American Health Research Articles

The Loss of Autonomy in Eating Disorder Treatment: A Patient Perspective.

In this text, the author's lived experiences as a youth with anorexia nervosa, anxiety, and depression are explored. Experiences with accessing North American health services, both in specialized eating disorder (ED) and disordered eating (DE) settings, as well as in healthcare more broadly are shared. This work seeks to shed light on a patient perspective in mental health and to draw attention to some of the ways that the current framings of EDs and DE within the biomedical system might perpetuate harm. In this piece, a collection of the author's lived-experiences and interactions with the healthcare system are explored. The medical framing of EDs as a defect of both mind and body can jeopardize one's autonomy and contribute to a sense of hopelessness. As mental health treatment increasingly prioritizes evidence-based approaches and standardized practices, there is a growing concern that this shift risks undermining the autonomy of those it aims to support. The dualistic conceptualizations of mental and physical health in ED/DE treatment, at times, can cause harm, particularly for those who do not present with the physical manifestations of an ED/DE but remain largely affected in day-to-day life. The imposition of rigid treatment regimens can inadvertently diminish personal agency, overshadowing the nuanced, individualized needs and preferences of patients. Lived experience narratives encompass the personal, subjective insights of individuals navigating mental health challenges, in turn, providing invaluable insight that conventional methods may overlook.

The effect of medical face masks on inhalation risk of bacterial bioaerosols in hospital waste decontamination station

There is insufficient research on bioaerosols in hospital waste decontamination stations. This study aimed to investigate the effect of three-layer and N95 masks in reducing the inhalation risk of bacterial bioaerosols in a waste decontamination station at a teaching hospital. Active sampling was conducted on five different days at three locations: the yard, resting room, and autoclave room in three different modes: without a mask, with a three-layer mask, and with an N95 mask. Bacterial bioaerosols passing through the masks were identified using biochemical tests and polymerase chain reaction (PCR). The median concentration and interquartile range (IQR) of bacterial bioaerosols was 217.093 (230.174) colony-forming units per cubic meter (CFU/m3), which is higher than the recommended amount by Pan American Health Organization (PAHO). The resting room had high contamination levels, with a median (IQR) of 321.9 (793.529) CFU/m3 of bacterial bioaerosols. The maximum concentration of bioaerosols was also recorded in the same room (2443.282 CFU/m3). The concentration of bacterial bioaerosols differed significantly between using a three-layer or N95 mask and not using a mask (p-value < 0.001). The non-carcinogenic risk level was acceptable in all cases, except in the resting room without a mask (Hazard Quotient (HQ) = 2.07). The predominant bacteria were Gram-positive cocci (33.98%). Micrococci (three-layer mask = 51.28%, N95 mask = 50%) and Coagulase-negative Staphylococci (three-layer mask = 30.77%, N95 mask = 31.82%) were the most abundant bioaerosols passing through the masks. The results obtained are useful for managerial decisions in hospital waste decontamination stations to reduce exposure to bioaerosols and develop useful guidelines.

MANEJO DO SORRISO GENGIVAL ATRAVÉS DO USO DA TOXINA BOTULÍNICA TIPO A

An aesthetically pleasing smile results from the combination of several factors, such as the position, size, shape, and color of the teeth, as well as the exposure and characteristics of the gingival tissue. When evaluating the gingival tissue in a smile, several important factors must be considered: excessive vertical growth of the maxilla, reduced length of the upper lip, excessive contraction of the upper lip, and disproportion between the length and width of the clinical crown of the anterior teeth. A minimally invasive approach that can be used as a complement to dental treatment is the application of botulinum toxin, a neurotoxin produced by the anaerobic bacterium Clostridium botulinum. This toxin blocks the release of acetylcholine in the presynaptic vesicles of neuromuscular junctions, inhibiting muscle contraction. The aim of this literature review was to analyze the use of botulinum toxin type A (BTX-A) in the management of gummy smile. The search was conducted in the databases Google Scholar, PubMed, Latin American and Caribbean Health Sciences Literature (LILACS), and Scientific Electronic Library Online (SciELO). The descriptors used for the search were "botulinum toxin," "gingiva," "periodontology," and "dental aesthetics," combined using the boolean operators AND and OR. Although the evidence demonstrates favorable results, the use of botulinum toxin to correct gummy smile has limitations. It is a temporary solution, and patients should be informed about the need for periodic reapplications and the potential side effects, such as facial asymmetries. The reviewed studies indicate that this technique is particularly effective in cases of gummy smile resulting from hyperactivity of the upper lip elevator muscle, providing a significant reduction in gingival exposure, with results lasting up to 12 weeks. The combination of different therapeutic approaches, along with a careful evaluation of the causes of gummy smile, allows dental professionals to offer more integrated and personalized solutions for each patient.

