!@#$%^&* doctor won't let me change contact lens brand

I recently had a contact lens exam, and the doctor choose to give me
Focus Night & Day lenses. I tried to buy similar spec lenses (Acuvue
advanced) and the on-line store just emailed me this:

--------------------------------------------------------------------
We are writing in regards to a recent order you have placed with us.

Your doctor's office has unfortunately informed us that your
prescription
is not valid for the lenses you have ordered. Your doctor says you are
prescribed to wear Focus Night & Day. Please
confirm if you would like us to send your lenses in the product
indicated
by your eye doctor. Any adjustments to the costs will be made unless
otherwise requested.

Please respond to this email and indicate how you wish us to proceed.
If
we do not receive your instructions within one week, we will
unfortunately
be required to cancel your order and refund your credit card.

 

Not only is it legit, but it's a requirement of the law (in the U.S.,
anyway). I'm gratified to see that the mail-order places are doing
what they are supposed to.

Lothar

 

Why do you want to switch brand?

It can be done, but you will require refitting and
follow-up from a trained professional. CL prescriptions
are brand-specific, no "generics".

Contact lenses are _NOT_ fungible commodities. They are
individually fitted items with unpredictable compatibility.
They all are made of different plastics and have different
thickness profiles.

One brand can be great (good correction, fit well,
comfortable and minimal deposits) while another with
_EXACTLY_ the same power, BC & Dia spec can be horrible.

-- Robert

 

OK, let's say that you have a cough and a low grade fever and your doctor
prescribes a common antibiotic such as erythromycin. After 7 days you
haven't improved, and so you call your pharmacist and ask for a different
antibiotic. You are still alive, no better, but no worse, either.

DrG

(Kiriakos Georgiou) wrote in

 

AND, which is a bigger nuisance, individual specimens from the same
6-pack can be excellent or rotten. So far it's running more rotten than
excellent for one eye.

 

Well, it might be the law - but I don't agree with it. The way I see
it as long as the power, base curve and diameter are the same I should
be able to wear whatever brand I want. The only benefit from not
being able to do so is $$$ to doctors and manufacturers. I got upset
enough by this to research it - I had the opportunity to buy whatever
brand I wanted from overseas, but the rep convinced me that the Focus
Night & Day that my doctor prescribed are currently the so called
state of the art, so I forked the $98 for 12 lenses, twice as much as
the next best. I'll see how it goes with these long term, maybe I'll
switch next time, but no, the doc is not getting a 'refitting' fee for
saying "yeap, looks ok to me".

 

Even if the power, base curve and diameter are the same, it does not mean it
will fit the same. This is due to differences in the plastic composition as
well as the fact that the curve is not just a spherical shape, and varies
between manufacturers. When a contact is prescribed, it is done so with an
assurance that if fits correctly. Fit needs to be rechecked periodically, as
the fitting requirements may change over time, and the same lenses may not
continue to have a proper fit.

If a different lens is chosen, the doc cannot just order it sight unseen -
they have to see it on your eye. That is the refitting fee. The "yeap, looks
ok to me" is the required assurance that it IS correct. That is medical
dispensing, and the law, which is there to protect people from getting
something that may otherwise blind them.

Sorry, I don't see how you can truly disagree with that, unless you like
playing Russian Roulette with your vision. This is not the same as buying
shoes on the internet.

 

So, switching from CIBA Focus Night & Day to J&J Acuvue Advance will
blind me. Please oh please!

.....and here is the kicker: CIBA, the FDA, and the doc are telling me
I can safely wear the Night & Day lenses without removing them at
night for up to 30 days, and these are the people who supposedly are
looking out for... me!???

Having worked at my father's RX lab since I was a little kid I made
more lenses by age 25 than your average doc will prescribe in his
lifetime. I have seen the reality on the front lines, at the lab and
at the many many opticians I dealt with (in Greece). If you stick to
the power, base curve, and diameter the doc prescribes, remove them at
night and clean them with a compatible no-rubbing system (like
AOSEPT,) you will be served well regardless of who made the lenses.
The raw material lenses are made from, regardless of type, costs
pennies and the manufacturing process is standarized and not rocket
science. I have worn many lenses I made myself

Also, it's best to avoid wearing the contacts if regular glasses will
do (eg around the home). Neither CIBA, nor the doc or the FDA will
tell you this, instead they will tell you that this product can be
worn for 30 days straight, which is crazy - I have the lenses and I
can see the deposit build-up every night when I remove them.

Anyway, back to writing software to pay the mortgage

K

 

Possibly. A remote possibility, but complications like
neovascularization, GPC and corneal abrasion are much more
likely first and will reduce visual comfort and acuity.

Yes. AFAIK, the N&D are made of a different material (silicone
hydrogel) with much greater oxygen permiability and generally lower
deposit attraction. Safer for long-term wear. Not perfectly safe,
but nothing is.

You made soft hydrogel CL's in your lab??? I've never heard of
this in a field lab. I believe in the old days that somtimes
opticians would grind the outside of hard (polymethylmethacrylate)
CL's but I don't think this has been done for many years.

AFAIK, AOSept is still rub with Miraflow. There are other
no-rub peroxide systems.

-- Robert

 

Women instinctively understand this because a size 6 in one brand is a
size 7 in another or a size 5 in yet another. Moreover, in the same
brand, shoes (or garments, for that matter) in a different style in the
same nominal size will vary widely in actual dimensions. Guys,
unfortunately, are able to order shirts by neck size and sleeve length
and not have to worry about anything else unless their particular
belly-shape or height is grossly different from 80% of the population.

 

These lenses are approved for doctors to prescribe for patients for up to 30
days wear. That does not that you personally can safely use them for 30
days, but that your doctor can fit them, monitor your response, and if it
proves safe for you personally, then prescribe them

Dr Judy

 

No, I haven't made any lenses for about 12 years now. Hydrogels are
new, but it's just another material, I am sure they are made like all
CLs. There is not much to it really so long you have all the
equipment. BTW, it wasn't a field lab, it was a full blown lab
putting out 100+ special RXs/day back in its glory days. For a small
country like Greece that's quite a bit. When we visited the UK to buy
surfacing equipment from Norville the lab there was putting out
something like 5,000 special RXs - either a day or a week, I don't
recall - it was an impressive number.

Kiriakos

 

I don't believe this is true of hydrogels. I've never heard
of them being custom ground, perhaps because the material
is somewhat variable, and so much depends on exactly how it
hydrates. It may not even be grindable! Mfrs doing production
runs can test and reset equipment by lot. A custom lab would
have to grind two or three test lenses for each sold.

-- Robert

 

I suppose there is less of a need for 'custom' contacts since most
contact RXs are simple enough for the optician to either have them
stocked or a phone call away from the warehouse. So if power
unpredictability is the only issue, it is conquered with
mass-production. With the right test equipment to facilitate
automation, I don't see why a small lab can't put out some impressive
output even with unpredictable material. How you compete with the big
brands is another question, but for some markets price can be a huge
weapon. Not everybody can afford the prices the industry is squeezing
out of people in USA & Europe. The big boys can sell a lens that cost
them $3 to make for $8, but if you trully sell an equally good product
for $3.50, you can compete.

K