How much to expect from OD?

#7 08-25-2006, 01:00 PM

I told my OD (via lens tech) that I'd like to give some soft torics a
try before I make up my mind whether to live with the RGP annoyances
(that they claim to be unfixable). The lens lady called back and said,
"the doctor said no, he doesn't think they will work for you because
you don't have enough astigmatism."

I said that that seemed impossible since my last "full power" Rx was

R: PL -1.5x180
L: +0.25 -1.0x180

Since I'm happier with 0.25 to 0.5 less cyl correction, a left toric
with -0.75 and right with -1.25 seems nearly perfect.

She said, "I'm just relating what the doctor said, he said he'd be
happy to pass your file along to another doctor if you want to get a
second opinion."

Not very subtle! I guess I will be looking for another eye doc.

Charles wrote:

- quote -

> This is a followup to my thread "I think my OD gave up on me". The
> brief summary is: I asked to try RGP contacts. The first set back was
> pretty good, but they were "low riders" and I got glare from the top
> edge of the lens. Night vision was slightly annoying due to some
> flaring/starbursting. So I went back and convinced them to address
> the problem, which they attempted with larger lenses, but the
> prescription came back with too much minus power (and some imbalance)
> resulting in eye strain. They ordered one more set and they came
> back with too much plus, resulting in blurry vision at distance. At
> that point, they basically gave up.
> As a result of feedback from this group, I requested that they modify
> the lenses for more minus and I would pay the bill ($50). They did
> this, and the lenses I got back gave clear vision, but caused (for
> some reason) frequent foggy/dry vision (still sharp) and terrible
> night vision in terms of starbursting.
> So now I'm kind of on my own. No followup was suggested. And as a
> matter of fact, none was ever suggested after the first fitting. This
> bothered me not only because the correctness of the Rx would not be
> confirmed, but also because I wanted to make sure the fit was healthy
> for my eyes.
> Is it too much to ask that my doctor would actually take an interest
> in helping me achieve my goal of clear vision in contact lenses, and
> follow through to make sure I'm happy?
> From postings here and research elsewhere on the net, I know there are
> all kinds of options for contacts. First of all, many brands of soft
> toric. Within RGP there are all kinds of parameters: Size, curvature,
> rigidity of material, other material parameters, size of OZ,
> spherical, back toric, bi-toric, scleral, and surely numerous other
> things I, layman, haven't heard of. Is it appropriate to give up
> after the first try? I never told them I needed and easy or cheap
> solution.
> The followup after the very first set of lenses really was like that.
> I said "the vision is great, but I get a lot of glare, and kind of
> hazy night vision. Is there something we can adjust to fix that?"
> The reply was basically "no, you'll probably get used to it, have a
> nice day." And I was surprised that no over-refraction was done to
> see whether the Rx was correct (I read the eye chart, 5 feet away).
> One thought I have is this: I don't believe that if the OD was trying
> to fit himself in contacts that he would give up without thoroughly
> exploring the options. It doesn't seem right to tell me that this is
> as good as it gets yet. A more comforting response would be, e.g.,
> "There are some other parameters we could play with in RGP, but the
> trial and error process could get expensive. Why not try some soft
> torics first, and if that doesn't work out, we can consider the
> options."
> I'm really just interested in generating some discussion on this. I
> realize I'm a somewhat difficult patient since I'm astigmatic and have
> high standards for my vision. I need to decide whether I should
> search for a better OD or not. If I don't, then I have an okay pair
> of RGPs that I think could probably be better, but no avenue to
> improve them. I'll probably ask to try some soft torics, just so I
> know what the current generation is capable of.
> The whole experience kind of reminds me of the time I went to the MD
> complaining of fatigue. He ordered a blood test and a day later a
> nurse called and said "the blood test came back normal, have a nice
> day."

--

#6 08-20-2006, 03:27 AM

Just see other optometrists, get second and third opinions. It is
already clear you are super picky and very difficult. You are not happy
with +.25 or -.25, must be plano. I did tell you that you would never
be happy with orthoK as they would make you hyperopic and result in
blurry vision. I do not believe you when you said you can accomodate
thru a -6 lens when RGPs that slightly overcorrect you cause blurry
vision at all distances!

