Oops -- spellchecker going wild again.

(Now, with contacts, lasik, and IOLs, it is not longer possible to
draw generalizations.)

--
-d.

It can be quite depressing to realize that the OD, being, these days,
a Professional, who does many of the Professional things that an
opthamologist conventionally did, and who is consumed with the
complexities of pandering contact lenses and remedies for their
vagaries and pathological disadvantages, has very little time for
such things as refractions, and frequently can not be bothered
(assuming he does his own refractions) to tune to much better than
20/30, for the customer wanting ordinary inexpensive eyeglasses.

Possibly the prevalence of fat customers, who do not physically fit
the equipment, is, to some extent, of his own doing.  That, of course,
does beg the question that refractive error indirectly engenders
overeating.

But, I do remember that the fat girls almost always wore glasses.
(Now, with contacts, lassie, and Oils, it is not longer possible to
draw generalizations.)

--
Dicky

--
Dicky

It's debateable whether they cause obesity on their own or whether
it's simply a matter of the person over eating as an effect of the
depression.

There is a significant number of folks taking anti-depressants, but perhaps
they may need them.  Either side of that question - yes, I'm talking about
those meds.

-Aula

Are you talking about SSRI's that it seems half the population takes?

DrG

Perhaps you are unfamiliar with several psychotropic meds that are known to
have that side effect, even with close controls placed on caloric intake.

-aula

Sounds like an excuse to me.  Drugs don't make you fat.  Steroids,
often given for asthma, usually increase the appetite leading to
overeating.

Ann

Correct, but usually its due to excess intake of calories and lack of
exercise. Less often it can be due to some medicines, thyrod or
metabolism problems. I had a teacher who was quite obese, short and 220
pounds(my guess/estimate) and she once explained that it was due to her
asthma and other problems and the medicines she takes. She does not
overeat.

It depends on the cause of the obesity.

Maybe refer them to a diet tech? Obesisty is an epidemic just like
myopia is, but at least you can lose weight much easier than lose
diopters.

<http://tinyurl.com/mx6m3>

I'd like to add to the following to that list of devices:

o  Slit-lamps

I've had quite a few patients I've had to refer out for direct
gonioscopy because they couldn't fit behind the slit-lamp.  Or you
don't get the testing done.  Bringing a patient down to the OR to
perform Koeppe gonioscopy with a counterbalanced gonioscope costs big
bucks.  Most hospitals don't have one -- you have to typically go to a
University ophthalmology residency clinic.

And optic nerve/retinal nerve fiber layer evaluation with a +14D or
MaculaPlus using a head-mounted BIO is not nearly as nice as using a
contact fundus lens or Super66 non-contact fundus lens at a slit-lamp
because patients can't get their forehead close enough to the front of
the slit-lamp for me to obtain or sustain clear focus.

Same thing for Goldmann tonometry.  I can't count the number of times
having a TonoPen has alllowed me to check IOPs when I couldn't do it
with a slit-lamp Goldmann.

Good luck to ophthalmologists trying to perform ALT/SLTs on these
pateints.  Well, they can bill more for trabeculectomies anyways :(.

Hand-held slit-lamps are a poor substitute.

If this trend keeps up, I expect to start having problems at the
perimeter.

And I thought this was only me noticing this alarming trend.