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

[TorqueDog]

FWIW, my eye-glass prescription was -9.50 / -10.00 with some astigmatism, and LASIK brought my vision to 20/15 and it has stayed there for ~12 years (I'm 37). I'm definitely in the 95/100 that Knut mentioned that have a fantastic experience with it, and I was told my corneas were quite thick too, which helped.

[IamNotKenKing]

Originally Posted by Calgary Highlander

Can a person with severe astigmatism be a good candidate for laser eye surgery?

My glasses and contacts are unbelievably expensive. ~$700 for a years supply of contact lenses and the last pair of glasses I purchased was upwards ~$1000 ($300 frames and $700 for lenses).

Even just aside from the convenience of never wearing glasses, I'm starting to think there is a good just to get the surgery done and not worry about the yearly cost of lenses and glasses.

I am not an optometrist, but had surgery at Demong almost exactly 10 years ago, and it was a complete success. My eyes were -8.0 and -8.5, with astigmatism, although not a terribly strong one (I cannot recall the amount of astigmatism). I am so happy I had it done. Simply FYI...

[curves2000]

Knut,

I am wondering if there is a website or some sort of AHS contact line where I can see if some new drugs used to treat diabetic retinopathy and edema may be approved and paid for in Alberta? I know this may not fall into your expertise but I would like to see if the drug Vabysmo is approved, paid for, and if there is a dollar limit? It has been Health Canada approved

With the next generation of drugs coming online lately, I want to try and explore other treatment options potentially for my mom but I don't want to bombard her retina specialist . Every time I go there he is always so busy and it's a madhouse in that office with like 100 patients an hour.

Thanks again for all your help now and previously!

[Knut]

Originally Posted by curves2000

Knut,

I am wondering if there is a website or some sort of AHS contact line where I can see if some new drugs used to treat diabetic retinopathy and edema may be approved and paid for in Alberta? I know this may not fall into your expertise but I would like to see if the drug Vabysmo is approved, paid for, and if there is a dollar limit? It has been Health Canada approved

With the next generation of drugs coming online lately, I want to try and explore other treatment options potentially for my mom but I don't want to bombard her retina specialist . Every time I go there he is always so busy and it's a madhouse in that office with like 100 patients an hour.

Thanks again for all your help now and previously!

It is an exciting drug for Diabetic Retinopathy. They problem is that currently it is not covered in Alberta.

The following guide is a good general idea of what is covered and what the unit price of the drug is.

https://www.ab.bluecross.ca/dbl/pdfs...2022_09_06.pdf

Currently, Vabysmo is $1350 a shot. Which every 6-12 weeks adds up very quickly. So you can get it currently, but have to pay for it.

The process is this...

1)Health Canada approves the drugs for use in Canada

2) Province has a committee to meet to determine if it will be covered or not by health care. Unfortunately, this comes down weighing the cost of the drug to the public vs. the cost benefit of having someone treated for it.

This process can take a long time. Avastin (for treatment of Macular Degeneration) took 5 years after approval.

The retinal specialist is the right person to determine if Vabysmo is worth the price in regard to treatment vs. the standard treatment. They typically will nto offer it unless it is.

[curves2000]

Originally Posted by Knut

It is an exciting drug for Diabetic Retinopathy. They problem is that currently it is not covered in Alberta.

The following guide is a good general idea of what is covered and what the unit price of the drug is.

https://www.ab.bluecross.ca/dbl/pdfs...2022_09_06.pdf

Currently, Vabysmo is $1350 a shot. Which every 6-12 weeks adds up very quickly. So you can get it currently, but have to pay for it.

The process is this...

1)Health Canada approves the drugs for use in Canada

2) Province has a committee to meet to determine if it will be covered or not by health care. Unfortunately, this comes down weighing the cost of the drug to the public vs. the cost benefit of having someone treated for it.

This process can take a long time. Avastin (for treatment of Macular Degeneration) took 5 years after approval.

The retinal specialist is the right person to determine if Vabysmo is worth the price in regard to treatment vs. the standard treatment. They typically will nto offer it unless it is.

As always, many thanks again!

[Finger Cookin]

What're the biggest warning signs I should look for when determining if there are complications from a cataract surgery?

