OTC Readers

[Wes]

Here's one that irks me. Guy comes in wearing glasses, says he sees double with them. Didn't get them from me. Turns out they're +1.75 readers.

Now, he's not wearing them as readers, his distance rx (for contacts, not sure about for glasses, so possible uncorrected astigmatism as well) is +1.75 OU. Yes, he's wearing them as his distance correction and claims his ophthalmologist told him to. Readers usually have a pd of 60, sometimes 62. His pd is 72. Bad advice if indeed it came from the doc.

I see stuff like this pretty often and it really p!$$es me off. People standing in front of a rack of readers, self refracting, or worse, docs telling them to.

Docs, please say it aint so. I've been here long enough to know that none of the posters here advocate such things. It's been my experience that this forum is a group of the best and brightest, and also the most passionate about their profession. It's also been my experience that the bad apples far outnumber the good ones.

Who else thinks OTC readers should be illegal to avoid situations like these?

Wes

[Barry Santini]

You have to show the harm from their availability to the general public.
I don't think so .
Maybe an elderly senator's middle age daughter crashes from them .
Then you have a crisis.
THEN u get some concensus to make change.
In the absence of the right person getting harmed...nothing will get done!
Welcome to America, Borat!
B

[Wes]

Let's put this guy and his 72 pd with his 60 pd OTC 1.75D readers (1.05D BI OU)behind the wheel of a two ton machine in heavy traffic and see what happens. I don't want to be anywhere near him.

This scenario isn't possible without "harmless" OTCs. I've seen young people trying to buy them for correction rather than buy custom prescription glasses.

The world is full of ignorant people. When they harm themselves out of ignorance its pretty bad. When they cause harm to others, its tragic.

We as ECPs are NOT ignorant (I hope) of these dangers. OTCs are too imprecise and when used improperly can lead to loss of life. They should be banned, but as Barry said, it won't happen until someone "important" is harmed. I think they're as bad as ordering glasses online.

Wes

[optical24/7]

This is the sad fact....A person can "self refract" for OTC readers ( even used as primary distance glasses!) or *on-line* order for that matter ( no Rx required!) But I as a trained refractionist can not produce a pair of glasses for someone because I don't have "OD" nor "MD" after my name!


Informed Doctors, explain that to me.....

[rbaker]

OTCs are too imprecise and when used improperly can lead to loss of life.

Let's not go overboard here.

The FTC held hearings for over a year and there was no evidence presented that indicated any harm from the use of OTC readers. All of the eyeglass merchants presented their case to restrict the sale of OTC's but it was found that their claims of harm to the public were spurious and that it was in the best interest of the public not to place any restrictions on the sale of these products.

[Wes]

I thought it was maybe spurious a long time ago. This guy came staggering into my shop TODAY. If you saw the way he was bumbling around, you wouldn't think it was very spurious.
I'll agree theres no harm if used properly, but this? Yeah, I'll likely never see a situation like that again, but it gets you thinking.
Wes

[optical24/7]

Let's not go overboard here.

The FTC held hearings for over a year and there was no evidence presented that indicated any harm from the use of OTC readers. All of the eyeglass merchants presented their case to restrict the sale of OTC's but it was found that their claims of harm to the public were spurious and that it was in the best interest of the public not to place any restrictions on the sale of these products.

But, there is harm by having a trained refractionist provide an Rx? (non OD/MD) John Q Public can essentially refract himself, but somebody trained in the art can not? John Q can input any Rx he desires with online glasses. No Cl Act to even verify the accuracy of said.... Yet simple refraction is taboo for non OD/MD's? Makes a lot of sense doesn't it??:hammer:

[Oedema]

Just make a big deal with the patient that he needs to see his ophthalmologist ASAP! Sudden onset diplopia... could be an aneurysm :hammer:

Nothing like getting the message across to he ophthalmologist like annoying referrals back to his or her clinic.:D

[FVCCHRIS]

Just make a big deal with the patient that he needs to see his ophthalmologist ASAP! Sudden onset diplopia... could be an aneurysm :hammer:

Nothing like getting the message across to he ophthalmologist like annoying referrals back to his or her clinic.:D

I wouldn't refer him back to the same guy that started the whole problem. I'd refer him to an O.D. you know that can handle that problem quickly and permanently with a proper Rx. make them up and SHOW the patient what a qualified "O" can do. :)

[Crazy-bout-Optics]

I don't think we will ever see a time when OTC readers are illegal. As far as harm to the public goes and Gov intervention, when you consider the Gov allows the sale of Alcohol, Tobacco, and Prescription drugs, all of which kill thousands each year, yet the sale of said items are not banned. In the grand scheme of things, OTC readers don't pose much of a threat to public safety.


What it really comes down to is these people are self medicating, in essence.

We all know the best way to tackle this is through education to the Patient, and also realizing that many buy OTC readers simply because of the price. They can be bought at the Dollar Store, yet a pair from any Optical will cost much more. By possibly offering a package deal for readers (or for regular dist glasses) and enforcing the value of them over OTC readers those that get it will buy Rx readers. You can't help everyone as not everyone gets it.

