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Medical Forum / General / Vision / March 2005what's the effect of over-minusing by -0.50 in children?
Hi i heard from a friend that works as a tech at a private practice that has alot of medicaid pts. since medicaid doesn't pay for glasses with plano or -0.25 prescription. the doctor would write -0.50 even if the child doesn't need glasses. what do you guys think? would that make the chilren need glasses later on? TIA >Hi i heard from a friend that works as a tech at a private practice >that has alot of medicaid pts. since medicaid doesn't pay for glasses >with plano or -0.25 prescription. the doctor would write -0.50 even if >the child doesn't need glasses. what do you guys think? would that >make the chilren need glasses later on? TIA My first thought is that--as long as the patients *never fill* the prescription, then all we have is a crooked doctor committing Medicaid fraud.... I'll let others respond to the potential for actually inducing, or exacerbating, myopia if an emmetrope wore a minus lens. Sheez. > Hi i heard from a friend that works as a tech at a private practice > that has alot of medicaid pts. since medicaid doesn't pay for glasses > with plano or -0.25 prescription. the doctor would write -0.50 even if > the child doesn't need glasses. what do you guys think? would that > make the chilren need glasses later on? TIA If the children are over the age of 4, highly unlikely to make the children need glasses. The doctor is highly likely to be charged with fraud if he is selling glasses to children who don't need them. Dr Judy Dear Tammy, 1. The -0.5 diopter over-minus is probably correct -- although no one could ever prove it. 2. When you place a lens on the "natural" eye, or place it in a more-confined enviroment the eye will change its refractive state in the direction of the minus lens. That is the answer to you last question. No one will be able to do anything about your statement -- at all -- because no one checks. My opinion is the "second opinion" as reflected in the site: www.chinamyopia.org The "majority opinion" insists that any lens has on effect on the refractive status of the natural eye. None of these issues are resolved or settled. Best, Otis Engineering > Hi i heard from a friend that works as a tech at a private practice > that has alot of medicaid pts. since medicaid doesn't pay for glasses > with plano or -0.25 prescription. the doctor would write -0.50 even if > the child doesn't need glasses. what do you guys think? would that > make the chilren need glasses later on? TIA If the kid is really -0.25 then the -0.50 specs will help him see the blackboard, TV etc, and he'll only be over-minused by 0.25 dioptres... not a big problem I would have thought. If the kid is plano then he can see fine with no glasses and will probably refuse to wear them. From a business point of view, any doctor who writes prescriptions that aren't actually required surely couldn't last long in business as his patients would soon work out what the doctor is doing and vote with their feet (quite apart from the legal and ethical issues). Dom > > Hi i heard from a friend that works as a tech at a private practice > > that has alot of medicaid pts. since medicaid doesn't pay for glasses [quoted text clipped - 5 lines] > blackboard, TV etc, and he'll only be over-minused by 0.25 dioptres... not a > big problem I would have thought. A GREAT CRIME INSTEAD!!! WHY DON'T PEOPLE WEAR GLASSES IF THEY DO NOT NEED THEM? FOLLOWING YOUR IDIOTIC LINE OF THOUGHT EVERYBODY SHOULD WEAR GLASSES JUST BECAUSE THERE IS SOME IDIOT THAT SELLS THEM. IS THIS AMERICAN HUMOR? > If the kid is plano then he can see fine with no glasses and will probably > refuse to wear them. BEAT THE CHILD AND INSTALL THE GLASSES ALL THE SAME! > From a business point of view, any doctor who writes prescriptions that > aren't actually required surely couldn't last long in business as his > patients would soon work out what the doctor is doing and vote with their > feet (quite apart from the legal and ethical issues). THIS IS THE GREATEST OF ALL!!! EVERY DOCTOR PRESCRIBES WRONGLY, AS ANYBODY CAN TELL ONCE HE HAS SUBMITTED TO THE TORTURE OF GLASSES. THE FACT THAT PEOPLE REMAINS SILENT IT IS BECAUSE OF ITS GULLIBLILITY. > If the kid is really -0.25 then the -0.50 specs will help him see the > blackboard, TV etc, and he'll only be over-minused by 0.25 > dioptres... not a big problem I would have thought. If you are only -0.25 then you would not need glasses at all, and -0.5 would just make things tiring to see. > If you are only -0.25 then you would not need glasses at all, and -0.5 > would just > make things tiring to see. What you say is true (near vision only) for many young adults and folks about 40 years old. Not for children, however, who have a very strong accommodative system and can usually see fine at distance AND near despite being slightly overminused. The problems as I see it are: 1. the childs accommodative system may develop a "resting tone" which will cause them to become a slight accommodative myope. Thus they will feel dependent on their weak minus lenses even though they really don't need them. This will go away if they just don't wear their glasses for awhile, and it will subside naturally at around age 40 when ciliary muscle contraction becomes less effective. 2. the doctor who prescribes these glasses is ripping off the system and the taxpayer, not to mention the patient. They should be stopped and held professionally-accountable for selling people something they don't need. They should repay Medicare (+ damages IMHO). > 1. the childs accommodative system may develop a "resting tone" which > will cause them to become a slight accommodative myope. Thus they will feel > dependent on their weak minus lenses even though they really don't need > them. This will go away if they just don't wear their glasses for awhile, > and it will subside naturally at around age 40 when ciliary muscle > contraction becomes less effective. This is simply not true. The fact that people in advanced years have difficulty in seeing small characters is that they do not exercise themselves to read them. This thing is recognized by everyone. If you keep your visual system in full efficience, the presbyopia will be soon a thing of the past. On the contrary, you teach people to read only BIG type, which is a strain to the eye and a training in eccentric fixation, and in so doing you create all the condition for the eye system not to work anymore after some years of misuse. This is so clear that any un-learned man can recogize it very easily. Learned men are against truth because they think that what they have learnt may suffice for them, a thing which is not: truth cannot be learned, can only be lived. > 2. the doctor who prescribes these glasses is ripping off the system and > the taxpayer, not to mention the patient. They should be stopped and held > professionally-accountable for selling people something they don't need. > They should repay Medicare (+ damages IMHO). Then all the doctors are in this criminal situation, because no prescription is good forever, just after a few minutes of wearing the prescritpion it becomes less effective because the eye shifts quite rapidly. This is another fine truth that anybody who is not brainwashed by the propaganda of the vested interest can understand very easily. If this was not true, then WHY DO YOU CHANGE THE PRESCRITPION? The fact that doctors change the prescription is a simple demosntration that YOUR science is FULLY BOGUS. Either you are criminals or just idiots. To call you idiots is to treat you well. > This is so clear that any un-learned man can > recogize it very easily. Well, at least one. -MT > > This is so clear that any un-learned man can > > recogize it very easily. > > Well, at least one. > > -MT Have you ever changed one presctiption to one of your clients? Are you able to give a scientific (that is, foreseeable) explanation for the change? If you can answer me, I will quit from this list. > Have you ever changed one presctiption to one of your clients? > > Are you able to give a scientific (that is, foreseeable) explanation > for the change? There are some things I can explain, and even predict, but you will only make farting noises and tell me I'm stupid. > If you can answer me, I will quit from this list. You will quit anyway, eventually, because nobody is listening. Even newbies dismiss you after two or three sentences. You persist at embarrassing the schools that should have taught you, but didn't. -MT Dear RM, For once I agree on almost all your points. Best, Otis Enginer |
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