A question about eye exams

[agate]

Does everyone here get regular eye exams? Or have you had an eye exam in the last couple of years?

I'm asking because I'm about to go for my annual visit to the ophthalmologist. With diabetes, cataracts, and severe near-sightedness, I like eye exams that result in better vision for me. This often means new glasses every year but it's a small price to pay for seeing better.

I've been going to the same eye doctor for 14 years, and have no problems with him or with the optical department that is attached to his office, where I get the glasses rx's filled. But the last two years I've noticed how short the eye exams have been, compared to eye exams in the past.

I'm talking about the part where you sit in a darkened room and are shown charts with letters on them and asked which ones you can see. I've been having eye exams like that since I was 10, and ALWAYS they have been fairly thorough, lasting at least 15 minutes to half an hour.

This doctor's eye exams have been like that too except in the last 2 years, when that part has lasted about 2 minutes.

I got new glasses last year but the left lens has provided only blurry vision. This is the rx, not my eyes, because I tried some old pairs of glasses for comparison and got better vision in the left lens with one or two of them.

I can't help thinking that the doctor's office is trying to economize and just do brief eye exams for people like me (older people who can't or won't have the recommended cataract surgery).

Time is money, they say, and if they can shave off even 10 minutes from the time spent on eye exams, they can squeeze more patients into a day.

I don't know whether to say anything about this when I report there this week. What do others think?

Have your eye exams been very brief lately? I was just wondering if this was a trend among eye doctors. Maybe they've decided that they don't really need to do such detailed eye exams?

[Virginia]

My last exam, just a couple of months ago was kind of like that. I too had been getting lengthier exams. I have not had my new rx filled, but only because I have had so much fatigue lately that I haven't felt like going to choose new frames. I always get an eye exam every year because I had a blind spot in one eye due to optic neuritis, then a few years ago he told me I had a blind spot in both eyes. I have been going to that office since the 70s. The first ophthalmologist sold his practice to this man and it has been 30 to 35 years that I have been seeing him.

He is very conservative in his treatment of cataracts. He thinks people are too anxious to get the surgery and he got tired of hearing them say it is nothing to it, so now he sends all his cataract surgery patients to someone else. I kind of think I should have it, but he doesn't. My vision is getting more blurred. If I went to someone else I feel sure they would say to do it.

[agate]

I'm glad to know there is at least one eye doctor on the planet who isn't eager to do cataract surgery. I've always felt that unless my vision was so seriously impaired that I wasn't functioning at all well on account of it, I should avoid it--just because it is surgery, and any surgery has its risks. And the older you are, the riskier it is.

I make mistakes in reading numbers sometimes (have paid bills wrong several times--it's embarrassing but I'll try to be more careful) but otherwise my vision is adequate. Night vision is quite bad, and a bright day is painful without sunglasses, but those are just nuisances.

I have a feeling that cataract surgery is quite profitable for eye doctors. When I lived in WA state, and this was about 20 years ago that I noticed it, at least one eye doctor in town was advertising cataract surgery complete with a special van to transport people back and forth to the appointments.

I haven't seen any eye doctor here offering that, and so maybe as an idea it didn't work so well....

[agate]

I learned something about eye exams today. Maybe everyone else has known this for years but it was new to me.

For all of the decades when I've been having eye exams, the eye chart has always consisted entirely of block capital letters. In recent years a couple of times I did notice a couple of numerals in there. But otherwise capital letters.

Today during the eye exam I was doing especially badly, as I have done in the previous two years. I saw nothing on it with my left eye and only the top 4 characters with the right eye, with considerable effort.

But I was looking for/expecting capital letters.

Then while I was having quite a long wait in that room, I turned around and looked behind me. There was the eye chart on the wall in much bigger form, and I could see all of it. It had been projected onto a much smaller screen on the opposite side of the room, and that was the chart I was being asked to read but couldn't read most of.

