Bad optometrist?

[pathologyDO]

So first off, I am a 2nd year medical student and so I have some experience practicing interviewing standardized patients and feel like this doctor completely sucked at showing any empathy or partnering with me to gain her trust.... anyways..

Today I feel both angry and embarrassed after going to see a local optometrist located right next to a Target (not sure if technically a Target optometrist or not). I've been trying to get my contacts fitted for the past couple weeks and have been in 4 times now. The first time they did the whole "fitting" and then gave me a couple boxes, one of dailies and another of monthly to try - and then had me go home to test them out, never did any testing while I was wearing them to see if they were the right fit while I was there.

So I came back after a week because they were irritating my eyes and it felt like there was an eyelash in my eye, plus they were sliding around. A different optometrist gave me a different brand with different curvature to try out and sent me home, no testing with contacts in while I was there. Those felt even worse and slid around even more than the previous pair so after a couple more days I show up again, this time yet another new optometrist was there and gave me yet another type and again sent me home without testing them while I was there (makes 4 types I have tried at this point). That leads me to today...

I came in today frustrated and a little bit irritated that I have yet to get contacts that fit - I just want a pair that fits, and as a medical student I understand how patients can get annoying and may just be "picky" but I am legitimately not being so, I feel like my current lens isn't fitting correctly and it is bugging me. This current set the right eye feels perfect, but my left eye still has the eyelash in eye type of feeling as well as a little sliding, but not quite as much as previous lenses.

The optometrist was the original lady who did my fitting and lacked any empathy whatsoever... after telling her about my troubles with my current trial lenses she proceeds to not empathize or acknowledged how irritating this is, but she asks me questions like "are you sure you are using the right contacts, not other boxes?" and "are you sure you are putting the lenses in the right way?" After telling her "yes, I have been very mindful about putting certain ones in and if they are the proper side," she tells me that these will just have to do because no contacts are going to fit perfect and a little irritation is OK and will not harm my eyes unless they fit very badly.

So she didn't acknowledge my anger and irritation about having to continue going back to see her at all, managed to turn it around and suggest to me that I was the problem, and then disregarded how the left contact feels on my eye and told me to deal with it and wrote me a prescription for the ones I am currently using (again, despite my left eye not fitting well like my right eye is).

PHEW I know that was long winded and I'm sorry, but again I feel embarrassed and crappy that a doctor just ignored my feelings about having to do this so many times, and also ignoring how the current ones still don't feel quite right.

Is this just me being stupid? Is this is a bad optometrist?

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[KHE]

At the very least you should be given a reason why you are having these issues.

 

[mathcod]

sounds like a bad group of doctors.

 

[Ryan_eyeball]

In the future, I would try to establish care with only one doctor. Inquire if the doctor you are seeing is full time or if you'll be seeing multiple doctors. I personally never like seeing patients on followups that I haven't examined first.

Was this the very first time you've ever worn contacts? Sending patients home with multiple brands of CL's is inevitably a disaster. They never remember which ones worked well. Do you have astigmatism? Almost all astigmatism CL's have some CL awareness from lid interaction. Usually a CL that slides to much is too flat, and parameters need to be readjusted.

Some doctors may lack empathy because they see so much abuse in CL's. We constantly have to re-educate patients about wearing schedules, cleaning cases, not to use tap water, not to sleep in CL's. It can get exhausting.

She may have had some personal issues occurring outside the office. Everyone has a bad day as well. Remember to smile and be thankful that you have vision =) I'm sure you're situation will get worked out.

 

[Mad Jack]

If you see private practitioners they tend to be much better, as their business depends on their customer service skills.

 

[thiaeyemd]

Really tough to monday morning quarterback a patient-doctor experience. I am an ophthalmologist and you will see in your career that not all patients fit with with all doctors. Seems like a bad fit there. In your career you will have patients that you feel you spoke to them appropriately and normal etc.. but may complain or feel you were inappropriate. You may be right but difficult to hear a story about this from one side and make an honest call....

unless you want me to tell you what most people who ask that question want to hear most likely "Yes, that doctor was terrible and you deserve better".

