Dear Visa,

What is your current prescription?

A patient is taking medication for hypertension, and self-monitors
their blood pressure.  Despite the fact that everything seems fine,
medication runs out at the end of the year.  What are the odds that
the doctor will authorize more refills without seeing the patient
first?

Contact lenses are medical devices.  Recently, colored lenses were re-
classified from cosmetic to medical devices as a result of many eye
injuries.  Why wouldn't you want your doctor to see you on an annual
basis?  Or, do you think that eye doctors are unnecessary?  Also, you
assume that you are contributing to the doctor's bottom line, when in
fact you are only contributing to his top line.  Insurance may pay so
little for the exam that it doesn't cover the expense of seeing the
patient.

In article
<9726010d-9855-421d-976f-f2fe3c0bf9f3@f3g2000hsg.googlegroups.com>,

I don't blame the doctor.  The doctor can't afford this.  My OD showed a
prospective patient the door.  The patient wanted to pay, but he boasted
that he never followed instructions.  My OD couldn't afford this
patient.  If he went blind while under the care of this doctor, the
doctor could well be sued.  Who will the jury believe?  The patient who
went blind while under the care of the doctor, or the doctor who claims
he advised the patient that he was risking his eyesight by not following
instructions?

Dear Visa,

If you are in the USA, then perhaps it is not "legal" to buy your own
contact lenses.  If you think there is a "risk" then by all means
go to your OD and get another exam.  If it were 12 months, then
you could order them here.

http://www.findcontactlenses.com/

In other coutries it is probably not against the "law" to order these
contact lenses.

The choice is yours.

Besides checking refraction and contact lens power, your doctor will
check the health of your cornea and lids.  Your doctor is legally
responsible any adverse health effects the contacts cause if he
prescribes them.  He must check that the contacts have not caused
adverse health effects during the year of wear before he prescribes
them again.

Contact lens sellers are legally required to ensure that a  valid
prescription exists for any lenses they sell.

Only if you find a supplier out of country who is willing to risk
shipping to a US address;  legal requirements regarding valid
prescriptions apply to lenses sold to US residents, no matter where
the sale originates.

Dr Judy

As Dr. L wrote, contact lenses are medical devices.

The standard of care is typically that contact lens prescriptions
expire after a year.  And I cannot blame any doctor who chooses to not
extend a contact lens prescription beyond that time.

But doctors have discretion to shorten that time frame, or lengthen
that time frame, if in their medical opinion it is prudent.  And there
have been times where I have extended a prescription's expiration
date, but that is when (1) I have seen the patient for several visits
and have a history of knowing successful/healthy contact lens wear and
(2) the patient has an appointment set up in the near future.  The
purpose of extending the expiration date is to allow the patient to
get by until the next (soon) eye examination, not to avoid having to
get their eyes checked.

It sounds like you have neither a long history of successful contact
lens wear with this doctor and prefer to not get your eyes checked
soon.

When a doctor writes or extends a prescription, his license is on the
line.  If you have or have developed some pathology that causes you
harm but could have been prevented by having an eye examination, that
doctor is at real risk for malpractice; even moreso if his follow-up
schedule deviates from the community accepted frequency which is every
6-12 months for contact lens patients.  Many of these conditions are
asymptomatic.

Bottom line is, yes, most doctors don't want to write/extend
precriptions without getting paid because that is one way they put
food on their table, pay their mortgage and clothes on their
childrens' backs.  Even moreso, when doing so would be indefensible in
a court of law.

And you wouldn't?

Let's say -- hypothetically -- that there is no potential harm to you
or liability for the doctor to do so.  It costs the doctor money to
verify the prescription is correct and extend this to you, what
motivation does the doctor have to do so when you don't buy your
lenses from him and don't want to get your eyes checked?

And you've never been wrong about something you thought you were
"sure" about?  And you know for sure that your eyes are healthy?

Really?  So why did you get your eyes checked in the first place?

None that are legal.

Probably can't afford the exam, huh?  I love it when I hear people
drop that line on me as they throw their Coach purse over the
shoulder, climb back into their 2007 Lexus SUV and drive off to get
their daily expresso at Starbuck's.

There you go.

Why can't you get an eye test? I just love the twits that think they
know more than me. What is really funny is when they come in screaming
and whining that they have sore eyes from CL wear and I have to tell
them to stop wearing lenses for a few months.

The whole point is to make sure everything is ansd stays OK you fool.
There are a lot more things that can go wrong than you think and many
of these are detectable by me and my colleagues well before such
knowledgable entities such as yourself are aware of it.

The only problem here is that you are a cheapskate.

dr grant