediatric vision care would be provided as one of 10 “ essential health benefits.” According to the bulletin, HHS proposes that states should consider having pediatric vision care cover “routine eye examinations with refraction, corrective lenses and contact lenses.”

Under the intended approach announced by the HHS, states would have the flexibility to select an insurance plan that reflects the scope of services offered by a “typical employer plan” by using one of the following health insurance plans as a benchmark: one of the three largest small group plans in the state by enrollment, one of the three largest state employee health plans by enrollment, one of the three largest federal employee health plan options by enrollment, or the largest HMO plan offered in the state’s commercial market by enrollment. If states choose not to select a benchmark, HHS intends to propose that the default benchmark will be the small group plan with the largest enrollment in the state. Plans could modify coverage within a benefit category as long as they do not reduce the value of coverage.

“Not every benchmark plan includes coverage of all 10 categories of benefits identified [as essential health benefits],” according to the HHS bulletin, which added that among the most commonly non-covered categories of benefits among typical employer plans are pediatric vision services. To determine what pediatric vision services should be offered, HHS reviewed the Federal Employees Dental/Vision Insurance Program (FEDVIP). “The FEDVIP program is a standalone vision and dental program where eligible federal employees pay the full cost of their coverage,” stated the bulletin. “The FEDVIP vision plan with the highest enrollment in 2010 covers routine eye examinations with refraction, corrective lenses and contact lenses. For pediatric vision services we intend to propose the plan must supplement with the benefits covered by the FEDVIP vision plan with the largest enrollment. The rationale for a different treatment of this category is that CHiP [the Children’s Healthcare Program] does not require vision services. We also seek comment on an approach that lets plans define the pediatric vision services with required reporting as a transition policy.”

Public comments are due by Jan. 31, 2012 and can be sent to EssentialHealthBenefits@cms.hhs.gov.

The World Council of Optometry (WCO) has joined a group of International Agency for the Prevention of Blindness (IAPB) member organizations in supporting the World Health Organization’s (WHO) Action Plan on Avoidable Blindness and Visual Impairment.

Eight IAPB member organizations including WCO, have agreed to pool funding to support WHO’s work on the Action Plan. In 2012/13, $370,000 will be made available to contribute toward delivery of the 2009-13 Action Plan for the Elimination of Avoidable Blindness and Visual Impairment. An additional $340,000 is pledged in principle for 2013/14.

WCO president, Tone Garaas-Maurdalen said, “I am delighted that WCO, through funds from our partner Optometry Giving Sight, has been able to support WHO’s work on the Action Plan. This work is at the very heart of what WCO looks to achieve from our global health partnerships.”

The World Council of Optometry  is an international organization dedicated to the enhancement and development of eye and vision care worldwide. Collectively, the 150 organizations within our network represent over 300,000 optometrists, across six world regions. The World Council of Optometry is administered and hosted by the College of Optometrists in the U.K.

The International Agency for the Prevention of Blindness (IAPB) is the alliance which leads worldwide efforts in blindness prevention, with a membership of 117 organizations including virtually every major international eye health non-government organization (NGO), as well as global apex bodies for the eye health professions.

Harris Corp., an international communications and information technology company, has been awarded a pair of contracts to help improve the prevention, diagnosis and treatment of eye-related injuries and diseases affecting active-duty service members and veterans.

The National Defense Authorization Act of 2008 directed the Department of Veterans Affairs (VA) and Department of Defense (DoD) “to establish a center of excellence in the prevention, diagnosis, mitigation, treatment and rehabilitation of military eye injuries.” For the past year, Harris has worked with the resulting Vision Center of Excellence and Defense Health Information Management System to design, develop and deploy a Defense and Veterans Eye Injury and Vision Registry to record the occurrence, treatment and outcomes of military eye-related injuries.

Under the first new contract, Harris will operate, maintain and enhance the registry for three years, working as a subcontractor to Pelatron, Inc. The total contract value for Harris is $2.8 million.

Under the second, five-year $14.3 million contract, Harris will populate the registry with information from medical records and other documentation for all eye injuries sustained by service members. DoD and VA medical researchers will mine this massive dataset for information on care and outcomes that will be used to improve eye-injury treatment protocols on and off the battlefield.

“As eye injury rates on the battlefield remain high, the Defense and Veterans Eye Injury and Vision Registry is a critically important new tool in the effort to improve care for our service members and veterans,” said Jim Traficant, president, Harris Healthcare, based here. “The work done by Harris to collect treatment and outcome information will allow the Vision Center of Excellence to conduct multidimensional studies to improve readiness, and enhance patient care and outcomes.”

A pilot study in the August 30 online edition of PLoS Biology notes that  video game playing can help improve amblyopia in adults. Although there are several effective methods of amblyopia correction for pediatric patients, including occlusion therapy and atropine drops, there are no proven treatment options for adults.

In this study, researchers recruited 20 adults with amblyopia aged 15 to 61 years. The patients were randomized into one of three treatment arms: an “action” videogame group; a “non-action” videogame group; and a control group.

Patients in the action group were asked to wear an occlusion patch over their good eye and were instructed to play Medal of Honor: Pacific Assault, a fast-paced, first-person shooter.

Patients in the non-action group were asked to wear an occlusion patch over their good eye and were instructed to play SimCity Societies, a slower-paced, construction and management simulation.

Finally, patients in the control group received conventional occlusion therapy only. Patients in both gaming groups played for 40 total hours, two hours at a time, over the course of one month.

At one-month follow-up, the researchers determined that patients who spent 40 hours playing either game exhibited a 30% improvement (1.5 LogMAR lines) in visual acuity from baseline. In comparison, the researchers noted that patients often require a minimum of 120 hours of occlusion therapy alone to gain just one LogMAR line.

Additionally, patients in both gaming groups experienced average improvements of 16% in positional acuity, 37% in spatial attention and 54% in stereopsis.

“This study is the first to show that video game play is useful for improving blurred vision in adults with amblyopia,” said lead author Roger Li, O.D., Ph.D., research optometrist at the Helen Wills Neuroscience Institute and School of Optometry at University of California, Berkeley. “Very surprisingly, besides enhanced visual attention, all participants showed a remarkable improvement in amblyopic visual acuity following a short period of video game play.”

Despite these findings, Dr. Li noted that further research is required to determine the clinical safety of video game therapy. “It is very important that patients should not try self-treating amblyopia,” he said. “Patients should consult their eye doctors. Response to treatment must be closely monitored to avoid possible unwanted conditions, such as double vision, reverse amblyopia, eye strain and headache.”