How would you handle this???

[mrmac]

We got an rx in this week from a ophthalmologist office ( they dispense eyeglasses). The script read... -1.50 -.50 x 0 ou. Now we all know they meant axis 180, but last year we had received another script from that office and there was an input error and they actually meant axis 90. So we called the office for a clarification and they in turn called the customer and said " if they don't know that axis 0 is really axis 180, then they are incompetent and you should have your glasses made here" . The customer called us saying she was appalled at how unprofessional they are. Suggestions....

[Fezz]

I would...............RELAX, grab a homebrew, watch an episode of The Chew, and read Kubla Kahn by Coleridge, and not worry another second about it.

[Barry Santini]

Give her a coupon toward Zenni and have them input the same Rx.
see if they call back for clarification.

B

[braheem24]

That's one way to make Zenni the authority

[Robert Martellaro]

Writing a cylinder power with a zero axis is unconventional, so much so that it requires verification to confirm errors of omission, that is, they intended to write 10, 05, 90, and so on.

Very bad form from the doctor's staff. One might want to nip this behavior in the bud- discuss it with the office manager, or the doctor.

[m0002a]

In the past, I have seen quite a few instances where an OD office will deliberately try and cause problems for a patient who takes an Rx to an outside optical for dispensing. They will "accidently" mis-write the numbers, or make the numbers hard to read correctly, or otherwise trying to cause the outside optical problems with dispensing correctly. With more widespread understanding of FTC regulations, I don't see that happening as much as it used to, but given that the OD office said to customer: "if they don't know that axis 0 is really axis 180, then they are incompetent and you should have your glasses made here" it is pretty clear what their intention was in writing the Rx that way.

[rdcoach5]

Writing a cylinder power with a zero axis is unconventional, so much so that it requires verification to confirm errors of omission, that is, they intended to write 10, 05, 90, and so on.

Very bad form from the doctor's staff. One might want to nip this behavior in the bud- discuss it with the office manager, or the doctor.

I agree 100 %. There's no way of telling what was left out of this totally incorrect writing of an Rx. You have to call to verify . Yes , also talk to the office manager.

[icmor]

I also agree. I feel it's very important to maintain a consistency in how Rxs are written and the terminology we speak. Deviating from it shows either incompetence or ignorance. It still grinds me when someone refers to a minus power as "negative". Maybe I'm just old school...

[Chris Ryser]

I guess that all of us should know that perfect horizontal line starts at 0 and ends at 180 degrees..........................and the full circle consist's of 360 degrees.

[EyeSore]

We got an rx in this week from a ophthalmologist office ( they dispense eyeglasses). The script read... -1.50 -.50 x 0 ou. Know we all know they meant axis 180, but last year we had received another script from that office and there was an input error and they actually meant axis 90. So we called the office for a clarification and they in turn called the customer and said " if they don't know that axis 0 is really axis 180, then they are incompetent and you should have your glasses made here" . The customer called us saying she was appalled at how unprofessional they are. Suggestions....

I guess if you'd made the glasses and there was an issue , they would have said your office was "incompetent" for not calling to check the rx .

[Robert Martellaro]

I guess that all of us should know that perfect horizontal line starts at 0 and ends at 180 degrees..........................and the full circle consist's of 360 degrees.

One needs to add that we don't use the 'bottom half of the clock' (181 through 0) for astigmatism because the cylinder is repeated over 180, for example, 30 is the same as 210, 45 is the same as 225, etc. Prism and corneal topography are a different story however (and a different topic).

[waynegilpin]

I would call the office and speak to the practice manager. Explain to him/her politely that phone calls are cheaper than lenses and that unless they are willing to cover your remake costs, you will continue to call if there is any ambiguity in their Rx's. I would also mention, without going into details, that you are a professional would never speak badly of another practice and request that they do the same. Then wait. Ball is in their court. The reply should tell you all you need to know about the office. If the reply is inappropriate, ask to have the ophthalmologist call you. Wait a day and write a letter if you don't receive a call. Send it to the home address if you think it might be trashed before it gets to appropriate person.

