how to find a good OD for contact fitting

Discussion in 'Contact Lenses' started by max, Nov 2, 2003.

  1. max

    max Guest

    are there any questions i can ask over the phone
    to help determine if i have found a good OD for
    contact lense fitting ?

    for example, are there newer methods/instruments for fittings
    that would reflect somebody keeping up with the times ?

    thanks in advance
    max, Nov 2, 2003
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  2. What an excellent question. I could have saved myself a lot of time,
    money, peace of mind, and headache if I had know to ask the question,
    "Do you prescribe silicone hydrogels?" when I first decided that I
    wanted to wear contacts. Any doctor who answered no to that question
    (or didn't know what I was talking about) would not be somebody who I
    would to trust the safety of my eyes to.

    Lothar (not a doc)
    Lothar of the Hill People, Nov 2, 2003
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  3. max

    drfrank21 Guest

    You have to careful because if you're asking these questions
    to a receptionist who answers the phone you may get dead silence
    (the recept may know the provider fits, for example, the
    Ciba Night and Day lenses but may not have a clue to what
    silicone hydrogels are). And thus you may get a misleading view
    to the capability of the doctor. Anyway, these lenses are NOT the answer
    for every patient if the patient needs torics, rigid, or multifocal
    lenses. The night and days are good lenses but are not the only suitable

    In general, most optometrists are very well versed in contact lenses
    versus opthalmologists where most (and understandibly so) do not place
    much emphasis or else they delegate the fitting altogether to a technician.

    frank (am a doc)
    drfrank21, Nov 3, 2003
  4. max

    The Real Bev Guest

    I think it's fair to ask how many fittings will be included in the price
    and what the policy is if you can't get an acceptable fit. People
    expect one or two, rather than the multi-dozen of my experience which
    apparently put my fitter in the red.
    Friends' recommendations may or may not be useful. If they have simple
    vision problems and you have complex vision problems, their
    recommendations are worthless.

    My computer doesn't have to be friendly;
    civil is entirely sufficient.
    The Real Bev, Nov 3, 2003
  5. Excellent point. I was suggesting that people ask that question of
    the doctor, not the receptionist, but good luck getting through to the
    doctor on an initial inquiry!
    Another excellent point, and I certainly was not trying to suggest
    that a potential new contact lens wearer should necessarily try to be
    fitted with silicone hydrogels. It's certainly true that not
    everybody can be fitted with them, nor should some people even try.
    In fact, I am undecided as to how well they are working for me
    (although I am very optimistic). I do believe though that if a doctor
    prescribes silicone hydrogels for patients for whom they are
    appropriate, then he/she is a doctor who is current with the latest
    research, and is not of the "old school." Sorry if I offended any
    docs out there, but that's what I believe!

    That's a very interesting observation. With the two ophthalmologists
    who I have dealt with for contact lenses, they have both delegated the
    fitting to a technician, one of whom seemed far more knowledgeable
    about contacts than the doctor. The other ophthalmologist, I believe
    to be a well-known authority on contact lenses, so perhaps I got lucky
    there (although I did my research on him before I "hired" him). The
    only reason why I have favored ophthalmologists is that I believe that
    some of the problems I have been experiencing are medical conditions,
    possibly requiring medications prescribed by an M.D., but *without
    question* the best advice I have gotten about contact lenses to date
    has come from optometrists.

    Lothar of the Hill People, Nov 4, 2003
  6. That's a good piece of advice. But don't reject a potential doctor
    just because he/she only includes one or two fittings in the price.
    With my last doctor, I theoretically had an unlimited number of
    appointments to get successfully fitted (that's what I was told,
    anyway), but I was dumped by the doctor after he apparently decided
    that I was no longer worth his time. My current doctor charges an
    initial fee, plus a much reduced fee for each additional visit, and I
    am more than happy to pay this even if it ends up costing me more
    money in the long run. I feel that a doctor deserves to be
    compensated something for every office visit, and if that keeps my
    doctor willing to have me continue to return as many times as I feel I
    need to, then it's worth the cost.

    Lothar of the Hill People, Nov 4, 2003
  7. max

    The Real Bev Guest

    My friend assured me that the guy liked challenges, which I found to be
    true. He had two more possibilities up his sleeve when I finally
    settled for the softies, but I bailed because he said they were REALLY
    expensive and I figured I'd already dealt with as much expense as I was
    willing to.

    I asked the guy at Costco what he was willing to do, and he said "three
    or four fittings."
    I figured that the guy wasn't out of pocket for any of the RGPs I
    returned, but maybe that isn't true. Yo, Docs! How much do you get
    charged for RGPs that get returned?
    The Real Bev, Nov 4, 2003
  8. I got charged US$150 for a pair of Menicon Z's that I was told that
    Menicon would probably refund after I returned them. I returned them
    a month ago, and my doctor's office hasn't credited me yet. I'm glad
    you reminded me to follow up on this!

