Contact Lens Trials

This is a follow-up to what I wrote in the last post to the thread: "Toric
in one eye, multifocal in the other".

I haven't done anything about this since then, as I have been very busy. I'm
wondering what I should do to follow up?

I'm not happy that my O.D. didn't want to give me trial lenses of the
Purevision Toric in -5.0 power for the right eye, and a Purevision
Multifocal for the left. As I wrote, he didn't think the multifocal in the
left would be a good idea at all (although eye docs who write here thought
it was feasible). He thought reducing the - power of the right eye (distance
in monovision) to -5.0 (instead of -5.25) was a good idea, to improve near
vision a little. Yet, he didn't want to give me a trial lens at the 5.0
power, but just wanted to order me a box. I said I'd "think about it", and
left it open, and haven't called back since. (Please see that other thread
for details.)

What do the eye docs here think about that? Would you not want the patient
to try a particular lens, before buying it? And if the patient wanted to try
a multifocal in one eye, even if you didn't think it was the best idea,
would you let him/her try it? Getting a good contact lens choice for an
individual patient, especially a presbyopic one like me, requires a lot of
trial and error, no? And the manufacturers give you free lenses to try on
patients, no?

As said, I quite likely will look for a new eye doc next year. (This one
didn't even give me a glaucoma test. Isn't that a standard part of an eye
exam?) (So, his unwillingness to give me more trial lenses is likely to lose
him a patient.) But for this year, I have already assigned my VSP benefits
to this doc, and had an exam with him, so I have to decide what to do for
this year.

Have any other patients here experienced that--eye docs who were reluctant
to give trial lenses?

Should I just accept it, and buy a box of the Purevision Toric -5.0
(cylinder .75) for the right eye, without having ever tried that lens
(although I did try it, wearing right now, in -5.25), and Night&Day -4.5
(same as I have worn for years) in the left? Or, should I call again and
speak to the doctor, perhaps catch him in a better mood, and be more
insistent on getting the trial lenses mentioned, before deciding for sure
what to order?

Curious to hear feedback about this from other eye docs and patients. (Once
again, for more details, look at the thread I cited at the beginning of this
post.)

Thank you for your feedback. :-)

On Nov 24, 12:35 pm, "MS" <m...@nospam.com> wrote:
> This is a follow-up to what I wrote in the last post to the thread: "Toric
> in one eye, multifocal in the other".
>
> I haven't done anything about this since then, as I have been very busy. I'm
> wondering what I should do to follow up?
>
> I'm not happy that my O.D. didn't want to give me trial lenses of the
> Purevision Toric in -5.0 power for the right eye, and a Purevision
> Multifocal for the left. As I wrote, he didn't think the multifocal in the
> left would be a good idea at all (although eye docs who write here thought
> it was feasible). He thought reducing the - power of the right eye (distance
> in monovision) to -5.0 (instead of -5.25) was a good idea, to improve near
> vision a little. Yet, he didn't want to give me a trial lens at the 5.0
> power, but just wanted to order me a box. I said I'd "think about it", and
> left it open, and haven't called back since. (Please see that other thread
> for details.)

I expect his reluctance to trial the multifocal was because you didn't
like it when you tried it previously. You are currently successfully
wearing the -5.25 toric trial. Toric trials often have to be ordered,
there is a cost in office time and sometimes shipping costs to do this
and B&L has a generous return policy for lenses. From his point of
view and knowing you and your eyes quite well he is likely very
confident that the lower power will work so might as well order the
lenses now and exchange later if need be. There is an expense to
doctor and office time even if the trial lenses are free from the
company.

Dr Judy

"Dr Judy" <(E-Mail Removed)> wrote in message
news:a50dd04e-f96a-4f1b-bc50-(E-Mail Removed)...

