 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / General / Vision / July 2005Choosing a contact lens
Many people on this list have chosen a contact lens, but the context in which I'm doing it may be interesting. I have had a cataract operation in the left eye, but may postpone an operation on the other for two or three months. The right eye is -11D, as the other one formerly was, and despite the cataract there is still enough vision that correction of the myopia is beneficial. The RGP lens I'm now wearing, however, is toast: it won't last even two or three more months. (Contact lens prescription is about -9D.) Does anyone have suggestions for a lens to be worn before the operation?  SignatureRobert T. Kopp http://analytic.tripod.com/ Focus N&D or Purevision. DrG > Many people on this list have chosen a contact lens, but the context in > which I'm doing it may be interesting. I have had a cataract operation in [quoted text clipped - 6 lines] > even two or three more months. (Contact lens prescription is about -9D.) > Does anyone have suggestions for a lens to be worn before the operation? If you want to avoid the fitting fee for a new lens that will be used for only three months, simply have your fitter order a replacement RGP. If you don't mind paying a fitting fee for such a short term use, then consider a soft lens. The new silicone hydrogels (Pure Vision, Night and Day) are best but are pricier than the regular disposable hydrogels (lots to chose from there!), either montly, biweekly or daily disposable. The best lens for you is the lens that fits you best -- you need your contact lens fitter to assess the lens on the eye to chose one to start with and to assess again after it has been worn for a few weeks to make sure it is not causing problems. Dr Judy > If you want to avoid the fitting fee for a new lens that will be used for > only three months, simply have your fitter order a replacement RGP. If you > don't mind paying a fitting fee for such a short term use, then consider a > soft lens. Aren't you kind of assuming that the CL Rx is unexpired? Or do you "replace" lenses ad infinitum per patient request? w.stacy, o.d. >> If you want to avoid the fitting fee for a new lens that will be used for >> only three months, simply have your fitter order a replacement RGP. If [quoted text clipped - 3 lines] > Aren't you kind of assuming that the CL Rx is unexpired? Or do you > "replace" lenses ad infinitum per patient request? Even if expired, he only needs a cl check, not a fitting. Don't know about you, but I charge a higher fee to refit into a new material than to check and reorder an existing lens. Dr Judy > w.stacy, o.d. > Even if expired, he only needs a cl check, not a fitting. Don't know about > you, but I charge a higher fee to refit into a new material than to check > and reorder an existing lens. I disagree slightly, probably semantics, but it's worth discussing. I indeed charge higher fee for refitting into a new material, but I consider re-prescribing the identical lens to be a refit, although a lower value/complexity refit. My reasoning is this: To re-prescribe is different than to just check a contact lens fit. We have to actually write the Rx and be responsible for a new interval of contact lens wear for that patient, at least a year's worth. In a contact lens evaluation, we are not prescribing, so less is done/charged for. w.stacy, o.d. >> Even if expired, he only needs a cl check, not a fitting. Don't know >> about you, but I charge a higher fee to refit into a new material than to [quoted text clipped - 10 lines] > worth. In a contact lens evaluation, we are not prescribing, so less is > done/charged for. We all work differently, I don't consider dispensing the same lens to be a re fit. I'm in Canada, where there is less Internet buying. I dispense lenses for virtually all of my contact lens wearing patients so seldom write a prescription for them. When patients come in for their annual CL progress checks, the fee is the same whether they order new lenses that day or not. There is a fee for dispensing the contact lenses (fee + cost of materials) when they order and that fee covers the year's worth of lenses. If there is a change of materials so that a fitting needs to be done with follow up progress checks, then I charge an extra fee. I think the OP should check with his fitter as to what the actual fees in his particular case would be. To me, it seems wasteful to spend anything more than the minimum for a contact that will be used for only three months. Dr Judy > w.stacy, o.d. > We all work differently, I don't consider dispensing the same lens to be a > re fit. I'm in Canada, where there is less Internet buying. I dispense [quoted text clipped - 6 lines] > If there is a change of materials so that a fitting needs to be done with > follow up progress checks, then I charge an extra fee. It sounds like your "fee for dispensing" is nearly the same as my "refit with no changes" fee. The difference (to me) is, if they take the Rx out for filling elsewhere, I still get my fee and you don't (apparently, unless I misunderstand you). Do you separate that fee out on your receipts, or just lump it in with the contacts? If so, then it's really just a contact lens markup, isn't it? w.stacy, o.d. >> We all work differently, I don't consider dispensing the same lens to be >> a re fit. I'm in Canada, where there is less Internet buying. I [quoted text clipped - 14 lines] > receipts, or just lump it in with the contacts? If so, then it's really > just a contact lens markup, isn't it? In Ontario, where I practise, health professionals are required by law to provide materials at cost and to provide itemized receipts showing fees separate from materials, so my fee is shown separate on the receipt. It creates confusion for the patients since opticians and Internet have a price with mark up included and no fee. As examples, if a patient had a cl progress check and ordered contacts, there would be a fee for the progress