Comments on: Patients Say the Funniest Things http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/ Personal Opinion Blog of David Langford Tue, 10 Jan 2012 17:54:02 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: optoblog.com » Blog Archive » Socialized Healthcare http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/comment-page-1/#comment-493 optoblog.com » Blog Archive » Socialized Healthcare Thu, 17 Dec 2009 09:42:55 +0000 http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/#comment-493 [...] next thing you know, big brother is telling you that you really don’t need an eye exam all that [...] [...] next thing you know, big brother is telling you that you really don’t need an eye exam all that [...]

]]> By: optoblog.com » Blog Archive » Wal-Mart Steps in [It] With 1-800 Contacts http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/comment-page-1/#comment-176 optoblog.com » Blog Archive » Wal-Mart Steps in [It] With 1-800 Contacts Thu, 31 Jan 2008 04:19:48 +0000 http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/#comment-176 [...] previous blog posts about 1800: http://www.optoblog.com/2007/10/09/check-yearly-live-another-year/ http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/ [...] [...] previous blog posts about 1800: http://www.optoblog.com/2007/10/09/check-yearly-live-another-year/ http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/ [...]

]]> By: optoblog.com » Blog Archive » Check Yearly, Live Another Year http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/comment-page-1/#comment-175 optoblog.com » Blog Archive » Check Yearly, Live Another Year Wed, 10 Oct 2007 05:35:05 +0000 http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/#comment-175 [...] another example of why everyone should consider getting a yearly eye exam despite what Canadian studies say. A college student came in for a routine eye exam to get more contacts since the last doctor [...] [...] another example of why everyone should consider getting a yearly eye exam despite what Canadian studies say. A college student came in for a routine eye exam to get more contacts since the last doctor [...]

]]> By: optoblog.com » Contact Lens Prescription Provided to Patients http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/comment-page-1/#comment-174 optoblog.com » Contact Lens Prescription Provided to Patients Thu, 20 Sep 2007 23:18:42 +0000 http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/#comment-174 [...] is finalized, I give them their copy. I even make it good for 2 years since that is what Utah law requires (unless there is a medical reason to make it [...] [...] is finalized, I give them their copy. I even make it good for 2 years since that is what Utah law requires (unless there is a medical reason to make it [...]

]]> By: Michael Judkins http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/comment-page-1/#comment-164 Michael Judkins Fri, 10 Aug 2007 21:51:56 +0000 http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/#comment-164 Yeah. I the thing I really took exception to was the capatalized statment that AV was a two week lens. Every person in the chair is differnet and I fit the lens according to the patinet not what some taylored study or the rep says. Yeah. I the thing I really took exception to was the capatalized statment that AV was a two week lens. Every person in the chair is differnet and I fit the lens according to the patinet not what some taylored study or the rep says.

]]> By: John Coghlan http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/comment-page-1/#comment-173 John Coghlan Wed, 08 Aug 2007 14:19:22 +0000 http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/#comment-173 I think that what we all agree on is that every patient is different. You need to set recommended follow up on a case by case basis. This is where any legislation can fall down as it just works on averages. With silicone hydrogels you have a greater chance of causing GPC in some patients. Sone patients never deposit lenses and a clean AV lens at 3 weeks probably breathes as well as a 2 week one. Some people could use them for 3 months! What happens with single use lenses. You can use these many times if you want too. We then get into the issue of deposits and secondary tissue irritation etc and what materials deposit more......arguments on this go on forever I think that what we all agree on is that every patient is different. You need to set recommended follow up on a case by case basis. This is where any legislation can fall down as it just works on averages. With silicone hydrogels you have a greater chance of causing GPC in some patients. Sone patients never deposit lenses and a clean AV lens at 3 weeks probably breathes as well as a 2 week one. Some people could use them for 3 months! What happens with single use lenses. You can use these many times if you want too. We then get into the issue of deposits and secondary tissue irritation etc and what materials deposit more……arguments on this go on forever

]]> By: David Langford http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/comment-page-1/#comment-163 David Langford Tue, 07 Aug 2007 16:41:35 +0000 http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/#comment-163 I wouldn't make a diagnosis over the web. I would encourage you to make an appointment with an eye doctor in person for a thorough evaluation. Here is a good example of the type of condition we were talking about: http://www.uihealthcare.com/depts/med/ophthalmology/contactlens/picofthemonth/corneovasc.html I wouldn’t make a diagnosis over the web. I would encourage you to make an appointment with an eye doctor in person for a thorough evaluation.

Here is a good example of the type of condition we were talking about:
http://www.uihealthcare.com/depts/med/ophthalmology/contactlens/picofthemonth/corneovasc.html

]]> By: Ida http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/comment-page-1/#comment-172 Ida Sun, 05 Aug 2007 02:46:26 +0000 http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/#comment-172 Hey people. I'm a 27 year old female from Norway. I've been wearing contacts pretty much every day since I was 18, and all day long. I haven't let my eyes rest by wearing glasses. In January I noticed that I had developed alot of blood vessels on the white part of the eyes. On the sides, and also under the eyelids. Since I discovered this problem I've worn my glasses as much as possible, but the vessels have not disappeared or been reduced at all. Is this corneal neovascularization? And is it possible to get rid of the vessels, with some kind of treatment (laser?). This is such a big problem for me, I'm having a hard time facing people because of how my eyes looks. Hey people. I’m a 27 year old female from Norway. I’ve been wearing contacts pretty much every day since I was 18, and all day long. I haven’t let my eyes rest by wearing glasses. In January I noticed that I had developed alot of blood vessels on the white part of the eyes. On the sides, and also under the eyelids. Since I discovered this problem I’ve worn my glasses as much as possible, but the vessels have not disappeared or been reduced at all. Is this corneal neovascularization? And is it possible to get rid of the vessels, with some kind of treatment (laser?). This is such a big problem for me, I’m having a hard time facing people because of how my eyes looks.

