Poly for children mandated by law?

[Aarlan]

Hello all,

Sorry it's been a while since I checked in on the O-board. I hope everyone is happy and healthy.

I have a question. I was having a discussion about children in polycarbonate lenses with another associate. I had suggested that poly was definitely appropriate, but trivex (since it has many properties similar to that of poly in terms of tensile strength and impact resistance) would be another option. My colleague responded that poly was MANDATED BY LAW, and that not selling Poly was illegal.

Pardon my ignorance, but in all my years I hadn't heard that it was legally mandated. Yes the 'duty to warn' movement established the proper standard of care, and that in almost all cases poly for children was a virtual necessity (out of concern for their safety, and for litigous reasons...again 'standard of care'), and most opticals sell poly to children as a matter of policy, but when, if ever, was it a legal obligation? Which law, federal or state?

Now, for some background, I'm from the state of CT, and the person I was speaking to was from MA. Are there state statutes that are in effect there? Is there a fed reg that I'm somehow ignorant of?

Thanks for your time.

AA

[chip anderson]

Thus far nothing is mandated by law for children specificly. As to a liability lawsuit, this is another matter. In many Rx's CR-39 is all you can get.

Chip

However, if the poly people can spend the right amount in your legislature, and with those "experts" that influence the legislature who knows what the wind will blow in.

[Rocn32]

In our office, if the parent should insist on a lens not made of poly, we simple have them sign a waiver of release form. My experience has only seen several parents who refused to purchase poly lens for their child.

[ziggy]

My colleague responded that poly was MANDATED BY LAW, and that not selling Poly was illegal.

Welcome back! Aarlan. Your right Trivex is ok to use.
I never stoped being amazed by some opticians. AA you tell your associate I said he was a dumb a$$. Not only is Trivex an option but so is CR-39, mid/hi-index and yes even glass. You as an optician have a "DUTY TO WARN" thats it. This is not only with kids but every patient. The above statement was,(most likley) told to your friend by some retail manager who wanted to increse his poly percentage. Aarlan, as a rule of thumb, if you hear an optician say something is aginst the law,in reguards to optics, you can bet they, A. have NO idea what the heck they are talking about, and B. they are most likley wrong.

[Fezz]

. Aarlan, as a rule of thumb, if you hear an optician say something is aginst the law,in reguards to optics, you can bet they, A. have NO idea what the heck they are talking about, and B. they are most likley wrong.

I agree 100%! I have had plenty of conversations with this type of moron. I have learned to let them spit there ignorance and patiently ask them about there law degree. Laws are tough for the lawyers and judges to follow. How in the heck did this typical, uneducated, wingnut get there fancy law issues certified? These folks like to tell you how you can only use poly, not trivex, trivex is not as strong, as clear, as impact resistant, as optically pure, blah, blah, blah........ These "Opticians" are the same Blowhards who love to hear themelves blabber on at the optical meetings or seminars.

[allanon]

Not mandated here in Virginia... although I think it should be :)

I write all my kid scripts as "Poly only unless parental consent." I used to write "Poly Only" until a parent raised a fuss at a 1hr and I had to hear about it over the phone. CR39 in kids as insisted by well-informed parentals should be negligence.

[gemstone]

Poor little ones deserve the best acuity we can give them. Gentex would love for it to be law. They have made many $$ by those stupid opticians that think it's the law. Poor little guys.

[ziggy]

I had an "optician" tell me once that "it was aginst federal law to dupe a Rx off a pair of specs". I told him if he could show me that law in writing I would break my PD stick and give up my license. Still got both.

[ziggy]

Not mandated here in Virginia... although I think it should be :)

I have never seen a kid or adult have an eye injury due to not wearing poly lens, never, not one. Ive seen a lot of poeple hurt who didnt wear glasses when they should have.. but never one who had glass,cr-39 or something other than poly lens.

[MarcE]

all of the above statements are correct
Remember that you can make ANSI approved safety specs from CR-39, Mid-index, or anything else, including glass. I think the kiddies will be OK in CR-39.

