How long does an RX last?

Discussion in 'Optometry Archives' started by timbirr, Jul 23, 2005.

  1. timbirr

    timbirr Guest

    Went to my opthalmologist in the spring and she decided I needed to
    think about getting progressive lenses.

    So, the doctor gave me a new prescription. Pre-printed on all the
    prescriptions is the phrase "Not valid after four months."

    I didn't really care, since I went off to get new glasses fairly
    quickly. But, I was curious. I went to three different optical goods
    stores -- all independent shops.

    One is associated with a practicing opthalmologist. The second was
    associated with two practicing optometrists, while the third store was
    in a shopping center strip mall and has an optometrist available for
    limited hours.

    I really disliked the shopping center spot, but I asked the woman
    helping me how long my prescription was valid for. She said four
    months. No "ifs, ands or buts."

    At the optometrist shop, I asked the same question. The woman told me
    that the opthalmologist I consulted has the "four months" statement on
    all prescriptions, but in our state, by law, Vision RX's are good for
    two years.

    At the final shop (where I ended up filling my RX), the one associated
    with a different opthalmologist, the optican (and he was a certified
    optican) told me that my opthalmologist was a fine doctor, but has a
    thing about this four months, that it is a quirk and that they
    routinely ignored the four month statement and If I needed it filled ,
    say, seven months later, it would be no problem.

    So, just curious about this expiring RX, what is the usual and
    customary?
     
    timbirr, Jul 23, 2005
    #1
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  2. timbirr

    Mark A Guest

    The laws in question are promulgated and enforced by each state. Most state
    laws say that the Rx is good for 1 year (sometimes 2) from the date of the
    exam, or the expiration date on the Rx, whichever is sooner.

    The optical shop associated with a different ophthalmologist can legally get
    around that since the different ophthalmologist can legally write his own Rx
    (with or without giving you an exam).

    Unless you have some special problem, the ophthalmologist is probably tying
    to drum up more business by limited the Rx to 4 months. However, unless you
    have some special eye problem, you are much more likely to get a better Rx
    at an optometrist than an ophthalmologist, assuming that you make a slight
    effort to find a respected optometrist.
     
    Mark A, Jul 23, 2005
    #2
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  3. timbirr

    timbirr Guest

    As mentioned, the expiration was not really an issue with me, I was
    just curious about the different interpretations of the "law."

    I have ocular hypertension -- but no damage as of yet and no treatment
    other than watchful waiting, so I see the opthalmologist regularly.

    A bit curious why you would submit that an optometrist would give a
    better exam than an MD. I would say they could give "just as good," but
    I would be surprised if they consistently "beat out" the physician.
     
    timbirr, Jul 23, 2005
    #3
  4. The can of worms that you have just opened has been debated for nearly
    a hundred years. The argument that an optometrist provides a better
    glasses prescription is based on the premise that the two professions
    are taught to view the eye differently.
    An ophthalmology resident becomes an MD first, and then during his
    residency he specializes in diseases and surgery of the eyes. During
    that two year residency he is expected to master his surgical
    techniques and the diseases of the eye. Refraction is often limited to
    a couple of weeks study during a typical ophthalmology residency.
    Opthalmologists training is based on the "medical model" of the eye.
    That model of the eye views the eye like any other organ in the body.
    When it breaks, you need to fix it.
    An optometrist typically goes to undergrad for 4 years in any
    scientific discipline, and then his entire 4 years of grad school are
    dedicated to the eye. An optometrist cannot do surgery on the eye and
    never becomes an MD. The optometrist views the eye with a different
    orientation because he spends most of his 4 years on the "functional
    model" of the eye. The functional model is a series of beliefs that
    view the eye as a gateway to the complex visual system, with an
    emphasis on perception and interpretation of the image. An optometrist
    is more likely to prescribe prism in a pair of glasses before
    strabismus surgery. An optometrist is more likely to prescribe vision
    therapy for a child who reverses his letters and numbers. Refraction
    is given much more emphasis during optometry school than during an
    ophthalmology residency.

    I often tell my patients that getting an eyeglass prescription from
    your opthalmologist is like getting your physical from a cardiologist.
    He can do one, but he probably hasn't done one for years and he doesn't
    necessarily pay attention to all of the results. You get your best
    physical from a primary care doctor and your best refraction from an
    optometrist.
     
    doctor_my_eye, Jul 23, 2005
    #4
  5. timbirr

    Mark A Guest

    As I already said, if the "other" ophthalmologist owns the store where you
    purchased the lenses, then the optician could legally get the "other"
    ophthalmologist to extend the Rx expiration date even without giving you an
    exam (but not past the default time for your state).

    Ophthalmologists are medical doctors. They get the same general medical
    training as all other doctors on a wide variety of medical issues. After
    medical school, they go into residency for a specialty. When they open a
    practice of their own, they spend most of their time dealing with eye
    diseases, surgery, and only part of their time giving eye exams.

    OD's are trained to give eye exams as part of their OD (Dr of Optometry)
    schooling, and obviously eye care is the focus (no pun intended) of their
    medical education. When they receive their OD degree and start working, they
    spend almost all of their time giving eye exams.

    Certainly, ophthalmologists are very intelligent people, but common sense
    would suggest their on the job experience in giving eye exams (especially
    for those without any eye diseases) is much less than an OD.

    My own experience, having worn glasses for 50 years, has been that I have
    had horrible Rx's from ophthalmologists, and generally very good Rx's from
    OD's.
     
    Mark A, Jul 23, 2005
    #5
  6. timbirr

    Dr. Leukoma Guest

    The answer to your question depends upon the laws of the state of
    jurisdiction. In Texas, there is no mandatory expiration date for a
    spectacle prescription. However, by the same token, it can be whatever
    the issuing doctor says it is. In the absence of an expiration date,
    it is customary practice not to fill any prescription that is more than
    two years/old.

    With regards to eye examinations, an optometrist is held to the same
    standard of care as an ophthalmologist in the eyes of the law. In
    Texas, it is quite common for MD's to delegate the refraction to a
    technician. In Texas, the rules governing optometry specifically
    prohibit delegation of the refraction part of the exam.

    DrG
     
    Dr. Leukoma, Jul 25, 2005
    #6
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