Also you report RGPs arent comfortable. Why dont you just stick to
glasses, I can see(pun intended) that you are much happier with
glasses. You wont be happy with toric contacts, they dont do nowhere
near as good a job as RGP contacts and wont be comfortable either.

#5 08-19-2006, 11:34 PM

marcia_jay via MedKB.com wrote:

- quote -

> May I ask how you found this optometrist? Was this someone you had
> gone to before for a long time, or someone new you tried?

To write it down sounds kind of bad, but I originally found this doc
because I was looking for a vision therapist. That's his expertise, or
rather developmental optometry. Maybe I was expecting too much for him
to admit if he's out of his comfort zone dealing with RGP contacts.
Having said that though, I did see the contact "expert" of the practice
for my original followup due to a schedule conflict with my normal
person. It's possible that the expert guy would have done things
differently if I had come back to him with my complaints, although he's
the guy who more-or-less blew off my original concerns.

Thanks for the replies. I'll start asking around for where other
people go. If it comes to it, I could go to the local university (as
suggested), which has a well respected optometry program. Downside is
the 40 minute drive.

#4 08-19-2006, 08:08 PM

Charles wrote:
- quote -

> This is a followup to my thread "I think my OD gave up on me". The
> brief summary is: I asked to try RGP contacts. The first set back was
> pretty good, but they were "low riders" and I got glare from the top
> edge of the lens. Night vision was slightly annoying due to some
> flaring/starbursting. So I went back and convinced them to address the
> problem, which they attempted with larger lenses, but the prescription
> came back with too much minus power (and some imbalance) resulting in
> eye strain. They ordered one more set and they came back with too much
> plus, resulting in blurry vision at distance. At that point, they
> basically gave up.
> As a result of feedback from this group, I requested that they modify
> the lenses for more minus and I would pay the bill ($50). They did
> this, and the lenses I got back gave clear vision, but caused (for some
> reason) frequent foggy/dry vision (still sharp) and terrible night
> vision in terms of starbursting.
> So now I'm kind of on my own. No followup was suggested. And as a
> matter of fact, none was ever suggested after the first fitting. This
> bothered me not only because the correctness of the Rx would not be
> confirmed, but also because I wanted to make sure the fit was healthy
> for my eyes.
> Is it too much to ask that my doctor would actually take an interest in
> helping me achieve my goal of clear vision in contact lenses, and
> follow through to make sure I'm happy?
> From postings here and research elsewhere on the net, I know there are
> all kinds of options for contacts. First of all, many brands of soft
> toric. Within RGP there are all kinds of parameters: Size, curvature,
> rigidity of material, other material parameters, size of OZ, spherical,
> back toric, bi-toric, scleral, and surely numerous other things I,
> layman, haven't heard of. Is it appropriate to give up after the first
> try? I never told them I needed and easy or cheap solution.
> The followup after the very first set of lenses really was like that.
> I said "the vision is great, but I get a lot of glare, and kind of hazy
> night vision. Is there something we can adjust to fix that?" The
> reply was basically "no, you'll probably get used to it, have a nice
> day." And I was surprised that no over-refraction was done to see
> whether the Rx was correct (I read the eye chart, 5 feet away).
> One thought I have is this: I don't believe that if the OD was trying
> to fit himself in contacts that he would give up without thoroughly
> exploring the options. It doesn't seem right to tell me that this is
> as good as it gets yet. A more comforting response would be, e.g.,
> "There are some other parameters we could play with in RGP, but the
> trial and error process could get expensive. Why not try some soft
> torics first, and if that doesn't work out, we can consider the
> options."
> I'm really just interested in generating some discussion on this. I
> realize I'm a somewhat difficult patient since I'm astigmatic and have
> high standards for my vision. I need to decide whether I should search
> for a better OD or not. If I don't, then I have an okay pair of RGPs
> that I think could probably be better, but no avenue to improve them.
> I'll probably ask to try some soft torics, just so I know what the
> current generation is capable of.
> The whole experience kind of reminds me of the time I went to the MD
> complaining of fatigue. He ordered a blood test and a day later a
> nurse called and said "the blood test came back normal, have a nice
> day."
> --

Unfortunately, fitting gas perm lenses is fast becoming a lost
art and many colleagues do not know how to troubleshoot
problems well (that and it takes up chair time). But, depending
where you live, should be someone who is competent and
know his/her way around gas perms. Call around and, before
you make an appt, inquire about how much experience the
potential provider has in fitting gas perms. If they hedge, or
don't even respond then I would move on.

