Dr RX

[OHPNTZ]

For the opticians who fit contact lenses:

1. Do you carry malpractice insurance? What happens if say a patient develops a central corneal ulcer with one of your fits? What about Acanthamoeba?

2. Do you have a patient questionaire? Do you ask about systemic health problems (ie. Dry eye with sjogrens, or reduced corneal sensitivity with diabetes, etc)?

[HarryChiling]

I disagree that writing a prescription in bifocal form and saying SV only means that it could be dispensed as bifocal. It just means that you get the notion that the distance rx is nil and maybe that is for convenience. I believe that a prescription with an add can be dispensed as bifocal. Never the prior though. I would hope the dispenser would just fill it as written and nothing else.

I do a fair amount of low vision and I sometimes get these calls for +6.00 adds. I say, fill as SV only! What, you cannot read? Trying to make a bifocal sale? Geez!

I was waiting for that, thank you. This is a prime example of why you would want to specify the condition. Now I knew it was low vision and I usually suspect that from any add above a +3.25 and will ask the patient if they are Ok or if the doctor is following them for any condition. The patients always tell me ARMD, DR, or RP. Or any of the other low vision conditions. Without that information how would I know you want high magnification? What if I put your NVO lens in an aspheric with a flat back curve? I would think they look great and the patient would think they look great but they would lose a significant amount of mag which would bring them back into your office for a recheck or disatisfied, I would assume you would rebill the follow-up under the 99 codes for a low vision eval? Why not inform me of your intentions and the patient can be satisfied on the first go.

[HarryChiling]

Do you carry malpractice insurance? What happens if say a patient develops a central corneal ulcer with one of your fits? What about Acanthamoeba?

No, don't have insurance the store however does. They see the doctor before they are fit and when they are done they see the doctor again in our office.

Central Corneal Ulcer - If the cornea was comprimised when I was sent the patient for a fit that is the doctors fault for OK'ing a fit in the first place, other than that if they come in for follow up visits they would be checked for fit or signs of overwear.

Acanthamoeba - This is ridiculous, like somehow I dispense in an unclean enviornment I won't even dignify the acanthoameoba and it reflects poorly on your for mentioning it like somehow we are dispensing unclean products or cleaners, if they get it for real it is again more than likely a cause of a comprimised cornea than any lens or solution. We also inform them not to wear their lenses in the shower or hot tub to help avoid that.

If this question was serious then maybe you need to re evaluate your patient health assesment.

[HarryChiling]

I seem to notice an alarming trend when doctors are commenting on opticians and their scope. Doctors seem to want to refer to all opticians when making up these scenarios as the LCD (lowest common denominator) let me tell you something it is just as insulting as me saying you shouldn't be able to prescribe therapuetics or do dilations becasue their may still be some OD's left from the days of not having the relevent education.

It is safe to assume that if you are posting on these forums the level of optician that visits isn't the same as the schmuck that works down the road in teh local Walmart.

I am willing to assume that all the OD's on this board are not chop shop doctors working at a Walmart if you can assume that the opticians on this board are not working their either, deal or no deal?

[AdmiralKnight]

I disagree that writing a prescription in bifocal form and saying SV only means that it could be dispensed as bifocal. It just means that you get the notion that the distance rx is nil and maybe that is for convenience. I believe that a prescription with an add can be dispensed as bifocal. Never the prior though. I would hope the dispenser would just fill it as written and nothing else.

Excuse me, but if someone walks into my dispensary with a Bifocal Rx, I would assume that it'd be fine to be a bifocal. Where in there is the logic flawed? I would most likely fill them as readers if it says so, but If I see a bifocal script, and the patient is interested in one, I'm not going to turn them down. This isn't me 'Trying to make a bifocal sale', and it's starting to get on my last nerve the ammount of people coming on here basicly calling all Opticians con artists. If you want a reading RX, write a reading RX! Why in the world would you even leave it open for misinterpritation by writing it as a bifocal script? Obviously I'd think something is amiss if I saw a +6.00 add, and I would call the OD, but being that you've already explained that you work in an area with no formal dispensing course (unlicensed state, I'm guessing) Why would you make it even that much harder for your patient to get the correct glasses they need?

I do a fair amount of low vision and I sometimes get these calls for +6.00 adds. I say, fill as SV only! What, you cannot read? Trying to make a bifocal sale? Geez!

