# Why don't optometrists believe their patients? **URL:** \ **Category:** Factual Questions\ **Created:** [March 16, 2009, 2:38pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619 "2009-03-16T14:38:13Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![Gary\_T](https://avatars.discourse-cdn.com/v4/letter/g/3ec8ea/32.png) [@Gary\_T](https://boards.straightdope.com/u/Gary_T)\ **Post date:** [March 16, 2009, 11:29pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/41 "2009-03-16T23:29:41Z")
> [@cromulent](#): > > Is it crazy for me to be a little offended by all the “your doctor wants to buy a boat” comments? No, it’s not crazy. While perhaps meant in some degree of jest, they do imply the dishonor of making a professional recommendation for the purpose of personal gain. We in the auto repair field get some of those comments too. I’ve found it’s best, though, to not take them personally. Trust that your clients/customers have respect for you and what you do, and the overwhelming majority of the time they will. ---
**Author:** ![Musicat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/musicat/32/20189_2.png) [@Musicat](https://boards.straightdope.com/u/Musicat)\ **Post date:** [March 16, 2009, 11:43pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/42 "2009-03-16T23:43:52Z")
Some people are more observant than others, but the system handles everyone as the lowest common denominator. Example. When I first went to a certain ophthalmologist, he had me take several exams/tests, including a peripheral vision one. OK, maybe the first visit needs a benchmark, so I went along with it. At the next appointment, I was ushered into the peripheral vision room, but I balked at paying $35 for a test that I thought was totally unnecessary, so the doc was consulted. He said most people aren’t aware if their peripheral vision is failing. I said I would be acutely aware, and made a bet with him. I’d take the test, and if the results hadn’t changed from the last one, I wouldn’t be charged for the test; otherwise, I would. I passed, wasn’t charged, and refused to take any more in the future unless I felt I needed it. The good doc and I reached an understanding and he didn’t ask any more. I’m sure I wasn’t a typical patient. Oh, yeah – his yacht was already paid for and his kids were thru college, so maybe he had some leeway. ---
**Author:** ![Rigamarole](https://avatars.discourse-cdn.com/v4/letter/r/77aa72/32.png) [@Rigamarole](https://boards.straightdope.com/u/Rigamarole)\ **Post date:** [March 16, 2009, 11:48pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/43 "2009-03-16T23:48:17Z")
> [@Boyo\_Jim](#): > > I don’t know why I keep reading the thread title as _Why don’t optimists believe their parents?_ Maybe you need to have your eyes checked. ---
**Author:** ![NinjaChick](https://avatars.discourse-cdn.com/v4/letter/n/71c47a/32.png) [@NinjaChick](https://boards.straightdope.com/u/NinjaChick)\ **Post date:** [March 17, 2009, 2:47am UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/44 "2009-03-17T02:47:13Z")
> [@RickJay](#): > > I second and third those who point out that, for health reasons, an eye exam is just smart. But, that aside, if you just need lesnes, you can order contact lenses online. Why do you need a prescription? Well, for one, it can be a fight to actually get a written copy of your actual prescription (IME). And also, when I’ve ordered online, they’ve at least once followed through on calling the doctor to confirm that it’s right, so if it’s an expired prescription, they’ll cancel the order. > [@Gary\_T](#): > > No, it’s not crazy. While perhaps meant in some degree of jest, they do imply the dishonor of making a professional recommendation for the purpose of personal gain. We in the auto repair field get some of those comments too. I’ve found it’s best, though, to not take them personally. Trust that your clients/customers have respect for you and what you do, and the overwhelming majority of the time they will. I don’t mean any offense by it, really, and in fact the optometrist I saw last week was very nice. Mostly I just get irritated because of the combination of two factors: I need corrective lenses to function as I have for over ten years now; and I periodically need to pay someone a significant amount of money effectively to tell me that I need corrective lenses to function. I guess I’m outside the norm in that I could always tell if my prescription had changed over the course of a year, but even still, it feels slightly like being treated like a child. “Well, we’d better just make sure you’re not having any vision problems, because I know better than you - and by the way, I make a whole lot of money for doing so.” Maybe it’s just my inner control freak, but it feels somewhat disrespectful, like the assumption is that they feel they’re profiting off your stupidity, because you’re too dumb to notice that you’re seeing flashes of light or what have you. Tangentially, since we’re here and there seem to be some optometrists: is the exam worth anything if they don’t dilate your eyes? ---
