I have a feeling that an unscrupulous pt would go to pretty extensive lengths to "prove" that the stateside optician gave the wrong PD in court, rather than trying to sue a faceless, nameless Chinese labOriginally Posted by MikeAurelius
I have a feeling that an unscrupulous pt would go to pretty extensive lengths to "prove" that the stateside optician gave the wrong PD in court, rather than trying to sue a faceless, nameless Chinese lab
Surprise, I agree with you, AGAIN. Are you sure you weren't an optician in a past life?
Mike, yours is not not the only state in the union. In most, it is not part of the Rx. Also, I've found that the times when the doc did put it on the Rx, it was binocular, and I don't do binocular. There's another can o' worms! Also, I can make glasses without a pd. It's a bit harder without an axis for cyl or some other such omission...
In a recent ruling by the SC State Board of Opticianry, an Optician is liable for the result if he supplies a pd. They're trying to discourage the phenomenon, and I support them. I wish other states the best; I have an excellent board, and I tell people about it. I've been asked by several to run for a position, but I see no need, as I feel these guys are doing a good job. I do not give compliments lightly...
Mike, all the best, you're a smart guy. Just be aware, as this country has a federal system of govt, with those powers not specifically given to the Federal govt belonging to the states, laws governing opticianry vary widely. Other opticians deal with different situations than you do. Keep posting, and make sure it doesn't get personal.
PS, If I'm ever in your area, I want to come by your lab and have you teach me a few things and pick your brain.
Wesley S. Scott, MBA, MIS, ABOM, NCLE-AC, LDO - SC & GA
“As our circle of knowledge expands, so does the circumference of darkness surrounding it.” -Albert Einstein
Thanks, and I try *real hard* not to make it personal, thanks.
I appreciate your kind words and thoughts, and would be delighted to have you drop by, although I'm sure it would be you teaching ME. Brain picking is easy, putting into practice is much much harder!
On this topic, I guess I'm going to have to agree to disagree -- I can go back and forth on each point, but until the individual states make a ruling like Kansas has (and I'm not from Kansas, Minnesota is my state), nothing is going to change (much). I'm just saddened that I see such obstinate dislike bordering on hatred for the on-line operations that would lead to refusing to serve someone walking in your door.
I see every person walking through the door as an opportunity. It is up to the person greeting them to either turn them away and risk never seeing them again, or to greet them as a friend and help them make some decisions about what it is that they think they are going to accomplish using an on-line operation. And remember, not all on-line operations are in China. Some are in Canada, and some are right here in the USA. They are here to stay, and we all better get used to living with it. The FTC required that every patient receive a written copy of their prescription. What happens when the FTC decides that the PD is part of the prescription? Then the whole paradyne shifts again. (Note I said WHEN, not IF.) All it will take is a bunch of complaints from people who have been turned away from getting a PD...
There...I've said my bit. Carry on.
"Thanks, and I try *real hard* not to make it personal, thanks.
No you haven't, I've seen you bicker with Darryl. It's not professional and you are and owe us better.
I appreciate your kind words and thoughts, and would be delighted to have you drop by, although I'm sure it would be you teaching ME. Brain picking is easy, putting into practice is much much harder!
For theorists, theory is easier. For practicioners, practice is easier. And the opposite, of course. I'm a lab guy and I cut my teeth at the end of the glass period of military eyewear. As you've said, and I agree, glass is the premier optical material. I would greatly like to sit in your lab and learn from you. I mean this.
On this topic, I guess I'm going to have to agree to disagree -- I can go back and forth on each point, but until the individual states make a ruling like Kansas has (and I'm not from Kansas, Minnesota is my state), nothing is going to change (much). I'm just saddened that I see such obstinate dislike bordering on hatred for the on-line operations that would lead to refusing to serve someone walking in your door.
It's not hatred for anything, but it's a dislike for the reduction of a medical device to a commodity and the cheapening of our professional services, our skill, our expertise and discerning eye to the point where it is expected to be FREE, JUST BECAUSE! I never refuse to serve someone. I give them alternate proposals to their original request.
I see every person walking through the door as an opportunity. Me too, but if they're never buying anything, they're not a customer. It is up to the person greeting them to either turn them away and risk never seeing them again,or to greet them as a friend and help them make some decisions about what it is that they think they are going to accomplish using an on-line operation. Agreed, and I try this approach. And remember, not all on-line operations are in China. Some are in Canada, and some are right here in the USA. They are here to stay, and we all better get used to living with it. The FTC required that every patient receive a written copy of their prescription. What happens when the FTC decides that the PD is part of the prescription? I hope it's monocular. Then the whole paradyne shifts again. (Note I said WHEN, not IF.) All it will take is a bunch of complaints from people who have been turned away from getting a PD...
