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Medical Forum / General / Vision / January 2007why are prescriptions required for eyes?
I can see why prescriptions are required for drugs, because those can be easily abused or sold in the black market. But to me, eye prescriptions don't seem that critical. My analogy is shoes. You could probably mess up your feet/knees/legs/back by wearing the wrong size or type of shoes, or improper inserts long term. Yet a shoe prescription from a podiatrist is not required for people to buy shoes. Of course, everyone should get an initial refraction done professionally. But what's wrong with buying disposable contacts that are a little higher or lower than your prescription to see how they perform? You're not going to be seriously injured. Maybe get some headaches or eyestrain, that's all. And if you do have problems, then go see the optometrist (just like you'd see a podiatrist if shoes were giving you problems). > I can see why prescriptions are required for drugs, because those can > be easily abused or sold in the black market. But to me, eye [quoted text clipped - 12 lines] > go see the optometrist (just like you'd see a podiatrist if shoes were > giving you problems). I have mixed feelings. There is a podiatrist who visits my father's Home. He gets a bunch of money for trimming toenails. It's all charged to Medicare. He wants my dad to get surgery. My sister takes him in to a doctor. The doctor is not happy. My dad has one kidney. It barely works. He is diabetic. He has no feeling in his feet. He is 90. He has no problems with his feet other than needing the corns filed off. He is not a candidate for this surgery. Things are weird. I shared an office for five years with a woman who's father was a pharmacist. They had prescription aspirin. The tens require a prescription. Of course, you can just take two fives. No prescription. Still, I'm going to see the OD. If I had to pay for it, I might think twice about it. >> I can see why prescriptions are required for drugs, because those can >> be easily abused or sold in the black market. But to me, eye [quoted text clipped - 9 lines] >> are a little higher or lower than your prescription to see how they >> perform? You're not going to be seriously injured. I've been told that too-tight contacts can cause otherwise-symptomless corneal damage -- how do you know whether your choice is too tight or not? >> Maybe get some >> headaches or eyestrain, that's all. And if you do have problems, then [quoted text clipped - 4 lines] > Home. He gets a bunch of money for trimming toenails. It's all charged > to Medicare. My 89-year-old MIL had terrible circulation (her feet were dark purple and the skin was frighteningly thin) and with MD was unable to actually see her feet, much less bend over to cut her own gnarly toenails. Manicurists refused to even touch her feet for fear of damaging them (as would I), much less try to trim the nails. In her case there was no other option, and the cost was entirely justified. The first podiatrist she tried made her cry from the pain, and the bitch just told her to suck it up. The second one was very gentle and was willing to give her topicals if she needed them -- which she didn't. Good guy. > He wants my dad to get surgery. My sister takes him in to > a doctor. The doctor is not happy. My dad has one kidney. It barely [quoted text clipped - 6 lines] > require a prescription. Of course, you can just take two fives. No > prescription. A friend filled a prescription for 2.5x-strength naproxen, even though she gave me a couple of big bottles of Aleve (good stuff!) after her mom died. Go figure. > Still, I'm going to see the OD. If I had to pay for it, I might think > twice about it.  SignatureCheers, Bev 1010101010101010101010101010101010101 What do you think you're doing, Dave? -- Hal 9000 A better analogy would be "Why do I need a licensed funeral director? Why do I need a dentist? Why do I need a licensed vet? Why do I need a lawyer? The answer, obviously, that all of the professions have evolved over the centuries so that the individuals who practice those professions have invested a lot of time, money and effort to becoming masters of their chosen professions. They are the gatekeepers of the information that you want to "play with" as an unlicensed non-professional. > I can see why prescriptions are required for drugs, because those can > be easily abused or sold in the black market. But to me, eye [quoted text clipped - 12 lines] > go see the optometrist (just like you'd see a podiatrist if shoes were > giving you problems). On Jan 26, 7:38 pm, "doctor_my_...@msn.com" <doctor_my_...