[Knut]

Originally Posted by Finger Cookin

What're the biggest warning signs I should look for when determining if there are complications from a cataract surgery?

It depends when the surgery was done. Is it 1 day, 1 week, 1 month ? There is a a lot to go into it though as there are different implants, different surgeries etc.

If you are concerned you could always book with your Optometrist early to see if there is anything to be concerned about. Sometimes you get shuffled out of the Ophthalmologist office before you can ask all the questions. There is an Alberta health care billing code for post cataract appointments with your optometrist.

[NinePack]

Great thread Op, appreciate it !

I would like too ask you a question.

I usually wear glasses and recently started getting into contacts. Started with dailys like them alot but find them expensive. If i was too buy weekly or monthly, once i open then and use them, has there expiry started or can i use them for a day or 2 and put them in solution? And count the amount of days until they reach a month or week with use?

[Knut]

Originally Posted by NinePack

Great thread Op, appreciate it !

I would like too ask you a question.

I usually wear glasses and recently started getting into contacts. Started with dailys like them alot but find them expensive. If i was too buy weekly or monthly, once i open then and use them, has there expiry started or can i use them for a day or 2 and put them in solution? And count the amount of days until they reach a month or week with use?

A 2 week lens is good for 2 weeks once opened, a 1 month lens 1 month once opened. Once they are out of the sterile blister pack they are only good for the period of time on the label (health Canada/FDA approval as a medical device).

If you wear them longer nothing may happen, but just like consistently going over the speed limit there is a greater risk of something bad happening.

Dailies vs. Monthly lens cost break-even point is about 2.5 days on average (Once you factor in solution etc). If you use contacts 1-2 x per week it is actually more cost effective to use dailies.

Also, if you lens has sat in the solution for over a week without being used, you should put it back in fresh solution for 4-6 hours before use. Reduces the risk of infection.

[NinePack]

Thanks for your info, i really appreciate it. Ive ordered some monthys i want to wear them almost everyday now as i am loving contacts vs glasses.

[Finger Cookin]

Originally Posted by Knut

It depends when the surgery was done. Is it 1 day, 1 week, 1 month ? There is a a lot to go into it though as there are different implants, different surgeries etc.

If you are concerned you could always book with your Optometrist early to see if there is anything to be concerned about. Sometimes you get shuffled out of the Ophthalmologist office before you can ask all the questions. There is an Alberta health care billing code for post cataract appointments with your optometrist.

Surgeries are next month, I'm getting single vision IOL in each eye. Two weeks apart. As the opinion is that my anisometropia would be quite bad if I only get the one eye done.

I am travelling to Calgary for each surgery, with the post op appointments back in Lethbridge with my Optometrist.

[jg13]

How much is a standard eye test these days? I haven't been to the optometrist in over 15 years because up until the last couple years I felt I had great vision. Now my left eye is noticeably worse than my right eye.

Is it possible to fix just the one eye with laser surgery?

[Buff]

In August I had my eye exam so I could get contacts lenses. I wear them every day changing them every two weeks. My doctor asked if I noticed any problems from distance to close up but I hadn't noticed that at all. He told me he noticed a very slight change and I'm at the age where I could soon need transition lenses. Nope, I didn't notice anything... Until I got home that night. It has become noticeably worse the past couple of months.

Two questions. One.. I separated my shoulder and can't get my dominant hand comfortably to my face so I've wearing my glasses for the last week. The difference between near and far is much less with my glasses than with contacts. Is this normal? There is a chance my glasses didn't get updated but I don't recall as it'd been forever since I've had a change in vision.


Two. Are transition contact lenses more costly than "normal'?

Just preparing myself for my upcoming optometrist appointment.

[Knut]

Originally Posted by jg13

How much is a standard eye test these days? I haven't been to the optometrist in over 15 years because up until the last couple years I felt I had great vision. Now my left eye is noticeably worse than my right eye.

Is it possible to fix just the one eye with laser surgery?

It varies quite a bit. You can get super basic exams for $79 or more advanced (peripheral retinal imaging, more time with the doctor and more advanced equipment) for up to $200. Also if you have private insurance most places direct bill.

