I am an Optometrist, Ask me anything (Part 2)

[Knut]

Originally Posted by Reggie Dunlop

Went yesterday to the optometrist for an exam because I suspected I needed a new prescription for reading. He noticed a retinal tear in one of my eyes and referred me to an ophthalmologist who got back to me right away and offered me an appointment for this morning.

I am now back home following laser surgery. That was fast! I understand waiting times t see an opthamologist can be up to 24 weeks

There are on-call Ophthamologists for stuff like this. A general referral takes a long time but a retinal tear is an urgent referral.

There is an on-call number we have to consult with the on-call guy on cases. They will squeeze them in if there is any risk for vision loss.

[D as in David]

I was in the ER two Sunday evenings ago for a possible TIA and was scheduled with an ophthalmologist the next morning @8:15. If they deem it urgent, the system moves fast.

[Reggie Dunlop]

Originally Posted by Knut

There are on-call Ophthamologists for stuff like this. A general referral takes a long time but a retinal tear is an urgent referral.

There is an on-call number we have to consult with the on-call guy on cases. They will squeeze them in if there is any risk for vision loss.

I'm glad I got in so quickly.

[Huntingwhale]

Hopefully LASIK questions are appropriate here. I just came from a consultation with LASIK MD and was bit surprised to learn that not only has my vision actually slightly improved since my last optometrist exam 6 years ago, but that if I choose to proceed it is recommended that I undergo the monovision surgery on only my dominant eye instead of having it on both eyes. I can opt into both eyes if I want, but monovision was recommended. The pro and con seem to be that having LASIK on both eyes results in better overall distance vision but the need for reading glasses up close as you get older, whereas monovision is more of a balance between less issues with up close reading, but not quite as good far/distant vision.

I have worn only a single contact lense in the past on occasions when I only had a single lense left, but found it weird. I'm going to do it for the next few days as they recommended it's a way to get used to it, but still feels weird. From what they told me, your brain adapts to it after a few weeks so you don't even notice it eventually.

Has anyone gone the monovision route and have any suggestions of it's worthwhile, or just do both eyes? They told me I can always come back and do the other eye if I can't get used to it, so at least there is that option.

[Knut]

Originally Posted by Huntingwhale

Hopefully LASIK questions are appropriate here. I just came from a consultation with LASIK MD and was bit surprised to learn that not only has my vision actually slightly improved since my last optometrist exam 6 years ago, but that if I choose to proceed it is recommended that I undergo the monovision surgery on only my dominant eye instead of having it on both eyes. I can opt into both eyes if I want, but monovision was recommended. The pro and con seem to be that having LASIK on both eyes results in better overall distance vision but the need for reading glasses up close as you get older, whereas monovision is more of a balance between less issues with up close reading, but not quite as good far/distant vision.

I have worn only a single contact lense in the past on occasions when I only had a single lense left, but found it weird. I'm going to do it for the next few days as they recommended it's a way to get used to it, but still feels weird. From what they told me, your brain adapts to it after a few weeks so you don't even notice it eventually.

Has anyone gone the monovision route and have any suggestions of it's worthwhile, or just do both eyes? They told me I can always come back and do the other eye if I can't get used to it, so at least there is that option.

It can work great for some. Give the Monovision contacts a good 2 weeks to see if you adapt. If you do not adapt in 2 weeks you will not like the Monovision LASIK

[McG]

my optometrist has recommended that I go for a consultation for LRE. I saw that you discussed LALs for Photon's wife on the previous page.

He is concerned that I will run out of lens strength; I'm -12 in one eye and -10 in the other. Obviously, I would have to have both eyes done unless I want to try to single handedly bring back monocles.

There are no cataract issues. I'm 60. This is entirely to address lens strength. I've got bifocal contacts, progressives (with Italian lenses - very thin and light but expensive), and tbh, I'm okay with them. One eye is doing more work than the other as one eye stayed the same and the other got weaker.

Optometrist advised that I can get in line with Alberta Health Care for whatever the wait is, or I can go to a private clinic and have the Lens surgery done relatively soon.

I'm going to take the recommendation and talk to an eye surgeon about LRE.

I was quoted $10k per eye top of the line all in (I assume LAL) done in a couple of weeks. I haven't been able to find the $20k cost online...and someone that I know recommends "$5k per eye" because that's what they paid.

Is the process here 1) go speak to the surgeon so that 2) I can firm up price options and therefore decide 3) if I want to wait or pay to jump the queue?

My optometrist told me that he had no problem writing up another prescription for me but that I should consider this now as I'm as young as I'm going to get for recovery and it saves buying another round of lenses and contact lenses.

it's my eyes so I would really like to understand what I'm getting into here before I get too far.

