Is Retinal Detachment Surgery Covered by Health Insurance?

• Written by Anjali Sharma

  Reviewed by Akhil Pillai

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The retina, a tissue layer at the back of the eye, converts light into signals sent to the brain for vision. When the retina detaches, vision becomes blurry and, if untreated, can lead to permanent loss. While retinal detachment is more common in individuals over 60, surgical treatments, such as laser surgery, can often restore vision.

Wondering if insurance covers the procedure? Coverage depends on your policy and medical necessity. Read on to learn more about your options.

What is Retinal Detachment?

When the retina is detached from its position, the separated retinal cells result in a lack of oxygen and nutrition supply to the eye, which affects vision. This condition is called retinal detachment.

Causes of Retinal Detachment

Some common causes of retinal detachments are:

• Ageing
• Eye injury
• Previous family history of retinal detachment
• Cataract surgery
• Diabetic retinopathy
• Thinning of retina
• Nearsightedness
• History of retinal tears, etc.

Symptoms of Retinal Detachment

Retinal detachment does not cause any pain. However, there are symptoms which can help in timely diagnosis:

• Seeing light flashes in one or both eyes
• Suddenly seeing a lot of floaters (dark spots, threads, flecks, lines drifting across your vision)
• Partial loss of vision
• Shadow covering your vision

Diagnosis of Retinal Detachment

Retinal detachment is diagnosed through eye check-ups to examine your vision, the appearance of your eyes, blood flow in the eyes, ability to see colours and eye pressure.

Different types of tests that can diagnose a retinal detachment are:

• A retinal examination using bright light and special lenses to detect any tear, hole or detachment in the retina.
• Ultrasound imaging is used to check for any injuries or bleeding in the retina obstructing vision.

Common Surgical Treatments for Retinal Detachment and Their Costs

Here are some common types of surgeries used to treat retinal detachment. Also, retinal detachment surgery costs in India are discussed below:

• Photocoagulation: Laser surgery for retinal holes is used in cases where the retina is not detached but has a hole or a tear, which is fixed with the help of a laser. The retinal tear laser surgery cost ranges from ₹ 3000 to ₹ 5000.
• Cryopexy: In this procedure, intense cold application through a special probe is done to the retina to create scar tissue, preventing the extension of the retinal tear. The cost of this retinal detachment treatment is similar to the cost of laser surgery to repair retinal tears.
• Pneumatic Retinopexy: This procedure treats minor detachments by injecting a gas bubble into the eye to close the tear. Afterwards, laser surgery may be required to seal the tear. The cost of this treatment starts at ₹ 40,000.
• Scleral Buckling: In this procedure, a synthetic material is used to reattach the retina to the eyeball. The cost ranges from ₹ 40,000 to ₹ 60,000.
• Vitrectomy: In this procedure, the doctor removes the vitreous present in the back of your eye and replaces it with a bubble of gas or a bubble of silicon oil. The bubble pushes and keeps the retina at its position while it heals. The gas bubble disappears in 6 months, but a silicon oil bubble is removed once the retina is healed. The cost of this treatment starts from ₹ 50,000.

In addition to these procedures, stem cell therapy can also be used to repair irreversible damage to the retina and to restore lost vision. It involves the use of a stem cell graft to do a retinal transplant for retinal detachment. However, this procedure is still in its research phase but has a lot of potential in curing retinal damage.

What to Do After Retinal Detachment Surgery?

Recovery after retinal detachment surgery may take up to 6 weeks. For successful recovery, follow your doctor’s advice and do the following:

• Wear an eye patch as recommended by your doctor.
• If a bubble has been injected, follow your doctor’s advice to hold your head position for quick healing.
• Use eye drops without fail, as recommended by your doctor.

Is Retinal Detachment Surgery Covered By Insurance?

In most cases, surgery is the only option to treat retinal detachment. However, a simple procedure can also help in mild cases with just a retinal tear. Most treatment options available to fix retinal detachment can be completed within a day and do not require hospitalisation of more than 24 hours. Hence, these procedures are mostly covered under daycare treatments. Private retinal detachment surgery costs from ₹ 3000 to ₹ 1,10,000. You should check your health insurance policy terms and conditions to ensure that retinal detachment surgery is covered.

Also Read:What is Contoura Vision Surgery?

In a Nutshell

Retinal detachment can be prevented through regular eye check-ups and maintaining good health, especially if you are over 60 years old. It is also recommended to invest in a comprehensive health insurance plan to protect yourself from the financial burden of expensive medical treatments, including eye surgeries. Care Health Insurance offers a variety of plans that cover a range of daycare treatments, including eye-related surgeries. For example, Care Freedom offers coverage for cataracts or procedures for retinal disorders under a specific disease category. The scope of coverage entirely depends on the policy terms and conditions. Kindly visit the official website or connect with our experts for more information.

Disclaimers: All plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.