 

[mathcod]

Well, if they never even looked at the trial lens when they put it on you, that's a concern for me. Also there is a big difference in contact lens comfort from cheapo biomedics to ultra or true-eye brands (as well as cost), so I'm not sure if different comfort parameters or fitting parameters were considered; but I do believe that sounds like a bad practice. I've seen toxic doctors, regardless of their specialty, but I rely on my hippocratic oath to trust someone, or if something stinks, get a second opinion.

 

[pathologyDO]

In the future, I would try to establish care with only one doctor. Inquire if the doctor you are seeing is full time or if you'll be seeing multiple doctors. I personally never like seeing patients on followups that I haven't examined first.

Was this the very first time you've ever worn contacts? Sending patients home with multiple brands of CL's is inevitably a disaster. They never remember which ones worked well. Do you have astigmatism? Almost all astigmatism CL's have some CL awareness from lid interaction. Usually a CL that slides to much is too flat, and parameters need to be readjusted.

Some doctors may lack empathy because they see so much abuse in CL's. We constantly have to re-educate patients about wearing schedules, cleaning cases, not to use tap water, not to sleep in CL's. It can get exhausting.

She may have had some personal issues occurring outside the office. Everyone has a bad day as well. Remember to smile and be thankful that you have vision =) I'm sure you're situation will get worked out.

This is a good idea, and I think that seeing the same doctor each time would have solved some of the problem. Yes, these are my first contacts. I can assure you that I kept straight which ones worked and which ones didn't between each visit and conveyed the details to the doctor each time I came back in, but by the time I had came back for a 4th visit it did start to get difficult to remember which worked best. This should honestly be the doctors or assistants job to have documented each time I came back in, although I understand I should be held somewhat accountable for that info too.

This doctor really preached for me to use the daily use contacts and so I said OK lets give those a go. Since that first meeting they have fitted me with different types of daily use CLs and when I told them this last time that the 8.7's were still uncomfortable in one eye, she just wrote me a prescription for them instead of switching me to try out a monthly with different BC. Kindof seems like she is trying to push the daily CLs for some reason - probably monetary reasons if I had to guess, then yet again I'm not sure how the whole contact lens business goes on the optometrist end and if she even gets some type of bonus for handing out samples or writing a prescription for a set of lenses even though the patient clearly stated they were still annoying him.

If you see private practitioners they tend to be much better, as their business depends on their customer service skills.

Bingo. This is what I will do next, it was a terrible idea to try and save a few bucks going to the Target walk-in optometrist.

Well, if they never even looked at the trial lens when they put it on you, that's a concern for me. Also there is a big difference in contact lens comfort from cheapo biomedics to ultra or true-eye brands (as well as cost), so I'm not sure if different comfort parameters or fitting parameters were considered; but I do believe that sounds like a bad practice. I've seen toxic doctors, regardless of their specialty, but I rely on my hippocratic oath to trust someone, or if something stinks, get a second opinion.

They definitely didn't, and until now I didn't even realize that wasn't normal protocol. An optometrist tech of sorts showed me how to put them in and then they setup a followup appointment for 2 weeks, handed me a pack of dailies + a pack of monthlies to test out, then gave me the boot.

When she told me that no lens would fit perfect and then she decided to write me a prescription anyways, I asked her about the dangers of an improperly fitting contact, you know, because I'm worried about that aspect. She said something to the tune of, "oh these are SOFT lenses (strong emphasis on soft), they would have to be fitted REALLY badly to cause any damage to your eye. You would have a massively inflamed eye and it would be very apparent by now if the lenses are going to cause damage." To which I just noded, but felt like that may have not been the most accurate statement on her part. Will a year of even moderately badly fitting contact use not also pose risks to the eye? I dunno.

 

[hello07]

Not seeing any of the CL's on your eyes on how they fit - are they well centered on the eye? do they swim flat or tight steep on the cornea is what I call negligent and irresponsible on their part. I want you to know, the majority of us OD's really do care about our patients vision and try to address every concern. The practitioners from what you are describing if you are correct sound like horrible OD's!
Do you have allergies? Seasonal allergies? Did they bother to invert your upper lids to see if they were clear or have GPC?