Thank you Knut for this thread as I have learned a lot!

[WideReceiver]

I’m going to Tokyo in April. I’m farsighted and may get reading glasses made there where they’re cheap. Any cautions about getting a prescription or getting reading glasses there? Should I get a prescription before I go?

[D as in David]

Originally Posted by WideReceiver

I’m going to Tokyo in April. I’m farsighted and may get reading glasses made there where they’re cheap. Any cautions about getting a prescription or getting reading glasses there? Should I get a prescription before I go?

Make sure you don't buy reading glasses that read right-to-left.

[Fuzz]

Originally Posted by D as in David

Make sure you don't buy reading glasses that read right-to-left.

Dad jokes are one thing, this is firmly in grandpa joke territory.

[Titan2]

Thanks Knut.

I wear prescription glasses for reading. They are bifocal for computer work and up close like the phone.

I have noticed when I don't have them on my vision is terrible. As in, I can't even make out what is on screen of my phone. This is concerning to me.

Do your eyes adjust to a new prescription which can mess up your normal vision? I assume the answer is yes. Do I need a different prescription as I can't see well when I have my glasses on and am not reading, like walking around or normal stuff. Do I need to go to a 'normal' bifocal so I can read but wear for normal use as well? I do plan to go into the optometrist to get it checked but wonder if you have thoughts.

Also, no offence, but are all optometrist basically the same for simple stuff like this? Like is the Costco or Walmart person good enough vs the FYI doctor type places which seem to be very expensive?

Thanks.

[Knut]

Originally Posted by McG

my optometrist has recommended that I go for a consultation for LRE. I saw that you discussed LALs for Photon's wife on the previous page.

He is concerned that I will run out of lens strength; I'm -12 in one eye and -10 in the other. Obviously, I would have to have both eyes done unless I want to try to single handedly bring back monocles.

There are no cataract issues. I'm 60. This is entirely to address lens strength. I've got bifocal contacts, progressives (with Italian lenses - very thin and light but expensive), and tbh, I'm okay with them. One eye is doing more work than the other as one eye stayed the same and the other got weaker.

Optometrist advised that I can get in line with Alberta Health Care for whatever the wait is, or I can go to a private clinic and have the Lens surgery done relatively soon.

I'm going to take the recommendation and talk to an eye surgeon about LRE.

I was quoted $10k per eye top of the line all in (I assume LAL) done in a couple of weeks. I haven't been able to find the $20k cost online...and someone that I know recommends "$5k per eye" because that's what they paid.

Is the process here 1) go speak to the surgeon so that 2) I can firm up price options and therefore decide 3) if I want to wait or pay to jump the queue?

My optometrist told me that he had no problem writing up another prescription for me but that I should consider this now as I'm as young as I'm going to get for recovery and it saves buying another round of lenses and contact lenses.

it's my eyes so I would really like to understand what I'm getting into here before I get too far.

Thank you Knut for this thread as I have learned a lot!

Sign of a good Optometrist that they are recommending what's best for the patient, not just what is best for their pocket book.

Most Refractive places will do a free consult on Refractive Lens Exchange. In my opinion it is worth looking into it. As part of the consult they will check for any potential contra-indications to the procedure (eg. retina problems) to make sure you are a candidate. $10,000 per eye seems expensive. Are you looking to get Multi-focal implants ?

[Knut]

Originally Posted by WideReceiver

I’m going to Tokyo in April. I’m farsighted and may get reading glasses made there where they’re cheap. Any cautions about getting a prescription or getting reading glasses there? Should I get a prescription before I go?

Like anywhere else there will be a range in quality. Low quality glasses will not wreck your eyes, they just may not work or break easily.

I would get a prescription before you go.

[Knut]

Originally Posted by Titan2

Thanks Knut.

I wear prescription glasses for reading. They are bifocal for computer work and up close like the phone.

I have noticed when I don't have them on my vision is terrible. As in, I can't even make out what is on screen of my phone. This is concerning to me.

Do your eyes adjust to a new prescription which can mess up your normal vision? I assume the answer is yes. Do I need a different prescription as I can't see well when I have my glasses on and am not reading, like walking around or normal stuff. Do I need to go to a 'normal' bifocal so I can read but wear for normal use as well? I do plan to go into the optometrist to get it checked but wonder if you have thoughts.

Also, no offence, but are all optometrist basically the same for simple stuff like this? Like is the Costco or Walmart person good enough vs the FYI doctor type places which seem to be very expensive?

Thanks.

That's normal when your eyes reach a certain "vintage". It is a myth that glasses make your vision worse. They enter the slow decline just like the rest of you regardless of what glasses you put in front of them.