The health-maximizing level of labor supply: a macroeconomic perspective on the American Health Puzzle

The health-maximizing level of labor supply: a macroeconomic perspective on the American Health Puzzle

Successful strategies for preventing and controlling violence against people with intellectual disabilities: a scoping review

BackgroundViolence against people with intellectual disabilities is unfortunately a reality all over the world, as they are one of the populations most vulnerable to various forms of aggression. Assertive prevention and control measures are crucial to tackle and reduce this problem. The aim of this study was to map and summarize the main measures for preventing and controlling domestic violence against people with intellectual disabilities. MethodsThis was a scoping review conducted in accordance with the JBI guidelines. The databases consulted were: National Library of Medicine (PubMed); Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science; Excerpta Medica DataBASE (EMBASE); Latin American and Caribbean Health Sciences Literature (LILACS) and SCOPUS. Studies included in this review reported on strategies to address domestic violence against people with intellectual disabilities, published in the last ten years, in Portuguese, Spanish or English.ResultsA total of 11 studies were included in this review. Six studies had high methodological quality and five had moderate. Cognitive-behavioral intervention programs, educational technologies and/or auxiliary tools, along with the full participation of people with intellectual disabilities in domestic violence prevention measures are appropriate strategies for dealing with this issue.ConclusionDomestic violence against people with intellectual disabilities is relatively unexplored in the health-field scientific literature. Prevention and control measures should be developed with the active involvement of people with intellectual disabilities, generating engagement and knowledge. Preventive measures should be adapted to the personal context and conditions of individuals with special needs, such as those with persistent or chronic mental disorders.

The healing effects of using tilapia skin to heal burns and wounds

Introduction: Tilapia skin, a freshwater fish, is being used to treat patients with severe burns. Objectives: The aim of this study was to identify the evidence on the use of tilapia skin in burn healing. Material and Methods: The methodology used was a literature review. The research was carried out by means of an electronic search for scientific articles published on the Scielo (Scientific Electronic Library Online) and Lilacs (Latin American Health Sciences Literature) and Pubmed websites. The health terminologies consulted in the Health Sciences descriptors (DeCS/BIREME) were used; evidence on the use of Tilapia skin in burn healing. Discussion: the good results with Tilapia skin, saline solution, hydrofiber with silver and silver sulfadiazine, however Tilapia skin and its derivatives showed better delineation of the wound edges, reduction of exudate, reduction of crust formation, maintenance of local humidity. This resulted in shorter healing times, fewer dressing changes and less pain related to dressing changes. Histological tests show biocompatibility between human skin and Tilapia skin, and in microbiological tests no bacterial growth was identified, and in biochemical analysis, Tilapia skin showed a higher percentage of type I collagen than observed in human skin, and proved resistant in tensile tests. Conclusion: The studies included in this review showed that the use of Tilapia skin as a biological dressing is effective in the treatment of burns, as it adheres well to the wound bed, has good tensile strength, no antigenicity, and reduces pain. The health care provided to burn patients is carried out directly by the nursing team, who perform all the dressings and assess the healing process. Using Tilapia skin as an alternative dressing for these patients allows nurses to provide better quality care and improve patient comfort.

NURSING PERFORMANCE IN PATIENTS WITH CHRONIC RENAL FAILURE AND DIABETES MELLITUS

The goal was to identify the importance of nursing care to the patient with renal impairment and diabetes mellitus. As for the methodology, we opted for a bibliographic review by searching in Latin American and Caribbean Health Sciences (Lilacs), Scientific Eletronic Library Online (Scielo) and Nursing Database (BDEF). and Discussion: It was observed that diabetes is a chronic disease that is characterized by changes in glucose metabolism, whether by poor insulin production-type 1, or by resistance to its action, as it has happened in type 2. That the performance of nursing in the care of patients with diabetes mellitus and chronic renal failure is critical, where the professional employs a systematization of nursing care ensuring the patient a whole and individualized care. It is concluded that the nursing team should act in the promotion of health and/or prevention of diseases such as diabetes and their comorbidities. Also, it was observed in this review that the actions of permanent education and orientation of patients for self-care should be intensely promoted by nurses, among this population who, because they have diabetes mellitus, are pre-discredted the risk factors for development of chronic renal failure.