    Lothar of the Hill People, Nov 4, 2003
  9. max

    Dr. Leukoma Guest

    To my knowledge, the company which is licensed to manufacture the Menicon
    lenses in the U.S. has no such policy, except as it pertains to defective

    Dr. Leukoma, Nov 4, 2003
  10. max

    Dr. Leukoma Guest

    With most labs in my area, the return credit is not 100%, and then only if
    the remake option has not yet been exercised. With one or more remakes, it
    is quite probable that your optometrist ate the lenses. Smart business
    practice, huh?

    Dr. Leukoma, Nov 4, 2003
  11. Oh, no, that does not make me happy! Thanks for the info though. My
    fitter was pretty insistent that I return the lenses to her when I was
    done trying them, so I assumed that she was going to get me a refund.
    Now I see why she charged me for them up front!

    Lothar of the Hill People, Nov 4, 2003
  12. max

    max Guest

    i appreciate all the replies.
    here is what i think i'm "hearing"
    1. make sure the OD is doing the fitting and not some technician
    2. expect to receive a few fittings at the initial cost.
    find out what that number is, and how much beyond that would cost per visit.
    3. without offending any ophthalmologists out there, i plan to go to an
    optometrist because i've had only bad experiences with
    ophthalmologists. plus, i guess, i figure that an
    optometrist would have much more "hands on" experience with fittings

    not mentioned, but am i right to assume that there is no cost
    for the trial soft toric contacts themselves (because the manufacturers
    are more than happy to supply them)

    thanks again
    max, Nov 4, 2003
  13. Don't dismiss a fitting by a technician too easily. The one who I am
    currently seeing is very well trained and published in contact lens
    fitting issues, has many years of experience, and impressed me a lot
    more than either of the ophthalmologists who I have dealt with
    recently--as far as how much time she has been willing to spend with
    me and take the time to answer all my questions, and her overall level
    of competence with contact lenses. I have found my doctors to be much
    less approachable and available, and I have been told on more than one
    occasion by a doctor that I should talk directly to the technician
    next time I call. The doctor is still always available for issues or
    questions that are beyond the technician's level of expertise.

    Having never been to an optometrist before, I don't have a sense for
    how much more personal attention I would have gotten from the doctor.
    I'd be interested in hearing people's opinions on that topic.

    Lothar of the Hill People, Nov 4, 2003
  14. max

    Dan Abel Guest

    You only get one body, and you have to make it last for your whole life.


    One-stop shopping may be convenient for groceries and such, but I have
    some doubts about eye care. The guy down the hall from me at work was
    advised that he needed to see an OMD every year due to certain risk
    factors. He also needed his eyesight checked every year for his glasses.
    So he found an OMD who did glasses, and was located conveniently. He
    wasn't very happy with his glasses, and really didn't save much time since
    he had to keep going back. And he had a sneaking suspicion that the
    doctor was doing glasses because he was semi-retired and didn't want to
    keep up with the latest medical advances. After a few years he switched
    doctors and started seeing both an OD for his glasses and an OMD for his
    other problems.
    Dan Abel, Nov 4, 2003
  15. Ah, that explains why my last fitter was pushing so hard for me to get
    my lenses through her, even though she claimed that they make very
    little profit on lenses and sell them mainly "as a service to their
    patients!" Well, in any case, I have yet to go to a fitter who was
    not very generous about handing out free trial lenses as often as I
    needed, until I was able to make a decision about ordering a supply.
    I had just assumed that they get as many free samples as they want,
    but I see now that's not how it works.

    Lothar of the Hill People, Nov 4, 2003
  16. max

    LarryDoc Guest

    They do. It's not 100% credit, though.


    Dr. Larry Bickford, O.D.
    Family Practice Eye Health & Vision Care

    The Eyecare Connection
    larrydoc at m a c.c o m
    LarryDoc, Nov 4, 2003
  17. I just talked to my old fitter this afternoon. She said they just
    sent me a 100% refund of the US$150 that I paid for them. I guess
    they're eating whatever was the un-reimbursed portion of the return.

    Lothar of the Hill People, Nov 4, 2003
  18. max

    max Guest

    your reference to "... each with overrefraction, slit-lamp check for rotation."
    leads back to one of my questions, or at least the intent of it:
    do all practitioners use the same methods/tools/instruments/devices
    for the contact lense fitting ?

    max, Nov 5, 2003
  19. max

    The Real Bev Guest

    Indeed. He had an office in an upscale hospital, clearly didn't work
    full time, and supported a full-time office girl and an aquarium full of
    nifty rented tropical fish. Maybe he did it as a hobby... These RGPs
    all differed in prescription in one or more areas. Are those
    "remakes?" I would assume that a remake is a replacement for a lens
    made in error, not one prescribed in error.

    "What's truly sad is that your vote counts the same as mine."
    -- S. Brown
    The Real Bev, Nov 5, 2003
  20. max

    max Guest

    thanks mike,
    what does over-refracting accomplish ?
    what does examining contacts under the microscope accomplish ?
    are these standard with you, but not bothered by others ?
    max, Nov 5, 2003
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