Are they a lined bifocal or are the Progressive (no line)? Lined bifocals are limited in that they only work in a very narrow focal point whereas progressives will give you vision over a much larger range.

I would highly recommend getting your eyes checked with your local Optometrist. The knowledge and equipment used is much higher quality vs the the chains.

https://eyerecommend.ca/clinic-locator is a good starting point to find an Independent Optometrist close to you

[WideReceiver]

Originally Posted by Knut

Like anywhere else there will be a range in quality. Low quality glasses will not wreck your eyes, they just may not work or break easily.

I would get a prescription before you go.

Good advice; thank you.

[Titan2]

Originally Posted by Knut

That's normal when your eyes reach a certain "vintage". It is a myth that glasses make your vision worse. They enter the slow decline just like the rest of you regardless of what glasses you put in front of them.

Are they a lined bifocal or are the Progressive (no line)? Lined bifocals are limited in that they only work in a very narrow focal point whereas progressives will give you vision over a much larger range.

I would highly recommend getting your eyes checked with your local Optometrist. The knowledge and equipment used is much higher quality vs the the chains.

https://eyerecommend.ca/clinic-locator is a good starting point to find an Independent Optometrist close to you

My vintage is 55 so the decline seems about right. No line so progressive I guess. My concern was that it seemed like the ability to read without the glasses deteriorated quite quickly after I got the new lenses, approx. a year ago. I started to notice the vision w/o glasses within about 5-6 months.

I will go to my local FYI, [edit: looking at that link FYI does not come up. Are they not considered independent?] unless you don't think they are reputable, as I have been happy with them before. Just very expensive.

[McG]

Originally Posted by Knut

Sign of a good Optometrist that they are recommending what's best for the patient, not just what is best for their pocket book.

Most Refractive places will do a free consult on Refractive Lens Exchange. In my opinion it is worth looking into it. As part of the consult they will check for any potential contra-indications to the procedure (eg. retina problems) to make sure you are a candidate. $10,000 per eye seems expensive. Are you looking to get Multi-focal implants ?

Thank you for responding so quickly!

I’m not sure if I’m interested in multi focal or not. You’ve given me something new to research and think about.

It’s not an emergency and I completely understand the priority for cataracts; do you have any thoughts about joining the ahs queue? Is it a long wait? My mom and mother in law both have had cataract surgery and they are both very happy and especially the difference it has made for them.

Have you heard any feedback from patients on LRE? I’ve worn glasses and/or contacts for 50 years so a bit nervous about messing around with my eyes!

Thanks again for sharing and your time.

[Knut]

Originally Posted by Titan2

My vintage is 55 so the decline seems about right. No line so progressive I guess. My concern was that it seemed like the ability to read without the glasses deteriorated quite quickly after I got the new lenses, approx. a year ago. I started to notice the vision w/o glasses within about 5-6 months.

I will go to my local FYI, [edit: looking at that link FYI does not come up. Are they not considered independent?] unless you don't think they are reputable, as I have been happy with them before. Just very expensive.

FYI is not independent. Not going to comment on if they are reputable as it is doctor dependent. The link i posted is a list of True Independent (Doctor owned) Optometry offices.

[Knut]

Originally Posted by McG

Thank you for responding so quickly!

I’m not sure if I’m interested in multi focal or not. You’ve given me something new to research and think about.

It’s not an emergency and I completely understand the priority for cataracts; do you have any thoughts about joining the ahs queue? Is it a long wait? My mom and mother in law both have had cataract surgery and they are both very happy and especially the difference it has made for them.

Have you heard any feedback from patients on LRE? I’ve worn glasses and/or contacts for 50 years so a bit nervous about messing around with my eyes!

Thanks again for sharing and your time.

You can only be on the AHS queue if you have symptomatic Cataracts. They will not add you until that point.

Lots of patients have had it done. It is a pretty straight-foward procedure but like all surgeries there is always a risk. Make sure you make an informed decision on it.

[McG]

Originally Posted by Knut

You can only be on the AHS queue if you have symptomatic Cataracts. They will not add you until that point.

Lots of patients have had it done. It is a pretty straight-foward procedure but like all surgeries there is always a risk. Make sure you make an informed decision on it.

Thank you. I don’t have any cataracts so it sounds like I will have to pay full rates for LRE. That helps me out with understanding!

[curves2000]

I am curious what your thoughts on the changes from AHS for services and billing for people in your profession? Is this unique to AB and a disaster waiting to happen? The savings from what I hear don't appear to be very high ($8 mil/year) Is this going to affect a lot of people?

If you are located in Calgary, accepting new patients and it works well location wise, PM your office if you wish. You have helped me out a few times in the past and can try and repay the favor with some minor visits. Pretty much just routine eye exams and no need for glasses from last visits for me so nothing important or complex.