]]> By: Michael Judkins http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/comment-page-1/#comment-171 Michael Judkins Fri, 03 Aug 2007 20:09:36 +0000 http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/#comment-171 Look at your shampoo bottle, lather, rinse and repeat. I am sure that advice is the result of extensive study as well. Do you follow it? The package insert on AV says "Wearing and replacment schedule should be determined by your eye care professional." They (Vistakon)only recommend 2 weeks. I am giving you a hard time because you assume I am causing harm to my patients by actually thinking, using clinical judgment, and setting an appropiate wearing and replacment schedule for each person. Cost of the lenses is not a factor in that decision. Even if it is the first time I have seen a patient I usually know what they are in and how they are wearing the lens. Call for their old RX, ask them how they wear the lens (and believe only half of what they say), and bring them back for return visits as needed. Assuming everone needs a high DK and 2 week replacment is just as bad as telling everyone to wear an AV extend wear for 30 days and to come back in a year. I could go on but I have to take the family camping. Take Care. Look at your shampoo bottle, lather, rinse and repeat. I am sure that advice is the result of extensive study as well. Do you follow it?
The package insert on AV says “Wearing and replacment schedule should be determined by your eye care professional.” They (Vistakon)only recommend 2 weeks.
I am giving you a hard time because you assume I am causing harm to my patients by actually thinking, using clinical judgment, and setting an appropiate wearing and replacment schedule for each person. Cost of the lenses is not a factor in that decision.
Even if it is the first time I have seen a patient I usually know what they are in and how they are wearing the lens. Call for their old RX, ask them how they wear the lens (and believe only half of what they say), and bring them back for return visits as needed.
Assuming everone needs a high DK and 2 week replacment is just as bad as telling everyone to wear an AV extend wear for 30 days and to come back in a year.
I could go on but I have to take the family camping.
Take Care.

]]> By: David Langford http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/comment-page-1/#comment-170 David Langford Fri, 03 Aug 2007 07:02:21 +0000 http://www.optoblog.com/2007/07/30/patients-say-the-funniest-things/#comment-170 "I examine people every year because they need it." I think we're arguing for the same thing here, so I'm not so sure why you're giving me grief. Oh, you take exception to my AV2 is a 2 week lens statement. I'm not the only one taking that position. It also says so on the label. If K-neo is so unpredictable in its presentation-even in high Dk lenses, then why not take the conservative approach? You think you're going to be the patient's best friend by saving them a few dollars on contacts? I prefer to do no harm (prevent K-neo in this case). "I take the time to examine the people in my chair." But if it's the first time you have ever seen them, why would you tell them to wear an AV2 for one month (patient remembers 2 months)? Are you just going to wait for them to present with k-neo next year (patient remembers to come back in 2-3 years)? When they finally have k-neo, then would you back them down to the recommended replacement schedule of 2 weeks like the package insert says? You know, the recommendation based off of their design, study, and testing of the lens. Recommending a 2 week replacement schedule for a 2 week lens has nothing to do with the rep. It's called science. At least we agree that we don't recommend eye exam intervals based on what legislators say. It should be based on good science, and I'm just saying let's get some data from unbiased sources. But even if studies confirm 2 years is okay, that wouldn't have helped the woman I saw last month. She had been getting yearly routine vision exams from another eye doctor, but came to me this year. Her vision was, and always has been, just fine. She just wanted more contacts. An abnormal FDT visual field, mild proptosis, and optic nerve rim tissue elevation led to further studies confirming a mass behind her orbit. Does anyone think any study claiming eye exams intervals should be every 2-3 years is going to convince me or that woman? “I examine people every year because they need it.”

I think we’re arguing for the same thing here, so I’m not so sure why you’re giving me grief. Oh, you take exception to my AV2 is a 2 week lens statement. I’m not the only one taking that position. It also says so on the label.
If K-neo is so unpredictable in its presentation-even in high Dk lenses, then why not take the conservative approach? You think you’re going to be the patient’s best friend by saving them a few dollars on contacts? I prefer to do no harm (prevent K-neo in this case).

“I take the time to examine the people in my chair.”

But if it’s the first time you have ever seen them, why would you tell them to wear an AV2 for one month (patient remembers 2 months)? Are you just going to wait for them to present with k-neo next year (patient remembers to come back in 2-3 years)? When they finally have k-neo, then would you back them down to the recommended replacement schedule of 2 weeks like the package insert says? You know, the recommendation based off of their design, study, and testing of the lens.

Recommending a 2 week replacement schedule for a 2 week lens has nothing to do with the rep. It’s called science.

At least we agree that we don’t recommend eye exam intervals based on what legislators say. It should be based on good science, and I’m just saying let’s get some data from unbiased sources.

But even if studies confirm 2 years is okay, that wouldn’t have helped the woman I saw last month. She had been getting yearly routine vision exams from another eye doctor, but came to me this year. Her vision was, and always has been, just fine. She just wanted more contacts. An abnormal FDT visual field, mild proptosis, and optic nerve rim tissue elevation led to further studies confirming a mass behind her orbit. Does anyone think any study claiming eye exams intervals should be every 2-3 years is going to convince me or that woman?

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