Tuesday 21 November 2017

Ask the GP: Clearing confusion about astigmatism and under-6 care

Minister Kathleen Lynch and Minister Leo Varadkar, pictured with under six year old children Isabella Heapes age 3 and Kiya O’Connor age 4 from Macken Street, Dublin at the launch of the online registration system for the new Free GP Care for Children Under 6 service
Minister Kathleen Lynch and Minister Leo Varadkar, pictured with under six year old children Isabella Heapes age 3 and Kiya O’Connor age 4 from Macken Street, Dublin at the launch of the online registration system for the new Free GP Care for Children Under 6 service

Nina Byrnes

Our GP advises on applying for the Under-6 free GP visit card and what treatment is available for astigmatism.

Question: I have two children under the age of six. My own GP is not  participating in the under-6 scheme. How do they avail of free GP care? Is there anything I need to do?

Dr Nina replies: As from July 1, 2015 all children under the age of six became entitled to a free doctor visit GP card. This card entitles the child to free GP visits. It does not cover hospital care or prescription expenses.

These cards will not automatically be offered. You must register your children for this service. The registration process is fairly straight forward. You need your name, date of birth, address and PPS number and the name, date of birth and PPS number of children under six. Most registration is online, although some GPs have opted for paper form registration.

In order to register, you should visit the HSE website www.pcrsonline.ie/portal/free-gp-care-web/pub.

Follow the instructions online. Page one requests your child's details. Page two requests the parents details. Page three asks you to select a doctor. If you know which doctor you want to register with, the easiest way to navigate this page is to type the doctor or practice name into the box and they will pop up. If you are not sure which doctor to register with, you can type a town name and participating doctors in the area will pop up.

Once you have completed the online request, the GP you have nominated is sent a request which they can accept or reject. Once a child is accepted, the card will be issued.

There are a few important points to note. You must register and receive a card in order to avail of free GP care. The doctor you select becomes your child's doctor. You must attend this doctor, or others in their centre of practice, in order to receive free GP care.

Out-of-hours care nominated by your doctor should also be covered, but you cannot attend any other practice and avail of free care. You can still choose which practice you attend. If you decide you would rather attend a different GP, you simply get the new GP to sign a 'change of doctor' form. Your card will then be changed to the new doctor's name and you can attend that practice. This holds true for all medical card patients. Changing is a simple, uncomplicated process.

Those patients who already hold a medical card do not need to apply. Their card will automatically come under the under-6 scheme. If they wish to change GPs, a 'change of doctor' form will need to be completed.

If your GP is not participating in the under-6 scheme, you have two options: you may continue to attend that doctor as a private patient, paying for each visit, or you may register with a new GP. It can be daunting trying to find a doctor.

One of the best ways to find out about practices and care in your area is to ask around. Friends, family, your local crèche or pharmacy and your local health office can all be a good source of advice.

Many practices have websites. These can help inform you. Details such as opening hours, appointment availability, accessibility, a team profile and services offered can help inform your decision to change.

Good luck.

Question: I had my eyes checked recently and I've been told I have an astigmatism and need glasses. I don't have any other vision problems. I'm not really sure what this is. Does it mean I'm short or far-­sighted? Can you explain?

Dr Nina replies: Astigmatism is a form of refractive error. Short-sightedness and far-sightedness are other refractive errors. When light enters the eye, it is curved by parts of the eye called the cornea and lens, and then directed back to the retina at the back of the eye.

A normal cornea is round like a football. In astigmatism the cornea can be altered in shape, more like a rugby ball. This alters the way light is bent and can result in blurred vision.

Astigmatism can run in families. Most cases are present from birth but other cases may develop later or occur secondary to injury, scarring or operations.

Astigmatism may not cause any problems and may not require any treatment. It may occur in conjunction with other refractive errors. If vision is affected, treatment may be recommended. The most basic form of treatment is glasses. The lenses of the glasses adjust the incoming light rays.

Contact lenses are another treatment option. It is important to use these correctly and maintain good eye hygiene when using contact lenses. These are not really suitable for younger children.

In recent years, laser eye surgery has become a popular choice for many eye problems. Some health insurance companies are now offering to provide some cover for laser eye surgery.

It is important to ensure the clinic you attend is properly registered and regulated and that you meet the doctor performing the surgery prior to the procedure date. There are some complications that can occur. Surgery may also correct other refractive errors.

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