Opthamologist Visit

[fkajoshaj]

Hey guys, so I went to the Opthamologist today because I had an appointment for my case of dry eyes (my optometrist was a good for nothing that kept offering some lame drops that never work) and so as he dilated my eyes, he asked me what I was doing with my life. I told him I was interested in Optometry..and he just cuts me off and says "WHY!?? Why would you do that to yourself? Cmon you don't want that. All you're really going to be doing is prescribing and selling glasses. This is where you want to be. All that debt youre going to be in and just to be limited to that???" lol he made a scene and sounded really pissed. He wants me to goto medical school and be an opthamologist if anything lol But I dont want to do medicine.


Why do you think he reacted the way he did when I told him I wanted to do optometry???


Also, is there a more MEDICAL approach to optometry? If so, do any optometrists out there work in that area? I don't like generalizing, but most optometric sites I go, all i see is refracting and prescribing glasses. I know there is more to it, but you barely see the medical side of optometry where I am from...( I reside in New York).

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[Jay12]

Hey guys, so I went to the Opthamologist today because I had an appointment for my case of dry eyes (my optometrist was a good for nothing that kept offering some lame drops that never work) and so as he dilated my eyes, he asked me what I was doing with my life. I told him I was interested in Optometry..and he just cuts me off and says "WHY!?? Why would you do that to yourself? Cmon you don't want that. All you're really going to be doing is prescribing and selling glasses. This is where you want to be. All that debt youre going to be in and just to be limited to that???" lol he made a scene and sounded really pissed. He wants me to goto medical school and be an opthamologist if anything lol But I dont want to do medicine.


Why do you think he reacted the way he did when I told him I wanted to do optometry???


Also, is there a more MEDICAL approach to optometry? If so, do any optometrists out there work in that area? I don't like generalizing, but most optometric sites I go, all i see is refracting and prescribing glasses. I know there is more to it, but you barely see the medical side of optometry where I am from...( I reside in New York).

Wow...an ophthalmologist who does not like the optometry profession...that's new..... Just go over to the ophthalmology forum and you'll read from many other ophthalmologists whom despise anything (or anyone) that has to do with optometry..........but don't let it deter you from making a decision to go into this field (if that's what you decided on doing).

 

[EyeBaller]

Why are you interested in optometry?

You say from your experience that you have only seen optometrists refracting and prescribing glasses, and yet you say you are interested... So now why the question about medical optometry? I'm just a little confused.

Anyway, there are plenty of optometrists working the "medical" field. Optometrists can prescribe medications and treat eye diseases, short of surgery. A lot of the time optometrists work WITH ophthalmologists whether it's referring patients for surgery or co-managing patients in the same office.

Of course, there are many optometrists out there who either aren't comfortable treating eye disease or cannot get on insurance panels in order to treat them, or simply do not have time to treat them (the latter one may be more typical of a commercial OD, not ALL commercial ODs).

As an aside and out of interest, what did the ophthalmologist offer you in terms of dry eye treatment?

 

[fkajoshaj]

Well the reason why I want to be an Optometrist is because I did my research and know what the position is capable of doing. I love the medical approach to it more, however, for some reason (not that i am scared to face blood/surgery), for some reason when im exposed to it, I faint. I have no clue why. I have the drive and courage to want to look at it, but for some reason its like a trigger in my body, that doctors cant explain b/c they can tell I am not afraid of approach

I always wanted to be a doctor, just never knew what kind of doctor. I like the field of optometry (no blood or gore), its a very clean and sophisticated profession and I love the patient interaction of it all.

I have heard, that the medical field of optometry doesnt pay as much as the "going to your optometrist to get your eye exam and prescription for glasses)?? Is there any where I can go to get educated better in terms of what are my options of work once I graduate Optometry school? I want to know whats out there, b/c all i am exposed to is glasses/contact lenses. Not that I mind doing it, but if thats all ill be doing then Im not sure that would be interesting.


For my dry eye situation, when I went to see my optometrist, he had nothing to offer me besides (systane, lotemax & blink) eye drops. Ive tried all three he gave me, and didnt find them to be of any help.

The OMD gave me (zaditor, zylet and systane).

 

[DrRobs]

Well the reason why I want to be an Optometrist is because I did my research and know what the position is capable of doing. I love the medical approach to it more, however, for some reason (not that i am scared to face blood/surgery), for some reason when im exposed to it, I faint. I have no clue why. I have the drive and courage to want to look at it, but for some reason its like a trigger in my body, that doctors cant explain b/c they can tell I am not afraid of approach

I always wanted to be a doctor, just never knew what kind of doctor. I like the field of optometry (no blood or gore), its a very clean and sophisticated profession and I love the patient interaction of it all.