There...I've said my bit. Carry on."
Wesley S. Scott, MBA, MIS, ABOM, NCLE-AC, LDO - SC & GA
“As our circle of knowledge expands, so does the circumference of darkness surrounding it.” -Albert Einstein
just tell them the PD is part of the dispensing requirement, it has to be part of frame selection, lens selection with proper alignment for the frame system in order to deliver a comfort pair of glasses. he should get that measured when he visit a store where he purchased the glasses.
Yeap
Do you trust an OD, sitting 3 ft away from a phoropter, in a dimly lit room, taking the pd off of the phoropter....OR...a pupilometer taken monocularly to the nearest tenth of a mm???
Our policy is to not give out pds, I have asked my lawyer about this and he told us not give out any measurements if we don't make the glasses. I have been getting more and more calls about this lately, they get the exam from us but want to get glasses online. I have read several places on here where there are a couple states that pds are required on the rx, does anyone know what they are?
Yikes! "nearest 0.1 mmm"?
I don't think so.....
B
Last edited by Barry Santini; 08-19-2010 at 08:10 AM.
If anyone has a state requiring the pd on the prescription, I would like to see a copy of the bylaw that requires that, in words. I have never heard or seen that as a law requirement, just as an opinion from dr's and opticians. Thanks
Brendan Bohl, ABOC
http://bbohl71.wix.com/vizionz
Yikes!! you caught me...yeah (embarressed)...I did do that, and I also apologized. Perhaps I should have written "I'm trying real hard NOW AND IN THE FUTURE not to make it personal."
And again, thanks for the kind words.
On medical devices...don't get me started LOL...I had a long long talk with an FDA inspector quite a few years back about the disparity of the FDA rules regarding inspections of the optical industry compared to equivalent medical industry manufacturers. He admitted quite frankly that it was easier and less expensive for the FDA to inspect a semi-finished lens maker and require them to keep records than it was to check and inspect all the laboratories that actually make the finished medical device. He agreed with me that it was pointless to inspect a company that makes semi-finished lenses and that all inspections should be of the labs...but he also said that due to budgetary restraints, they do what they can, despite the fact that it is guaranteed that a bad lens (AKA finished medical device) will come from a lab not from the semifinished manufacturer.
(And I agree with you about monocular vs binocular!)
Actually, my son's (and my) OD uses a PD stick and backs it up with a pupilometer. I forsee that when the FTC makes a change to the rules, they will dictate the fashion in which the PD is measured. They tend to be somewhat anal about things like that.
Ok... half of mm, in the tenths place, with a level of uncertainty...
U
Or, you can give them their PD, measured in Cubits....
I've been thinking about the PD being/not being part of the Rx. I'm surprised to find that I think it should be (whether or not it is, is a completely different matter, obviously varying from locality to locality).
My reasoning is that the PD is patient dependent. It's measured from the patient, and does not change based on lens style or frame chosen. Just like the other measurements to get a patients Rx are all patient dependant, and not based on other considerations. Other measurments, such as OC height, seg height, and POW measurements are all frame dependent. They will change from frame to frame.
There are rules. Knowing those are easy. There are exceptions to the rules. Knowing those are easy. Knowing when to use them is slightly less easy. There are exceptions to the exceptions. Knowing those is a little more tricky, and know when to use those is even more so. Our industry is FULL of all of the above.
Yeah, but W, the p.d. utilized in the job will depend on the purpose of the glasses: computer, distance, near only.
That's what a good optician is supposed to do: take raw refractive data with a known vertex distance and face-form agle, and go from there.
A good optician should make position-of-wear lens power adjustments, place optical centers properly based on the frame/lens purpose.
It does vary!
Agreed!
B
Did your od do this before your state mandated it? I have yet to see an od take a pd in the 5 states I have interned or practiced in.
I think we can learn something from the big boys.
Now, optometry is a bit of a distance from medicine, and opticianry even more so.
Nonetheless, medicine takes it upon themselves to self-regulate and control health care delivery.
In other words, they're not interested in "helping people that walk in the door as though they were a friend", they're interested in whether a particular practice is good for the populace.
If an optician thinks like a merchant, then they will do "whatever it takes" to make their customer happy. Their obligation is different if they think like a professional; a professional should do what's right in the big picture.