@msn.com> wrote: > A better analogy would be "Why do I need a licensed funeral director? > Why do I need a dentist? Why do I need a licensed vet? Why do I need [quoted text clipped - 4 lines] > information that you want to "play with" as an unlicensed > non-professional. I think you're misinterpreting my question. You're talking about licensed vs unlicensed. I'm talking about being legally required to have a prescription to buy something. Sure, the licensed professionals would be better choices for all of the above examples, but I'm not required to have a prescription or see a licensed professional to have a funeral, buy a toothbrush, buy dog food, or hire a lawyer. I have a choice to do it myself (amateur). >I can see why prescriptions are required for drugs, because those can > be easily abused or sold in the black market. But to me, eye [quoted text clipped - 12 lines] > go see the optometrist (just like you'd see a podiatrist if shoes were > giving you problems). If you agree that everyone should get an initial refraction done professionally, how are your going to enforce only allowing someone to only make an minor adjustment to the initial Rx? Either all refractions have be done by a licensed OD/MD, or none of them would have to be. One could argue about how long a refraction should be valid for before it expires, and in some states a Rx for contacts expires one year after the exam date, and in other states it is two years or longer. But expiration of a professionally done refraction is different than coming up with a new Rx on your own. But (if you really, really want to) there is always Photoshop. > If you agree that everyone should get an initial refraction done > professionally, how are your going to enforce only allowing someone to only > make an minor adjustment to the initial Rx? Either all refractions have be > done by a licensed OD/MD, or none of them would have to be. No, I didn't say that people should be legally required to have an initial refraction done. I just meant that it would probably be a good idea. And I also believe that refractions should only be done by licensed professionals. However, I also think that it should be fine for anyone to buy any pair of glasses or contacts without a prescription, just like we can buy shoes. > No, I didn't say that people should be legally required to have an > initial refraction done. I just meant that it would probably be a good > idea. And I also believe that refractions should only be done by > licensed professionals. However, I also think that it should be fine > for anyone to buy any pair of glasses or contacts without a > prescription, just like we can buy shoes. You can buy reading glasses at a discount store without an Rx. If you can legally alter your own Rx for contacts, then you are refracting yourself without a license. If you want to purchase lenses outside of the US, then there are some websites where you can just tell them your refraction without written copy of an Rx (I know they will do it for glasses, but not sure about contacts). Most of these sites will ship to the US. > > If you agree that everyone should get an initial refraction done > > professionally, how are your going to enforce only allowing someone [quoted text clipped - 8 lines] > for anyone to buy any pair of glasses or contacts without a > prescription, just like we can buy shoes. You can readily get prescription glasses for any Rx you want to invent using the pull-down menus on the web sites. It must be legal since the sites are easy to find. Contacts are a different story. I happen to agree with you that people should we within their rights to experiment with their own eyeballs if they so choose, but it's not currently legal. If you try hard enough, you can find sites to sell you contacts with no Rx though. -- Dear Charles, It is also legal to buy blood-pressure measuring equipment over-the-counter. Thus if you check you B.P. and find 120/80 you indeed have no problem. It is also legal to buy plus and minus lenses and look through them. You can buy them on the internet (a pair for $10). You can also find a Snellen on the internet. If you are reading the Snellen at 20/70, and find a -1.25 diopter minus lens "clears" the 20/20 line, then that is indeed your refractive STATE. The issue is this. Do you have the right to do this? If you wished you could go to the OD and have him check. His methods are the same a per above. He will check for retinal problems (organic) and the like. But once it is clear that a -1.25 diopter will clear the 20/20 line -- then you do have a choice in where you obtain that minus lens. Given the availablity of minus lenses of various powers, you could determine your own refractive STATE if you choose to do so. Otis > > > If you agree that everyone should get an initial refraction done > > > professionally, how are your going to enforce only allowing someone [quoted text clipped - 16 lines] > > -- > The issue is this. Do you have the right to do this? You have a very narrow and distorted idea of the issues. What are the chances your technique will yield an accurate prescription? Don't