> I expect his reluctance to trial the multifocal was because you didn't
> like it when you tried it previously. You are currently successfully
> wearing the -5.25 toric trial. Toric trials often have to be ordered,
> there is a cost in office time and sometimes shipping costs to do this
> and B&L has a generous return policy for lenses. From his point of
> view and knowing you and your eyes quite well he is likely very
> confident that the lower power will work so might as well order the
> lenses now and exchange later if need be. There is an expense to
> doctor and office time even if the trial lenses are free from the
> company.
>
> Dr Judy


The question is--what does one mean by "successful"? With contact-lens-only
(no reading glasses) fitting of presbyopic patients, whether monovision or
multifocal or a combination of the two, there is always a compromise between
near and distance vision, there is no perfect fitting. Of course, the goal
is to get the best compromise between the two, for the patient's needs. That
is often subjective, and has to be decided by the patient, regarding what
level of compromise he or she finds works best for him or her. That takes
trial and error, experimentation.

So, you write that I am "successful with the -5.25 toric trial. Yes, I can
get by with them, and my distance vision is better than before, when I did
not use a toric lens. However, the near vision is a bit worse. So, I wanted
to try to improve the near vision, without too much negative impact on
distance vision. To know what is a successful compromise, I have to try it,
no?

I guess one could figure that a quarter diopter is a small amount, so the
vision won't be too much different than now. So yes--changing to the 5.0
would probably work OK, I'm sure I could get by with them. But of course,
from my perspective, I want to find the best possible compromise, before
deciding on what to settle with. Is that too much to ask? One would think
doctors would want to keep their patients happy, in order to keep them.

I have been there when the office staff has called the optical company to
order a trial lens. it seems to proceed very quickly--no more than a minute
or two. Not a lot of office time. The optical companies charge postage to
the doctors, when they send them trial lenses? That surprises me, as it is
in the optical company's interest to have patients try their lenses.
Nevertheless, the postage charge to send one contact lens could not be very
high (less than an ounce=41 cents first class mail), not a big expense.
Again, one would think it is in the doctor's best interest to keep his
patients happy.

My two cents on that.

"Mike Tyner" <(E-Mail Removed)> wrote in message
news:a4mdnSE-(E-Mail Removed)...

> Somehow the 41 cents turns into $5.95 when I order trials.

> -MT

Do you mean that they charge $5.95 to ship each individual trial lens? I
think that's outrageous! In fact, the actual material and manufacturing cost
of one contact lens, plus the actual shipping cost, probably adds up to much
less than that. So the manufacturers are actually profiting from trial
lenses, which supposedly they are giving complementarily.

I don't think that's a very wise business decision. If manufacturers really
want patients to try their lenses, want doctors to prescribe trials of their
lenses for patients, they really should provide the trial lenses for free.



Regarding looking through a glass to see what the lessening of the right
eye's minus power by a quarter diopter would be like, sure., I could do
that. But looking through a glass for a moment, while sitting in the
optometrist office, is not anything like wearing a pair of lenses for a
week, in all different conditions, and seeing what one's vision is like in
different conditions, both near and far.

In article <(E-Mail Removed)>,
"Mike Tyner" <(E-Mail Removed)> wrote:

> "MS" <(E-Mail Removed)> wrote

> > that. But looking through a glass for a moment, while sitting in the
> > optometrist office, is not anything like wearing a pair of lenses for a
> > week, in all different conditions, and seeing what one's vision is like in
> > different conditions, both near and far.
>
> Still, 20 feet is 20 feet. Observing with/without the +025 lens would give
> reliable information.

I'm with you here, Mike. Observing under controlled conditions, like a
fixed distance and fixed illumination, tells a lot more than a week of
random circumstances. Especially for .25D. Vision isn't my area of
expertise, but human nature is the same. Have a good lunch? Everything
works fine. Have a fight with your spouse? Nothing works right.

"Mike Tyner" <(E-Mail Removed)> wrote in message
news:(E-Mail Removed) ...

> It seems like the doctor was agreeing with you. He sounded confident you'd
> be happy with -5.00, and you didn't trust him. There are several reasons
> to believe -5.00 would work.