I really hope you don't take that attitude when people are calling you for clairifacation on your scripts. If you do, it's no wonder you get a lot of people filling your Rx's wrong, they don't want you to belittle them when they ask you a question. :angry:

[LandLord]

I have no arguement about fitting contact lenses, but because you are so adamant about your privilege to do so...

1. Would you think it is acceptable to fit contact lenses, and change its prescription to allow for monovision when it was not originally intended?
2. Would you purposely change a spectacle prescription by adding any kind of lens power to get a certain level of acuity when you weren't sure why the prescriber wrote the rx that way?
3. Would you change a OU Plano +6.00 ADD written in bifocal form but stated in SV near only form and make it as a bifocal?

1. yes
2. no
3. probably not, because a 6.00 add is likely not available. with a lower add, I might.

[npdr]

Dear landlord,
Even if not mentioned or discussed, do you feel qualified to advise a monovision contact lens patient without prior consent from the prescriber?

[obxeyeguy]

I seem to notice an alarming trend when doctors are commenting on opticians and their scope. Doctors seem to want to refer to all opticians when making up these scenarios as the LCD (lowest common denominator) let me tell you something it is just as insulting as me saying you shouldn't be able to prescribe therapuetics or do dilations becasue their may still be some OD's left from the days of not having the relevent education.

It is safe to assume that if you are posting on these forums the level of optician that visits isn't the same as the schmuck that works down the road in teh local Walmart.

I am willing to assume that all the OD's on this board are not chop shop doctors working at a Walmart if you can assume that the opticians on this board are not working their either, deal or no deal?

Hmmm, almost 3 hours and no takers, hit a nerve eh.
And they say Chip has an OD chip, we get bashed as greedy, overselling neophytes everyday. Spend a day with me, and see how I work, and then judge me. I am extremely happy being an Optician, the lowest in the food chain. Let me do MY job.

[HarryChiling]

1. yes
2. no
3. probably not, because a 6.00 add is likely not available. with a lower add, I might.

Lens Type: Bifocal Manufacturer Name: Aire-O-Lite Material: Resin Style: RD15 Index: 1.50
Base Curves: 2.00,4.25,6.25,8.25,10.25
Add: 00.50,00.75,1.00,1.25,1.50,1.75,2.00,2.25,2.50,2.75,3.00,3.2 5,3.50,3.75,4.00,4.25,4.50,4.75,5.00,5.25,5.50,5.75,6.00,6.2 5,6.50,6.75,7.00,7.25,7.50,7.75,8.00,8.25,8.50,8.75,9.00,9.2 5,9.50,9.75,10.00
Lens Type: Bifocal Manufacturer Name: Signet Armorlite Material: Resin Style: D28 Index: 1.50
Base Curves: 00.50,1.50,3.00,4.50,6.25,8.25,10.00
Add: 00.75,1.00,1.25,1.50,1.75,2.00,2.25,2.50,2.75,3.00,3.25,3.50 ,3.75,4.00,4.50,5.00,5.50,6.00

Lens Type: Bifocal Manufacturer Name: Signet Armorlite Material: Resin Style: RD22 Aspheric Lenticular Index: 1.50
Base Curves: 10.00,12.00,14.00,16.00
Add: 2.00,2.25,2.50,2.75,3.00,3.50,4.00,4.50,5.00,5.50,6.00

Lens Type: Bifocal Manufacturer Name: Signet Armorlite Material: Resin Style: D22 Aspheric Lenticular Index: 1.50
Base Curves: 10.00,12.00,14.00,16.00
Add: 2.00,2.25,2.50,2.75,3.00,3.50,4.00,4.50,5.00,5.50,6.00

Lens Type: Bifocal Manufacturer Name: Vision-Ease Material: Glass Style: D25 Index: 1.53
Base Curves: 4.25,6.25,8.25
Add: 00.50,00.75,1.00,1.25,1.50,1.75,2.00,2.25,2.50,2.75,3.00,3.2 5,3.50,3.75,4.00,4.25,4.50,4.75,5.00,5.25,5.50,5.75,6.00

