This is the last time I am going to post in this thread because no way did I intend to start some kind of flame war and point fingers and degrade a profession. I just wanted to offer some kind of personal experience and reason as to why I applaud an OD who does not have the attitude show here of "i can treat any disease that an MD can treat...the only difference between me and a MD is surgery."
First of all, I did not make a blanket statement about the optometry profession. I said that in my personal experience as a patient, I prefer to be treated by an OMD than an OD when it came to managing ocular disease. Likewise, for contact lens expertise, I would go an OD over an OMD. I believe you're the one making a blanket statement saying that ODs would be more likely to spend the time to manage severe dry eye. Some people on this forum are just so sensitive and defensive about their chosen profession that they feel the need to constantly validate themselves. This is starting to look like one of the DO forums. There is more difference between an OD and an OMD other than just surgical knowledge, so get over it! The disease management training is not the same.
The reason I came across this thread to begin with is because my fiance, who is typing this for me, is a materials engineer PhD student, who after traveling with me to a couple optometrists specialized in designing and fitting therapeutic contact lenses, has become very interested in the potential for the field therapeutic contact lenses and will be applying to optometry school soon. So I have nothing against the profession, except that some ODs have a stick up their ***** and think they are physicians, instead of focusing on optometry, like developing their contact lens knowledge and experience.
I agree that anyone can screw up, no matter what your profession is.
And you know, I could have been unlucky and saw the world's worst 5 ODs and then got super lucky and am seeing the world's best corneal specialist. Geezus, I completely understand that. KHE, you are completely right that I am not a textbook example (I'm in my early 20's...but I did meet a bunch of people in the Sjogren's support group who only had eye symptoms, so I don't think its that uncommon, but I could be wrong), which can make it difficult for anyone and I could have gotten super lucky with my OMD who did everything right. But my OMD did have the same info as OD's number 3,4, and 5 who did absolutely nothing except to tell me to continue what I'm doing and sent me on my way and therefore did not catch on like my corneal specialist. Perhaps if I had went to one of you hot-shot ODs, you would have done everything my OMD has done.
So that's it...I apologize for pissing anyone off or making it seem I thought optometry was crap. I did not mean to. The rest of my post is to answer Carly Ess's question, of which I will just explain in chronological order:
OD #1: Did not understand why I was in pain; concluded that since my eyes were not red, they could not possibly be that dry, so just presribed PF drops 4x a day. Did not perform a schirmers or tbut. PF drops did nothing, came back for a return appt, and doc shooed me away.
OD #2: Did a schirmers, and TBUT. I had a low TBUT, but doc assured me that my MGs were fine (turned out he was wrong). Gave me allergy drops. Later at F/UP appts, was given steroids, restasis, and plugs. I had no improvement, felt worse, but doc told me that is pretty much all that can be done and an OMD would just do the same so I just have to deal with it.
OD #3,4,5: Agreed with OD#2. Only difference was increased dosage of Restasis.
What Corneal Specialist did differently in terms of treatment:
1. Looked at dry eye differently. He told me that he never simply treats symptoms by "plugging and dropping" and using steroids. He always looks for the CAUSE of problem...even if the problem seemed mild. I think this is key.
2. Removed my plugs - very upset that someone would even think about putting plugs in such an imflamed eye. Called up previous OD and had an argument with him right in front of me. If I wasn't so upset from the pain, I would have thought it was funny.
3. Realized that the preservatives in the steroids I was prescribed was causing further irritation and pain and called a compounding pharmacy to specially make me PF steroids, as well as compound Restasis in a different vehicle so it would not irritate me. I feel like this is something ODs could have done, but didn't.
4. Told me I had severe ocular rosacea despite no facial rosacea - by this point, 75% of my MGs had atrophied. I think that this is something ODs should have caught...I had even asked them. So put on tetracyclines and off-label use of Metrogel and Azasite. Was told by the OMD that if the ODs had caught this early on like they should have, my MGs would be not be atrophied, and I would be in less pain.
5. Ran blood tests for Sjogren's and some other diseases.
6. Referred me to a trusted OD in the same clinic for bandage lenses to help with my corneal erosions.
7. Put me on blood serum drops and lacriserts
8. Referred me to an OD to try out specially designed contact lenses...had to travel out of state for this...surprised how few ODs have this expertise.
9. Referred me to Boston Foundation for Sight for sclerals
10. Took me off allergy drops
11. Referred me to the allergist - turned out I had multiple food allergies contributing to eye inflammation.
12. Has told me he has more in his bag of tricks for subsequent f/ups...and that he has not run out of options unlike what previous ODs have told me.
13. Oh, he also cultured my eye, and took an eyelash to look for mites, which came up with nothing. But those were cool tricks, nonetheless.
The corneal specialist had enough medical training to realize to look further than just eye...he looked at the lids, at other diseases that could manifest as dry eye, and even looked at food allergies! This is the reason I think that ocular disease may be better managed by OMDs...of course, keeping in mind there are crappy OMDs out there, as well as superb ODs.
I mean, are blood serum drops, getting eye cultures, and allergy testing things that ODs tend to do to manage dry eye? I doubt it.
I hope that answers your question, Carly Ess.
Geez this was a long post.