check, a fee for dispensing and a material cost fee. If the patient doesn't order the contacts, then there is just the progress check fee. If the material was changed, then there would be a refit fee (higher) instead of the progress check fee. So I don't get a "refit" fee if the patient simply orders the same lenses from elsewhere, but I also don't think I do any extra work for that patient so shouldn't get the fee. If the patient has trouble with the "from elsewhere" lenses, the patient would pay me to diagnose the problem and then deal with the supplier, not with me, if the problem is quality control. Most of our patients have a contact lens service agreement with us -- one yearly fee that covers all their cl services, entitles them to lenses and solutions at cost and provides a discount on glasses. Dr Judy > w.stacy, o.d. If you don't mind me asking, whereabouts in Ontario do you practice? > In Ontario, where I practise, health professionals are required by law to > provide materials at cost and to provide itemized receipts showing fees > separate from materials, so my fee is shown separate on the receipt. It > creates confusion for the patients since opticians and Internet have a price > with mark up included and no fee. ok so now it appears that your "markup" is called a "material cost fee" Correct? your progress check is your professional evaluation fee. Right? so what exactly is the dispensing fee for? I'd guess it's for ordering, checking and handing the CLs to the patient? > As examples, if a patient had a cl progress check and ordered contacts, > there would be a fee for the progress check, a fee for dispensing and a > material cost fee. If the patient doesn't order the contacts, then there > is just the progress check fee. Understood. If the material was changed, then there > would be a refit fee (higher) instead of the progress check fee. Same ideas as my "refit different type" versus "refit same type", respectively. So I don't > get a "refit" fee if the patient simply orders the same lenses from > elsewhere, but I also don't think I do any extra work for that patient so > shouldn't get the fee. This is where we part company, I think. If the patient is simply refilling a valid, unexpired Rx, agreed. I'm not doing anything, including picking up a phone. But if the Rx is expired, and I do an evaluation, and the patient wants a new Rx (e.g. for another year), now I'm doing something extra, something more than just an evaluation. If the patient has trouble with the "from elsewhere" > lenses, the patient would pay me to diagnose the problem and then deal with > the supplier, not with me, if the problem is quality control. Does your refit fee include a followup eval, even if the lenses were purchased elsewhere? > Most of our patients have a contact lens service agreement with us -- one > yearly fee that covers all their cl services, entitles them to lenses and > solutions at cost and provides a discount on glasses. Do you do the same thing with glasses (at cost plus a material cost fee)? Is the discount on the materials, the fee or both? w.stacy, o.d. All this is very interesting, but I did not see where the patient mentioned cost as a factor, but simply wanted to know what would be the "best" lens for his situation. My assumption would be that his eye doc would slip him a trial lens or two to get him through the next two or three months. One box of Purevision is about half the price of one RGP lens in my practice. I, too, have been leaning towards separating fees from materials, particularly with my specialty lenses where I anticipate using several lenses during the fitting process, and where the length or duration of the process is somewhat open-ended. DrG > > In Ontario, where I practise, health professionals are required by law to > > provide materials at cost and to provide itemized receipts showing fees [quoted text clipped - 49 lines] > > w.stacy, o.d. > All this is very interesting, but I did not see where the patient > mentioned cost as a factor, but simply wanted to know what would be the > "best" lens for his situation. In my experience, patients indeed want the best lens, but after that is established, then many patients shop around for the best per lens price. I think that now that (in the US anyway), docs must give the written Rx at the completion of the fitting, anyone who is still lumping service fees with material costs (marking up) is going to lose. > I, too, have been leaning towards separating fees from materials, > particularly with my specialty lenses where I anticipate using several > lenses during the fitting process, and where the length or duration of > the process is somewhat open-ended. Good idea. If the FDA ever adopts the Canadian idea of "no markups" by o.d.s, everyone will have to do it or lose a significant part of their businesses. Sorry to have digressed so far from the sci. in this forum. w.stacy, o.d. >> In Ontario, where I practise, health professionals are required by law to >> provide materials at cost and to provide itemized receipts showing fees [quoted text clipped - 4 lines] > ok so now it appears that your "markup" is called a "material cost fee" > Correct? Material cost is my cost to purchase the lenses from the contact lens company, without markup ie, I charge the patient what B&L or CIBA charges me. > your progress check is your professional evaluation fee. Right? Yes > so what exactly is the dispensing fee for? I'd guess it's for ordering, > checking and handing the CLs to the patient? Yes. The dispensing fee represents my "mark up", except it is a standard fee, not a fee based on the cost of materials. Pharmacies and dentistsup here do the same, I don't know what the US practice is. >> As examples, if a patient had a cl progress check and ordered contacts, >> there would be a fee for the progress check, a fee for dispensing and a [quoted text clipped - 26 lines] > Does your refit fee include a followup eval, even if the lenses were > purchased elsewhere? I won't