I have heard, that the medical field of optometry doesnt pay as much as the "going to your optometrist to get your eye exam and prescription for glasses)?? Is there any where I can go to get educated better in terms of what are my options of work once I graduate Optometry school? I want to know whats out there, b/c all i am exposed to is glasses/contact lenses. Not that I mind doing it, but if thats all ill be doing then Im not sure that would be interesting.


For my dry eye situation, when I went to see my optometrist, he had nothing to offer me besides (systane, lotemax & blink) eye drops. Ive tried all three he gave me, and didnt find them to be of any help.

The OMD gave me (zaditor, zylet and systane).

There is definately more medical grounds in optometry now, if you choose, you can do everything but the surgery. You can perscribe Rx drops. In regards to the case of your dry eyes has anyone suggested punctal plugs? I don't know if you are severe enough for that, but its an option and optometrists can put punctal plugs in patients. The doctor I work for does everything but surgery. Our practice is 80% medical cases. Sure doesn't cover patients glasses but a lot of our exam fees get submitted to insurances. They typically don't pay for the refraction, medicare definately doesn't however sometimes secondaries will pick up that cost before it becomes a patient responsibility. The reimbursement rate for "medical optometrists" is lower than opthomolagists get in general, mostly when it comes to MA (however, theres a rumor that that is changing in PA at least). But if you take the time to get involved with the medical end, you can. Most optometrists it seems don't want to bother with that. Also, things like OCTs can only be billed by optometrist maybe once or twice a year, however a retina specialist can bill for those 4 times a year (i think, thats what our OCT salesman told us).

But yes, there is definately a need for more optometrists who are willing to do the medical end in my opinion because I think thats the driving force thats going to "change the public view", and maybe even the medical view. Insurances are more "limiting" for us, but it is improving more and more over the years the more optometrists fight to get those rights. Look at the AOA's website theres bounds of information in regards to that. Also, try to find an optometrist that does treat medical, you'll get a different view of the field and it will expand your knowlege on options. If you are lucky enough to find an opt like that too, try to learn some stuff about how the medical billing procedures are because learning that I think has helped me significantly, not only do I feel like I'm better prepared for school seeing all these medical patients it has opened my eyes to what exactly I would like to focus on in my future. Let me know if you wana know more about this, I kind of jambled everything I could up haha

 

[DrRobs]

I forgot to ad, you can only submit to a medical insurance if there is a MEDICAL diagnosis, so someone who only has refractive codes is probably going to pay out of pocket for their exam, unless the doctor they see accepts their vision plan if they have one. On the otherhand, some medical insurances (rarely but it happens) will pay for a "routine" exam that has only refractive codes. Insurance companies like to be tricky though, so its hard to explain there is so much involved...probably why a lot of opts choose not to do the medical stuff...

 

[EyeBaller]

Well the reason why I want to be an Optometrist is because I did my research and know what the position is capable of doing. I love the medical approach to it more, however, for some reason (not that i am scared to face blood/surgery), for some reason when im exposed to it, I faint. I have no clue why. I have the drive and courage to want to look at it, but for some reason its like a trigger in my body, that doctors cant explain b/c they can tell I am not afraid of approach

I always wanted to be a doctor, just never knew what kind of doctor. I like the field of optometry (no blood or gore), its a very clean and sophisticated profession and I love the patient interaction of it all.

I have heard, that the medical field of optometry doesnt pay as much as the "going to your optometrist to get your eye exam and prescription for glasses)?? Is there any where I can go to get educated better in terms of what are my options of work once I graduate Optometry school? I want to know whats out there, b/c all i am exposed to is glasses/contact lenses. Not that I mind doing it, but if thats all ill be doing then Im not sure that would be interesting.


For my dry eye situation, when I went to see my optometrist, he had nothing to offer me besides (systane, lotemax & blink) eye drops. Ive tried all three he gave me, and didnt find them to be of any help.

The OMD gave me (zaditor, zylet and systane).

Thanks for your response.. I don't think it's necessarily true that medical optometry pays less, but there's definitely a value to sale of goods such as glasses. For example, if you are treating glaucoma patients each patient can add $500-$600 to your practice per year, easily. Now if they also buy glasses every 1-2 years there's more value.

The key to medical optometry is being able to get on the plans and then billing appropriately for your time and services.