Lens Type: Bifocal Manufacturer Name: Vision-Ease Material: Glass Style: RD22 Index: 1.53
Base Curves: 6.25
Add: 00.50,00.75,1.00,1.25,1.50,1.75,2.00,2.25,2.50,2.75,3.00,3.2 5,3.50,3.75,4.00,4.25,4.50,4.75,5.00,5.25,5.50,5.75,6.00,6.2 5,6.50,6.75,7.00
Lens Type: Bifocal Manufacturer Name: Vision-Ease Material: Glass Style: D28 Index: 1.53
Base Curves: 4.25,6.25,8.25
Add: 00.50,00.75,1.00,1.25,1.50,1.75,2.00,2.25,2.50,2.75,3.00,3.2 5,3.50,3.75,4.00,4.25,4.50,4.75,5.00,5.25,5.50,5.75,6.00
Lens Type: Bifocal Manufacturer Name: Vision-Ease Material: Glass Style: RD22 Index: 1.53
Base Curves: 4.25
Add: 00.75,1.00,1.25,1.50,1.75,2.00,2.25,2.50,2.75,3.00,3.25,3.50 ,3.75,4.00,4.25,4.50,4.75,5.00,5.25,5.50,5.75,6.00
Lens Type: Bifocal Manufacturer Name: Vision-Ease Material: Glass Style: RD22 Index: 1.53
Base Curves: 10.25
Add: 1.00,1.25,1.50,1.75,2.00,2.25,2.50,2.75,3.00,3.25,3.50,3.75, 4.00,4.25,4.50,4.75,5.00,5.25,5.50,5.75,6.00,6.25,6.50,6.75, 7.00,7.25,7.50,7.75,8.00
Lens Type: Bifocal Manufacturer Name: X-Cel Optical Material: Resin Style: RD22 Index: 1.50
Base Curves: 4.00,6.00,8.00
Add: 00.75,1.00,1.25,1.50,1.75,2.00,2.25,2.50,2.75,3.00,3.25,3.50 ,3.75,4.00,4.50,5.00,5.50,6.00
Lens Type: Bifocal Manufacturer Name: X-Cel Optical Material: Resin Style: D28 Index: 1.50
Base Curves: 6.00
Add: 00.50,00.75,1.00,1.25,1.50,1.75,2.00,2.25,2.50,2.75,3.00,3.2 5,3.50,3.75,4.00,4.25,4.50,5.00,5.50,6.00

Lens Type: Bifocal Manufacturer Name: X-Cel Optical Material: Resin Style: D25 Index: 1.50
Base Curves: 4.00,6.00,8.00
Add: 00.75,1.00,1.25,1.50,1.75,2.00,2.25,2.50,2.75,3.00,3.25,3.50 ,3.75,4.00,4.50,5.00,5.50,6.00
Lens Type: Bifocal Manufacturer Name: X-Cel Optical Material: Resin Style: D28 Index: 1.50
Base Curves: 4.00,8.00
Add: 00.75,1.00,1.25,1.50,1.75,2.00,2.25,2.50,2.75,3.00,3.25,3.50 ,3.75,4.00,4.25,4.50,5.00,5.50,6.00
Lens Type: Bifocal Manufacturer Name: X-Cel Optical Material: Glass Style: RD22 Index: 1.53
Base Curves: 4.25,6.25,8.25,10.25
Add: 00.50,00.75,1.00,1.25,1.50,1.75,2.00,2.25,2.50,2.75,3.00,3.2 5,3.50,3.75,4.00,4.25,4.50,4.75,5.00,5.25,5.50,5.75,6.00

Lens Type: Bifocal Manufacturer Name: X-Cel Optical Material: Glass Style: RD22 Index: 1.53
Base Curves: 4.25,6.25,8.25,10.25
Add: 00.50,00.75,1.00,1.25,1.50,1.75,2.00,2.25,2.50,2.75,3.00,3.2 5,3.50,3.75,4.00,4.25,4.50,4.75,5.00,5.25,5.50,5.75,6.00

Lens Type: Bifocal Manufacturer Name: X-Cel Optical Material: Glass Style: RD22 Index: 1.53
Base Curves: 10.25
Add: 00.75,1.00,1.25,1.50,1.75,2.00,2.25,2.50,2.75,3.00,3.25,3.50 ,3.75,4.00,4.25,4.50,4.75,5.00,5.25,5.50,5.75,6.00

Lens Type: Bifocal Manufacturer Name: X-Cel Optical Material: Glass Style: RD22 Index: 1.53
Base Curves: 4.25,6.25,8.25,10.25
Add: 00.50,00.75,1.00,1.25,1.50,1.75,2.00,2.25,2.50,2.75,3.00,3.2 5,3.50,3.75,4.00,4.25,4.50,4.75,5.00,5.25,5.50,5.75,6.00

