[Source: Malmstrom Air Force Base, Mt | Airman 1st Class Daniel Brosam | September 22, 2016 ++]

[Source: Malmstrom Air Force Base, Mt | Airman 1st Class Daniel Brosam | September 22, 2016 ++]

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Vision loss due to cataracts is usually very gradual. This gradual loss of vision is the only symptom. Cataracts are not painful and do not cause burning or other similar symptoms. Vision becomes increasingly blurry and dull: Things appear as if seen through a veil or fog. Contrasts and colors become less clear as time goes on. Some people become very sensitive to the glare of the sun or other bright lights. Driving becomes more difficult, particularly at night. Poor vision increases the risk of falling and getting hurt. Spatial vision is affected as well. But cataracts may have surprising effects too: Sometimes people who wear glasses can suddenly see better without them. This is because the refractive power of their eye changes, affecting their ability to focus on objects at different distances. Improved vision without glasses does not last long, though.

About 90% of people who have a cataract have what is called a "senile" cataract. Here, the gradual clouding of the lens is caused by aging. Normally, the lens bends light and focuses it onto the retina (the back of the eye) to create sharp images. This makes it possible to see objects clearly, both close and far away. Cataracts affect this ability. Some people are born with a higher risk of developing cataracts. Ultraviolet light (UV light) and smoking are believed to increase the risk. Cataracts are more common in people who have diabetes too. In developing countries they are often caused by malnutrition and poor living conditions, and many people are already affected earlier in life. Cataracts can also develop following an inflammation or injury to the eye. Eye surgery and some steroid medications can lead to cataracts too.

Cataracts cause your vision to gradually worsen. At first you become more short-sighted. As mentioned above, people who used to be far-sighted might then find that they can see better without glasses for a short while. But their vision will gradually become more cloudy and blurred. If left untreated, cataracts can lead to blindness but this does not always happen. Both eyes are usually affected. The condition might progress more quickly in one eye than in the other, though. Its natural course can vary quite a bit. It can lead to quite sudden vision loss in some people, but hardly affect vision in others. The type and progression of symptoms depends on various things, including what area of the lens is cloudy. There are three main types of cataracts:

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  Cortical cataracts: Apart from causing blurred vision, this type of cataract leads to problems with glare in particular, for instance when driving at night.
  
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  Posterior subcapsular cataracts: This type of cataract is more common in younger people and progresses relatively quickly.
  
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  Nuclear cataracts: These cataracts affect your ability to see things in the distance more than your ability to see nearby objects. Vision is sometimes affected only a little, and the condition progresses relatively slowly.
  

There are many reasons why your vision may get worse over time. Because of this, other possible causes need to be ruled out before cataracts can be diagnosed. Your eye doctor (ophthalmologist) will first ask you about your symptoms and your general medical history. You will have a few eye tests done to find out how much your eyesight is affected and what might be causing the symptoms. The lens of the eye is examined using a slit lamp (a microscope with a light). The doctor looks at the eye through the microscope with the help of a line – or slit – of light that shines onto your eye. This makes it possible to take a close look at the lens and the parts of the eye behind the lens. This examination is not painful. In order to look at the back of the eye, doctors usually use medication to dilate (widen) your pupils. The pupils stay dilated for a few hours. During this time it is difficult to focus properly and you will be more sensitive to light and glare. For this reason, you should not drive a car for the next four to five hours. This effect can last longer in some people. If you're not sure whether your eyes have returned to normal, it's better not to drive.

There are no known scientific studies showing that particular preventive measures lower the risk of developing cataracts. It is thought that smoking increases the risk and that quitting smoking could therefore lower the risk. Stopping smoking has a lot of health benefits anyway. People who are exposed to a lot of UV light can protect their eyes from the sun, for instance by wearing sunglasses. Some steroid medications can increase the risk of developing cataracts. It might be possible to switch to a different medication. Dietary supplements are often claimed to be able to prevent eye diseases, but research has shown that this is not the case for cataracts.

