how to find a good OD for contact fitting

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

 

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)

 

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
lens.

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)

 

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.

--
Cheers,
Bev
*******************************************
My computer doesn't have to be friendly;
civil is entirely sufficient.

 

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

 

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

 

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?

 

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

 

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
lenses.

DrG

 

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?

DrG

 

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

 

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

 

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

 

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.

 

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

 

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

--LB

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

The Eyecare Connection
http//www.eyecarecontacts.com
larrydoc at m a c.c o m

 

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

 

mike,
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 ?

thanks
max

 

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.

--
Cheers,
Bev
=============================================================
"What's truly sad is that your vote counts the same as mine."
-- S. Brown

 

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 ?
thanks
max