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Supernumerary

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I just went to the OD yesterday to get contacts. I put them in this morning (they've been in about 45 min.) and my vision is worse with them than without them.

She said she didn't have time to do a full exam so she just "converted" my glasses Rx. Is this acceptable? I mentioned the blurriness yesterday and she said my eyes just needed time to adjust. I wore them all day yesterday too. How long does it take before you know you just have the wrong Rx. My vision right now is inadequate for the things I have to do in dental school. Should I insist on a new exam?

P.S. She charged me for an exam yesterday anyway.
 

Richard_Hom

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Dear Supernumerary,

As a dentist, I am quite surprised at your last statement. You should know that despite whatever you do for a patient, if they still are complaining about a problem after your treatment, I doubt if you would do it for "free", withdraw your insurance claim so that the patient can reuse their benefit elsewhere or refund their cash.

With that aside, it is standard procedure to "convert" spectacle power to contact lens power. If your equvivalent spherical power is greater than + or - 4 diopters the 13.5mm idfference between the plane of the spectacles and the contact lens is aobut 0.25 difference. In addition you may have a small degree of astigmastism which may not be corrected by the type of contact lens that you are wearing now. Therefore, you will see less in your soft ocntact lenses than in your spectacles.

But wait, there are several other reasons, but I'll go into those only if need be.

Yours truly,
Richard Hom, OD,FAAO
San Mateo, CA
Originally posted by Supernumerary
"...She said she didn't have time to do a full exam so she just "converted" my glasses Rx. Is this acceptable? ..."
 

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totally unacceptable. she did not have time to do a full eye exam? Were you a walk in or scheduled patient? Do you see as clearly as you would like with your present glasses? Did she mention astigmatism either in your glasses or contacts? You should see clearly instantly unless they are torics contacts that correct for astigmatism take a few minutes to settle in.
Go back to her again. If you are not happy with her professionalism and competency and she does not address your needs without proper explanation ( I don't have time) is not an excuse I suggest you contact the state optometric boards and file a complaint against her. Let her know that you are bringing up her state license in question- You'll see how fast she'll change her tune and give you the most thorough eye/contact lens exam there is with full explanation as to every step she id doing. Don't be scared of contacting a licensing board that protects you the public from OD's as the one you saw.
I am truly ashamed of some of my colleagues out there.
 

Supernumerary

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Thanks for your replies. It is good to know that it is possible to simply convert the prescriptions. My question concerning the bill, Dr. Hom, was not because I didn't expect to be billed. I was more than willing to pay for the fitting fee, and for the trial lenses. I realize that I am paying for the doctor's time and expertise. It just seemed odd that I would also be charged for a full exam when, in fact, no exam was performed. (I did have an appt for a full exam, but I was the last appt. I came early but she was behind.)

I would hate to think what would happen if a dentist decided that the last checkup a year ago was still valid, gave a clean bill of health and charged anyway. It just doesn't seem like that would go over too well with patients.

Anyhow, I'm not really upset with the office. I will definitely talk to them before doing else. Maybe there was just a misunderstanding; I am pretty ignorant when it comes to optometry.

I do have toric lenses (my Rx is almost entirely to correct astigmatism) and I left them in for 4 hrs. before deciding that the problem wasn't going away. Maybe I'm just a poor candidate for contacts. I will be going in again soon to request an exam and new prescription.

Thanks again for your help.
 

r_salis

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(I just learned how to do the prescription conversion for glasses-to-contacts, and for other back-vertex-distances :D ).

SN -- you're doing exactly what I would do in your situation -- giving your optometrist the benefit of the doubt, and returning to see what she can do to improve your contacts lens fit/prescription/etc. I would definitely bring up the issue of being charged a full exam rate for the time she spent with you, that seems a little strange to me. Hopefully she'll be able to make things right when you go back.

One other thing -- your comment about the "clean bill of health" assumption is not as big a deal with an eye exam as with a dental exam (from what I know...) in the case of a young patient in good health who was seen 12 mos ago. Assuming that you have no complaints with your current prescription (no headaches, eye strain, etc.), you'd probably be okay with the same prescription adjusted for contacts for another year, and your eye health is most likely to be fine if you have been in good health. From what I understand, teeth are a completely different story. ;)
 

cpw

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if you are wearing contacts for astigmatism she should spend more time with you if they're not sitting correctly. The contacts might be rotating on your eye more the longer you wear them (as they tend to dry out and steepen the longer you wear them during the day). I notice this by the end of every day (I have a large astigmatism too). Torics are a more complicated fitting.. if you're not happy with your vision go back for another follow up.. it should be included in your initial fitting fee. (and it should keep being included until you're happy with the fit.. it's what you're paying for). Her running late is not a good excuse for a crappy toric fit. It does take 20 minutes for torics to settle down, but if you're still noticing it hours later your axis is probably off on your contacts. I'd go back to your OD.
 

optcom

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" if you're not happy with your vision go back for another follow up.. it should be included in your initial fitting fee"

If the antibiotics from your MD did not work, will he/she do another office visit for free since it should included in your initial office visit? :eek:
 

r_salis

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Originally posted by optcom
"if you're not happy with your vision go back for another follow up.. it should be included in your initial fitting fee"

If the antibiotics from your MD did not work, will he/she do another office visit for free since it should included in your initial office visit? :eek:
What cpw meant by "not being happy with your vision" was "vision with the new contacts"... Contact lenses or glasses are appliances, in the same way that a set of dentures or a prosthetic arm are appliances. If your dentures aren't fitting properly within a short time of your initial fitting, you go back to the dentist for an adjustment at no charge. If you get a prosthetic arm and you are having problems with it at first, you go back to your doctor to have it fixed or adjusted -- as part of the initial fee.
 
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