No matter what your corneal curvatures are (which they should have been measured) there are multiple CL's out there that fit everyone. There are exceptions if your eyes are really steep and 8.4 8.3 BC still move on you.

It's not Target optometrists that are bad. It was those specific individual OD's working there that were bad.
What lenses did you try out? Brand? Rx? BC? LD?

 

[310]

This is a good idea, and I think that seeing the same doctor each time would have solved some of the problem. Yes, these are my first contacts. I can assure you that I kept straight which ones worked and which ones didn't between each visit and conveyed the details to the doctor each time I came back in, but by the time I had came back for a 4th visit it did start to get difficult to remember which worked best. This should honestly be the doctors or assistants job to have documented each time I came back in, although I understand I should be held somewhat accountable for that info too.

This doctor really preached for me to use the daily use contacts and so I said OK lets give those a go. Since that first meeting they have fitted me with different types of daily use CLs and when I told them this last time that the 8.7's were still uncomfortable in one eye, she just wrote me a prescription for them instead of switching me to try out a monthly with different BC. Kindof seems like she is trying to push the daily CLs for some reason - probably monetary reasons if I had to guess, then yet again I'm not sure how the whole contact lens business goes on the optometrist end and if she even gets some type of bonus for handing out samples or writing a prescription for a set of lenses even though the patient clearly stated they were still annoying him.



Bingo. This is what I will do next, it was a terrible idea to try and save a few bucks going to the Target walk-in optometrist.



They definitely didn't, and until now I didn't even realize that wasn't normal protocol. An optometrist tech of sorts showed me how to put them in and then they setup a followup appointment for 2 weeks, handed me a pack of dailies + a pack of monthlies to test out, then gave me the boot.

When she told me that no lens would fit perfect and then she decided to write me a prescription anyways, I asked her about the dangers of an improperly fitting contact, you know, because I'm worried about that aspect. She said something to the tune of, "oh these are SOFT lenses (strong emphasis on soft), they would have to be fitted REALLY badly to cause any damage to your eye. You would have a massively inflamed eye and it would be very apparent by now if the lenses are going to cause damage." To which I just noded, but felt like that may have not been the most accurate statement on her part. Will a year of even moderately badly fitting contact use not also pose risks to the eye? I dunno.

Soft contact fittings are really easy. Oasys 8.4 works for almost anyone without astigmatism. Also, checking the fit before you leave isn't really needed if you have it on the eye and it feels good, as long as it's checked at the follow up. You might be frustrated because you aren't meant to wear contacts. I can't either. Risks to eye health with soft lenses are minimal if the lenses are worn as directed.


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[pathologyDO]

Soft contact fittings are really easy. Oasys 8.4 works for almost anyone without astigmatism. Also, checking the fit before you leave isn't really needed if you have it on the eye and it feels good, as long as it's checked at the follow up. You might be frustrated because you aren't meant to wear contacts. I can't either. Risks to eye health with soft lenses are minimal if the lenses are worn as directed.


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Not sure why they didn't just give me oasys then? Again it seems like they were just trying to push for the daily lenses

Also, it wasn't feeling good when I left... They said usually it takes like 30 mins to adjust to the eye.

Not meant to wear contacts? Now I feel like you're just being devils advocate lol

 

[pathologyDO]

Not seeing any of the CL's on your eyes on how they fit - are they well centered on the eye? do they swim flat or tight steep on the cornea is what I call negligent and irresponsible on their part. I want you to know, the majority of us OD's really do care about our patients vision and try to address every concern. The practitioners from what you are describing if you are correct sound like horrible OD's!
Do you have allergies? Seasonal allergies? Did they bother to invert your upper lids to see if they were clear or have GPC?

No matter what your corneal curvatures are (which they should have been measured) there are multiple CL's out there that fit everyone. There are exceptions if your eyes are really steep and 8.4 8.3 BC still move on you.

It's not Target optometrists that are bad. It was those specific individual OD's working there that were bad.
What lenses did you try out? Brand? Rx? BC? LD?

