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I was in the contact lens room watching a patient put in the contacts that I wanted to give him. I mentioned how the prescription would be good for 2 years per Utah law.

“Wow, is that new?” he asked.
“Umm, it’s pretty new. The state lawmakers got together and decided that’s how it should be,” I answered.
Then he said, rather sardonically, “Why, because they’re all doctors?”

I laughed out loud. It’s so true. When lawmakers decide to micromanage an entire healthcare profession by telling us how long we have to make a prescription good for, then I think they better have some proof that this new policy won’t cause more problems than it helps. Where is their research that supports such a sweeping change? And the research can’t come from 1-800 or Canada because we know they have a biases.

Now, the Utah law does say that I can make it for less than 2 years as long as I document some medical reason why it should be less. So…since nearly every contact lens patient I see was brought up on AV2 contacts (or some other low oxygen lens that is cheap), I think I could probably make a one year expiration on most everyone since most everyone in that category has mild corneal neovascularization.

So do I? No, because I switch almost everyone into a high oxygen lens, my preferred method for treating K-neo, so if they’re wearing an AV Oasys or Ciba Night and Day, what more can I do to help them?

But if they refuse to switch to a more costly (yet healthier) contact lens, then I explain how we should decrease their wearing time, maintain an approved replacement schedule, and monitor it next year.

One question for you all. Why do you insist on telling your patients that it’s okay to throw away their Acuvue2 lens once a month?!??!! IT’S A TWO WEEK LENS!! You are the reason I see so much K-neo. I hope you’re proud of yourself.

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Okay, so how did your practices do this firework season? In my previous practice as an Indian Health Service optometrist in Browning, MT, I would see 2-3 injuries in June-July.

I left town for the 4th thinking I would escape having to deal with fireworks injuries, but guess what! I still saw a woman who got hit with a bottle rocket. Sure it’s two days after it happened. Her chief complaint? She needed new glasses, since the bottle rocket made her old ones have a permanent black cloud on them.

Luckily, this woman doesn’t have any damage to her eyes other than singed cilia. The scary thing is she was holding her kid while her husband lit off bottle rockets, so that firework could have just as easily hit a poor baby without any eye protection. He had a bottle, but this errant one was launched from being stuck in the ground instead of in the bottle.

My family traveled to another state where bottle rockets are also outlawed. My kids and I watched some legal, colorful fireworks, but when the person broke out the bottle rockets, I took my kids kicking and screaming into the house (yes, literally). I told them they could look at it through the window. Scary thing…the firework lighter was also just planting them in the ground instead of using a bottle.

So, I’m glad I didn’t let my kids be around bottle rockets. The TV news in my area has been reporting about organizations that would like to ban consumer fireworks, mostly citing the wild fire issues. To date 5 states have outlawed consumer fireworks. I am almost ready to agree, but I still dislike having my freedoms being infringed on. The nearest parallel I can think of to the fireworks issue are firearms.

People misusing firearms cause lots of problems just like people who misuse fireworks. Maybe instead of an all out ban, fireworks could be regulated like the gun industry. Maybe people should be required to pass a fireworks safety class and obtain a permit to light consumer fireworks. Maybe no one should be allowed to light off fireworks except under the direct, on site supervision of a fireworks permit holder.

The negative? Fireworks would become too expensive to (legally) buy since demand would go down and government taxes would go up to cover the cost of firework regulation. Fireworks could only be cheaply purchased from gangsters. Lots of otherwise good kids would get a juvi record. But perhaps there would be less impact from banning fireworks, than say alcohol, since no one really thinks about lighting fireworks except on Independence Day and Christmas.

People shoot guns and light off fireworks safely all the time- except guns and the shooting of guns are heavily regulated while fireworks are not. I am still not for the all out ban of fireworks. I would rather have common sense prevail instead of expensive government regulation, but if fireworks injury cases are any indication, it appears that self regulation isn’t effective, at least anecdotally. We need John Lott to commission a study about how pervasive this whole firework injury problem is and whether government regulation would be cost effective.

For the mean time, I’m not allowing my kids near bottle rockets.

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