In terms of where you can go, see if you can find a private practice OD who offers "full-scope" care. Also check out SUNY, contact the admissions office and ask them. They may be able to put you in touch with some faculty who have private offices where they practice "medical" optometry.

Again, not to start a flame war on treatment of dry eye but.. the optometrist tried an artificial tear (Systane) a re-wetting drop (Blink, to use with CLs) and a mild steroid (Lotemax). The ophthalmologist tried the same artifcial tear drop (Systane) and he tried Zylet which is a combination medication which actually contains Lotemax and an antibiotic (I'm not sure why you'd need an antibiotic for most dry eye cases, unless he felt you were at a considerable risk for infection due to the dryness with CL wear). The last drop Zaditor is for ocular allergies (similar to Patanol) and is really for relief of itching/redness related to allergies.

So treatment wise you received basically the same drops from both doctors. (aside of Zaditor which may not truly be indicated here).

(I know this forum isn't for medical advice, my intention isn't to do so, but point out to the OP the treatment he received was the same from OD and OMD.)

 

[fkajoshaj]

You guys are very helpful thanks for the time and effort. I think what will answer my questions even better is like you guys said and visit a medical optometrist.

so all i do is just call up SUNY admissions and ask them to set me up with a visit to a private practice of an medical optometrist??

Maybe more exposure will solidify my will and determination (which I am in need).


Also, the OMD dilated my eyes and used an anasthetic to reduce the mobility of my eyes! lol With the dilation, I experienced what it felt like to have impaired vision lol Now i definitely wont take my 20/20 vision for granted!

Thank you all, please inform me more on the medical optometry and how I can visit a medical optometrist practice and see for myself.


Anyone from NEW YORk too that can help??

 

[EyeBaller]

You guys are very helpful thanks for the time and effort. I think what will answer my questions even better is like you guys said and visit a medical optometrist.

so all i do is just call up SUNY admissions and ask them to set me up with a visit to a private practice of an medical optometrist??

Maybe more exposure will solidify my will and determination (which I am in need).


Also, the OMD dilated my eyes and used an anasthetic to reduce the mobility of my eyes! lol With the dilation, I experienced what it felt like to have impaired vision lol Now i definitely wont take my 20/20 vision for granted!

Thank you all, please inform me more on the medical optometry and how I can visit a medical optometrist practice and see for myself.


Anyone from NEW YORk too that can help??

I'm not sure if admissions will do that but it's worth asking them. Or see if you can set up a visit to the school to observe the different clinics.. maybe you can meet some doctors that way too. But get active and see what's out there.

Good luck!

 

[jefguth]

For my dry eye situation, when I went to see my optometrist, he had nothing to offer me besides (systane, lotemax & blink) eye drops. Ive tried all three he gave me, and didnt find them to be of any help.

The OMD gave me (zaditor, zylet and systane).

Ha, as Eyeballer mentioned, your ophthalmologist basically gave you the same thing, just added treatment for allergic conjunctivitis...

 

[DrRobs]

You guys are very helpful thanks for the time and effort. I think what will answer my questions even better is like you guys said and visit a medical optometrist.

so all i do is just call up SUNY admissions and ask them to set me up with a visit to a private practice of an medical optometrist??

Maybe more exposure will solidify my will and determination (which I am in need).


Also, the OMD dilated my eyes and used an anasthetic to reduce the mobility of my eyes! lol With the dilation, I experienced what it felt like to have impaired vision lol Now i definitely wont take my 20/20 vision for granted!

Thank you all, please inform me more on the medical optometry and how I can visit a medical optometrist practice and see for myself.


Anyone from NEW YORk too that can help??

Just call around to different optometrists in their area and find out informationa bout their practice, let them know what you are looking for, i.e. shadowing with a medical optometrist to solidify your decision and learn more...

I think a smaller practice you'll have more luck and a better chance of talking to someone who wont send you to a bunch of people/not let u talk to the doctor. Or even ask the staff for the doctors email (cuz u know doctors are always busy). Good luck.

 

[InspectorQ]

Am I the only one reading this correctly?

You want to become an optometrist, however you think your optometrist was not good and went to an opthamologist for something that an optometrist should have been able to treat you.


You didn't want to go to another optometrist? Is there a reason why?

 

[DrRobs]

Am I the only one reading this correctly?

You want to become an optometrist, however you think your optometrist was not good and went to an opthamologist for something that an optometrist should have been able to treat you.


You didn't want to go to another optometrist? Is there a reason why?