I was curious about just what I should have been seeing. They weren't all capital letters. Some were numerals. Some were lower-case letters. There was a lower-case a, for instance.

If I had known that ahead of time, I might have done better on the test.

It was just as short an exam, maybe a tad longer but this time I couldn't have objected because I'd made it clear to them that I had a ride coming that couldn't be postponed. I arrived on time (early, even) for an 11 o'clock appointment, and at 11:45 I was finally called into the examining room, where I had another long wait. This is par for the course for this eye doctor but I thought I would have enough time if I scheduled the return ride at 12:45.

No. I just barely flew out of there at 12:45. I was done with the eye doctor by 12:30 and had advanced to the optical department for a repair to my sunglasses but that just barely got done, and I had no time left for getting the new glasses rx taken care of.

So I spent a total of about 45 minutes in the examining room, including about 5 minutes with the actual eye doctor. The rest of the time, maybe to make up for the sketchy eye-chart exam, they put in several types of eye drops, did the slit lamp exam, checked for glaucoma, and briefly swung a flashing light around. The flashing light was new.

This time I wasn't pressured about cataract surgery but was told again that my vision won't ever be very good because of the cataracts.

With all of the eye drops, I haven't been seeing very well, as happens when there's an eye exam, and so it's probably better that I have to go back some other day about the glasses rx. At least I have it in my possession and I did wave it at the optical department person long enough for her to be aware that I will be back.

The eye doctor has always been very nice, and I'm glad that he hasn't moved on. So many of my medical providers have had to be replaced since I moved to this state. I'm on my third PCP now, my third dentist, my third neurologist, and second podiatrist. Oh yes, and my fourth audiologist. All of the changes have kept me hopping.

[Virginia]

Agate, I never get any new prescription filled on the day I go to the eye doctor. I can't see well enough to know what I am doing so I just take the rx with me and go back or usually some other place near my house to get it filled. Accept I haven't gotten my new prescriptions filled in a number of years. No reason for it. I want new glasses and new frames, but just haven't felt like going to choose any. It is so hard for me to stand on my feet and legs long enough to look around. I end up just going to the pharmacy, the bank and the grocery store and staying in the rest of the time.

I don't so much mind getting cataract surgery, but my doctor just keeps wanting to put it off. I have considered going to someone who does the surgery, just to see what they tell me. I kind of would like to go ahead and get it over with, so maybe I could see better. I don't want to wait until I am about to die and don't have time to enjoy my new eyesight. I am reminded of a, now deceased friend, who was in her 90s and had hip surgery. She told me she would have done it sooner if she had known she was going to live so long.

[agate]

I agree that it's not a good idea to go for glasses at an optical department on the same day as the eye exam just because the drops take all day to wear off, and in the meantime you can't see well. But getting back and forth to anywhere is such a project that I've usually combined the two anyway and just taken my chances on not seeing what kind of glasses I was signing up for. But it's certainly not the best way to do it.

Could you use a wheelchair just to get to the optical place, Virginia? You could sit there in your wheelchair and wait in line if you had to, and sit comfortably while waiting for them to deal with your glasses prescription, and wheel on out to your vehicle, load the chair in the trunk or the back seat, and travel without any walking or standing except for when you need to store the chair. Manual wheelchairs seem to fold up easily.

You might be able to get one on loan from the MS Society chapter under the circumstances.

[Virginia]

I am pretty sure I would have more trouble loading and unloading the chair than I would standing, or at least as much. I usually walk around in the glasses store and try to look at all the frames, so it would not be a real good idea for me. Also, I can't wheel a chair with my arms. I don't have the strength to do it, so I will just have to do the best I can on foot.

[agate]

Does your community have a paratransit service? The driver pushes the chair, takes you through the door and to the reception desk of whatever place you're going to. And there's the lift to raise or lower you and the chair into or out of the van. It might be worth while to sign up for that service if it's available, even if you use it only for something like an optometrist appointment.

