Aetna considers external ocular photography medically necessary for the following indications to track and serially compare the changes of the condition, where the results may have an impact on management and clinical outcomes:

• Acid chemical burn of cornea and conjunctival sac
• Acute inflammation of orbit, unspecified
• Adherent leucoma
• Adhesions of iris, unspecified
• Alkaline chemical burn of cornea and conjunctival sac
• Anterior dislocation of lens
• Anterior pigmentation
• Anterior synechiae
• Argentous deposits
• Band-shaped keratopathy
• Benign neoplasm of conjunctiva
• Benign neoplasm of cornea
• Benign neoplasm of eye, part unsepcified
• Benign neoplasm of eyeball, except retina and choroid
• Benign neoplasm of eyelid, including canthus
• Benign neoplasm of lacrimal duct
• Benign neoplasm of lacrimal gland
• Benign neoplasm of orbit
• Benign neoplasm of other specified parts of eye
• Benign neoplasm of skin of other and unspecified parts of face
• Blisters, with epidermal loss due to burn (second degree) of eye (with other parts of face, head, and neck)
• Bullous keratopathy
• Burn of unspecified degree of eye (with other parts of face, head, and neck)
• Burn with resulting rupture and destruction of eyeball
• Carcinoma in situ of eye
• Carcinoma of eyelid, including canthus
• Central corneal ulcer
• Central opacity of cornea
• Chemical burn of eyelids and periocular area
• Constant exophthalmos
• Corneal abscess
• Corneal deformity, unspecified
• Corneal degeneration, unspecified
• Corneal deposit, unspecified
• Corneal dystrophy, unspecified
• Corneal ectasia
• Corneal edema due to wearing of contact
• Corneal edema, unspecified
• Corneal membrane change, unspecified
• Corneal neovascularization, unspecified
• Corneal opacity, unspecified
• Corneal staphyloma
• Corneal ulcer, unspecified
• Deep necrosis of underlying tissues due to burn (deep third degree) of eye (with other parts of face, head, and neck), without mention of loss of body part
• Deep necrosis of underlying tissues due to burn (deep third degree) of eye (with other parts of face, head, and neck), with loss of a body part
• Deep vascularization of cornea
• Degeneration of pupillary margin
• Degenerative changes of chamber angle
• Degenerative changes of ciliary body
• Descematocele
• Diffuse interstitial keratitis
• Double pterygium, to follow in lieu of surgery
• Endothelial corneal dystrophy
• Erythema due to burn (first degree) of eye (with other parts face, head, and neck)
• Essential or progressive iris atrophy
• Exophthalmic ophthalmoplegia
• Exophthalmos, unspecified
• Exudative cysts of iris or anterior chamger
• Folds and rupture of Bowman's membrane
• Folds in Descemet's membrane
• Full-thickness skin loss due to burn (third degree NOS) of of eye (with other parts of face, head, and neck)
• Goniosynechiae
• Granular corneal dystrophy
• Herpes simplex disciform keratitis
• Herpes zoster keratoconjunctivitis
• Hyphema
• Hypopyon
• Hypopyon ulcer
• Idiopathic corneal edema
• Idiopathic cysts
• Implantation cysts
• Interstitial keratitis, unspecified
• Iridoschisis
• Juvenile epithelial corneal dystrophy
• Kayser-Fleischer ring
• Keratoconus, acute hydrops
• Keratoconus, stable condition
• Keratoconus, unspecified
• Keratomalacia NOS
• Late effect of other and unspecified external causes
• Lattice corneal dystrophy
• Limbar and corneal involvement in vernal conjunctivitis
• Localized adhesions and strands of conjunctiva
• Localized vascularization of cornea
• Macular cornela dystrophy
• Malignant neoplasm of conjunctiva, unless excision is planned
• Malignant neoplasm of the cornea, unless excision is planned
• Marginal corneal ulcer
• Minor opacity of cornea
• Miotic cysts of pupillary margin
• Mooren's ulcer
• Mycotic corneal ulcer
• Neurotrophic keratoconjunctivitis
• Nodular degeneration of cornea
• Orbital cellulitis
• Other and unspecified superficial injuries of eye
• Other anterior corneal dystrophies
• Other burn of cornea and conjunctival sac
• Other burns of eyelids and periocular area
• Other calcerous degeneration of cornea
• Other corneal degenerations
• Other deposits associated with metabolic disorders
• Other disorders of iris and ciliary body
• Other forms of keratitis
• Other prosterior corneal dystrophies
• Other stromal corneal dystrophies
• Pannus (corneal)
• Perforated corneal ulcer
• Peripheral degenerations of cornea
• Peripheral opacity of cornea
• Peripheral pterygium, progressive, to follow in lieu of surgery
• Phacolytic glaucoma
• Phlyctenular keratoconjunctivitis
• Pigmentary iris degeneration
• Posterior dislocation of lens
• Posterior pigmentations
• Posterior synechiae
• Pseudopterygium
• Pterygium, unspecified, to follow in lieu of surgery
• Ptosis of eyelid
• Pupillary abnormalities
• Pupillary membranes
• Recession of chamber angle
• Recurrent erosion of cornea
• Recurrent pterygium, to follow in lieu of surgery
• Ring corneal ulcer
• Rubeosis iridis
• Rupture in Descemet's membrane
• Sclerosing keratitis
• Secondary corneal edema
• Stromal pigmentations
• Subluxation of lens
• Superficial injury of conjunctiva
• Superficial injury of cornea
• Superficial injury of eyelids and periocular area
• Symblepharon
• Thyrotoxic exophthalmos
• Unspecified burn of eye and adnexa
• Unspecified corneal disorder
• Unspecified disorder of iris and ciliary body
• Unspecified keratitis
• Vascular anomalies of eyelid.

External ocular photography has no proven value for other indications (e.g., evaluating conjunctival hemorrhage, and monitoring pinguecula).

Aetna considers external ocular photography not medically necessary for the sole purpose of documenting the existence of an ocular condition in order to enhance the medical record.

External ocular photography can be used to document the progress or deterioration of certain conditions of the external structures of the eye including the eyelids, lashes, sclerae, conjunctiva and cornea.  It may also be used to document progress and deterioration of structures of the anterior chamber including the iris, and filtration angle.  These photographs are commonly made using slit lamp photography, goniophotography, stereophotography or close-up photography.  Regardless of the technique used for the picture taking, the pictures may be stored as prints, slides, videotape or digital medium.

External ocular photography is clinically useful for tracking slowly progressive conditions over prolonged periods of time, where it may be impractical to document progression with hand drawings due to the need to document fine detail, especialy where there is a lack of anatomic landmarks.