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Thread: Debate...I KNOW I AM RIGHT

  1. #1
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    Redhot Jumper Debate...I KNOW I AM RIGHT

    So... here's the dilema...

    A guy comes in with an outside Rx:

    R PL -1.00X 90
    L PL SPH. ADD + 2.50

    He wanted a computer only pair. He only wants it for the monitor, no near power. Typically, you cut the ADD power in half (+1.25). However, his monitor is farther than that. So (after I trial framed it), I came up with:

    R +0.75-1.00x90
    L +0.75

    The debate was two-fold. The Assistant Manager (unlicensed) said that I could not alter prescriptions in any way. She went on to say that if I determined it, that I should send them back to the prescribing Doctor for a final Rx. Nope.

    My point...I have done this for years. OD's prefer that I don't waste their chair time on things like this. Besides, I am NOT changing the prescription, I am adapting it to their reading distance. What do you think?

    PS, I made them and the Patient was overjoyed. Upon pick-up I was "reminded" that I made a pair of glasses with an "illegal" prescription. Nope.

  2. #2
    Rising Star IIxIPariahIxII's Avatar
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    Quote Originally Posted by kdw613 View Post
    So... here's the dilema...

    A guy comes in with an outside Rx:

    R PL -1.00X 90
    L PL SPH. ADD + 2.50

    He wanted a computer only pair. He only wants it for the monitor, no near power. Typically, you cut the ADD power in half (+1.25). However, his monitor is farther than that. So (after I trial framed it), I came up with:

    R +0.75-1.00x90
    L +0.75

    The debate was two-fold. The Assistant Manager (unlicensed) said that I could not alter prescriptions in any way. She went on to say that if I determined it, that I should send them back to the prescribing Doctor for a final Rx. Nope.

    My point...I have done this for years. OD's prefer that I don't waste their chair time on things like this. Besides, I am NOT changing the prescription, I am adapting it to their reading distance. What do you think?

    PS, I made them and the Patient was overjoyed. Upon pick-up I was "reminded" that I made a pair of glasses with an "illegal" prescription. Nope.


    Soooo, I've gotten this from both sides before. I've worked with doctors that without a doubt trust me to know the mathematics and trial the script without wasting their chair time. But I've also worked with doctors that preferred to do those tweaks themselves rather than the optician. Mostly because of prior optical not doing it right. All it takes is one time, especially in private practice, and bam. Never again. lol. As for your assistant manager. Is it illegal, not generally. But it may differ state to state for guidelines. Outside rx is trickier because you don't have access to the doctor, but generally if it was my doctor, I'd get them to write that script after I got it just right for the patient. Also depends on the practice and their SOP. I would generally say no. You were right. But I don't know your practice's or state's guidelines.

  3. #3
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    Quote Originally Posted by kdw613 View Post
    So... here's the dilema...

    A guy comes in with an outside Rx:

    R PL -1.00X 90
    L PL SPH. ADD + 2.50

    He wanted a computer only pair. He only wants it for the monitor, no near power. Typically, you cut the ADD power in half (+1.25). However, his monitor is farther than that. So (after I trial framed it), I came up with:

    R +0.75-1.00x90
    L +0.75

    The debate was two-fold. The Assistant Manager (unlicensed) said that I could not alter prescriptions in any way. She went on to say that if I determined it, that I should send them back to the prescribing Doctor for a final Rx. Nope.

    My point...I have done this for years. OD's prefer that I don't waste their chair time on things like this. Besides, I am NOT changing the prescription, I am adapting it to their reading distance. What do you think?

    PS, I made them and the Patient was overjoyed. Upon pick-up I was "reminded" that I made a pair of glasses with an "illegal" prescription. Nope.
    Illegal Rx huh? Better keep an eye out for the 'Optical Police'...

    You did your job and did it well as evidenced by the customer being 'overjoyed'.

    I've spoken with OD's on matters like this and you're right, they'd rather their time not be wasted if 'we' can fix it without sending a customer back to them. The customer will feel the same.

    Tell your "Assistant Manager" to pay attention, they just might learn something from you.

  4. #4
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    PA is not a license state. I always confirm computer Rx with OD. I know how to calculate it. I know what it should be (I've been doing this for 26 years), but if I did the Rx then it would ALWAYS come back to me that I am not the OD and why did I do that. Nope. OD can write the Rx. I will fill. I've just been there too many times. Usually all you need is just a confirmation... is this the Rx you want me to use? Yes? Then they document it in their records that it was prescribed by the OD and it doesn't come back to me that I wrote an Rx as an optician. (Although I know a lot of opticians that can refract way better than some ODs). Myself, I just see it as a cover your butt kind of thing.

  5. #5
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    If you sold him a PAL plano with a +2.50 add, you sold him a plano, and a +0.25, and a +0.50 ----and a +2.50 - surely you should get to sell him any one of those in SV form.

  6. #6
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    I'd point out I am interpreting the rx. Not prescribing. There is a difference.

    I'd also ask politely if they could find the law (as it is "illegal") that says I cannot do this- and again politely, because, there is none.

    If I get a complaint that my trial lensing resolves I would contact the prescriber to see if they want to check the rx or if I have permission to change it.

    That scenario often depends on your relationship with the prescriber.

    You could also point to this possible class action lawsuit if there is a law concerning interpreting. You can make a safe bet their internet lawyers would not allow this if it was against the law:

    https://help.zennioptical.com/hc/en-...ing-on-bottom-
    Last edited by Uncle Fester; 07-21-2020 at 10:11 AM.