**Author:** ![Algorithm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/algorithm/32/12204_2.png) [@Algorithm](https://boards.straightdope.com/u/Algorithm)\ **Post date:** [March 17, 2009, 3:41am UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/45 "2009-03-17T03:41:56Z")
It’s not that the doctor “knows better than you”, it’s that getting regular exams is a good idea. For many diseases, discovering them before symptoms manifest improves the prognosis long term. Encouraging routine exams improves the overall health of a population, and the fact that doctors profit off it is an externality. ---
**Author:** ![sailor](https://avatars.discourse-cdn.com/v4/letter/s/a587f6/32.png) [@sailor](https://boards.straightdope.com/u/sailor)\ **Post date:** [March 17, 2009, 5:06am UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/46 "2009-03-17T05:06:36Z")
> [@StuffLikeThatThere](#): > > I don’t know from pupil distance, but I do know that last time I got a prescription for contacts and for glasses at the same time, they were different correction strengths. I brought it up with my sister (who works in the optical shop affiliated with my optometrist) and discovered that this was indeed correct. To get the same vision, eyeglasses and contact lens prescriptions are written quite differently. Is this possibly what’s going on with the prescription? The reason for this is that the distance between the eye and the corrective lens also counts. If the needed correction is small then the difference will be minimal but as the strength of the needed correction increases the distance becomes mores critical and needs to be compensated for. You can try this with your eyeglasses just by moving them back and forth. Interpupillary distance is easy to measure and not as critical as the power of the lenses. In the case of contact lenses it is not only the power of the correction but also the base curvature of the cornea which can change. I agree that often doctors in America have that air of superiority which I also hate but I also understand where they are coming from. The doctor-patient relationship has become adversarial and they think they are looking at their next lawsuit. I can understand that. In China you can go into any eyeglass store and they will be very friendly and do whatever you want and whatever you tell them and I love that plus the fact that the price of eyeglasses is ridiculously low. I always buy prescription eyeglasses for a lot of my friends here. Right now I have about a dozen prescription eyeglasses in my luggage for a bunch of people. Some of them with complex prescriptions, bifocals, tinted, etc. I think the average price came in at just about under $20 per set. I know enough about eyeglasses prescriptions that I can discuss the issues with the seller and make decisions. I do this for my friends every year and they have always been happy to get eyeglasses for 1/10 of what they would pay at home but, of course, they understand they alone are assuming all risks. And consumers in developed countries do NOT want this, they want _better_ care, they just don’t want to pay for it. The problem is for those who _are_ willing to spend less and assume the risk because they do not get that option, unless they travel abroad. We all agree it is good to have periodical checkups of eyes and other body parts and functions. What we do not agree is on _how_ good it is when it comes to deciding _how much_ we want to spend on it. ---
**Author:** ![UltraVires](https://avatars.discourse-cdn.com/v4/letter/u/ecccb3/32.png) [@UltraVires](https://boards.straightdope.com/u/UltraVires)\ **Post date:** [March 17, 2009, 5:07pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/47 "2009-03-17T17:07:29Z")
> [@Algorithm](#): > > Encouraging routine exams improves the overall health of a population, and the fact that doctors profit off it is an externality. I have no problem with a doctor “encouraging” exams, but in the OPs situation she is forced to pay big $$$ if she wants new glasses/contact lenses at the previous strength. This tends to increase prices because, unlike the auto service poster above, a consumer can’t choose a do-it-yourself option with medicine. The government has decided in its wisdom to not only regulate prescription drugs, but prescription lenses as well. My heart breaks when I read about young kids getting hooked on prescription eyewear.. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [March 17, 2009, 9:28pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/48 "2009-03-17T21:28:41Z")