[ak47]

Jump on your horse and grab your six-shooter !!

[fjpod]

I would have called to verify. And there is no excuse for the staff of the OMDs office saying what they did.

All that being said, I have seen glitches lately with EHRs and auto-lensometers where the auto-lensometer may read 180 but the EHR interprets that as 0. So, I think we are going to see more of this. My Huvitz sometimes prints out 180 as 0 or 180.

People say, "Oh doctors should use EMRs because we can't read their handwriting"...but it is just as easy, if not easier, to slip on a keyboard and change the whole "meaning" of an Rx.

Just curious...was the Rx handwritten or printed on a computer? Anybody who would handwrite axis 0 has no business writing Rxs. Could have been done by staff and not the doctor. Most likely was copied right from an EHR glitch.

[tmorse]

We got an rx in this week from a ophthalmologist office ( they dispense eyeglasses). The script read... -1.50 -.50 x 0 ou. Know we all know they meant axis 180, but last year we had received another script from that office and there was an input error and they actually meant axis 90. So we called the office for a clarification and they in turn called the customer and said " if they don't know that axis 0 is really axis 180, then they are incompetent and you should have your glasses made here" . The customer called us saying she was appalled at how unprofessional they are. Suggestions....

You might consider a letter of complaint to the appropriate regulatory authority for Ophthalmologists, signed by both the Optical store owner and the lady in question, might tighten up this office's RX writing procedure.

[waynegilpin]

You might consider a letter of complaint to the appropriate regulatory authority for Ophthalmologists, signed by both the Optical store owner and the lady in question, might tighten up this office's RX writing procedure.

Wow, you go straight to nuclear don't you?

[Uilleann]

There is a (admittedly extremely rare) precedent for writing a three digit number in a case such as this. We try to do it all the time regardless, as it is simply a good practice to be in and eliminates any chance for ambiguity in reading the script.

"000" would at least serve to eliminate some of the doubt. Though, I would also argue that the vastly more accepted methodology across the world in our field would be to write "180" as to remove any question or doubt. The ball would be in the court of the prescribing office - and in particular in the direct hands of the individual writing the SRx to show otherwise. Which of course, they cannot. Who looks the fool then in the eyes of the patient?

[VHB]

I used to get Rxs from an MD with one cyl as minus and the other as plus. I would call and every time got a snippy "Fill it as written." Eventually I discovered he was using two sets of trial lenses, not a phoropter. Happy to say he's retired.

[tmorse]

I used to get Rxs from an MD with one cyl as minus and the other as plus. I would call and every time got a snippy "Fill it as written." Eventually I discovered he was using two sets of trial lenses, not a phoropter. Happy to say he's retired.

Many years ago I too received a similar Rx, written in plus cyl for one eye, and in minus cyl for the other. This was from an area OD and when I called him to confirm Rx, I received this snippy response, "You know how to transpose, don't you?". Go figure.

[Uncle Fester]

pm sent

[m0002a]

I think they are just upset that a patient walked out the door and went to a different optical to purchase eyewear. I would not take it personally or as an insult to anyone's optical knowledge. A lot of similar stuff goes on between some OD offices and patients (when a patient leaves with just an Rx) that other opticals don't even hear about, and that are clearly violations of FTC regulations.

[braheem24]

Check old rx, Trial frame it and move on to the next person wanting to give you money.

Life's too short to act like an optician.

[tigerlilly]

I don't see this so much with glasses, but with contact lens Rxs it's wrong all the time. Today it was a pt in Focus Dailies (the old ones, not the newer Dailies Aqua Comfort Plus, and how dumb is it to make the names so similar?) with a BC of 8.7. The Rx specific Focus Dailies 30 pack, which clarifies that it's the old lenses, since the new lens doesn't come in a 30 pack. The lens only comes in an 8.6, so the pt wouldn't be able to fill this if he were trying to buy online. I think that's why offices do it. It wouldn't surprise me if there are also offices who screw up the glasses Rx for the same reason.