you realize that people OVERestimate the amount of minus needed when they attempt self-refraction? And even so, do you just ignore astigmatism? > If you wished you could go to the OD and have him > check. His methods are the same a per above. In your dreams. > Given the availablity of minus lenses of various powers, > you could determine your own refractive STATE if > you choose to do so. You might get a reasonable estimate but I guarantee that novices, especially nearsighted young people, will on average OVERestimate their own refraction. If that's what you want then you can sleep well at night. -MT > You can readily get prescription glasses for any Rx you want to invent > using the pull-down menus on the web sites. It must be legal since the [quoted text clipped - 3 lines] > legal. If you try hard enough, you can find sites to sell you contacts > with no Rx though. Unless the website business is operating outside the US, then you must send or fax a copy to them of the Rx, or provide the phone number of the OD so they can verify. But there are some websites that are outside of the US that will make any pair of lenses you want without an Rx. I don't know about contacts, but I would bet you could order whatever you want from some places. Even though they will ship to the US, it probably is illegal to do so, just like it is technically illegal to purchase drugs from Canada and have them shipped to the US. But I doubt that the customs services has stopped very many of these shipments of lenses. > licensed professionals. However, I also think that it should be fine > for anyone to buy any pair of glasses or contacts without a > prescription, just like we can buy shoes. My father has US$300 shoes. They look like regular tennis shoes. They were prescribed by a podiatrist. > >I can see why prescriptions are required for drugs, because those can > > be easily abused or sold in the black market. But to me, eye > > prescriptions don't seem that critical. > But (if you really, really want to) there is always Photoshop. Never thought of that. We had a mandated financial report at work that was needed Right Now. It was a yearly report. The software had a bug in it, and the numbers simply didn't add up. It was one page. The accounting folks knew what the numbers were supposed to be. I suggested to the Little Cheese that I just edit the print file and fix it. I told her it would take two hours, a few seconds to do the edit and the rest to figure out how to make it editable and then convert it back to a print file. The Big Cheese came by and asked what the problem was. He said my solution was ridiculous. Just import into Excel, or retype it. Å clerical person could do that, you didn't need a computer programmer. >I can see why prescriptions are required for drugs, because those can > be easily abused or sold in the black market. But to me, eye [quoted text clipped - 12 lines] > go see the optometrist (just like you'd see a podiatrist if shoes were > giving you problems). The most obvious reason why lens prescriptions are legally required is to minimize the risk of operating dangerous machinery, such as automobiles. Can you imagine drivers, pilots, ship captains, etc. self-prescribing? People cannot be trusted to be responsible and use common sense in such situations. How could you even tell if you hit on the correct prescription? > The most obvious reason why lens prescriptions are legally required is to > minimize the risk of operating dangerous machinery, such as automobiles. > Can you imagine drivers, pilots, ship captains, etc. self-prescribing? > People cannot be trusted to be responsible and use common sense in such > situations. How could you even tell if you hit on the correct prescription? The examples you gave are regulated. Still, there's a lot of dangerous machinery that aren't. > > I can see why prescriptions are required for drugs, because those > > can be easily abused or sold in the black market. But to me, eye [quoted text clipped - 19 lines] > common sense in such situations. How could you even tell if you hit > on the correct prescription? None of these professions require proof of a doctor's prescription, only proof that you can see. -- > > > I can see why prescriptions are required for drugs, because those > > > can be easily abused or sold in the black market. But to me, eye [quoted text clipped - 22 lines] > None of these professions require proof of a doctor's prescription, > only proof that you can see. Not my experience. If you fail the vision screening, then you don't get a driver's license without a form from an eye doctor. I've done this twice, my wife once. > > > > I can see why prescriptions are required for drugs, because > > > > those can be easily abused or sold in the black market. But to [quoted text clipped - 26 lines] > get a driver's license without a form from an eye doctor. I've done > this