Adverse effects resulting from the use of zolpidem hemitartrate: A literature review

Objective: To investigate and discuss the risks associated with the use of the drug in order to clarify the possible damage to health. Methods: Through an integrative review, using the guiding question “What are the main adverse effects and impacts of using zolpidem?”. The search was carried out in the main databases: Latin American and Caribbean Health Sciences Literature (LILACS), Medical Literature and Retrieval System onLine (MEDLINE/PubMed®), Periódicos CAPES and Scientific Electronic Library Online (Scielo). MESH (Medical Subject Headings) and DeCs (Health Sciences Descriptors) were used as descriptors in the search strategy. The search strategy followed the criteria of the Boolean operator “AND”, which combines terms. The terms used were zolpidem “AND” adverse effects AND overdose, during the month of September 2024. Results: Zolpidem is a drug of paramount importance for the treatment of cases of insomnia, and long-term medical therapy should be monitored to assess efficacy, the emergence of adverse effects and the onset or worsening of comorbid conditions. Conclusion: Strict prescription control and continuous evaluation of its impact on patients' physical and mental health are essential to avoid abuse and serious complications.

Hypnosis for depression: Systematic review of randomized clinical trials with meta-analysis

IntroductionMajor Depressive Disorder (MDD) is one of the most debilitating diseases worldwide and has seen a significant increase in diagnoses during the pandemic, demanding more and better therapeutic tools to manage the post-pandemic scenario. ObjectiveThe aim of this systematic review is to provide a comprehensive analysis of the last 20 years of clinical research on Hypnotherapy (HT) to determine whether this intervention has evidence to support its recommendation for the treatment of MDD. MethodsThis review included only randomized clinical trials (RCTs) involving adult populations diagnosed with MDD, regardless of the severity level (mild, moderate, or severe) according to any validated diagnostic criteria, compared to a control group (active treatment or none), with any follow-up duration and free access to the manuscript. The bibliographic survey was conducted across seven distinct databases: MEDLINE (PubMed), Embase, CENTRAL, PsycINFO, Scopus, ScieELO, and Latin American and Caribbean Health Sciences Literature (LILACS). The risk of bias was assessed by two independent investigators using Cochrane's revised tool (RoB 2), and the final judgment was made by consensus. To better analyze the included studies, the certainty of the evidence was evaluated through the Grading of Recommendations Assessment, Development and Evaluation (GRADE). ResultsThere is not enough evidence to indicate that hypnosis-based interventions may reduce the severity of depression, which precludes the clinical recommendation of this intervention for patients in the real world, pending the production of better evidence of effectiveness and safety, although no evidence of significant adverse effects was found.

Use of Lasers in the Nonsurgical Treatment of Peri-Implantitis: A Systematic Review of the Literature.

Peri-implantitis is an infectious disease that causes inflammation of the tissue surrounding an implant. The aim of this systematic review of the literature is to assess the effect of the use of lasers in the nonsurgical treatment of peri-implantitis in order to estimate its benefits compared with conventional therapies. The review's protocol has been registered on PROSPERO international prospective register. The research strategy was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The inclusion criteria were as follows: in vivo studies, written in English, measurements of clinical parameters, minimum follow-up at 6 months and with nonsurgical control group, studies about photodynamic therapy, randomized clinical trial, and clinical trial. Electronic (on PubMed, Cochrane, Latin American and Caribbean Health Sciences Literature, and Report Evidence-based Practice Centers databases) and manual searches (in articles' references) were conducted until July 2021. Risk of bias was assessed for each reference thanks to the Cochrane Collaboration's tool. A total of 12 randomized clinical trials, with a high level of evidence, were selected and investigated in this systematic review. A table summarizes data extracted from these articles. It appears that the parameters improve favorably by using lasers, but without any significant difference. In accordance with the analysis of studies, our results show that laser therapy with specific characteristics allows to obtain beneficial therapeutic effects on wound healing in the short and the medium-term concerning the clinical parameters in the nonsurgical treatment of peri-implantitis. Concerning its long-term usefulness, it has yet to be confirmed. However, its benefits remains limited since the results agree that the effects of the laser are similar to those obtained by using conventional therapy.