  7. #7
    Eyes eastward... Uilleann's Avatar
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    I would view it as you gave the pt an exact power - within the range of the written SRx - and therefore, you haven't changed anything (as mentioned above). I'd like to see it argued otherwise in court. Anyway, who is going to bring the suit in the first place - the overjoyed pt? Not likely.

  8. #8
    What's up? drk's Avatar
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    That's what an optician does: design lenses.

    When an Rx gets released, it becomes less a doctor's order (which is what it's supposed to be, but we all know SpRxs are only half that) and more "just data".

    Data with which someone needs to design lenses. Hopefully a great optician, vs. all the other alternatives out there.

    AAANNNDDDD....that's why I don't dig releasing Rxs. But I do.
    Last edited by drk; 07-22-2020 at 10:00 AM.

  9. #9
    OptiBoard Apprentice Lawman Nick's Avatar
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    This may be hyperbole, but I wanted a pair of distances glasses, I would be upset if I had to go back to the doctor.

  10. #10
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    [QUOTE=Uncle Fester;559616]

    That scenario often depends on your relationship with the prescriber.

    yup

  11. #11
    One eye sees, the other feels. OptiBoard Gold Supporter
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    Quote Originally Posted by Uncle Fester View Post
    I'd point out I am interpreting the rx. Not prescribing. There is a difference.
    Cut & Paste from my website:

    The important details of a refraction and individual needs are carefully interpreted using only the finest materials available.
    Moreover, kdw613 is trial framing the work distance, which is the gold standard for task eyeglasses. I wish you were in southeast Wisconsin.

    Hints and notes of caution:

    Don'ts

    Don't adjust the distance/infinity Rx.

    Don't adjust Rxs for minors, especially children, w/o an ok from the prescriber.

    Don't modify the add power for "reading" when there are binocular disorders w/o notifying the prescriber. Task eyeglasses should not need a call though.

    Do's

    Get a trial frame and lenses, or at a minimum, a variety of flippers.

    When making the appointment ask if they use a desktop monitor, draw or paint, etc., and if they perform any other frequent tasks between 20cm and 100cm, measuring that work distance before they see at the optician/prescriber.

    Demonstrate the effectiveness of task glasses with a trial frame- tape a reading card on the back of your vertically telescoping table mirror set to a realistic distance and height to mimic their desktop monitor.

    However, some folks handle blur better than others, and may have greater depth of focus due to smaller pupils, and more or less accommodative demand based on their distance Rx. If they don't "see" much improvement, and the frequency of use is low, back off, and move on to other possible needs, sunglasses, distance/near only, etc.

    Aim for the least blur not the darkest print. Note the discomfort looking around the room and out the window. Some folks might need a slight undercorrection for the best compromise of acuity and visual comfort, and/or ask if they can move their monitor back 5cm to 10cm.

    Rule of thumb: On average, most desktops are at 65cm, and need 65% of the add @40cm, that is, +2.00 and +2.25 adds get +1.25, and +2.50 adds get +1.50, and are my usual starting points when assembling the trial frame.

    Best regards,

    Robert Martellaro
    Roberts Optical Ltd.
    Wauwatosa Wi.
    www.roberts-optical.com
    ~~~~~~~~~~~~~~~~~~
    Science is a way of trying not to fool yourself. - Richard P. Feynman

  12. #12
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    Quote Originally Posted by Uncle Fester View Post
    ...That scenario often depends on your relationship with the prescriber...
    This sums it up. I've seen it both ways. Some docs are like "Why are you bothering me with this crap?" and some, if you do it yourself, are like "Why did you feel you could go ahead and do that for MY patient?!?" There is no winning.

    My general rule: When in doubt, ask the doc. Once you get to know the docs preference, remember it, and handle it that way going forward, until told otherwise.

    Also, that AM needs to blow it out her ***.

    Edit: Wow, we can't use the 3 letter word for butt? Harsh.

  13. #13
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    Edit: Wow, we can't use the 3 letter word for butt? Harsh.
    We here at Optiboard are a cultured group. We prefer 'derrière' as a synonym for 'butt'.

  14. #14
    Master OptiBoarder AngeHamm's Avatar
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    Quote Originally Posted by Lelarep View Post
    This sums it up. I've seen it both ways. Some docs are like "Why are you bothering me with this crap?" and some, if you do it yourself, are like "Why did you feel you could go ahead and do that for MY patient?!?" There is no winning.
    100%. I've had docs appalled that I wasn't doing these calculations and appalled that I was. You can't win.
    I'm Andrew Hamm and I approve this message.

  15. #15
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    Quote Originally Posted by AngeHamm View Post
    100%. I've had docs appalled that I wasn't doing these calculations and appalled that I was. You can't win.
    Exactly! That's why I error on the side of caution... Would you like me to use... Rx? I think in my case I have had most Drs act like "I'm the OD!"

  16. #16
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    Some of you need to toughen up a bit. Use your expertise, do your job, make the customer happy and if an OD get's cranky tell them to pound sand. Simple as that.

  17. #17
    Eyes eastward... Uilleann's Avatar
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    Look. The doc has specified a prescription with a range of powers. Let's call it 5 to 1. You are smart enough to understand that in that range is a 3. The patient asks for a 3. Specifically asks for a 3. You give them a 3. You haven't changed a thing. Where exactly is the legal issue? Are we truly so neutered as a profession that we can't figure this out?

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    Master OptiBoarder OptiBoard Silver Supporter ak47's Avatar
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