This is true, but think about this, a lot of optometrists who dont see medical cases and have no other optometrists who do in the area, or maybe they are "old timer optometrists" who dont treat medical cases, they are used to treating "medical cases" like dry eyes to optometrists. Thats the big issue we should be fighting for students entering school to learn, I mean I'm entering school now but I work for an optometrist who it seems "works outside the box" because she wants to go above and beyond to do all she can to treat her patients needs and our practice, as I said before is at least 80% medical, whether its dry eyes , convergence insufficiency, macular degeneration, gluacoma, retinis pigmetosa, toxo, to even nuclear sclerosis...we use medical insurance whenever we can, and quite frankly its a benefit to you and the patient when u can use a MEDICAL insurance over a vision plan that pays u crap.

 

[Doc97]

Well the reason why I want to be an Optometrist is because I did my research and know what the position is capable of doing. I love the medical approach to it more, however, for some reason (not that i am scared to face blood/surgery), for some reason when im exposed to it, I faint. I have no clue why. I have the drive and courage to want to look at it, but for some reason its like a trigger in my body, that doctors cant explain b/c they can tell I am not afraid of approach

I always wanted to be a doctor, just never knew what kind of doctor. I like the field of optometry (no blood or gore), its a very clean and sophisticated profession and I love the patient interaction of it all.

I have heard, that the medical field of optometry doesnt pay as much as the "going to your optometrist to get your eye exam and prescription for glasses)?? Is there any where I can go to get educated better in terms of what are my options of work once I graduate Optometry school? I want to know whats out there, b/c all i am exposed to is glasses/contact lenses. Not that I mind doing it, but if thats all ill be doing then Im not sure that would be interesting.


For my dry eye situation, when I went to see my optometrist, he had nothing to offer me besides (systane, lotemax & blink) eye drops. Ive tried all three he gave me, and didnt find them to be of any help.

The OMD gave me (zaditor, zylet and systane).

Both your OD and your OMD are giving you similar treatment with the Zylet/Lotemax --neither of which are a long term solution for the dry eye. Obviously they feel that you have an inflammatory component to your condition for which the Zylet/Lotemax should afford you some relief. I suppose the OMD added Zaditor as he suspected an allergic component although you didn't mention an itching complaint.

There are, of course, sophisticated work ups you can do to determine the best possible source of dry eye (TBUT, Schirmer Test, tear osmolarity) but it sounds like these docs went with what is easiest and cheapest--throw some gtts and see what sticks. Assuming you're a young person, we don't see much dry eye on young people that's not contact lens or allergy related. If the condition is chronic, you're going to have to find a better solution than the Zylet. On a young patient I've thoroughly examined, I'd consider starting 3G/day of Omega 3 Fatty Oils--they should find some measure relief after 4-6 weeks, about the max time I'd want anyone on an antiinflammatory. If we don't get success here, we'd try the Restasis BID or punctal occlusion.

Hard to argue with your OMD's other advice as I personally believe that there are way too many ODs. The AOA doesn't seem to get it. There's also way too many OMDs, for that matter. A situation that has not gone unnoticed by the powers that be who have decided to limit the number of OMD residencies.

Yep, plenty of OMDs around here. Have had plenty of specialists drop by unanounced, hat-in-hand looking for referrals. It's not always the new guy either, who is compelled to go out and beat the bushes.

That was quite a ramble.

 

[qwopty99]

Hey guys, so I went to the Opthamologist today because I had an appointment for my case of dry eyes (my optometrist was a good for nothing that kept offering some lame drops that never work) and so as he dilated my eyes, he asked me what I was doing with my life. I told him I was interested in Optometry..and he just cuts me off and says "WHY!?? Why would you do that to yourself? Cmon you don't want that. All you're really going to be doing is prescribing and selling glasses. This is where you want to be. All that debt youre going to be in and just to be limited to that???" lol he made a scene and sounded really pissed. He wants me to goto medical school and be an opthamologist if anything lol But I dont want to do medicine.


Why do you think he reacted the way he did when I told him I wanted to do optometry???


Also, is there a more MEDICAL approach to optometry? If so, do any optometrists out there work in that area? I don't like generalizing, but most optometric sites I go, all i see is refracting and prescribing glasses. I know there is more to it, but you barely see the medical side of optometry where I am from...( I reside in New York).

Geez - I just read this for the first time.

 

[aphistis]

Leave the case discussion out of the discussion, please. SDN isn't for giving or seeking personal medical advice.