It's also the second ruleOriginally Posted by Wes
Posts? What posts? The first rule of vanishing posts is "you don't talk about vanishing posts."
It's also the second rulePosts? What posts? The first rule of vanishing posts is "you don't talk about vanishing posts."
Best solution ever!
shhhh ! I have secretly infiltrated idispense's posts and have discovered that if he/she deletes them periodically then the vanishing posts can not be referred back to and then CHRIS can not claim that this or that post has been discusssed before and extradite idispense back to Canada ..... keeep this to your self ... uh oh he is coming I have to run and hide ....
Along those lines I'm wondering something and I've seen two large shops with opposite takes on this--If the Rx has the PD on it is it ok for the Optician to retake the PD anyway? Occasionally I've checked the supplied one and it isn't the same. Do we call the Dr, go with the one we took, or go with the Dr version? I don't know that a Dr is very likely to clarify when the PD is done for a specific reason and not just their general measurement. I get particularly worried when the PD's , OD and OS are the same , that they were taken as binocular.
When I measure them and they are the same I like to notate that mono pd was taken so the next person reading the order will know for sure it was mono. I would love a good argument for my management that it is ok to retake or check the PD that the DR office supplies . Am I ok for thinking this or out of line for not trusting the DR at face value? Thanks! I'm in CA by the way.
Could you change a fitting height on a Rx?
Can you change the add?
Can you wrap compensate?
Can you measure your own measurement?
Of course you can. In fact, you MUST.
thanks!
Sorry for the late reply but this issue has come back to life in my work. Not only do we get the PD on the RX but I'm being told I can't verify it by taking my own PD measurements , and consequently, if they differ, changing them, without calling the DR and asking permission to change it. IF the DR took Binocular then we have to put down half of that as though it was mono. This is where it gets really sticky because the Dr doesn't specify how this was taken or in what context it is being supplied. His assistant (who in many states is not required to be licensed, when working directly under the DR) is not the one with their license on the line if they are wrong. We are either way. So we are left between the proverbial rock and a hard place. -Not to mention the coworkers, especially uncertified in the background chorus "ooh ooh , you're supposed to type the RX EXACTLY as written." augherrrrr! It is to the point that if I take a mono PD and both eyes are the same I put in the notes that I took mono just so the next guy will know how the measurements got there; ie this 30/30 is really a 30/30. (yes it is a large retailer) If the DR puts a mono pd on the rx and some opticians are required to go with that than it doesn't take much to realize that if the order is for progressives both eyes could easily be wrong. WE have to use the DR PD but that doesn't excuse us if we have to do a Redo later. This really bothers me , and suffice to say the more I learn the more it bothers me. (math once again falls victim to politics?) So the arbitrary use of a DR PD without some assured autonomy for those who "like" to be accurate (seriously-yea right?) and this really takes our integrity and not just our value but the choice to do things with value and integrity back a notch without recourse. I tried to call our state board on this and still have not been able to pin them down to a concrete answer as to what the state law is on the responsible application of the Dr supplied PD. They then said to get clarity I should call the state optometric society. So, I did. The optometric society said that the answer to that question was privileged to those that are paid members--so I looked into joining... --only to find that "members" are optometrists, not Opticians. I think you are right that this measurement is placed their by well meaning Dr who perhaps had to comply with the two door laws but then the retailer upper level management-also well meaning, -but not necessarily certified- see the DR supplied one and consider , "oh oh its a DR so we,-: "you must use this!". Not really sure how someone without certification or license can mandate someone with a license not to take this measurement , but it happens, I'm living it. If you read that rant, thanks , love to get the feed back. Refreshing to come home and be able to pitch to the choir.
Wow. Run. Don’t look back. Get the heck out of that practice. They don’t need an optician, just sales robots.
+1. That's awful.
Also, why in the world is an OD providing PDs?
I'm Andrew Hamm and I approve this message.
+1 Agreed. Did you say this is a large retailer and not a private practice? I assume this is just the rules coming from management? So sad.
Even when I worked for chain/retail optical, we never had nonsense like that. Sounds like the doctor's on a company-endorsed power trip.
If I worked somewhere that did that I would just change the PDs if they were given to me wrong. Then if I was questioned why I didn't use the measurements written down I would say, "Because they were wrong."
I would do all that while looking for a better opportunity though of course!
This, of course, has absolutely nothing to do with licensure, certification, or board status. That's a red herring best put to bed, and left out of the discussion. But yes, you're 100% spot on with the political and bureaucratic nature of many stores - particularly chain retailers. It certainly seems in your best interest to seek a new employment situation with all possible haste. You're certainly not in an environment that values even basic quality over quantity.
But do we have to accept their PD? Some of these offices take binocular PD's; some just plain aren't right and aren't taken by licensed opticians who are going to be responsible for following up on their work. Is there an issue if we want to retake a PD when the one provided causes concern.
The PD responsibility zombie rises from the dead.....
Just what is so wrong with using a binocular PD?
Nothing is wrong with it per se, especially for small Rxs. But I know I don't need to explain to you if a patient's eyes are not symmetrical it will create horizontal prism and depending on their Rx it could be within tolerance or it could not.
I think many pd on rx are taken by autorefration unit...and They are often soo wrong.
on autorefraction due to position I have a 70mm PD..... with pupillometer or by hand I have a binocular 67.5...
When in doubt, re-measure. A PD is not part of an Rx.
But if they look in any direction except straight ahead, the consequences apply.
Now what?
Yes Barry and if the patient moves their head up or down, their heights will be wrong. But the point of what we do is start from a position of the highest accuracy possible, to minimise errors and maximise the patient's vision for as large a part of their life as possible.
Nothing is perfect, but that doesn't stop us aiming for perfection.
If there's a PD on a computer-printed RX, I always assume it was generated by an autorefractor and disregard it.
I'm Andrew Hamm and I approve this message.
I was told that we should keep using an existing PD even it it is slightly off because a person's brain gets use to it and it would be more of an issue for them to have to readjust if it is not that far off. The issue of late that regenerated this issue was in looking at a customer's former pd it appeared that one eye was off from the PD given. I was going to re-measure the PD but was then told not to for the reasons given above. The horizontal prizm was probably about .3. Does anyone have more insight as what concern there is for changing a PD that has been used for several years?. I do not recall any questions on the ABO about people getting 'use to' a new PD or it causing a problem. However I have heard it come up in conversation. Up until now if I thought there was any doubt about the PD I just retook it. This was the first time someone intervened and said no. ( I wasn't too happy but I stayed cool, aughhh) Yes there is some adjustment sometimes with a new Rx but as to the harm of adjusting to a correct measurement I'm skeptical. Anyone have some insight? many thanks for the validation above.
I think of it as adjusting by baby-steps. If my PD reading is off from someone who has, oh let's say been wearing the same pair for 15 years, I will usually attempt to shift the PD in the right direction by small increments. Adjusting by a half millimeter at a time will offer a better fit without shocking the patient. Be sure to thoroughly document a gradual shift so that the intent doesn't get lost with future pairs.
We do the same thing with growing children. They (hopefully) aren't wearing outdated RXs but we do shift the PD to grow with them. At some point they were looking through a more narrow PD than what we remeasure the new pair for and the brain adapts. Not quite the same, but another example of not reusing a PD.
Have I told you today how much I hate poly?
Technically, you are right. BUT, sometimes it's better to let a sleeping dog lie.
Last edited by waynegilpin; 12-14-2020 at 05:35 PM.
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