Lens Type: Bifocal Manufacturer Name: X-Cel Optical Material: Glass Style: RD25 Index: 1.53
Base Curves: 4.25,6.25,8.25,10.25
Add: 00.50,00.75,1.00,1.25,1.50,1.75,2.00,2.25,2.50,2.75,3.00,3.2 5,3.50,3.75,4.00,4.25,4.50,4.75,5.00,5.25,5.50,5.75,6.00

I could go on, but you could look them up here http://optics.onlineopticianry.com

ndpr,
I wouldn't do a monovision fit without consent from the doctor and wouldn't recommend doing one without consent either, but for an optician to fit lenses I believe in most states the doctor has to give consent anyway, so it's kind of a moot point is what I am trying to say.

[HarryChiling]

Hmmm, almost 3 hours and no takers, hit a nerve eh.
And they say Chip has an OD chip, we get bashed as greedy, overselling neophytes everyday. Spend a day with me, and see how I work, and then judge me. I am extremely happy being an Optician, the lowest in the food chain. Let me do MY job.

I agree I think the assumption is made that if you are an optician you just landed there, whihc is not the case for most I have seen on this board. I wanted to be an optician. You know how angry I consistently make OD's by saying things like you should have been an MD if you wanted to prescribe meds, most ODs now adays have requirements to enter their programs that rival medical school so when I say that I know it is only to pluck a nerve like you mentioned. ;) Most ODs nowadays went to optometry school because they chose to be optometrists. I chose to be an optician because I chose to be an optician and their is nothign more insulting for me to hear then phrases like you should have went to optometry school. Then that means all the thigs I hate about the job would be my responsibility and all the things I love about my job (fabrication) would be delegated to someone else. I would be a misreable OD, but am a happy and great (at least in my mind) optician.

I do have a question for you npdr, when OD's call their RGP manufacturer for a consult do you think it is an OD that desings the lens from your drum readings or an Optician? And Leonardo Da Vinci, when he thought of the idea fo contact lenses would you consider him an optometrist or an optician? What about Galileo Galilei was he considered a optician by you or a optometrist?

I find most opticians have a fascination with physics invloved in the eyewear, optometrists tend to value the biological processes of vision. Why can't we both be professionals in our own spectrums of science?

[npdr]

HarryChilling,

No question that either contact lens dispensing opticians (a la Craig Norman, etc) are par excellence when it comes to contact lens fitting. I also acknolwedge their expertise when they consult in fitting queries from doctor accounts.

Whenever I call, though, I get the visual imagery that they're leafing through some book just like we would be doing.

[HarryChiling]

HarryChilling,

No question that either contact lens dispensing opticians (a la Craig Norman, etc) are par excellence when it comes to contact lens fitting. I also acknolwedge their expertise when they consult in fitting queries from doctor accounts.

Whenever I call, though, I get the visual imagery that they're leafing through some book just like we would be doing.

I would have to guess that some do, but other would have the nomograms memorized. I guess the point I was trying to get at was the design isn't very difficult at all and the fitting isn't very difficult at all. It's easier to learn when when you are over your head then to try and fit every situation. I can tell when it is better for me to let our doctor fit the lens then to fit it myself and I hardly ever fit lenses, but when my family, friends, or previous clients come into the office they don't want the doctor fittign the lenses they want me to do it, and any talk of incompetence would have them storming out of the office and would have me quiting on the spot. A good optician is worth his or her weight in gold and often I find the offices that don;t value opticians and what they can do are also the offices that have opticians that have no value or they tend to lose optician when they do have value. Probably why most doctors tend to have a negative opinion of opticians, the good ones do their job so well they don't stand out.

[LandLord]

Dear landlord,
Even if not mentioned or discussed, do you feel qualified to advise a monovision contact lens patient without prior consent from the prescriber?

No offense, but the question sounds kind of silly. Why would I need consent? Monovision fitting ain't brain surgery.

[Johns]

Excuse me, but if someone walks into my dispensary with a Bifocal Rx, I would assume that it'd be fine to be a bifocal.

I really can't get too worked up about all the hot air being blown around here about what we can and can't do. I practice in Ohio, and it is very clearly written in the law what I can do...and I do it to the full extent.

