Test Driving a Cataract

Gratefully, I have not yet reached the point of requiring or even thinking about requiring cataract surgery. Most of us (human beings) will need to have the cataract conversation with our optometrist sometime in our early to mid seventies; and, well, let’s just say I still have an 8-month-old baby at home. Recently, however, I had an experience that gave me a brief and unsettling glimpse at what may lay ahead for me in a few decades.

With my family out of town, I decided to head up to the mountains for some late-season skiing. Although recent snows made for a great day on the slopes, they also contributed to some slushy driving on the way up.

Unfortunately, I did not check that my windshield wiper fluid was up to an adequate level; and with all the muck being thrown onto my windshield from fellow cars, I soon found that my wiper fluid ran out completely. I did my best to wipe the windshield immediately, while the muddy water was still wet; but I was soon left with a frighteningly opaque film that made it difficult to navigate the road, especially when hit with glare from the sun.

As soon as I could, I pulled over in a safe area to grab some snow that I could use to wipe off the mud. Although this got me back down to ground zero, within minutes of returning to the road I was back in the same predicament, and I knew there would be no stopping until I got to the next town. Obviously I’m here to tell the tale, so all’s well that ends well, but I can tell you it was not a comfortable experience at the time.

By now you’re probably asking yourself what in the world this has to do with cataracts. Well, on pretty much a daily basis, I use the analogy of a dirty windshield to describe cataracts. If that windshield is dirty, it doesn’t matter how good your prescription is – you can’t see as well as you should. Glare definitely becomes an issue. And because that windshield (cataract) gets worse bit by bit, sometimes it seems like you’re doing fine, and all of a sudden you realize you’re in trouble.

I didn’t realize just how apt this windshield analogy was until I lived through it myself. If you or a loved one has ever been told they have cataracts, an annual comprehensive eye exam is vitally important to ensure that vision hasn’t gotten worse than you think!

 

My Optometry Turn-ons

When I first graduated from optometry school, I assumed that as I practiced I would find an aspect of optometry that particularly interested me and could turn into somewhat of a specialty.  Now that I’m a few years removed from optometry school, here are a few things I’ve realized I’m passionate about:

1) Communication.  I feel strongly that every patient leaving my office should understand the current state of their eyes and their options for correcting any problems with their eyes.  I try to be very clear about all this during the exam, and if anyone sends me an email after their exam asking questions, I typically send a pretty detailed reply to make sure nothing is left unsaid or under-explained.

2) Good prescriptions.  Whether for glasses or contacts, I want things spot-on.  I was extremely picky about my vision growing up – probably to a fault – and I am picky about my patients’ vision.  This is why if you come in saying you recently got a glasses prescription somewhere else and only want contacts from me, I’ll still remeasure your glasses prescription to make sure things are as exact as I want them (we use the glasses Rx to determine the contact lens Rx).  And yes, I am aware of the fine line between a thorough exam and causing my patients a nervous breakdown from having to answer “1 or 2” too many times 🙂

3) Having options.  My prescribing philosophy is to offer each of my patients any and all options that I would consider for myself if I had their eyes.  If I’m offering you a separate pair of glasses specifically for the computer, it’s because if I had your prescription, I would probably want those glasses.  If I think you would benefit from part-time or full-time contact lenses, or from LASIK, I try hard always to bring up these options and how they could help enrich your life.  Before I had LASIK, I had prescription glasses, prescription sunglasses, and daily disposable contacts for part-time wear.  I had options for whatever came my way.

4) Technology.  I love my optomap because I think it gives me a better view of the back of the eye and a more perfect comparison from year to year to check for change.  I love my computerized refraction system because it makes the process of checking glasses prescriptions more efficient and more precise.  I truly believe the exam I can give you with my technology is better than the tradition exam with all manual equipment and dilating drops in your eyes (which isn’t to say there is never a reason to use dilating drops, just fyi).

Give your eyes a break!

For better or worse, as an eye doctor I am not immune to eye problems (shock!).  In fact, much of my initial interest in the field was due to the fact that I’d worn glasses and contacts since I was ten years old.  To this day, many of my opinions on different eye treatments or products come from my own personal experience treating my own eye issues!