Something that may help, if possible and feasible in your office, would be to trial frame him in his correct Rx if you can get a copy of it and have him compare them to the OTC readers he is using. If his readers are indeed cause that much prism I think he will immediately see the difference and not return to his Ophthalmologist when he realizes the bad advice he was given.

~Crazy

[Barry Santini]

The world is full of ignorant people.

True

When they harm themselves out of ignorance its pretty bad.

True

When they cause harm to others, its tragic.

Very True

I think they're as bad as ordering glasses online.

Maybe not...

Given the state of training AND competance of ophthalmic dispensing in this country, I humbly submit that a good percentage of online eyewear will be "as good" as what John Q gets locally, in their "doctor's offices"\


This then....is the *real* problem... with our industry's perspective on pay and accomplishment in ophthalmic dispensing.


Yet, you can't legislate that all violins will be *stradivarius* in quality. And the same applies to eyewear.


Wes

The question is: What are you?

Barry

[Barry Santini]

and not return to his Ophthalmologist when he realizes the bad advice he was given.

~Crazy

Actually, in my neck of the woods, the number one reason for not returning to their doctor's office is the attempts made by the same to "capture" the Rx before it walks out...

in these cases... on their way to me.

B

[Crazy-bout-Optics]

Actually, in my neck of the woods, the number one reason for not returning to their doctor's office is the attempts made by the same to "capture" the Rx before it walks out...

in these cases... on their way to me.

B

In any office where they Pt feels they are being "sold" to they will often leave. I bet the reason they do go to you is because you are honest with them and due to the reputation you have built up for yourself. People trust you. If I read the original post correctly, the Pt took the Ophthalmologist's advice, yet went somewhere else to complain and get an opinion, not back to the Ophthalmologists' office. Maybe in this case by not offering product and just telling the Pt to go buy OTC readers, the Dr did more harm than good??

[Barry Santini]

Any "Dr." who recommends OTCs is doing their patient a tremendous disserve. In another thread, I asked (rhetorically?) if anyone thought it bordered on malpractice?

Of course, we all know the reason why ECPs do this: It is because eyewear is inconvenient, especially non-fulltime wear eyewear, and people lose/misplace them.

If they were more convenient, the public might/would pay more.

Ane even if you share, in your deepest heart-of-hearts, the feeling that *everyone* is entitled to save money (or at least not spend one more dime than they have to...and not just on eyewear) then...

As I've said before...

These same ECPS should be recommending on-line eyewear, aka, $39 and below, to their petients. Why saddle them with compromised vision/and or prism from incorrect PD, particularly if the only reason you recommend OTCs is low cost?

I think you see where I'm heading....

Barry

[obxeyeguy]

I think you see where I'm heading....

Barry

I do see where you are heading, and it will feel better when you stop.;) I stopped selling OTC readers years ago, but offered to make any "adequate" spherical Rx in any frame for the cost of the frame only. At least they received quality lenses, good frame, proper PD, and a proper fit. Oh, and I got to make a couple bucks. Right or wrong, I don't know, but that was what I settled on.

Lately, I have more and more people coming in, many my own customers looking for OTC readers, and for not a "lot" of money. Many of these people are in fact supplementing their regular eye wear or CL's, and don't want to spend a bunch of $$.

When I tell them I don't carry them, and explain what I will do, I seem to get this deer in the headlights thing. You sell shoes, but no shoe laces? I am being perceived as not a "full service" optical shop because I don't carry what is legally able to be bought almost anywhere. Many of these people also perceive that what they do buy from me in OTR will in fact be better than most of the others, true or not.

I have the feeling of being somewhat d##ed if I do, and d##ed if I don't. For me right now, I have decided to put a line of "better" OTC readers in, and see where it goes, as I don't think anyone has died from wearing a pair yet. I am a professional, and I am a businessman, and just trying not to blur the lines too much.

[Judy Canty]

I do see where you are heading, and it will feel better when you stop.;) I stopped selling OTC readers years ago, but offered to make any "adequate" spherical Rx in any frame for the cost of the frame only. At least they received quality lenses, good frame, proper PD, and a proper fit. Oh, and I got to make a couple bucks. Right or wrong, I don't know, but that was what I settled on.

Lately, I have more and more people coming in, many my own customers looking for OTC readers, and for not a "lot" of money. Many of these people are in fact supplementing their regular eye wear or CL's, and don't want to spend a bunch of $$.

When I tell them I don't carry them, and explain what I will do, I seem to get this deer in the headlights thing. You sell shoes, but no shoe laces? I am being perceived as not a "full service" optical shop because I don't carry what is legally able to be bought almost anywhere. Many of these people also perceive that what they do buy from me in OTR will in fact be better than most of the others, true or not.