ALLANON - I might suggest that you add Trivex to the script

This has been addressed before on this board, but remember that most state Medicaid programs won't pay for poly, but they will pay for glass, even on children. And most states (if not all) won't let you bill the patient for the difference. Our state Medicaid kids get poly by default anyway, It's just one of the "value-added" benefits that you get at our place.
I don't know how to handle round segs in poly, though. Poly round segs cost me more than the Medicaid reimbursment.

[gemstone]

all of the above statements are correct
Remember that you can make ANSI approved safety specs from CR-39, Mid-index, or anything else, including glass. I think the kiddies will be OK in CR-39.

ALLANON - I might suggest that you add Trivex to the script

This has been addressed before on this board, but remember that most state Medicaid programs won't pay for poly, but they will pay for glass, even on children. And most states (if not all) won't let you bill the patient for the difference. Our state Medicaid kids get poly by default anyway, It's just one of the "value-added" benefits that you get at our place.
I don't know how to handle round segs in poly, though. Poly round segs cost me more than the Medicaid reimbursment.

CR39!:hammer:

[Fezz]

Gentex would love for it to be law.

Doesn't GENTEX=ESSILOR? I BELIEVE SO. I guess than that Essilor would love for it to be law.

[Dave Nelson]

I have never seen a kid or adult have an eye injury due to not wearing poly lens, never, not one. Ive seen a lot of poeple hurt who didnt wear glasses when they should have.. but never one who had glass,cr-39 or something other than poly lens.

Same. Thirty years,zip eye injuries from cr-39.

[Chris Ryser]

Doesn't GENTEX=ESSILOR? I BELIEVE SO. I guess than that Essilor would love for it to be law.

You are guessing right.....................an optical lens is made and molded exactly like those party spoons and forks and from the same basic materials. The only extra is the hard coat.

Make you own deductions on the profitability. :bbg:

[Joann Raytar]

Same. Thirty years,zip eye injuries from cr-39.

We've seen one injury. Car airbag deployed and split a CR-39 lens in half. Don't know if it was the lens or the eyewire which broke as well but the patient ended up with a really good gash on his lid.

[RT]

Poly and Trivex are sometimes referred to as "high impact resistant" materials, because they pass certain tests that other materials can't. For a long time, poly was the only material in that category, which is why the Polycarbonate Lens Council brought forth the Duty To Warn notion so aggressively. That group does not appear to still be functional.

But as noted by other posters, Duty to Warn is merely a concept designed to avoid liability in potential lawsuits due to product failure, and is not "law". The concept was basically "Well, I warned Mommy and Daddy that they weren't purchasing the most impact resistant lens material, so it's not my fault Junior lost an eye".

I'll leave it to the government-conspriacy theorists on the board to debate whether the lack of large numbers of product liability suits is because all lens materials naturally protect our eyes and thus use of high-impact materials is silly, or is really because the widespread use of high-impact materials in high risk cases (kids, sports goggles, etc.) has been generally successful.

[EyeFitWell]

Check out this thread from a couple months ago,
http://www.optiboard.com/forums/showthread.php?t=20933

[MarcE]

I had an "optician" tell me once that "it was aginst federal law to dupe a Rx off a pair of specs". I told him if he could show me that law in writing I would break my PD stick and give up my license. Still got both.

It's not "federal law", but it is Kansas statute:

65-1504b. Unlawful to dispense ophthalmic lens or lenses without prescription order. It shall be unlawful for any person to dispense an ophthalmic lens or lenses without first having obtained a valid, unexpired prescription as defined in K.S.A. 65-1501a, and amendments thereto, or order therefore from a duly licensed optometrist or a person licensed to practice medicine and surgery. An ophthalmic lens shall include a contact lens with or without power.

In addition
65-8-4. Content of prescription. . . .
(b) No prescription for spectacle lenses shall include instructions to obtain the specifications from existing lenses without examination.