 

During a recent family ski trip, I experienced some pretty significant eye irritation (above picture is not me, btw).  Wind blowing through my ski goggles, swimming every day with the boys, and waking up at night to deal with a fussy baby all conspired to give me red, dry eyes.  Although I was able to get the symptoms more or less under control with a mix of drops I’d brought along, I knew the underlying problem was still present.

 

This eye irritation continued even after arriving home, up until a couple of days later, when it magically seemed to stop.  Having not used any eye drops the previous couple of days, I reflected on potential sources of improvement, and I realized the answer was pretty simple: between a couple of short naps over the weekend and a great night’s sleep the previous night, I was better slept than I had been for several weeks!

 

Exposure-induced dry eyes are a major issue these days, especially with the high rate of computer and smartphone use, and especially here in the dry Mountain West.  Studies have shown that our blink rate decreases to 1/2 or even 1/3 of normal when we’re staring at a computer screen, and that leaves our eyes exposed to the dry air.  Although we live in a society that seems to want to treat all medical issues with medicine or surgery (soapbox alert) – as opposed to lifestyle changes – often there truly is nothing like a good night’s sleep to give our eyes the protection and the break they need!

 

Costco Glasses: to buy, or not to buy?

Not infrequently, my patients ask me how I feel about the quality of glasses that are produced by the Costco Optical, which is located approximately 8 feet from the entrance to my office.  I believe the unspoken question  underlying this query is something to the effect of, “How can Costco possibly provide a high quality product when it costs so much LESS than most nearby opticals?”  Glad you asked 🙂

As a disclaimer, I am not personally employed BY Costco or the Costco Optical – I lease space inside of Costco and operate as an independent Doctor of Optometry.  As such, I am not privy to the inner workings of Costco, including but not limited to figures such as costs and margins.  However, I am generally familiar with principles of optical management, macroeconomics, and Costco’s promise to keep margins low.  Upon this knowledge shall I base the rest of this post.

Here’s my short answer to the aforementioned patient question: Costco Optical is fantastic, they have been ranked #1 by Consumer Reports for overall customer satisfaction, and I’m convinced many of my patients really only come to see ME because they want to go to Costco Optical.

As for my answer to the underlying question of “How do they do it?” here’s my take on it.  Everything that Costco Optical makes is great quality, but they do have a limited selection of available products.  Whereas many independent opticals may choose from 10 or 20 different progressive lens designs, Costco uses maybe two or three.  Where some opticals may offer sunglasses in any number of materials and designs, to my knowledge Costco has just polarized polycarbonate (maybe in two different colors?).  Where some opticals have thousands of frames on their boards, Costco has…less than thousands – I actually have no idea how many frames they keep on hand.

The point I’m going for here is that Costco doesn’t have as wide of a selection as some independent optical shops, but the products they do offer are top quality at a fraction of the price of most independents.  Why such a price difference?  Partly due to economies of scale (lower material and production costs when in bulk; and with fewer products to order, each order is bulkier) and partly because Costco’s model is to keep low margins, whereas the standard mark-up at many independent optical shops is in the neighborhood of 2.5 times (as in 250%).

Again, I have no knowledge of Costco’s margins or costs, but assuming an $80 wholesale cost of a Flexon Nike frame, an independent optical may easily mark it up 2.5 times to a retail cost of about $200.  Costco obviously doesn’t go for 200% margins, but maybe something closer to 20% (I completely made up that figure for argument’s sake), which would give a price around $100.  Same frame, very different price.

I’ve already written about the insane price difference between Costco and most independent eye care providers for an annual supply of contact lenses.  Again, economies of scale.

Am I saying there’s no value to independent opticals?  Absolutely not.  If you value a wider selection of more designer frames or want to make sure you’re always getting the latest and greatest lens material or design, you may be better served by an independent optical shop.  But you’ll pay for it.  Through the nose. As a very small example, the premium non-glare treatment that Costco Optical includes on all of its lenses at no additional charge would be a $100 upgrade at most independent opticals.  I’m just saying…

My name is Scott, and I’m a recovering perfectionist

I wanted to leave my subject line as “…and I’m a perfectionist,” a la Alcoholics Anonymous or other similar recovery programs.  However, I was afraid that at a glance it would come off really pompous – more like “I’m perfect” instead of “I’m a perfectionist.”  So here we are.