Some people can compensate for the vision loss, temporarily or even in the longer term, by wearing glasses or contact lenses. There are no medications for the treatment of cataracts. The only effective treatment is surgery. Cataract surgery involves removing the cloudy lens and replacing it with a new, artificial lens. The lens capsule – an elastic membrane surrounding the lens of the eye – is left in the eye during surgery. Only the inner core and the outer cortex of the lens are broken up into small pieces using ultrasound. The pieces are then sucked out of the eye through a small cut. This procedure, called phacoemulsification, is the standard technique in Germany and some other countries. Once the lens has been removed, an artificial lens is implanted into the lens capsule. Whether and when surgery is an appropriate treatment option is very much a personal decision. The extent to which vision loss is affecting someone’s life will play a very important role. Another factor to consider is the presence of other (eye) conditions, which could affect the outcome of cataract surgery.

• 
  Stand on one foot -- https://go4life.nia.nih.gov/exercises/stand-one-foot --
  
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  Walk heel to toe -- https://go4life.nia.nih.gov/exercises/heel-toe-walk
  
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  Walk in a straight line with one foot in front of the other -- https://go4life.nia.nih.gov/exercises/balance-walk
  

A number of lower-body exercises – especially those that strengthen your legs and ankles – also can help improve your balance. These include the following exercises:

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  Back leg raise -- https://go4life.nia.nih.gov/exercises/back-leg-raise
  
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  Side leg raise -- https://go4life.nia.nih.gov/exercises/side-leg-raise
  
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  Knee curl -- https://go4life.nia.nih.gov/exercises/knee-curl
  
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  Toe stand -- https://go4life.nia.nih.gov/exercises/toe-stand
  

As you progress in your exercise routine, try adding the following challenges to help your balance even more:

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  Start by holding on to a sturdy chair with both hands for support. Note: In the beginning, using a chair or the wall for support will help you work on your balance safely.
  
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  When you are able, try holding on to the chair with only one hand.
  
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  With time, hold on with only one finger, then with no hands at all.
  
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  If you are really steady on your feet, try doing the balance exercises with your eyes closed
  

[Source: National Institute on Aging Daily Digest Bulletin | September 19, 2015 ++]

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  Strength exercises can help maintain or add to your muscle strength. Strong muscles support and protect joints. Weight-bearing exercises include using resistance bands or weighted wristbands.
  
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  Endurance exercises make the heart and arteries healthier and may lessen swelling in some joints. Low-impact endurance exercises include swimming and bicycling.
  
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  Flexibility exercises help to keep joints moving, relieve stiffness, and allow for more freedom of movement for everyday activities. Flexibility exercises include upper- and lower-body stretching, yoga, and tai chi.
  

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  Skilled nursing care is covered by TRICARE in the U.S. and U.S. Territories within skilled nursing facilities if you have a hospital stay of three or more days. Remember, you are an outpatient until the doctor formally admits you into the hospital. You become inpatient on the day you’re formally admitted to a hospital with a doctor’s order. The day of discharge also doesn’t count as an inpatient day. Some services covered in a skilled nursing facility include: semi-private rooms, meals, physical and occupational therapy, speech-language pathology services, and ambulance transportation, when other transportation is dangerous to your health, to the nearest care not available at the facility.
  
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  If you can stay home, but still need assistance, you may decide home health care is best for you. Home health care is provided by nurses, nurses’ aides, or therapists who come into your home to help you with medication or other services. Physical, speech and occupational therapists can visit to help you function better. Medical social service workers can visit to make sure you receive proper care. Coverage is the same as Medicare for these services.
  
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  Hospice Care is care for those who are terminally ill. It emphasizes supportive services such as pain control and home care. When you choose hospice care, you've decided that you no longer want care to cure your terminal illness and/or your doctor has determined that efforts to cure your illness aren't working.
  

TRICARE and Medicare do not cover assisted living facilities or long term care. Remember, long term care is care that you need if you can no longer perform everyday tasks by yourself due to a chronic illness, injury, disability or the aging process. Plan ahead and research long-term care insurance, like the Federal Long Term Care Insurance Program before you need it.

Before making an appointment with the specialty care provider, call your regional contractor 3-5 days after your primary care manager enters the referral to check the status. If you are overseas and are referred to a host nation provider, be sure to coordinate your care through your overseas call center.

-- His/her residence, other than because of military assignment, in the territorial jurisdiction of the court;

-- His/her domicile in the territorial jurisdiction of the court; or

-- His/her consent to the jurisdiction of the court.