Good thing you don't dispense in Kansas - you would have to buy a new PD stick.

[allanon]

I have never seen a kid or adult have an eye injury due to not wearing poly lens, never, not one. Ive seen a lot of poeple hurt who didnt wear glasses when they should have.. but never one who had glass,cr-39 or something other than poly lens.

That's a good thing. I highly recommend a book by John Classe called "Legal aspects of optometry."

It may enlighten you.

[efsamuel]

I think really common sense needs to be the biggest issue in dispensing poly for kids. We have several young patients with +4 and up Rx's. I usually let mom and dad make the discision between a high index vrs poly. I think when dealing with a sufficent CT to begin with may as well have a lens that will stay in some of the kids frames out there. The best example is a boy (4 yrs) w/ +6.50/+5.25 in a 1.67 nice looking rectangular frame. Mom is happy as when he starts kindergarten next year his glasses will look just like everyone elses, and his eyes (big to begin with) will not be "bugged out". Obviously every RX will not work this way but look at what the final product is going to have and you may have the "saftey" already covered.

[allanon]

I think really common sense needs to be the biggest issue in dispensing poly for kids. We have several young patients with +4 and up Rx's. I usually let mom and dad make the discision between a high index vrs poly. I think when dealing with a sufficent CT to begin with may as well have a lens that will stay in some of the kids frames out there. The best example is a boy (4 yrs) w/ +6.50/+5.25 in a 1.67 nice looking rectangular frame. Mom is happy as when he starts kindergarten next year his glasses will look just like everyone elses, and his eyes (big to begin with) will not be "bugged out". Obviously every RX will not work this way but look at what the final product is going to have and you may have the "saftey" already covered.

That's our thinking, too. Little Johnny at -9.00 does't deserve to be chastized because poly is too thick.

On another note... I had a guy catch a bungee cord with his 1.67's and they were fine. The frame gave him a nice shiner.

Then there's the welder that dropped his torch. It bounced and smacked his lens near the eyewire screw. Looks like he took a cigarette lighter to his lens.

[ziggy]

It's not "federal law", but it is Kansas statute:

65-1504b. Unlawful to dispense ophthalmic lens or lenses without prescription order. It shall be unlawful for any person to dispense an ophthalmic lens or lenses without first having obtained a valid, unexpired prescription as defined in K.S.A. 65-1501a, and amendments thereto, or order therefore from a duly licensed optometrist or a person licensed to practice medicine and surgery. An ophthalmic lens shall include a contact lens with or without power.

In addition
65-8-4. Content of prescription. . . .
(b) No prescription for spectacle lenses shall include instructions to obtain the specifications from existing lenses without examination.

Good thing you don't dispense in Kansas - you would have to buy a new PD stick.

Do you have a link, I would like to read the entire statute. Thanks

[ziggy]

That's a good thing. I highly recommend a book by John Classe called "Legal aspects of optometry."

It may enlighten you.

I'll make a call in the morning and try and get a copy. Most of the books deal with the "what if's" if this is not like that it would be an interesting read. Thanks for the heads up.

[EyeFitWell]

I posted this question not too long ago when I came across my first parent unwilling to pay for poly. The lesson I walked away with is, you cannot force parents to pay more for poly. You can give parents poly at N/C for a certain age, but you cannot require them to pay for any upgrade. It is, however, our duty as Opticians/OD/MD to inform patients of the potential risks, and make them aware of poly as an option. From there, the choice is in their hands.

[allanon]

I posted this question not too long ago when I came across my first parent unwilling to pay for poly. The lesson I walked away with is, you cannot force parents to pay more for poly. You can give parents poly at N/C for a certain age, but you cannot require them to pay for any upgrade. It is, however, our duty as Opticians/OD/MD to inform patients of the potential risks, and make them aware of poly as an option. From there, the choice is in their hands.

I guess you could deny the sale depending on how strongly you felt about it. We don't have a waiver and have never needed one, but then again, if it were a stock lens, we'd do it in poly anyway.