[flatcap]

My current glasses work well enough overall, but it has been two years since my last exam so I should probably schedule one soon.

I think it most important, so I always get the frame issue sorted out first. These days, that isn't hard to do if you look at what manufactures offer online. You don't have to buy your frame there — sometimes you can't anyway so it's moot — but you can see what they have to offer.

Armed with this knowledge, you can ask your local optician to get the frame you want. If the frame is a brand under the Luxottica banner, which is common, they can most likely order it for you. Most opticians will do that and still cover the frame if it fails during whatever time period their policy specifies. That is usually a year or two, or it has been in my experience.

If you want the option of returning a frame that you order though your optician, that depends on their policy. Last time, I had mine get a Ray-Ban frame, and it would have cost me $25 had I declined to purchase it.

If you go off the map pursuing a frame from an in independent brand such as Barton Perreira, you might find that you can't get it locally. For a variety of reasons, your optician might not have any relationship whatsoever with the maker. That typically means you have to get the frame wherever you can.

That, in turn, will leave you in a spot if you can't get the frame you want either online or though another retailer. If you can, return policies vary. Also, if you do bring your own frame, your optician usually won't warrant it in any way, nor the lenses you purchase for it. I had to sign a waiver the last time I brought my own frame with me. Not even fitting was covered; had they broken it, I would have been on my own. Of course, they wouldn't guarantee the rx was correct, either, since another optometrist had written it.

One obvious thing that shopping online for an optical frame can save you is the effort you would expend getting to and around your optician's office to find and try on a frame from the pitifully limited selection they typically offer.

All of this might still sound like a lot of work, and it can be, but one does have choices. More choices, probably, than you might have thought. Opticians are motivated to sell you what they have on the floor. It's up to you to learn what else is out there.

Lastly, I agree that eye exams aren't what they used to be. As I said elsewhere, neither are physical exams. A lot of things aren't. I'm not quite past my expiration date, but seeing it coming is no longer an abstraction.

Meanwhile, I'll be wearing good glasses.

Hope this helps.


Luxottica

The largest frame manufacturer on the planet. If you've heard of the brand, they probably make it.

Only registered and activated users can see links., Click Here To Register...


Barton Perreira

An independent, boutique brand. I have been wearing one of their acetate frames for several years now. The frame still looks like new and works fine.

Barton Perreira sells all of their frames online, both optical frames and sunglasses.

Only registered and activated users can see links., Click Here To Register...


SALT. Optics

Another independent. I have an acetate frame from them as well, also still in service after several years. It will likely last forever at this rate.

SALT. sells only their sunglasses online at this time. Optical frames are retail only.

Only registered and activated users can see links., Click Here To Register...


Shuron

If you're looking for classic, traditional eyewear, you should check out Shuron. They are among the few Made-in-America eyeglass frame makers out there.

As far as I know, any optician anywhere can get you one of their frames. Shuron frames also come in specific sizes — I wear 50-22-150 — so what amounts to a custom fit is possible. If they are worth their salt and willing, your optician should be able to help you choose the correct size. Shuron will even send samples of the frame you want in different sizes to try on. I believe returns are free, including shipping.

Only registered and activated users can see links., Click Here To Register...

[agate]

Wow, flatcap, I've never gone into the frames matter scientifically at all. You're really an authority on them! I just entrust myself into the hands of the optician/optometrist who is showing them and hope they'll come up with something that doesn't look ghastly and will hold together without slipping down my nose or pinching at the nose or ears.

I was seriously thinking of writing a rave Yelp review about the glasses frames I currently use though, and now, thanks to you, I know that they're probably carried by Luxotica because Luxotica shows Sferoflex as one of its brands, and these super-wonderful frames say "Sferoflex" on them.