I often take such a scipt and make SV, bifocals, and even trifocals for the patients. No big deal here:

4725.40 Dispensing optician, ocularist definitions.

As used in sections 4725.40 to 4725.59 of the Revised Code:
(A) “Optical aid” means an instrument or device prescribed by a physician or optometrist licensed by any state to correct human vision, including spectacles, eyeglasses, contact lenses, and accessories. Contact lenses shall be dispensed only in accordance with a written prescription designated for contact lenses.
(B) “Optical dispensing” means interpreting a prescription of a licensed physician or optometrist and designing, adapting, fitting, or replacing the prescribed optical aids, pursuant to such prescription, to or for the intended wearer; duplicating lenses, other than contact lenses, accurately as to power without a prescription; and duplicating nonprescription eyewear and parts of eyewear. “Optical dispensing” does not include selecting frames, transacting a sale, transferring an optical aid to the wearer after an optician has completed fitting it, or providing instruction in the general care and use of an optical aid, including placement, removal, hygiene, or cleaning.


Ain't life grand? :D

[chip anderson]

For OpHwhatever:
Yes, I have $1,000,000 per eye malpractice.
In the event of a corneal ulcer, acanthameba or whatever, I send the patient back to prescribing doctor, if he's available. If not I find the patient one who is available.
Sudden loss of vision, etc. Same thing.
Yes, I do a slit-lamp exam on every patient, and stain every one with flouresene. If I see something I don't like or can't identify, I sent them back to the doctor.
And yes, I have for many years played with contact lens prescriptions and do whatever is needed. If I can't find what is needed, I send the patient back to the doctor. The doctors who refer to me are happy with this both ways.

Chip

[Johns]

I don't look down on opticians, and I am fortunate to work along side a very talented one in my office...but...

(I pity that poor optician)

With specs, I don't suggest types of lenses (I don't even know what all is out there...that's where I rely on the Optician) for fitting. I do have a problem with those who will do over-refractions over the specs. I don't have a problem with those who would change an add...however, I would caution that when I determine an add, it's not always based on a standard 40 cm working distance. IF you assume that it is for and add adjustment, or computer use lens, you may be making an error...

I am learning so much on this forum! Now I think I know why none of those computer specs I whipped up do any good!

The add is really not always based on a 40 cm working distance?
:drop: This is just so facinating! I think that I'm beginning to figure out how this whole bifocal thing works!

Please enlighten us some more!

[AdmiralKnight]

I really can't get too worked up about all the hot air being blown around here about what we can and can't do. I practice in Ohio, and it is very clearly written in the law what I can do...and I do it to the full extent.

I often take such a scipt and make SV, bifocals, and even trifocals for the patients. No big deal here:

4725.40 Dispensing optician, ocularist definitions.

As used in sections 4725.40 to 4725.59 of the Revised Code:
(A) “Optical aid” means an instrument or device prescribed by a physician or optometrist licensed by any state to correct human vision, including spectacles, eyeglasses, contact lenses, and accessories. Contact lenses shall be dispensed only in accordance with a written prescription designated for contact lenses.
(B) “Optical dispensing” means interpreting a prescription of a licensed physician or optometrist and designing, adapting, fitting, or replacing the prescribed optical aids, pursuant to such prescription, to or for the intended wearer; duplicating lenses, other than contact lenses, accurately as to power without a prescription; and duplicating nonprescription eyewear and parts of eyewear. “Optical dispensing” does not include selecting frames, transacting a sale, transferring an optical aid to the wearer after an optician has completed fitting it, or providing instruction in the general care and use of an optical aid, including placement, removal, hygiene, or cleaning.


Ain't life grand? :D

Well, in practice that's exactly what we do, ours is a bit less defined than your's though.

The Dispensing Opticians Act defines optical dispensing as:
(i) supplying, preparing and dispensing optical appliances
(ii) interpreting prescriptions of legally qualified medical practitioners and optometrists and
(iii) the fitting adjusting and adapting of optical appliances to the human face and eyes in accordance with the prescriptions of legally qualified medical practitioners and optometrists

The Dispensing Opticians Act requires a prescription from a legally qualified medical practitioner or optometrist, except in cases where the optician supplies duplications, replacements, reproductions, or repetitions of optical appliances.

[steff]

Hi guys,

Question (and no disrespect to anyone intended)...

I always write my scripts Distance, then with a near add, and on the bottom, I'll write SVD SVN b/f progs... whatever. If I don't mind what gets made up, I'll leave it blank for the dispenser to decide. If I write something, I expect it to be made up as stated. Do you mean that if I want SVD and SVN separate, I should write 2 rxes - a D rx, and a N rx (and thus no add)?