We tried out the Dailies aquacomfort first, and those I tried really hard to deal with but realized they weren't going to feel better. These are my first contacts and I thought maybe it was like having braces and you need to wear them awhile to get used to the scratchy feeling, but my wife has contacts and told me that wasn't the case.

So we tried dailies aquacomfort & a monthly brand, then they gave me acuvue moist, then proclear, which worked perfect on my right eye but my left eye was not having it, still uncomfortable, but better than the previous ones. Lastly she gave me the "Cadillac" of CLs called Dailies Total 1 and those in fact fit decent, only a little bit of "lag time" as my wife calls it, but they have none of the scratchy feeling the others did - so I guess I may have to compromise and put up with either some lag time or a scratchy left eye.

My BC was measured at 8.7 and they didn't give me any diameter value on my prescription, just BC and Sph

Something that caught my eye is that her Rx for the proclear says BC 8.60, but all the websites say that proclear is a 8.70 BC brand? confused

 

[310]

Not sure why they didn't just give me oasys then? Again it seems like they were just trying to push for the daily lenses

Also, it wasn't feeling good when I left... They said usually it takes like 30 mins to adjust to the eye.

Not meant to wear contacts? Now I feel like you're just being devils advocate lol

Well, different doctors have different go-to lenses. Acuvue 1-day moist with the low base curve is a daily disposable lens that will usually work. I'd rather not throw any healthcare practitioner under a bus for an exam that I wasn't sitting in on.

But if you have dry eyes, allergies, irregularities in the conjunctiva, etc. it can be hard to wear any contact lens. You're basically planting a piece of plastic on one of the most sensitive parts of your body and hoping your body will be okay with it. Also, first time wearers tend to lots of stuff stuck to the lenses from not putting them in smoothly, which makes them less comfortable.


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[KHE]

Not sure why they didn't just give me oasys then? Again it seems like they were just trying to push for the daily lenses

Also, it wasn't feeling good when I left... They said usually it takes like 30 mins to adjust to the eye.

Not meant to wear contacts? Now I feel like you're just being devils advocate lol

1) It should not take 30 minutes to get adjusted to a contact lens.

2) They are pushing dailies because daily lenses are by FAR AND AWAY the healthiest option for your eye.

Total 1 is a fantastic lens but I would not expect a young, healthy person to need that. (I presume you are young and healthy.) If you are, you should be evaluated by someone you are comfortable with to determine what sort of ocular surface disease you may have.

 

[pathologyDO]

1) It should not take 30 minutes to get adjusted to a contact lens.

2) They are pushing dailies because daily lenses are by FAR AND AWAY the healthiest option for your eye.

Total 1 is a fantastic lens but I would not expect a young, healthy person to need that. (I presume you are young and healthy.) If you are, you should be evaluated by someone you are comfortable with to determine what sort of ocular surface disease you may have.

She didn't mention that they were for people with ocular disease and didn't say I had any eye pathology (besides myopia).

Anyways I will probably try and use these samples and if I still cannot ignore the scratch then I may go see a private practice OD.

I think most of my frustration is because she lacked any empathy towards my frustrations - to me a sign of a bad doctor.

Thanks for the advice everyone I sure do appreciate it

 

[Commando303]

So first off, I am a 2nd year medical student and so I have some experience practicing interviewing standardized patients and feel like this doctor completely sucked at showing any empathy or partnering with me to gain her trust.... anyways..

Today I feel both angry and embarrassed after going to see a local optometrist located right next to a Target (not sure if technically a Target optometrist or not). I've been trying to get my contacts fitted for the past couple weeks and have been in 4 times now. The first time they did the whole "fitting" and then gave me a couple boxes, one of dailies and another of monthly to try - and then had me go home to test them out, never did any testing while I was wearing them to see if they were the right fit while I was there.

So I came back after a week because they were irritating my eyes and it felt like there was an eyelash in my eye, plus they were sliding around. A different optometrist gave me a different brand with different curvature to try out and sent me home, no testing with contacts in while I was there. Those felt even worse and slid around even more than the previous pair so after a couple more days I show up again, this time yet another new optometrist was there and gave me yet another type and again sent me home without testing them while I was there (makes 4 types I have tried at this point). That leads me to today...

