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).

Why Buy Brand Name Contact Lens Solution?

I recently read an article extolling the virtues and explaining the science of Clear Care contact lens solution.  Within the article, its authors made the point that store brand (generic) versions of solutions are not and should not be considered interchangeable for  name brands.

Growing up, I was always taught that generic medications were the same as their brand-name counterpart, and I think a lot of people believe this to be true.  In the world of eyes, at least, such is not always the case.  Following are three reasons to buy brand name contact lens solution:

1) Inactive ingredients often vary between brand name and generic solutions, and these variations may result not only in decreased eye comfort (more irritating preservatives, etc) but also decreased efficacy for the intended task (not as effective for disinfection, etc).  One comparison would be to drink a glass of apple juice and assume you’re getting all the nutrition that you would receive from an apple – the main ingredients are the same, but sometimes the little details make a big difference!

2) Often overlooked in contact lens care is the importance of regularly changing your lens case.  Almost without fail, whenever a widespread problem with contact-lens related eye infections develops, it is found that a ridiculously high percentage of affected individuals had cases that were many months or even years old.  Brand name solutions typically give a new case with each bottle of solution, whereas many store brands do not.

3) With brand name solutions, you always know what you’re getting.  The formula doesn’t arbitrarily change, so if it works for you now, it should work for you next year (assuming you’re using it properly!).  Store brand solutions don’t have this reliability – if the company selling the solution finds a different manufacturer that they prefer for whatever reason (probably cost), they can switch whenever they want and you’ll never know.  But you may wonder why the solution all of a sudden stopped working well for you…

For more information about proper use of contact lens solution, read my previous post on the subject.

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.

WWID? (aka Golden Rule Optometry)

Image via Wikipedia

Some time ago, when I was still working at a stand-alone private practice, I occasionally felt conflicted regarding which vision correction options I should offer my patients.  Especially in that setting, certain options could add a LOT to the patient’s financial obligation, and I was definitely conscious of that.  I feared ever getting into a situation where my recommendations could ever be tainted by a desire to “up-sell” my patients.

Although opening a practice inside Costco has lessened some of my concerns regarding astronomical costs for my patients (see my post on potential savings through Costco), I have continued to abide by a philosophy developed at my previous practice – namely, I recommend to the patient whatever options I would want if I had their eyes.  If a patient’s prescription is so low that contacts aren’t really necessary to enjoy swimming, basketball, etc, I let them know contacts are optional.  If the prescription is incredibly high, I let them know it’s a strong recommendation.  If they abhor the very idea of contacts but have a pretty substantial prescription, we’ll definitely talk about prescription sunglasses or possibly LASIK.

Frankly, I’m somewhat grateful that I don’t profit from the sale of contacts or glasses, because it really allows me to remain objective about what to recommend!  With this golden rule philosophy, I can feel confident that I am offering each patient the best options available without judging their ability to pay; and I let them choose what they can, or want to, afford.

I am an Independent Doctor of Optometry

I recently read an article written by a fellow optometrist suggesting that Costco optometrists are somehow employed and/or controlled by the corporate powers that be. The idea was that my prescribing habits – which contact lenses I fit, for example – are potentially skewed by my association with Costco.

Let me just cut to the chase and say this suggestion is false!

As Costco states on their website, on the sign standing by the warehouse entrance, and on the sign just outside my office (see above), I am an “Independent Doctor of Optometry.” This means that I actually lease office space inside Costco and am free to practice optometry how I see fit. Although I would LOVE Costco employee benefits, I do not receive any, because I am not employed by Costco.

I love it when the contact lenses I recommend happen also to be stocked by the Costco Optical for convenience to my patients, but just as often as not, my patients order their lenses through the Costco Optical and receive them within about a week. They still receive the amazing Costco prices, and I got to prescribe whatever lens was best for that patient, so everyone is happy 🙂

I love working side by side with Costco Optical as a business partner because of the great prices, products, and service they provide my patients; but my decisions are my own.

 

My LASIK Experience

Dr. Oster, LASIK surgeon extraordinaire

I was horrified just now to realize that my last blog post was before Thanksgiving!  As it so happens, it was also before I went “under the laser,” as it were, for my LASIK procedure.   

As an eye doctor, I have co-managed a few dozen patients for LASIK and PRK (defined and compared in my page on laser vision correction).  I have also visited several laser vision surgery centers and observed surgeries, and I really thought I knew what the LASIK experience entailed for my patients. 

Turns out, I was wrong.  Which is not to say that I think I was an awful doctor to my patients before, or that doctors who haven’t had LASIK shouldn’t be trusted with LASIK patients.  However, I do feel that going through LASIK myself made me a 100% better resource for patients who are wondering what to expect with the procedure.

I suppose since the post is entitled “My LASIK Experience,” I should at least comment on  my personal LASIK journey.  I am not one of those people who spent years pining for LASIK before they could actually have it done.  By nature, I’m somewhat conservative; and the idea of having elective surgery that could in any way impair my vision if gone amiss was unappealing to me for a long time.  Finally, after seeing so many perfect patients and so many amazing advances in the surgical technology, my stance on the issue softened somewhat. 

The final straw for me was my absolute inability to wear contact lenses consistently and comfortably here in the dry, thin air of Colorado.  If I ever got greedy and wore my contacts two days in a row (gasp!), or even just for an entire day (the nerve!), I paid for it with red and irritated eyes the next day.  I convinced myself I didn’t mind wearing glasses all the time, and I tried to embrace my new reality by building up a collection of four or five cool frames that I mixed and matched with the day’s outfit.  Eventually, my nose got tired of supporting glasses 24/7, and I was pushed even closer to my LASIK.

My surgery was performed at TLC Laser Eye Center in Denver, and I have nothing but good things to say about them.  My consult was great and actually a lot of fun with the cool instruments, the people there were and are great, and the surgery went off without a hitch.  They tell you exactly what to expect, and they are right on.  There are certainly some mildly uncomfortable or inconvenient aspects of laser eye surgery and its recovery, but the trade-off of a few mildly uncomfortable days for years and years of great vision is a no-brainer for me. 

 

Of course, hindsight is 20/20 – or in my case, 20/15 😉