Good luck to you.

frank

#3 08-19-2006, 07:44 PM

May I ask how you found this optometrist? Was this someone you had gone to
before for a long time, or someone new you tried?

To find someone really good, who works for you, who fits with you, you may
have to keep trying. Like, ask everyone local you know (friends, coworkers,
neighbors) who has contacts about who they go to. If you hear "I absolutely
LOVE my doctor" you can get the name and number of their doctor, call the
office, explain what happened, and ask how they would handle it. Call a few
places until you hear what makes you feel like you might get the attention
you need. Only then, make the appointment.

It's YOUR eyes, and your comfort, so don't give up because of the convenience
or comfort of the doctor. If you can afford to, keep going until you find
someone right.

Charles wrote:
- quote -

> This is a followup to my thread "I think my OD gave up on me". The
> brief summary is: I asked to try RGP contacts. The first set back was
> pretty good, but they were "low riders" and I got glare from the top
> edge of the lens. Night vision was slightly annoying due to some
> flaring/starbursting. So I went back and convinced them to address the
> problem, which they attempted with larger lenses, but the prescription
> came back with too much minus power (and some imbalance) resulting in
> eye strain. They ordered one more set and they came back with too much
> plus, resulting in blurry vision at distance. At that point, they
> basically gave up.
> As a result of feedback from this group, I requested that they modify
> the lenses for more minus and I would pay the bill ($50). They did
> this, and the lenses I got back gave clear vision, but caused (for some
> reason) frequent foggy/dry vision (still sharp) and terrible night
> vision in terms of starbursting.
> So now I'm kind of on my own. No followup was suggested. And as a
> matter of fact, none was ever suggested after the first fitting. This
> bothered me not only because the correctness of the Rx would not be
> confirmed, but also because I wanted to make sure the fit was healthy
> for my eyes.
> Is it too much to ask that my doctor would actually take an interest in
> helping me achieve my goal of clear vision in contact lenses, and
> follow through to make sure I'm happy?
> From postings here and research elsewhere on the net, I know there are
> all kinds of options for contacts. First of all, many brands of soft
> toric. Within RGP there are all kinds of parameters: Size, curvature,
> rigidity of material, other material parameters, size of OZ, spherical,
> back toric, bi-toric, scleral, and surely numerous other things I,
> layman, haven't heard of. Is it appropriate to give up after the first
> try? I never told them I needed and easy or cheap solution.
> The followup after the very first set of lenses really was like that.
> I said "the vision is great, but I get a lot of glare, and kind of hazy
> night vision. Is there something we can adjust to fix that?" The
> reply was basically "no, you'll probably get used to it, have a nice
> day." And I was surprised that no over-refraction was done to see
> whether the Rx was correct (I read the eye chart, 5 feet away).
> One thought I have is this: I don't believe that if the OD was trying
> to fit himself in contacts that he would give up without thoroughly
> exploring the options. It doesn't seem right to tell me that this is
> as good as it gets yet. A more comforting response would be, e.g.,
> "There are some other parameters we could play with in RGP, but the
> trial and error process could get expensive. Why not try some soft
> torics first, and if that doesn't work out, we can consider the
> options."
> I'm really just interested in generating some discussion on this. I
> realize I'm a somewhat difficult patient since I'm astigmatic and have
> high standards for my vision. I need to decide whether I should search
> for a better OD or not. If I don't, then I have an okay pair of RGPs
> that I think could probably be better, but no avenue to improve them.
> I'll probably ask to try some soft torics, just so I know what the
> current generation is capable of.
> The whole experience kind of reminds me of the time I went to the MD
> complaining of fatigue. He ordered a blood test and a day later a
> nurse called and said "the blood test came back normal, have a nice
> day."
> --