 

Growing up, I feel like it was mostly pretty easy to be a perfectionist.  My life was fairly simple, without too many moving parts, and no one of the parts was so complex that I couldn’t strive for something close to perfect.  My perfectionist attitude served me well in many aspects of my life, resulting in a high level of success and enjoyment in school, sports, music, and other activities.

 

About the only major frustration I associate with my perfectionism growing up was the complete disconnect between my expectations and my abilities for art projects.  I was and am a horrible artist, and I’m pretty sure I cried and whined enough to my mom that she usually helped me to make my projects look the way I want them.  Lesson learned . . . or perhaps not learned, depending on which lesson I was supposed to be taught 🙂

 

As life went on and became more complex and less controllable, I had several experiences (read: borderline meltdowns) that made me realize I could either keep trying to control and perfect everything and die of a heart attack at age 40, or learn to choose my battles and hopefully be an overall happier and healthier person while still maintaining a high level of performance in my daily endeavors.

 

So again, here I am, in the process of learning to choose my battles and balance high precision with low stress.  Actually, one large factor that led to my owning a Costco practice was trying to simplify my life so I wouldn’t go crazy trying to control too many things!  As much as I try not to let my own personal brand of crazy affect those with whom I interact, I do occasionally struggle to know when to stop asking “Which is better – 1 or 2?” in pursuit of that most-perfect of all glasses prescriptions.  Please just know that I’m aware of the potential panic attack I  may induce within YOU, and I will try to ask only as many questions as I need to get a prescription I know you will like 🙂

 

 

 

Related articles

• Perfection or Perfectionistic? (psychologytoday.com)
• The battles of a perfectionist (livingordersablog.com)
• Nobody’s perfect… (missunderstoodgenius.wordpress.com)

There’s a Rebate for that!

Contact Lens Annual Supply

Many – but I’m sure not all – contact lenses wearers are aware of the benefits of ordering a full annual supply of contacts at the time of your exam.  Not only are you less likely to cause eye irritation by over wearing your lenses because you’re worried you’ll run out, but you can also save some serious dollars through instant or mail-in rebates!

Here’s the short story on contact lens rebates: they generally only apply to buying a full year’s worth of lenses, although some brands offer a lesser rebate for a smaller supply.  Rebates are also generally limited to the newest lens brands from the lens manufacturers, who try to encourage patients to upgrade to the newest technology.  Besides, the older lenses usually cost less in the first place.

Because rebates are generally only available for newer lens brands, this also means that sometimes your total cost for an annual supply of newer lenses isn’t much more than for older lenses, after you factor in the rebate.

Lastly, more expensive lenses often have more substantial rebates.  Specialty lenses like multifocal and toric lenses sometimes have a larger rebate than standard soft lenses, and daily disposables definitely have the largest rebates of any lens.  My most-prescribed daily disposable has an ongoing $100 rebate if you buy them through the Costco optical ($85 rebate) and get the coupon from our office at your exam ($15 rebate).  When using this rebate and factoring in the cost of contact solutions that you DON’T have to buy with dailies (on average, $80-100 for the year), your total cost of ownership for the year is almost identical with dailies as with a standard reusable lens!

Bottom line: if you can afford to put out a little extra money initially to buy the full year’s worth of contacts at once, it will benefit you both financially and health-wise in the long run.  At your next exam, be sure to ask if your brand of contacts offers a rebate for an annual supply, and make sure you walk out of our office with a coupon if applicable.

Thanks for a Great First Year!

Last month marked the one year anniversary of Clarity Eye Care opening for business inside the Thornton Costco.  In the past twelve months, we have learned tons about what works, what doesn’t work, what to expect, and what not to expect in the practice.  It’s been a crazy, great year.

I’m happy and grateful to say that we have seen growth during our first year, and that’s sort of the impetus for this post – to thank everyone who has helped grow this practice.  When I took the practice over last year, the previous doctor had only been seeing patients about 25 hours per week.  We immediately bumped that up to a more full-time schedule, and I was worried about how long it would take to fill it up!  Certainly a number of our patients come to us largely because of our convenient location inside Costco, but we also see a lot of new patients who tell us their friend recommended our office to them.  Thank you for that.