write an Rx for contact lenses untill after three months of wear with a least one followup. The refit fee would not include follow up beyond that point. But frankly, I have never done a refit where the px bought the initial lenses elsewhere. >> Most of our patients have a contact lens service agreement with us -- one >> yearly fee that covers all their cl services, entitles them to lenses and >> solutions at cost and provides a discount on glasses. > > Do you do the same thing with glasses (at cost plus a material cost fee)? > Is the discount on the materials, the fee or both? Glasses are at invoice cost plus a dispensing fee. We discount the fee, not the materials. > w.stacy, o.d. > > Even if expired, he only needs a cl check, not a fitting. Don't know about > > you, but I charge a higher fee to refit into a new material than to check [quoted text clipped - 9 lines] > for a new interval of contact lens wear for that patient, at least a > year's worth. What does "be responsible" mean? If half of the six-pack of lenses he prescribed for you is just WRONG, can he be expected to acquire replacements for you at no charge? > In a contact lens evaluation, we are not prescribing, so > less is done/charged for. > > w.stacy, o.d. Yeah, yeah, dead horse, I know! It's a continuing problem, though. Is Sunsoft/Optical Sciences quality control better than Cooper's? SignatureCheers, Bev -------------------------------------------------------------- "Never keep up with the Joneses. Drag them down to your level. It's cheaper." -- Quentin Crisp 1908 - 1999 >>My reasoning is this: To re-prescribe is different than to just check a >>contact lens fit. We have to actually write the Rx and be responsible [quoted text clipped - 4 lines] > prescribed for you is just WRONG, can he be expected to acquire replacements > for you at no charge? That's part of it. There is a legal liability we take on every time we write an Rx (glasses, contacts, drugs), and IMO we need to charge for that liability. I'd say most docs will replace lenses that are the wrong Rx, and write a new Rx for no extra charge. > Yeah, yeah, dead horse, I know! It's a continuing problem, though. Is > Sunsoft/Optical Sciences quality control better than Cooper's? Who knows? I don't much trust any corporation. w.stacy, o.d. > >>My reasoning is this: To re-prescribe is different than to just check a > >>contact lens fit. We have to actually write the Rx and be responsible [quoted text clipped - 9 lines] > that liability. I'd say most docs will replace lenses that are the wrong > Rx, and write a new Rx for no extra charge. In my case, the problem is that the prescription is probably right, it's half the lenses that are wrong, possibly because the acceptable manufacturing tolerances are much looser than those my eyes would accept :-( I think the Sunsoft trial lenses are OK, but I'm really worried about ordering them because of my experience with Cooper. The optometrist said that they just couldn't replace them like the previous optician did, which means I'll probably have to take them to court if the Sunsofts behave like the Coopers. > > Yeah, yeah, dead horse, I know! It's a continuing problem, though. Is > > Sunsoft/Optical Sciences quality control better than Cooper's? > > Who knows? I don't much trust any corporation. I don't think "trust" is the right word. I expect competence, I guess, an an unwillingness to cheat their customers. The company I worked for found it cheaper to simply replace the expensive units than to re-design the product so that particular component wouldn't fail. That's a business decision, and as long as they're willing to overnight-deliver a replacement at their expense to a customer in Tahiti (which they were) that's OK. Goddam contacts are lots cheaper than GPS instruments :-( SignatureCheers, Bev ==================================================================== "My parents just came back from a planet where the dominant lifeform hX?lo bilateral symmetry, and all I got was this stupid F-Shirt." > Many people on this list have chosen a contact lens, but the context in > which I'm doing it may be interesting. I have had a cataract operation in [quoted text clipped - 6 lines] > even two or three more months. (Contact lens prescription is about -9D.) > Does anyone have suggestions for a lens to be worn before the operation? I seem to have gotten something started here! Now that the operation is scheduled for Aug. 18, pretty soon, I wish I knew someone with a prescription like mine so I could just obtain three or four lenses from them. SignatureRobert T. Kopp http://analytic.tripod.com/ > I seem to have gotten something started here! Now that the operation is > scheduled for Aug. 18, pretty soon, I wish I knew someone with a > prescription like mine so I could just obtain three or four lenses from > them. Your original post said RGP lenses. Why would you need 3 or 4 of them???? Have you ever worn soft lenses? If so, you should be able to get a couple of trials to tide you over, from your o.d., optician, or your surgeon. What would a RGP cost you, maybe $60. You're having a multi thousand dolar operation, what are you fretting about? w.stacy, o.d. >> Many people on this list have chosen a contact lens, but the context in >> which I'm doing it may be interesting. I have had a cataract operation in [quoted text clipped - 12 lines] > prescription like mine so I could just obtain three or four lenses from > them. Hmm, your surgery is about 5 weeks away. It will take about that long to determine which soft lens fits you properly, likely closer to three to six months if you are stopping long term use of an RGP, especially an old, dirty, worn out high minus RGP. Are you sure your RGP won't last another month? Dr Judy |
Reply to this Message |
 Sign In
 Join
 My Latest Posts My Monitored Threads My Blog My Photo Gallery My Profile My Homepage Start New Thread Enable EMail Alerts Rate this Thread
|
©2008 Advenet LLC Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.