Adaptation of WHO COVID-19 guidelines by Caribbean countries and territories.

The normative role of the World Health Organization (WHO) involves creating evidence-based, principled guidelines to guide its Member States in making well-informed public health decisions. While these guidelines often need to be adapted to ensure contextual relevance, foster better implementation and adherence, adapting existing guidelines is more efficient than creating new ones. Here we describe the adaptation of the WHO coronavirus disease 2019 (COVID-19) living guideline on pharmacological interventions for the Caribbean using the grading of recommendations, assessment, development and evaluation (GRADE)-ADOLOPMENT method. The Caribbean Public Health Agency and the Pan American Health Organization led the effort, assembling a diverse panel of 16 experts from seven Caribbean countries and territories. The adaptation process, involving 15 steps, was guided by an experienced methodologist and included selecting relevant clinical questions and prioritizing them based on regional needs. The panel evaluated the latest WHO guidelines and integrated additional local data. They adjusted the direction and strength of several recommendations to better fit the Caribbean context, considering local values and preferences, resources, accessibility, feasibility and impact on health equity. Ultimately, we changed the direction of two recommendations and the strength of five, tailoring them to regional realities. This effort highlights the importance of adapting global guidelines to local settings, improving their applicability and effectiveness. The adaptation process also serves as a valuable opportunity for skill transfer and capacity-building in guideline development. Continued research is needed to assess the impact of these adaptations on health-care outcomes in the Caribbean.

Etiology, Epidemiology And Methods Of Preventing Sudden Death Of Cardiac Origin In Sports

Introduction: Numerous epidemiological studies have consistently shown an association between moderate aerobic exercise and decreased risk of coronary heart disease (CHD) and death, and even a small amount of exercise provides a significant reduction in risk compared to a sedentary lifestyle Objective: The aim of this study was to identify the etiology, epidemiology and prevention of sudden cardiac death in sports. Methodology: The methodology used was a literature review. The research was carried out by means of an electronic search for scientific articles published on the Scielo (Scientific Electronic Library Online) and Lilacs (Latin American Health Sciences Literature) and Pubmed websites. The health terminologies consulted in the Health Sciences descriptors (DeCS/BIREME) were used; the etiology, epidemiology and ways of preventing sudden cardiac death in sports practices. Discussion: An important distinction must be made between hypertrophic cardiomyopathy and “athlete's heart syndrome”. In this syndrome, intense physical training leads to various morphological and physiological alterations, especially left ventricular hypertrophy. Conclusion: The complete health safety of athletes consists of periodic pre-participation clinical assessment as well as emergency measures, mainly in competition venues, consisting of the availability of health professionals

Newborn Hearing Screening Success… Patient Care Failure.

To assess the efficacy of a newborn hearing screening program in an urban hospital 24 years after a longitudinal study identified failings in its program and recommended solutions. A hospital-specific, Pennsylvania database was queried to determine rates of in-hospital testing, referral, and diagnosis for Temple University Hospital (TUH), and to compare these with reporting sites statewide. At TUH, interviews with newborn hearing screeners and audiologists were conducted to identify barriers to care. In the year 2022, 2,006/2,069 newborns (97%) were successfully screened prior to hospital discharge at TUH. (63 babies were never tested). There were 73 who did not pass automated auditory brainstem response testing (ABR) in at least one ear. All of these 73 infants returned for repeat automated ABR testing and 50/73 passed in both ears. 23/2006 (1%) were referred to diagnostic testing. 13/23 were successfully scheduled. 11/23 passed in both ears. 2/13 were found to have hearing losses. 10 infants (43%) were lost to follow-up and were never diagnosed. Examining lost-to-follow-up rates statewide, we identified a relationship between successful follow-up and local median family income. Legislation on the state level and improvements in audiometric technology have led to highly successful in-hospital screening with relatively low false-positive rates. Despite this, inadequate outpatient follow-up testing and inequities in the American health care system continue to delay audiometric diagnosis and habilitation of congenital hearing loss. Lack of transportation, childcare for siblings, and newborn insurance status impede access to diagnostic testing. Level 3 evidence-retrospective review comparing cases and controls. Laryngoscope, 2024.

Forensic Psychiatry Analysis and Methods for Assessing The Mental Health of A Serial Killer.