Yes you can but it may not be worth it if let’s say that eye is giving you better reading vision than the right eye. You should really see an Optometrist to make sure it’s just a prescription issue and not something else causing the blurry vision.

[Knut]

Originally Posted by Buff

In August I had my eye exam so I could get contacts lenses. I wear them every day changing them every two weeks. My doctor asked if I noticed any problems from distance to close up but I hadn't noticed that at all. He told me he noticed a very slight change and I'm at the age where I could soon need transition lenses. Nope, I didn't notice anything... Until I got home that night. It has become noticeably worse the past couple of months.

Two questions. One.. I separated my shoulder and can't get my dominant hand comfortably to my face so I've wearing my glasses for the last week. The difference between near and far is much less with my glasses than with contacts. Is this normal? There is a chance my glasses didn't get updated but I don't recall as it'd been forever since I've had a change in vision.


Two. Are transition contact lenses more costly than "normal'?

Just preparing myself for my upcoming optometrist appointment.

Just some terminology clear up. Transition = change Colors. Progressive/Multifocal = different prescriptions for near and far.

Contacts typically give everyone worse near vision Vs glasses (has to do with something called vertex distance). Glasses sit on average 13 mm from your face Vs contacts sitting 0mm. There is a magnification effect from that. Could also be your old glasses are under corrected giving you some near vision in exchange for far vision.

Multifocal contacts do cost more but are worth it if you want freedom from glasses. They come in Dailies, Bi-weekly and monthly lenses. It is very important to get a proper fit done for them at the Optometrist as there are multiple options and typically it takes a few visits to get them right.

[indes]

I have a question for my fiancee who has rapidly deteriorating eyesight.

She has gone from a -2 to a -4 in the last two years (she's 33) and was recommended some contact lenses/glasses that are apparently a brand new technology this year to slow down the deterioration.

Have you heard anything about this? We don't have insurance and haven't priced them out yet but I don't imagine they will be cheap.

My other question is should there be some more follow up? It seems she just goes in every 6 months and they change the prescription, is there anything else we can be doing?

Thanks for this thread!

[Knut]

Originally Posted by indes

I have a question for my fiancee who has rapidly deteriorating eyesight.

She has gone from a -2 to a -4 in the last two years (she's 33) and was recommended some contact lenses/glasses that are apparently a brand new technology this year to slow down the deterioration.

Have you heard anything about this? We don't have insurance and haven't priced them out yet but I don't imagine they will be cheap.

My other question is should there be some more follow up? It seems she just goes in every 6 months and they change the prescription, is there anything else we can be doing?

Thanks for this thread!

I am travelling right now overseas with spotty internet but the only advice I would give to this is to get a second opinion on this. Ask for a Cycloplegic (dilated) refraction and full binocular vision work up.

[CroFlames]

I have a cataract in one eye, and astigmatism.

I've consulted once with an ophthalmologist, but the wait times are so ridiculous these days I can't remember what he said.

I'm interested in the toric lens to fix both the cataract and the astigmatism. But I recently learned about limbal relaxing incisions after cataract surgery to fix astig, and so I'm now wondering if I should go with the plain jane lens, and opt for the incisions?

[Knut]

Originally Posted by CroFlames

I have a cataract in one eye, and astigmatism.

I've consulted once with an ophthalmologist, but the wait times are so ridiculous these days I can't remember what he said.

I'm interested in the toric lens to fix both the cataract and the astigmatism. But I recently learned about limbal relaxing incisions after cataract surgery to fix astig, and so I'm now wondering if I should go with the plain jane lens, and opt for the incisions?

You would need to see the Ophthalmologist to determine your candidacy first. The Toric IOL can fix large amounts of astigmatism, but the Limbal Relaxing Incisions only mild amounts.

If you are in Alberta you should not have to wait more than 6-9 months max for Cataract Surgery. In some cases it is 3 months after referral. Nearly every Cataract surgeon in Calgary is serving 90% of patients within 37 weeks according to the Alberta Wait Time website.

http://waittimes.alberta.ca/WaitTime...e#WaitTimeInfo

[MoneyGuy]

Any significant risk in using eye drops past the best-before expiry date?