How much to expect from OD?

Discussion in 'Optometry Archives' started by Charles, Aug 19, 2006.

  1. Charles

    Charles Guest

    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

    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

    Charles, Aug 19, 2006
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  2. Charles

    otisbrown Guest

    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

    As you said -- they do this for free.


    otisbrown, Aug 19, 2006
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  3. Charles

    Charles Guest

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

    Charles, Aug 19, 2006
  4. Charles

    drfrank21 Guest

    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.

    drfrank21, Aug 19, 2006
  5. Charles

    Charles Guest

    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.
    Charles, Aug 20, 2006
  6. Charles

    Ace Guest

    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.
    Ace, Aug 20, 2006
  7. Charles

    Charles Guest

    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, Aug 25, 2006
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