Maybe other frames are just as durable. I must have fallen right on my glasses because the bruising is in exactly the design of my glasses, right down to the two places where the nosepads are on my nose. In spite of that impact--a 105-lb. human slamming face forward into the glasses and hitting the hard floor--and those glasses and frames didn't break. OK, the glasses are made of shatterproof plastic to prevent just that kind of breakage but the frames surprised me. They were just a bit bent out of shape on one side. Easily fixed.I have an assortment of eyeglass repair tools but none of them were involved. I just bent it back manually.

I'd have expected tiny screws to go flying but no. They frames are spring-loaded. I always insist on spring-loaded frames. Whatever the reason they stayed together, I'm very very glad they did.

[flatcap]

Many Shuron frames — I edited my post above to include them as a source — have spring hinges. I prefer fixed hinges myself because I find the glasses slip less if properly fitted. Spring hinges, while providing for a 'universal' fit, typically don't have enough tension in them to prevent the glasses from slipping over the ears and down the nose.

I should also mention Art-Craft. Mostly old-school stuff. Like Shuron, some of their frames feature spring hinges.

Only registered and activated users can see links., Click Here To Register...

As for their durability, both Shuron and Art-Craft frames are pretty sturdy. I never fell wearing mine, thankfully, but it would have probably taken my falling directly on them to break them.

Regarding my Barton Perreira frame, I did fall while wearing it one time. I was literally knocked out, so I didn't know it until I woke up that my glasses had flown across the floor. They were undamaged.

[jingle]

I just got home from an appointment with my optometrist -- a man I love and respect. I see him every 6 months because I have macular degeneration and now he's moved that to every 4 months. And I have no insurance for that except the bit Medicare pays. Today's visit was $161. Yikes.

[flatcap]

I am sorry to hear you are suffering from macular degeneration, but am glad you have an optometrist you can trust to take care of you. Like other good doctors, they are hard to find.

The insurance business, if I may say so, sucks. I have it, but it is not of much help. I carry it only because it comes in a supplemental health care package from my previous employer. If I let that go, everything else goes with it.

I will probably pay less than $161 for an eye exam, though. My relationship with my optometrist is solid, and I am lucky to be paying less than that amount, courtesy of the meager insurance coverage that I do have.

As for Medicare, it's a shame it doesn't cover eye exams. It's a shame that Medicare doesn't cover dental work. It's a shame that Medicare isn't accepted everywhere. And it's a shame that the US doesn't have workable, compassionate, universal heath care.

Other first-world countries, including Canada right across our northern border, have done it and so can we. It is a matter of having the political will and, so far, we are getting what we are voting for: healthcare insufficient to cover the needs of all of us.

[agate]

jingle, I'm so sorry you have macular degeneration. You mention seeing an optometrist regularly--you also see an ophthalmologist, right?

If you're at a low-income level, you can often qualify for Medicaid. I've been lucky enough to be in that category. Medicaid has worked well for me for years. I understand that when it comes to Medicaid-eligible nursing homes, a person usually isn't very lucky at all, and so I'm trying to avoid that situation.

Insurance companies do change their coverage from time to time, and it's good to keep a weather eye on it.

I was paying full price for glasses and frames for years because my insurance didn't cover it. Medicaid always took care of the eye exams (required for diabetics annually, I think) but the glasses were my problem. Then suddenly it came to light that my insurance plan was covering some of the cost of glasses. I'm not sure how or when that changed but for the last few years I've had a welcome break on the cost of glasses and frames. This year, for instance, the new glasses I'll get soon will have had $521 covered by this insurance plan, which is the AARP Medicare Complete HMO with United Health Care.

The plan also has hearing aid coverage though I still wound up paying quite a bit for the hearing aids.

[Virginia]

Jingle, so sorry you have macular degeneration. My ophthalmologist charges me very, very little for doing the refraction. I have to be checked pretty often due to having a blind spot in each eye. This is because I had optic neuritis due to MS. So that is how he gets around most everything he does for me. It is a shame that you have to pay as much as you do as often as you go.