Not trying to stir the pot here, just trying to clarify what's going on...

steff

[AdmiralKnight]

I think the point is that most opticians think of what you write as a suggestion, that was the original point of this thread. If you write a script in bifocal form and write "2 pairs, svd and svn" on the bottom, most of us will do just that, two pair. But unless there's a reason why this person can't have bifocals, we're also going to assume this script will be fine for them as well. If you specifically want to exclude something you should write "not suitable for bifocals" or something to that extent to give us a clue. If I saw that on the bottom of an Rx, I'd be more likely to stop and call, than if I get a note saying "SV Readers" On the bottom of an Rx. If I see THAT note, I'll just assume the patient mentioned to you that he wanted readers, and it was you giving me a heads up. It's all about communication here people :D

[LandLord]

Hi guys,

Question (and no disrespect to anyone intended)...

I always write my scripts Distance, then with a near add, and on the bottom, I'll write SVD SVN b/f progs... whatever. If I don't mind what gets made up, I'll leave it blank for the dispenser to decide. If I write something, I expect it to be made up as stated. Do you mean that if I want SVD and SVN separate, I should write 2 rxes - a D rx, and a N rx (and thus no add)?

Not trying to stir the pot here, just trying to clarify what's going on...

steff

I can only answer for myself. As I stated earlier, I would not blindly follow the Rx. I would question the patient to make sure it was consistent with their needs.

[steff]

Fair enough. I thought you meant I should write 2 separate scripts... :hammer:

My bad

steff

[HarryChiling]

Hi guys,

Question (and no disrespect to anyone intended)...

I always write my scripts Distance, then with a near add, and on the bottom, I'll write SVD SVN b/f progs... whatever. If I don't mind what gets made up, I'll leave it blank for the dispenser to decide. If I write something, I expect it to be made up as stated. Do you mean that if I want SVD and SVN separate, I should write 2 rxes - a D rx, and a N rx (and thus no add)?

Not trying to stir the pot here, just trying to clarify what's going on...

steff

As an optician I have to interpret the Rx given to me by the doctor, if I interpret wrong or spend too much time on the phone trying to decipher a Rx I end up with wasted time and money, as the prescriber you may think you are doing me a favor by writing what you want on the Rx but if the patient walks into my stor eand then starts asking for various other things that you did not write on your Rx it would be foolish of me to not go over there options. In most cases there is a reason why this person took their scrit and walked from your office, if I take your script and follow it according to what you write, our business may suffer the same fate.

Steff,

The question is vali and I understand that most often when the doctor is writing the Rx they make a recommendation because they hear a patient want, but if that patient did not intend on buying their eyewear there they may not be telling you something that they walk into my office and tell me. The patient I think would be better served by the doctor recommending that they discuss their eyewear needs with the optician. If they stay in your office you have just saved yourself from cutting your optician off at the kness when it comes to lens recommendations and if they come to mine you have saved me.

And for the moron doctor to say they are writing their bifocal Rx's for differing working distances without writing that on the scritp this is only self serving and I only hope no one that come to my offic has seen you for an exam. The Rx belongs to the patient not the doctor and by making it hard for the optician to decipher you are only devalueing your script and your services.

[Dannyboy]

Fitting contact lenses is really no brain surgery...we fit all types of contact lenses to the full extend allowed by law. Frankly monovision is starting to be the least modality that we fit. Opticians do have a conscience and do care for the patient and believe it or not we can make clinical decisions...yes clinical decisions that are within our scope of practice. If I feel a patient may have an ulcer I will refer them to the OMD. If the patient is not a candidate for monovision because of occupation we simply do not fit him in monovision. If the patient requires specs to compensate the monovision in certain situations we will do it.
If anything is outside our current scope we will involve a friendly refractionist (OMD or OPTOM). We do informed consent. People like you have no respect to the little accomlishments that we have obtained as opticians. Shame on you. Implying that we are not competent ...Frankly I am sick of those comments or insinuations.

Dannyboy:(

[steff]

Aargh!! Dannyboy... were you referring to me???

No offense at all. I am not implying that you are not competent, nor trying to get into a debate about what you should and shouldn't do.

Just trying to get a handle on the whole 'optician' thing... we don't have them here!

steff

[chip anderson]

Steff: Whar's thar?