twice, my wife once. What I mean is, I can self prescribe my glasses so long as I pass the vision test. The FAA/DMV doesn't care as long as I can see. The idea that an Rx is required to protect the public from blind pilots doesn't make sense. -- >> > > The most obvious reason why lens prescriptions are legally >> > > required is to minimize the risk of operating dangerous [quoted text clipped - 14 lines] > that an Rx is required to protect the public from blind pilots doesn't > make sense. You may be correct - no agency has ever required me to present a doctor's vision prescription before issuing me a license. Practically though, the need to pass a vision test effectively forces me (and most everybody else) to get a proper exam and prescription. My point is it's a public safety issue. Even if you could evaluate your own vision accurately and write your own prescription, who would fill it? Opticians I have dealt with have always required a doctor's prescription (not more than two years old) before they will make lenses/glasses. Assuming you had a trial-lens "frame", and a box of trial lenses (in 1/4 diopter steps), and a days traing and experience you could probably determine your refractive STATE that would not be much difference that a measurement made in an office. After all they are the same thing. What the OD can do in his office is to check for retinal-organic problems. And also check for eye-ball pressure. But once these items are cleared off the table, then verifying your refractive STATE would not take much training. Just on man's opinion. Otis > > > > > I can see why prescriptions are required for drugs, because > > > > > those can be easily abused or sold in the black market. But to [quoted text clipped - 31 lines] > > --- Hide quoted text -- Show quoted text - > Assuming you had a trial-lens "frame", and > a box of trial lenses (in 1/4 diopter steps), > and a days traing and experience you > could probably determine your refractive STATE > that would not be much difference that > a measurement made in an office. And after all, getting a prescription that is somewhere in the ball park is quite good enough, right? > After all they are the same thing. In your little mind, perhaps they are. > What the OD can do in his office is to check > for retinal-organic problems. And also [quoted text clipped - 3 lines] > table, then verifying your refractive STATE > would not take much training. How many patients have you refracted in this manner, and how did your results compare to actual medically trained professionals who refracted the same patients themselves? Inquiring minds want to know. Otis? Could you please answer the last question?? It wouldn't make you seem very credible if you have no sound basis for these assertions, so I'm sure you'll be EAGER to clear this up. Thanks. -- >> Assuming you had a trial-lens "frame", and >> a box of trial lenses (in 1/4 diopter steps), [quoted text clipped - 23 lines] > > Inquiring minds want to know. > Assuming you had a trial-lens "frame", and > a box of trial lenses (in 1/4 diopter steps), [quoted text clipped - 16 lines] > > Otis It may not take much training, but how many people would do it, and where would they get the trial frames and lenses? A decent refraction from an OD can be had for about $50 or less. > The most obvious reason why lens prescriptions are legally required is to > minimize the risk of operating dangerous machinery, such as automobiles. > Can you imagine drivers, pilots, ship captains, etc. self-prescribing? > People cannot be trusted to be responsible and use common sense in such > situations. How could you even tell if you hit on the correct prescription? Um, perhaps you notice that you can see better? That being said, I truly envy anybody who can order his own contact lenses -- I've had three fitters and dozens of trial lenses, only a few of which are good enough to actually use and NONE of which have been duplicable. SignatureCheers, Bev * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Do not try to solve all life's problems at once -- learn to dread each day as it comes. -- Donald Kaul Literally, prescribe means before (pre) and write (scribe). It is simply putting the numbers down on paper. Why does it have to come from a licensed practitioner? Because there are laws that say such. The laws were enacted as professions became licensed and responsible for their actions, as well to protect the professions. The wrong glasses can cause problems with depth perception and acuity, thus causing drivers to crash and injure people. They can cause eyestrain, double vision and headache. You can also read posts from Cletis in this NG which is probably the best reason not to allow open slather prescribing. The government decided to protect the public from themselves and deluded individuals like Cletis. dr grant |
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