Thanks for trusting your eyes to us, for trusting us to take good care of your friends and family and sending them to us; and for appreciating our focus on clear communication and pricing, as well as efficient, technology-driven exams.  Thanks for coming back year after year and for taking good care of your eyes.

Moving forward, we certainly still have room to grow, so feel free to keep telling everyone how great we are  🙂  I feel strongly about being available for walk-in exams as needed, so measures will be taken to ensure that we’re never so booked up that we’re inconvenient.  But we’ll cross that bridge when we get there – thanks in advance for helping us get there!

If there’s anything we’re NOT doing to meet your eye care needs, please let us know so we can continue to improve.  We’re grateful for the opportunity to be your eye care provider.  Thanks again.

 

Less is More, aka “Life, Simplified”

Communication (Photo credit: elycefeliz)

I recently had the opportunity to take a week off and go on a trip with my wife and three boys.  Beyond providing the simple joy of relaxing apart from the cares of the world, our vacation also reminded me that our modern American lives tend to be full of way too many distractions!

Especially when we haven’t had a chance to get away from these distractions for a while, I don’t think we truly understand how much they complicate our lives, clog up our brains, and increase our anxiety levels.  When we’re not anxiously checking Facebook for status updates, we’re compulsively checking our email – which, by the way, comes directly to our phones so we can obsess about it at all times.  Texts and calls must be returned immediately, lest we miss out on something or feel less than 100% connected.

While I am all about interpersonal relationships and connections, I do find it funny to ponder how different this life philosophy is from even just 5-10 years ago.  I used to write letters . . . on paper . . . and wait at least a week for a reply.  And somehow I survived.  Surely I don’t need to spend half my waking hours sending and receiving texts, checking my email, or surfing the web for that next great meme.  Not to mention the fact that if I am so consumed by these activities, they are likely crowding my subconscious thoughts even when I’m not directly participating in them.

What point am I attempting to make with this unfocused blather?  Basically that I would like to figure out how to manage my interpersonal communication so that I’m reasonably accessible to my family, friends, and patients; without letting it consume me.  I was more or less off the grid for an entire week, and yet my life did not fall apart.  It was beautiful.

It’s not easy, though.  Old habits (addictions?) die hard, and I still find myself gravitating toward my phone, iPad, or computer when I have idle moments.  But in case you ever send me a text or email and I don’t respond imMEDiately, there’s certainly a chance that I’m trying to simplify and de-stress my life.  Hopefully most people can appreciate and support that pursuit  🙂

My practice does not define me (and I mean this in a good way)

As a small business owner (or perhaps just as a working adult?), I constantly have to work on the balance between my personal life and my business.  If I were so inclined, I’m sure I could find projects and obsessions to keep me working on the business pretty much all hours of the day.

Unfortunately, the more I ponder and work on my practice, the more I associate its success with my own personal success.  As in, my success as a person.

So, as we are faced with a fully reasonable and predictable lull in patient traffic for a period of days or weeks, I find myself fighting the urge to be incredibly upset by this perceived lack of success.  As a person.  Which it obviously is not.  But I have to remind myself of that, because I do spend a lot of time thinking and working on this business.

What’s my point?  I love being an optometrist, and I love to solve complex problems and help people.  But before I’m a doctor, I’m a husband and a father, and my success in that realm trumps any other measure of professional success.

Bottom line #2:  I need a hobby!  Then, even if work is slow, I have other endeavors to keep me occupied and productive.  How’s that for a plan?  Or I could just start blogging incessantly, and my posts would become so frequent, they would just blend into the white noise . . .

Local Allergy Forecast

Check out the above link – very cool!  And for more information regarding eye allergies, read my recent post on the subject.

Related articles

• Allergy Season is Here! (costcoeyeexam.wordpress.com)

LASIK Thoughts ...

Here is a great website for all of the allergy suffers out there.

Easy to use – select your state, choose your city and get the 4 day allergy forecast for your area.

http://www.pollen.com/allergy-weather-forecast.asp

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