And optical devices without professional fitting and oversight is bad for people.
If you truly think you're going to prevent the person from purchasing eyewear online by denying them their P.D...
If you see no possible way that person is ever going to spend a dollar in your place of business..
If you have zero interest in the opportunity presented to you by someone walking into your store..
Then you better stop writing contact lens RX's too, because there was a day when noone got those online either. Your best bet might be to switch back to the old Jewelry store with the optical in the back room.
:drop::drop::drop:
If you truly think that your professional responsibility is going to be influenced by optical outlaws...If you truly think you're going to prevent the person from purchasing eyewear online by denying them their P.D...
If you see that a person is just a means to a dollar...If you see no possible way that person is ever going to spend a dollar in your place of business..
If you have zero interest in the responsibility presented to you by someone walking into your "store"...If you have zero interest in the opportunity presented to you by someone walking into your store..
Then you probably are something like a jewelry store with an optical in the back room, already.Your best bet might be to switch back to the old Jewelry store with the optical in the back room.
:) :) :)
A PD is not part of a prescription. A rough PD is needed to refract, but it is not by any means an accurate measure. Mike if you were familiar with the practice of refracting you would realize that the PD in the refraction is really just the refractionist centering the phoropter so that the lens is centered in front of each eye. Since the aperature of the phoropter is so large and the centering is often done by guesstimation this is not a PD that should be rellied on in the fabrication of glasses and if it was the patient would be just as well off printing those rulers from the sites and measureing in mirrors. I am amazed at how you can advocate GLASS lenses for their accuracy and discount the measures that go into them, some would misconstrue that as being hypocritical.
Somewhere there is a disconnet with these patients, price, service, convenience, etc. Find it and shore up the ship. Not every patient is going to buy glasses in your store but they shouldn't expect you to help them circumvent your sales process either. The few times I had to deal with a patient asking I just told them no and why. I have invested time and energy into my career and feel that my time is worth something, I'm not sorry for that and I can't help patioents or customers that don't respect that. Then send them to the nearest Walmart vision center and tell them it's a crap shoot if they get a qualified optician but it's the best they're gonna do in town.
Well, yes. But by that logic, the Rx will vary based on usage as well. If the doctor provides a distance PD along with the Rx, the Optician should be able to extrapolate from that what PD should be based on glasses usage, just as they extrapolate the Rx based on glasses usage (near, intermediate, music stand 31.43 inches away, etc.).
I completely agree, I just feel that this includes PD adjustments as well as the others you listed. POW lens power adjustments are based on the Doctor's Rx, just as PD adjustments could be if the PD were included in the Rx.That's what a good optician is supposed to do: take raw refractive data with a known vertex distance and face-form angle, and go from there.
A good optician should make position-of-wear lens power adjustments, place optical centers properly based on the frame/lens purpose.
There are rules. Knowing those are easy. There are exceptions to the rules. Knowing those are easy. Knowing when to use them is slightly less easy. There are exceptions to the exceptions. Knowing those is a little more tricky, and know when to use those is even more so. Our industry is FULL of all of the above.
Your point is logical, but seriously, how much easier is it to simply turn the pupillometer knob to 33cm fixation than to take a Dr.'s infinity p.d. and feed it into a formula to modify it?
Plus, why should an OD go around providing accurate p.d.s when many of the Rxs won't get filled, anyway? Why not do it when needed?
Plus, dispensers are loathe to even trust the lens powers in an Rx---do you want to further reduce your own input?
I think my argument trumps yours on mere practicality.
Last edited by drk; 08-19-2010 at 09:41 AM.
I say charge for the pd. On a side note pupilometers are overrated. Confrontational PD measurments are more accurate. Also the sales of online eyewear are not going away, so create a side store online and compete with them.
Shimpy, prostitution is not going away either. Are you saying that we should pick up some of these?
Well, by that, why even provide an accurate Rx if they aren't going to get filled? Or did you mean that the opticians will just ignore the PD the Dr. writes and remeasure it themselves?
Since when has this industry been practical?:shiner:I think my argument trumps yours on practicality.
I see your points, I just don't completely agree with them.
My next question is, how long before online retailers spend enough money lobbying to get PD's mandated on Rx's....
I hope that day never comes, but I won't be surprised when it does.
There are rules. Knowing those are easy. There are exceptions to the rules. Knowing those are easy. Knowing when to use them is slightly less easy. There are exceptions to the exceptions. Knowing those is a little more tricky, and know when to use those is even more so. Our industry is FULL of all of the above.
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