Psychosis is a mental illness that causes an alteration in the notion of reality, where a world of its own is formed in the mind of the psychotic, in other words, he lives in a delirium and suffers hallucinations, hearing voices and having bizarre visions. Objectives: To carry out a literature review on Forensic Psychiatry and how to assess the mental health of a serial killer. Method: The methodology used was a literature review. The research was carried out by means of an electronic search for scientific articles published on the Scielo (Scientific Electronic Library Online) and Lilacs (Latin American Health Sciences Literature) and Pubmed websites. The health terminologies consulted in the Health Sciences descriptors (DeCS/BIREME) were used; regarding Forensic Psychiatry and how to assess the mental health disorder of a serial killer.The inclusion criteria were: original article, published in Portuguese and English, freely accessible, in full, on the subject, in electronic format and published in the last years (2010 to 2024), totaling 26 articles. Results and Discussion: While antisocial personality disorder is a medical diagnosis, the term “psychopathy”, which belongs to the psychiatric-forensic sphere, can be understood as a “legal diagnosis”. There is still no effective treatment for so-called “serial killers”. Conclusion: Personality disorders, especially the antisocial type, still represent a real challenge for forensic psychiatry today. The most appropriate and fair place for its sufferers, as well as homogeneous treatment recommendations, are still unanswered questions.

Assessing mental health professionals’ attitudes toward routine outcome monitoring across Eastern and Western cultures: an examination of invariance and latent mean differences†

Objective To investigate the attitudes of mental health professionals towards Routine Outcome Monitoring (ROM) in Eastern and Western cultures. Method Two samples of American (N = 455) and Chinese (N = 505) mental health professionals completed the prevalent Monitoring and Feedback Attitudes Scale (MFA). We tested the measure’s psychometric characteristics, measurement invariance, and latent mean difference across cultures. Results Confirmatory factor analysis (CFA) found a two-factor structure of the MFA within both cohorts. The MFA subscales showed excellent internal consistency in both the Chinese and American samples. The MFA demonstrated partial scalar invariance between the two cultural groups, supporting the comparison of latent means among Chinese and American professionals. Chinese professionals perceived greater harm from ROM than their American counterparts. Conclusions The findings show that the MFA is a valid tool to evaluate and compare the US and Chinese mental health professionals’ attitudes toward ROM, suggesting that the measure may be useful in both Eastern and Western cultures.

Sentinel surveillance in bacterial pneumonia in children under 5 years old in a fourth-level pediatric hospital in Colombia 2016-2022

ObjectivesSentinel surveillance for bacterial pneumonia (SSBP) allows the monitoring of immunopreventable diseases. The results of the SSBP carried out at HOMI, Fundación Hospital pediátrico de la Misericordia, are presented. MethodsThe daily active search for cases was carried out in accordance with the protocol of the Pan American Health Organization from January 2016 to December 2022. ResultsThere were 6970 suspected cases of bacterial pneumonia (BP). Among the 3048 (43.7%) patients with probable BP, cultures were obtained from 2777 (91.1%), and BP was confirmed in 190 (6.2%). The causes were Streptococcus pneumoniae in 98 (51.6%) cases, Spn19A in 47 (48%), Spn3 in 16 (16%), and Spn6C in 4 (4%). Haemophilus influenzae was found in 32 (16.8%) cases: non-typeable H. influenzae in 20 (62.5%), H. influenzae type b in five (15.6%), and H. influenzae type a in two (6.2%). Other bacteria were found in 60 (31.6%) cases. A total of 51.6% and 42.9% of patients with S. pneumoniae had decreased sensitivity to penicillin and ceftriaxone, respectively. ConclusionsThe serotypes included in the conjugate vaccines for pneumococcus and H. influenzae b decreased significantly, and serotype turnover was observed. Among the S. pneumoniae cases, Spn19A, Spn3, and Spn6C were the most frequent serotypes and associated with multiresistance. The SSBP allows us to determine the clinical behavior of the disease and to detect the serotypes emergence.

