+0.25 OU pediatric reading glasses

[DrEyeBall]

I truly wish I could post a photo of this child. She has a constant chin-up head tilt with 3 mm fissures OU. I shouldn't have included that info in my initial post because I really wanted to discuss +0.25 OU pediatric reading glasses (but it is one of the most bizarre missed diagnosis cases I've ever seen). It probably just annoyed people and set a bad tone for the discussion.

The issue truly does frustrate me, though, and I still can't think of a good reason to ever give a kid +0.25 OU other than $. If people think differently, I'm interested in their opinion.

Your point about this specific case and maybe that specific doctor is accurate. However, the mudslinging probably is not needed. While there are some people who may believe there is some rationale for this Rx, we know that others probably are doing it for the money. Just like some MDs probably really think they are doing the patient a service removing the cataract before the patient has problems. You will witness alot of poor and questionable practice patterns in your career...from both ODs and MDs.

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[PBEA]

I guess the bottom line is that there are many ways to treat patients. There are some ways we can all agree are right, some we can all agree are wrong and some that we will not agree with each other. What we need to see is that this is not an OD vs MD thing. There are plenty of good people in both professions. We also each have our share of questionable people. We can have these discussions without accusing the etntire group or the other of being greedy pigs or being stupid.

Well said.

 

[PBEA]

Actually, from the offices I'm thinking of, the parents were told that the children HAD to wear them, or they were at risk of going blind. This is also in a patient population that is not buying things for cosmetic reasons. They're giving up clothing and food for themselves to buy their kids these "necessary" +0.25 glasses. If it happened once or twice, I would just assume that the parents misunderstood, but when several people are saying the same thing, it gives you pause.

In all the degeneration of this thread, I still have yet to see a good explanation for why +0.25 glasses would be medically needed. I've seen a few (IMO iffy) reasons for doing so, but no necessary ones. We've jumped to talking about -0.75 and +2.00, which are both different issues.

As I see it, kids (or parents asking for them) wanting glasses just to have glasses is akin to patients demanding antibiotics for colds. From that individual patient's standpoint, there's not a lot of harm in taking them, but it's really not in their best interest for multiple reasons (some of which have already been touched on).

The cosmetic contact debate is probably a whole other thread in itself. I've seen two patients in the last 6 months who are now bilaterally in the 20/200 BCVA range thanks to these (gotten from gas stations, which is, again, a whole other issue).

BTW, I should say that my initial response was not to say that ODs are evil greedy bastards by nature (because, as mentioned there are plenty of those among both ODs and OMDs). It was simply to point out that this does happen, in response to those who said this couldn't be going on.

Dave

Your story about some OD who rxs +0.25 multiple times and says that they will go blind is probably a load of smelly horseshiit. IF it is true then I would say you practice near one of those "bad" seeds we are all describing. That is a big IF.

I agree with there being no medical reason for rxing +0.25, but again I really, really doubt you are getting the truth from these people. Maybe employ a little deductive reasoning, or perhaps dont take pt histories so literally.

Indiscriminant use of abx IS NOT the same thing as rxing +0.25!! Totally and thoroughly disagree with your comment here.

 

[PBEA]

I truly wish I could post a photo of this child. She has a constant chin-up head tilt with 3 mm fissures OU. I shouldn't have included that info in my initial post because I really wanted to discuss +0.25 OU pediatric reading glasses (but it is one of the most bizarre missed diagnosis cases I've ever seen). It probably just annoyed people and set a bad tone for the discussion.

The issue truly does frustrate me, though, and I still can't think of a good reason to ever give a kid +0.25 OU other than $. If people think differently, I'm interested in their opinion.

As for you, PBEA, what's all this "setting you straight" and "you don't know wtf you're talking about" stuff in your posts? All you've demonstrated thus far is that you're very angry and defensive.

Look, if I started a thread that talks about how Ive seen 10 refractive sx cases in the last couple of years that looked like someone took a flamethrower to the cornea, and then I proceeded to blame OMDs and how can "these people live with themselves" then I would expect to don my own flame ******ant suit and prepare for some scorching. If you want to try and blame ODs (Im an OD, remember) for doing something that is not indicated then prepare to be scorched. Am I angry? yeah maybe a little (although I rather enjoy the discussion with some on this thread). Am I defensive? No, more like frustrated (with threads like this one).

 

[JR]

In my expirience it takes about 2 thread pages before these threads degenerate into flame wars. This one is now two pages long. Enough said. Closing....