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Thread: Has sight testing been harmful to optometrists in BC?

  1. #101
    What's up? drk's Avatar
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    Quote Originally Posted by throughalensdarkly View Post
    Doesn't a phoropter just "try on" different lenses?
    No
    Doesn't an OD's refraction rely on patient feedback?
    Yes
    Seems fairly similar to someone trying on readers until they find a pair that works.
    No
    Nobody's diagnosing or practicing medicine, it's just trying on different lenses until you find a pair that works.
    That's practicing optometry.
    Not saying OD's can't do a better job of refracting or that there aren't other benefits to having a proper doctor such as yourself take a look at your eyes, just noting the broad similarities
    . So broad as to be meaningless
    A person isn't going to try (or at least wouldn't be successful at) suing the company that made the readers when they find out that they have glaucoma or something.
    Product liability doesn't equal professional liability.
    Why is it so different for glasses that aren't off the shelf ready readers?
    Do you work for Warby Parker or something? Is your argument to de-regulate spectacles?
    Try not to be so "glasses" focused. You, being an optician (I think) can only see a pair of specs. Look at this from the perspective of a patient with a health problem (yes, vision loss is a health problem): Don't people need trained, licensed professionals to fix their health problems? Or, just anyone?
    Again, people should get proper eye exams from proper medical professionals. But if they don't want to do that, why shouldn't they be able to buy a pair of glasses?
    They can buy a pair of glasses as it is, now, can't they? Can't people buy glasses? There's a whole lot of glasses buying going on, out there.

    You mean, why can't just anyone off the street measure refractive error and make glasses and sell people glasses. THAT'S THE ISSUE. It's not a "consumer's rights issue" (I WANT GLASSES AND I WANT THEM NOW!). It's a "consumer safety issue". (I WENT BLIND BECAUSE I WENT TO SOME IDIOT WHO DIDN"T KNOW WHAT THE HECK THEY WERE DOING!).

    It isn't providing substandard medical care to duplicate an old pair of glasses - it isn't providing medical care of any kind.
    Yeah, you're quite wrong on that one. I don't know your background or who trained you, but you're shockingly ignorant of your role.

  2. #102
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    Lol winding you up just became my new favourite hobby drk! I'm not attacking anybody, just thinking out loud and seeing what kind of feedback I get. Turns out that feedback is mostly defensive/combative! Look I'm not saying what I think is definitely right, and I certainly don't know everything. That would take an ego more like your own... Also, you say I'm shockingly ignorant of my role in the same breath as you say you don't know what I do (even though it says optical lab tech on each post I make... I hope your inattention to detail and massive ego serve your patients well:). No, I do not work for Warby Parker, and just to really hammer it home I think everybody should have a proper eye exam regularly. But people don't. We can't make them. They still deserve a pair of spectacles if they're willing to pay for them. They haven't received a medical examination so I'm not sure who you think is going to be liable for undiagnosed medical issues. If the patient can't see out of the resulting glasses they have recourse in the form of a warranty from the optical providing the sight test and the specs.

    I'll restate the basic premise in even less offensive terms than last time:
    1. People can buy Tylenol without a prescription. They assume some risks as Tylenol can do you harm if misused, and it only treats symptoms. If those symptoms are the result of some undiagnosed medical issue the person isn't curing the problem, just treating symptoms. They also won't find out about the problem until they see a doctor (even then it might be missed). This is 100% legal, and should be.
    2. Sight testing/autorefraction gives people the data they need to have a pair of glasses created to treat their visual symptoms. They aren't going to get any underlying problems diagnosed, like Tylenol. They DON'T assume any significant risk by wearing glasses, even with the wrong rx - unlike Tylenol. By comparison to Tylenol, so far it seems less risky to the patient.
    3. If the resulting pair of spectacles doesn't work, the optical will lose money doing a redo, providing some incentive for sight testing to be as accurate as possible. If the person isn't getting what they need through this method, they might think "hey I should see a doctor about this". If the glasses do the trick and the person does have a medical issue it will go undiagnosed. Just like with Tylenol.

    Once again I'd like to see every country provide a healthcare system that flat out pays for comprehensive eye exams. In the likely continuing absence of such systems, isn't sight testing and buying glasses a reasonable option for people so they can see well enough to live their lives? I'm allowed to let my brain tumour go undiagnosed and buy Tylenol, but I'm not allowed to let my glaucoma go undiagnosed and buy glasses? Seems strange is all I'm saying.

    EDIT: Oh yeah! Almost forgot, when you quote me and reply
    Nobody's diagnosing or practicing medicine, it's just trying on different lenses until you find a pair that works.


    That's practicing optometry.

    Doesn't that reduce your role to just refracting? Shouldn't you include all the medical knowledge/training/skills in your definition of optometry? If you don't, I suspect you may become obsolete in the near future. That's a pretty myopic view for an optometrist to take. Oh well, back to the grind!
    Last edited by throughalensdarkly; 02-22-2018 at 05:20 PM.

  3. #103
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    Quote Originally Posted by throughalensdarkly View Post
    Doesn't a phoropter just "try on" different lenses? Doesn't an OD's refraction rely on patient feedback? Seems fairly similar to someone trying on readers until they find a pair that works. Nobody's diagnosing or practicing medicine, it's just trying on different lenses until you find a pair that works. Not saying OD's can't do a better job of refracting or that there aren't other benefits to having a proper doctor such as yourself take a look at your eyes, just noting the broad similarities. A person isn't going to try (or at least wouldn't be successful at) suing the company that made the readers when they find out that they have glaucoma or something. Why is it so different for glasses that aren't off the shelf ready readers? Again, people should get proper eye exams from proper medical professionals. But if they don't want to do that, why shouldn't they be able to buy a pair of glasses? It isn't providing substandard medical care to duplicate an old pair of glasses - it isn't providing medical care of any kind.
    Just had a patient today, his vision in the left eye had gone down about six months ago. His VA had dropped from 20/20 to 20/40- OS. He didn't rush right in because he figured his Rx had changed and he would come in next time he was eligible for new glasses under his plan. He comes in, we are able to improve the VA OS to ALMOST 20/20... Meanwhile, dilated exam showed vitreo-macular traction with an epi-retinal membrane. The cause of his refractive error shift was due to retinal traction and separation.

    Not all refractive error changes are harmless, even if the VA improves with simple refraction. When you change a patient's Rx (or confirm that it hasn't changed), and you improve the VA, you are giving the patient a false sense of security that "everything is alright".

  4. #104
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    Good point, not going to argue with you. That's why you guys are infinitely more valuable than an autorefractor. Again, I think we should all get eye exams regularly, just like we should have a regular checkups with a doctor for the rest of our bodies. But if someone doesn't want to have those checkups, what can we do? Do these people not deserve to be able to at least treat their symptoms?

    Something I should have added was that it's important sight testing isn't marketed/advertised/made to see like a real eye exam. Maybe it should be required that at every sight testing the patient is told "You should really see an optometrist for a proper exam, this procedure won't find any medical problems you might have. I can recommend Dr. so-and-so, here is their phone number"?

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