I have the feeling of being somewhat d##ed if I do, and d##ed if I don't. For me right now, I have decided to put a line of "better" OTC readers in, and see where it goes, as I don't think anyone has died from wearing a pair yet. I am a professional, and I am a businessman, and just trying not to blur the lines too much.

Nicely put!

Now, who wants my old Hilco EqualEyes kit?

[harry888]

I'm an OD and I wear +2.00 magnifiers. Happily

My distance is +0.25 and I have about 12 progressives in different designs I just can't wear.

I have some Ophthalmic +2.00s and can't tell the difference.

I did get 6 pair at the dollar store, there was something wrong with two of them. I do tell patients that quality varies.

To not give patients the option of magnifiers makes an OD seem like that OD was more interested in eyeglass sales than the exam.

Sometimes those magnifiers are in the patients best interest.

Harry

[Barry Santini]

So, if my clients "wanted" and found adequate $39.00 complete Rx eyewear...

should I be sure to provide it, since they "want" it?

In the end, it's a dilemmic question.

Provide, or not to provide.

Harm, or no harm.

Takes yer pick.

B

[rbaker]

refractionist (changed from OD) was more interested in eyeglass sales than the exam.

This is the primary conundrum of the whole eye care business.

[Wes]

So today a guy comes in to pick up his glasses. Pd 75, od +2.75 - 1.00. Os +2.00 - .50 and a +1.75 add. He puts them on and tells me he's so happy to finally be able to see. I ask him how long he's been without glasses and he says this is his first pair!?!?!

The next question is the very obvious; how have you managed without glasses? READERS!!!!
Did I mention the 75 pd? Roughly 1.5D bi prism? Really? This guy is 50 yrs old and this is his first real pair of glasses? Readers!?!? Ugh. Sometimes I hate living in south carolina.
Wes

[Wes]

So let's not ban them. Let's require that they be dispensed by a qualified ecp. The public gets their cheap junk (oops I mean inexpensive readers) and they're prevented from improperly using them for distance correction.

I don't know any ecp that thinks self refracted readers for distance vision are the way to go.
Wes

[optical24/7]

i'm an od and i wear +2.00 magnifiers. Happily

how lucky for you! Keep in mind that what works for you may not be the answer to others. It's easy to recommend what works for us personally. But your patients may have differing needs and requirements ( i.e lifestyle/ occupation).

my distance is +0.25 and i have about 12 progressives in different designs i just can't wear.

an emmetrope/w emerging presbyopia.. An opticians nightmare...non-compliance nor enough neural adaption time for lens design.

i have some ophthalmic +2.00s and can't tell the difference.

you must have an avg. Npd pd and/or do limited, short term near work. The avg. Otc reader has an oc placement of 60-63 mm. My npd is 71. I have many patients that have npd's of 53 or less. Is 1.25 to 1.75 diopters prism base out/in for extended near work considered proper and adequate, and in the patients best interest?

i did get 6 pair at the dollar store, there was something wrong with two of them. I do tell patients that quality varies.

kinda like a crap shoot, right? Qc varies greatly, not to mention optical quality of acrylic lenses.


to not give patients the option of magnifiers makes an od seem like that od was more interested in eyeglass sales than the exam.

a profesional should recommend the best solution for the patient. That's why they come to you to begin with. It's up to them to decide on treatment vs cost. They want your expert advice. Do you screen whom you recommend otc to? ( avg. Pd's, low near work, ect? I hope so!)


sometimes those magnifiers are in the patients best interest.

agreed... Upon needs/wants/resources and best form of treatement.

harry

fwiw....

[drk]

Ad hoc, people.

You are seeing the irrationality of ad hoc laws.

Listen, it should be totally unregulated or totally regulated, in order to make sense.

There are arguments for both sides.

[Chris Ryser]

There are arguments for both sides.

Here is another one. Last year I bought for the fun of it 6 pairs grooved rimless FosterGrant for $ 1.00 each.

The frames are some of the sturdiest I have seen including spring hinges, and the lenses are hard coated poly. Quality of the whole is very good.

I could not even get the frame nor the lenses for the finished job I paid $1.00 for.

Times have changed and I wish it would not have been so, but we will have to live with it, as well as the increasing Rx business with the on line opticals.

So why don't opticians change the system and charge their real effort in time spent working with the customer and on the frame and lenses. Then the material might be a lot cheaper and the cost to the customer goes up according to work involved. This way a higher cost can be justified.

1 Example (and could give many more): If you pay a lab to tint or UV a lens and pay XX$s do it yourself and make the difference............furthermore you will be ahead of the optical shop that works with unqualified employees.

It looks like the old fashioned multiplier system is on the way out, and higher prices will be paid for advertised quality work and time.

[Wes]

I don't know what it is with South Carolina, but it sure seems like hyperopes who can't afford real glasses and who buy otc readers consistently have larger than average pds. Much larger, like in the 70s.
I know we've been over this before but it just grates on my nerves and it irks me even more when they want me to be complicit in their "menace to society" by repairing them. Grrrr!