FATORES ASSOCIADOS À QUALIDADE DE VIDA DE CUIDADORES DE IDOSOS COM DEMÊNCIA

The objective of this study was to analyze the factors that influence the quality of life of caregivers of elderly people with Alzheimer's dementia. An integrative literature review study was conducted using the secondary databases Virtual Health Library, Latin American and Caribbean Health Sciences Literature, Scientific Electronic Library Online and Online System for Search and Analysis of Medical Literature based on the specific descriptors retrieved in the Health Sciences Descriptors. The factors associated with the quality of life of caregivers of elderly people with Alzheimer's dementia were burden, functional decline and dependence of the elderly to perform activities of daily living, degree of dementia severity, longer time since diagnosis and living with the demented elderly, socioeconomic conditions, psychological stress and decline in social relationships, environment domain, psychological and physical. It is essential that care is also cared for, both from the point of view of health and in relation to public policies of social security and assistance.

FATORES ASSOCIADOS AOS TRANSTORNOS MENTAIS COMUNS ENTRE PROFESSORES

Objective: To identify the main common mental disorders identified among teachers. Materials and methods: This is a literature review with research in several virtual libraries, such as the nursing database (DENF), Latin American and Caribbean Health Sciences Literature (LILACS) and Scientific Electronic Library Online (SciELO). Results: Stress is one of the most common problems faced, characterized by a state of permanent tension, causes an intense imbalance in the body, which can trigger several serious diseases. Conclusion: The lack of motivation to work is one of the main factors that lead many teachers to look for other jobs and suffer from mental illnesses. The revaluation of education professionals, together with better salaries and a decent workload, would lead to a greater demand for the area and a better quality of life.

The Fractured Insurance Landscape of Laser Therapy for Scar Revision.

Fractional laser therapy improves skin texture, range of motion, and quality of life for patients with traumatic scars. Nevertheless, anecdotal evidence suggests declining insurance coverage for laser therapy. We aimed to characterize the landscape of insurance coverage for fractional laser therapy present our six-year reimbursement trends. We cross-sectionally analyzed the 60 largest American health insurers by enrollee size and market share. For each, we identified their laser therapy policy for scar revision and extracted their documentation, prior, and continuing authorization requirements and treatment guidelines. We also collected retrospective institutional claims data from 2017 to 2022 to investigate trends in reimbursement. Of the 60 largest health insurers, we identified 11 (18.3%) policies on scar revision and 40 policies (66.7%) on reconstructive surgery, including scar revision. Nineteen policies considered laser therapy medically necessary with evidence of functional impairment refractory to prior treatment. Three insurers denied laser coverage under any circumstance. Of the 1,531 claims submitted by our institution for burn scar laser therapy, 13.8% were denied. Patients with Medicare (ORadj, 3.78) or Medicaid (ORadj, 2.80) had significantly greater odds of coverage than privately insured patients (p<0.01). There was a 14.5% annual reduction in the odds of reimbursement during the study period (ORadj, 0.86, p < 0.01). Laser therapy is a powerful treatment that is not widely available to patients with traumatic scars. Our institutional data suggest this access may be further eclipsed by decreasing trends in coverage since 2017. Strategies are needed to protect patient access to this life-changing treatment.

A Cross-Sectional Analysis of American Insurance Coverage of Upper and Lower Lid Blepharoplasty.

Dermatochalasis is a common condition that can cause obstruction of peripheral visual fields and impairment of daily activities. These effects can be addressed with a blepharoplasty, which may be considered a cosmetic procedure by American health insurers. The authors assessed insurance coverage of all indications of blepharoplasty and their medical necessity criteria. A cross-sectional analysis was conducted of 70 insurance policies for blepharoplasty. The insurance companies were selected based on their state enrollment and market share. A web-based search and telephone interviews were utilized to identify the policies. Medically necessary criteria were extracted from the publicly available policies. Of the 70 insurance policies assessed, 67 (96%) provide coverage for blepharoplasty. There were 7 indications for coverage, the most common being dermatochalasis causing functional visual impairment (n = 56, 80%), prosthesis difficulties in an anophthalmic socket (n = 44, 63%), and congenital ptosis (n = 38, 54%). Of companies that indicated coverage for dermatochalasis, 95% required visual field loss testing to qualify for coverage. Significantly more companies required a 30% loss in the superior visual field for coverage versus the literature-recommended amount of 24% loss (n = 14 versus n = 3, 26% versus 6%, P = 0.0067). There is a great discrepancy in insurance policy criteria for coverage of blepharoplasty, especially regarding requirements for visual field testing. Unfortunately, this disparity does not reflect the current literature as to whom may gain significant functional benefit from blepharoplasty.