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  Status checks. Lenders will independently check a borrower's military member/family member status. In the nine years since implementation of the narrower rules, some borrowers were not being truthful about their military status in order to get access to these quick, but often expensive, loans. Now, lenders will either check the Defense Department’s Defense Manpower Data Center database or one of the nationwide credit reporting agencies, which will also have access to the DoD database. The information on a borrower’s military status is not a permanent part of the borrower’s credit report, according to Lori Dietrich, director of product management for Experian, one of the national credit reporting agencies. Lenders will request the information when asking for a credit report, or they can also ask for the information without asking for a credit report. Experian will charge a “nominal fee” to lenders for pulling the information, according to Dietrich. Whether that cost is passed on to the borrower depends on the lender.
  

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  Lender disclosures. Lenders must provide written and oral disclosures to the borrower about the Military APR and the payment obligations.
  

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  Fewer options — maybe. Generally, most loans will be under that Military APR of 36 percent. But troops and families might not be eligible for certain loans now — if all the fees bring the Military APR calculation to more than 36 percent. The Military APR calculation has to include application fees and certain other fees that are legal and charged to other borrowers, but aren’t required to be included in the calculation of other non-military borrowers’ APRs under the Truth in Lending Act. When there are these fees, the Military APR may be higher than the regular APR. The costs and effects will vary, depending on the financial institution. “These are good protections for the service member. [The new rules] have had minimal impacts on the products we offer,” said Tom Kientz, chief operating officer of Armed Forces Bank, which operates 48 branches on 25 military installations in 15 states. “I wouldn’t be surprised if it led more service members back to traditional banks,” he said, since the high-cost lenders will no longer be available for troops. But some banks have been eliminating some products, or have decided not to offer certain loans, to these covered military borrowers, said Nessa Feddis, vice president and senior counsel for the American Bankers Association’s Center for Regulatory Compliance. Small-dollar loans will be difficult for banks to offer, she said. One large bank, and some others, have decided to eliminate car refinancing loans, she said.
  

Some have expressed concerns about unintended consequences from rules that are based on good intentions. The full effects remain to be seen, said Steven Lepper, a retired Air Force major general who is president and CEO of the Association of Military Banks of America, which represents banks that have branches on military bases. “What I’m hoping as a veteran, and as a person who represents military banks, is that an effect of the [new rules] will not be to reduce lending to military members,” he said. Having seen the effects of financial products on service members during his career, Lepper said, “I’m really passionate about providing military members responsible sources of lending. You can’t deny that military members often will need to borrow money. If they borrow from payday lenders, they only get themselves into deeper holes.

1. Go to the DFAS website www.mypay.dfas.mil

2. Click on the “Forgot or Need a Password?” link and enter your Login

3. Choose to send a temporary password to your email and go back to mypay.dfas.mil and log in to activate your account

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  Social Security number
  
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  Online login or password
  
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  Debit or credit card number
  
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  Bank account information
  
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  Driver's license information
  
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  Children's personal information
  
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  OPM breach (Office of Personnel Management)
  
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  IRS breach (Internal Revenue Service)
  

[Source: Nextgov | Heather Kuldell | September 22, 2016 ++]

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  A sergeant with dependents who is stationed at Fort Bragg, North Carolina, receives $1,236 a month in BAH, compared with $1,053 without dependents, according to the Defense Department’s BAH calculator.
  
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  A captain with dependents at Fort Bragg receives $1,488 compared with $1,344 without.
  
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  A sergeant with dependents at Joint Base Lewis-McChord, Washington, receives $1,635 a month in BAH, compared with $1,281 for a single soldier.
  
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  A JBLM-based captain with dependents receives $1,941 in BAH a month, compared with $1,701 for one without dependents.
  

If you are not sure if your paperwork is in order, here’s what you must do: Check your leave and earnings statement against iPERMS, or the Personnel Electronic Records Management System, then go see your human resources specialist. In many cases, the required paperwork could be as simple as a marriage license or a divorce decree or a birth certificate, Riley said. The problem isn’t just BAH. The Army has been trying for the last three years, following a scathing audit by the Government Accountability Office, to make sure all soldiers’ financial documents are up-to-date. “We’ve got to be able to prove that every soldier is entitled to all payments they receive,” Riley said. “From base pay to his subsistence allowances to his housing allowances, everything has to be supported by a document.”