--
Message posted via MedKB.com
http://www.medkb.com/Uwe/Forums.aspx/vision/200608/1

#2 08-19-2006, 07:03 PM

Answers are nice, but in the end I need the lenses. I don't think they
can evaluate and prescribe lenses via webcam...

otisbrown[at]pa.net wrote:

- quote -

> Dear Charles,
> I am certain that the ODs who are dealing with you -- are
> doing the best they can, consistent with the time available.
> Maybe you are expecting too much from them. Perhaps
> you can get a more complete answer to your questions
> and problems on sci.med.vision.
> As you said -- they do this for free.
> Best,
> Otis

--

#1 08-19-2006, 05:39 PM

On Sat, 19 Aug 2006 14:52:51 GMT, "Charles" <nospam[at]nospam.com> wrote:

- quote -

> This is a followup to my thread "I think my OD gave up on me". The
> brief summary is: I asked to try RGP contacts. The first set back was
> pretty good, but they were "low riders" and I got glare from the top
> edge of the lens. Night vision was slightly annoying due to some
> flaring/starbursting. So I went back and convinced them to address the
> problem, which they attempted with larger lenses, but the prescription
> came back with too much minus power (and some imbalance) resulting in
> eye strain. They ordered one more set and they came back with too much
> plus, resulting in blurry vision at distance. At that point, they
> basically gave up.

[snip]

Next recommendation, although it might not be feasible.

Call an Optometry college and make an appointment with the contact
lens resident.

The "job" of a contact lens resident for their one year of extra
training is to gain experience and to try and make "difficult
patients" like yourself happy. They typically will spend as much time
as is necessary and will keep having you come back and make changes
until you get happy or you give up.

Another option is to contact the American Academy of Optometry and see
where the closest "diplomate in contact lenses" practices.

P.S. I hate to tell you this, but many ODs who classify themselves as
"contact lens experts" are nothing of the sort.

08-19-2006, 05:00 PM

Dear Charles,

I am certain that the ODs who are dealing with you -- are
doing the best they can, consistent with the time available.

Maybe you are expecting too much from them. Perhaps
you can get a more complete answer to your questions
and problems on sci.med.vision.

As you said -- they do this for free.

Best,

Otis

Charles wrote:
- quote -

> This is a followup to my thread "I think my OD gave up on me". The
> brief summary is: I asked to try RGP contacts. The first set back was
> pretty good, but they were "low riders" and I got glare from the top
> edge of the lens. Night vision was slightly annoying due to some
> flaring/starbursting. So I went back and convinced them to address the
> problem, which they attempted with larger lenses, but the prescription
> came back with too much minus power (and some imbalance) resulting in
> eye strain. They ordered one more set and they came back with too much
> plus, resulting in blurry vision at distance. At that point, they
> basically gave up.
> As a result of feedback from this group, I requested that they modify
> the lenses for more minus and I would pay the bill ($50). They did
> this, and the lenses I got back gave clear vision, but caused (for some
> reason) frequent foggy/dry vision (still sharp) and terrible night
> vision in terms of starbursting.
> So now I'm kind of on my own. No followup was suggested. And as a
> matter of fact, none was ever suggested after the first fitting. This
> bothered me not only because the correctness of the Rx would not be
> confirmed, but also because I wanted to make sure the fit was healthy
> for my eyes.
> Is it too much to ask that my doctor would actually take an interest in
> helping me achieve my goal of clear vision in contact lenses, and
> follow through to make sure I'm happy?
> From postings here and research elsewhere on the net, I know there are
> all kinds of options for contacts. First of all, many brands of soft
> toric. Within RGP there are all kinds of parameters: Size, curvature,
> rigidity of material, other material parameters, size of OZ, spherical,
> back toric, bi-toric, scleral, and surely numerous other things I,
> layman, haven't heard of. Is it appropriate to give up after the first
> try? I never told them I needed and easy or cheap solution.
> The followup after the very first set of lenses really was like that.
> I said "the vision is great, but I get a lot of glare, and kind of hazy
> night vision. Is there something we can adjust to fix that?" The
> reply was basically "no, you'll probably get used to it, have a nice
> day." And I was surprised that no over-refraction was done to see
> whether the Rx was correct (I read the eye chart, 5 feet away).
> One thought I have is this: I don't believe that if the OD was trying
> to fit himself in contacts that he would give up without thoroughly
> exploring the options. It doesn't seem right to tell me that this is
> as good as it gets yet. A more comforting response would be, e.g.,
> "There are some other parameters we could play with in RGP, but the
> trial and error process could get expensive. Why not try some soft
> torics first, and if that doesn't work out, we can consider the
> options."
> I'm really just interested in generating some discussion on this. I
> realize I'm a somewhat difficult patient since I'm astigmatic and have
> high standards for my vision. I need to decide whether I should search
> for a better OD or not. If I don't, then I have an okay pair of RGPs
> that I think could probably be better, but no avenue to improve them.
> I'll probably ask to try some soft torics, just so I know what the
> current generation is capable of.
> The whole experience kind of reminds me of the time I went to the MD
> complaining of fatigue. He ordered a blood test and a day later a
> nurse called and said "the blood test came back normal, have a nice
> day."
> --