> -MT

No, it is not a matter of "not trusting him that 5.0 would work". In fact,
it was I who suggested that. Only, that I think it would be best to try it
out, to see if that particular compromise (between near and far) is right
for me.

Actually, I'm sure too that it would "work", if by work you mean acceptable,
passable, able to get by. But as said, in coming to a compromise between
near and far vision, one wants to find the best possible compromise, not
just settle for anything that "works".

If you were prescribing a presbyopic contact lens solution for yourself, or
someone in your family, wouldn't you want to experiment to find the best
solution for that person? Would you order a box of lenses for yourself,
without having a trial of that particular lens and strength first?

"Dan Abel" <(E-Mail Removed)> wrote in message
news:dabel-(E-Mail Removed)...
> In article <(E-Mail Removed)>,

> I'm with you here, Mike. Observing under controlled conditions, like a
> fixed distance and fixed illumination, tells a lot more than a week of
> random circumstances. Especially for .25D. Vision isn't my area of
> expertise, but human nature is the same. Have a good lunch? Everything
> works fine. Have a fight with your spouse? Nothing works right.

Dan---real life is full of "random circumstances", it isn't usually looking
at everything with "fixed distance and fixed illumination". In one's daily
life, one has to use one's vision for all sorts of purposes, seeing all
different kinds of things, different sizes, different distances, and with
different illumination. Not "fixed" at all.

Therefore, the best way to see if lenses will work for you in real life, is
to try them in real life. Common sense.

In article <cRq2j.6812$Mr.1326@trnddc04>, "MS" <(E-Mail Removed)> wrote:

> "Dan Abel" <(E-Mail Removed)> wrote in message
> news:dabel-(E-Mail Removed)...
> > In article <(E-Mail Removed)>,
>
> > I'm with you here, Mike. Observing under controlled conditions, like a
> > fixed distance and fixed illumination, tells a lot more than a week of
> > random circumstances. Especially for .25D. Vision isn't my area of
> > expertise, but human nature is the same. Have a good lunch? Everything
> > works fine. Have a fight with your spouse? Nothing works right.
>
> Dan---real life is full of "random circumstances", it isn't usually looking
> at everything with "fixed distance and fixed illumination". In one's daily
> life, one has to use one's vision for all sorts of purposes, seeing all
> different kinds of things, different sizes, different distances, and with
> different illumination. Not "fixed" at all.
>
> Therefore, the best way to see if lenses will work for you in real life, is
> to try them in real life. Common sense.

Common sense sucks. Under controlled conditions, common sense is
sometimes wrong. Trusting other people's common sense is a bad idea.
Show me.

"Dan Abel" <(E-Mail Removed)> wrote in message
news:dabel-(E-Mail Removed)...

> Common sense sucks. Under controlled conditions, common sense is
> sometimes wrong. Trusting other people's common sense is a bad idea.
> Show me.

Not talking about "other people's common sense". I would trust my own
judgment, in trying different lens combinations (in conjunction with an eye
care professional) to deal with my myopia-presbyopia, to determine which
combination works best for me. No one else could make that determination.

"Anon E. Muss" <(E-Mail Removed)> wrote in message
news:(E-Mail Removed)...
> On Mon, 26 Nov 2007 03:13:12 GMT, "MS" <(E-Mail Removed)> wrote:
>
> As long as you are willing to pay up, then I see no reason a doctor
> couldn't accommodate you.

You and others say that it costs an eye doctor more to try more lenses on a
patient, even though they are complimentary.

Assuming that is the case, even if looked at only from a business
perspective (disregarding such characteristics as conscientiousness, caring,
etc.), is it a wise business decision to save a few pennies (or even a few
dollars) by denying a patient trial lenses, when the doctor might lose that
patient as a result (as well might happen in my case)? Isn't it smarter to
keep one's patients happy, so they keep coming back to you, even if that
costs a few more dollars in trial lenses?

Eye docs might want to lobby contact lens manufacturers, however (through
their professional organizations) for a more liberal policy and allotment of
trial contact lenses, since it is also in the manufacturer's best interests,
to have more patients try their lenses.