I came in today frustrated and a little bit irritated that I have yet to get contacts that fit - I just want a pair that fits, and as a medical student I understand how patients can get annoying and may just be "picky" but I am legitimately not being so, I feel like my current lens isn't fitting correctly and it is bugging me. This current set the right eye feels perfect, but my left eye still has the eyelash in eye type of feeling as well as a little sliding, but not quite as much as previous lenses.

The optometrist was the original lady who did my fitting and lacked any empathy whatsoever... after telling her about my troubles with my current trial lenses she proceeds to not empathize or acknowledged how irritating this is, but she asks me questions like "are you sure you are using the right contacts, not other boxes?" and "are you sure you are putting the lenses in the right way?" After telling her "yes, I have been very mindful about putting certain ones in and if they are the proper side," she tells me that these will just have to do because no contacts are going to fit perfect and a little irritation is OK and will not harm my eyes unless they fit very badly.

So she didn't acknowledge my anger and irritation about having to continue going back to see her at all, managed to turn it around and suggest to me that I was the problem, and then disregarded how the left contact feels on my eye and told me to deal with it and wrote me a prescription for the ones I am currently using (again, despite my left eye not fitting well like my right eye is).

PHEW I know that was long winded and I'm sorry, but again I feel embarrassed and crappy that a doctor just ignored my feelings about having to do this so many times, and also ignoring how the current ones still don't feel quite right.

Is this just me being stupid? Is this is a bad optometrist?

Clearly, this is a post designed to seek sympathy rather than advice, so, all right, based on your description, you were given poor care.

 

[pathologyDO]

Clearly, this is a post designed to seek sympathy rather than advice, so, all right, based on your description, you were given poor care.

Pretty much, although by posting on SDN I was more than ready for some backlash as usual. Thanks for the sympathy though

 

[hello07]

Dailies total 1 - just about everyone loves them. You can usually wear them longer than normal without feeling dryness compared to other one day brands.
If your lids, conjunctiva and cornea are all normal than try Avaira 2 week disposable 8.5 BC 14.2 LD this is another lens that many pts love because of comfort and vision.
Good Luck and sorry about the experience you had with those lousy OD's. There's always a very few bad apples in a field of great tasting apples.

 

[ophthope]

Ophthalmology resident here. You're getting a lot of good advice here. As KHE said the dailies are by far the healthiest way to wear contacts. Poor contact lens fit can abso-freaking-lutely be a problem even if they are only 'a little irritating.' Seen plenty of ulcers in patient's that felt like theirs fit perfect, you don't want to wear an ill fitting medical prosthetic device that sits on your cornea all day.

Since no one has mentioned it yet though - you may just not be tolerant of contacts. Some people aren't. It may be worth it to get evaluated for Lasik and see if you qualify. Lasik is statistically safer anyway, but those numbers may be from the pre-dailies era for all I know.

Nobody can really comment on the quality of your eye doctor though. She may have just been having a bad day. You'll have them too.

 

[310]

Ophthalmology resident here. You're getting a lot of good advice here. As KHE said the dailies are by far the healthiest way to wear contacts. Poor contact lens fit can abso-freaking-lutely be a problem even if they are only 'a little irritating.' Seen plenty of ulcers in patient's that felt like theirs fit perfect, you don't want to wear an ill fitting medical prosthetic device that sits on your cornea all day.

Since no one has mentioned it yet though - you may just not be tolerant of contacts. Some people aren't. It may be worth it to get evaluated for Lasik and see if you qualify. Lasik is statistically safer anyway, but those numbers may be from the pre-dailies era for all I know.

Nobody can really comment on the quality of your eye doctor though. She may have just been having a bad day. You'll have them too.

Disagree about a couple things. Ulcers occur almost exclusively from contact lens misuse and not the actual fit of the contact as long as modern soft contacts are being used. Also, contact lens intolerant people are generally not great candidates for LASIK bc it will exacerbate dryness.


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