#-1 08-19-2006, 02:52 PM

This is a followup to my thread "I think my OD gave up on me". The
brief summary is: I asked to try RGP contacts. The first set back was
pretty good, but they were "low riders" and I got glare from the top
edge of the lens. Night vision was slightly annoying due to some
flaring/starbursting. So I went back and convinced them to address the
problem, which they attempted with larger lenses, but the prescription
came back with too much minus power (and some imbalance) resulting in
eye strain. They ordered one more set and they came back with too much
plus, resulting in blurry vision at distance. At that point, they
basically gave up.

As a result of feedback from this group, I requested that they modify
the lenses for more minus and I would pay the bill ($50). They did
this, and the lenses I got back gave clear vision, but caused (for some
reason) frequent foggy/dry vision (still sharp) and terrible night
vision in terms of starbursting.

So now I'm kind of on my own. No followup was suggested. And as a
matter of fact, none was ever suggested after the first fitting. This
bothered me not only because the correctness of the Rx would not be
confirmed, but also because I wanted to make sure the fit was healthy
for my eyes.

Is it too much to ask that my doctor would actually take an interest in
helping me achieve my goal of clear vision in contact lenses, and
follow through to make sure I'm happy?

From postings here and research elsewhere on the net, I know there are
all kinds of options for contacts. First of all, many brands of soft
toric. Within RGP there are all kinds of parameters: Size, curvature,
rigidity of material, other material parameters, size of OZ, spherical,
back toric, bi-toric, scleral, and surely numerous other things I,
layman, haven't heard of. Is it appropriate to give up after the first
try? I never told them I needed and easy or cheap solution.

The followup after the very first set of lenses really was like that.
I said "the vision is great, but I get a lot of glare, and kind of hazy
night vision. Is there something we can adjust to fix that?" The
reply was basically "no, you'll probably get used to it, have a nice
day." And I was surprised that no over-refraction was done to see
whether the Rx was correct (I read the eye chart, 5 feet away).

One thought I have is this: I don't believe that if the OD was trying
to fit himself in contacts that he would give up without thoroughly
exploring the options. It doesn't seem right to tell me that this is
as good as it gets yet. A more comforting response would be, e.g.,
"There are some other parameters we could play with in RGP, but the
trial and error process could get expensive. Why not try some soft
torics first, and if that doesn't work out, we can consider the
options."

I'm really just interested in generating some discussion on this. I
realize I'm a somewhat difficult patient since I'm astigmatic and have
high standards for my vision. I need to decide whether I should search
for a better OD or not. If I don't, then I have an okay pair of RGPs
that I think could probably be better, but no avenue to improve them.
I'll probably ask to try some soft torics, just so I know what the
current generation is capable of.

The whole experience kind of reminds me of the time I went to the MD
complaining of fatigue. He ordered a blood test and a day later a
nurse called and said "the blood test came back normal, have a nice
day."

--

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