> [@jtgain](#): > > I have no problem with a doctor “encouraging” exams, but in the OPs situation she is forced to pay big $$$ if she wants new glasses/contact lenses at the previous strength. Yeah, it’s crap to be less than perfect, but life isn’t fair. And while you can spend thousands on “eyewear” a basic exam and basic corrective lenses are well within the reach of all but the poorest Americans. There are charities for those who are destitute, and you can always try to negotiate a payment plan. Fact is, contacts are a _luxury_ in all but a very few, rare medical conditions. If she wants them yes she’ll have to pay for them. > [@](#): > > My heart breaks when I read about young kids getting hooked on prescription eyewear.. What? “Hooked” on eyeware? Please tell me this is sarcasm. ---
**Author:** ![rocking\_chair](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/rocking_chair/32/2918_2.png) [@rocking\_chair](https://boards.straightdope.com/u/rocking_chair)\ **Post date:** [March 17, 2009, 10:24pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/49 "2009-03-17T22:24:56Z")
> [@KRM](#): > > **NinjaChick** , haven’t you ever put on a new pair of glasses and thought, “OMG, there are leaves on trees!”? i said that with my first pair of glasses in third grade. before that i always passed the “memory” test. my mother thought i was making it up, until the person adjusting my glasses told her i couldn’t see individual leave unless i was in the tree. ---
**Author:** ![NinjaChick](https://avatars.discourse-cdn.com/v4/letter/n/71c47a/32.png) [@NinjaChick](https://boards.straightdope.com/u/NinjaChick)\ **Post date:** [March 18, 2009, 12:33am UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/50 "2009-03-18T00:33:41Z")
> [@Broomstick](#): > > Yeah, it’s crap to be less than perfect, but life isn’t fair. And while you can spend thousands on “eyewear” a basic exam and basic corrective lenses are well within the reach of all but the poorest Americans. There are charities for those who are destitute, and you can always try to negotiate a payment plan. Fact is, contacts are a _luxury_ in all but a very few, rare medical conditions. If she wants them yes she’ll have to pay for them. I don’t deny that they’re a luxury (though they are the only way my vision can be fully corrected), and while I wish that the lenses were cheaper, my beef isn’t with needing to pay for the actual lenses. It’s needing to pay an optometrist to confirm that yes, I do need contacts. I know I need contacts, I know what brand and prescription I wear, I know I’m not having any problems with them. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [March 18, 2009, 12:58am UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/51 "2009-03-18T00:58:48Z")
> [@NinjaChick](#): > > I don’t deny that they’re a luxury (though they are the only way my vision can be fully corrected), and while I wish that the lenses were cheaper, my beef isn’t with needing to pay for the actual lenses. It’s needing to pay an optometrist to confirm that yes, I do need contacts. I know I need contacts, I know what brand and prescription I wear, I know I’m not having any problems with them. If you want that to be different, you’d best work to change the laws and medical practice standards. ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [March 18, 2009, 1:14am UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/52 "2009-03-18T01:14:25Z")
> [@Broomstick](#): > > What? “Hooked” on eyeware? Please tell me this is sarcasm. Well, you know, you start them out on sunglasses, then you move them to prescription lenses…then before you know they it, they’re selling their milk money for bi-focals. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [March 18, 2009, 1:43am UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/53 "2009-03-18T01:43:03Z")
I don’t think the optometrist doubts you need contacts - few people would bother with them unless they were necessary - but rather that he/she needs to confirm your prescription hasn’t changed (which _most_ people can’t detect as easily as you, and the rules are set for the _average_ person in this case) and that you aren’t developing some disease whose symptoms YOU haven’t noticed but that might appear on a routine eye exam, particularly those diseases that are treatable if caught early. Failure to do these things is a breach of professional ethics for the optometrist. ---
**Author:** ![CrazyCatLady](https://avatars.discourse-cdn.com/v4/letter/c/dfb087/32.png) [@CrazyCatLady](https://boards.straightdope.com/u/CrazyCatLady)\ **Post date:** [March 18, 2009, 4:18am UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/54 "2009-03-18T04:18:05Z")
> [@jtgain](#): > > I have no problem with a doctor “encouraging” exams, but in the OPs situation she is forced to pay big $$$ if she wants new glasses/contact lenses at the previous strength. Actually, if she wants to wear glasses, she can wear them for as many years as she wants without going back in for an exam. Or, I guess she could order several extra boxes of contacts while her script is valid and avoid getting an exam. But we’re not talking about all that much money–you can get an exam and contact fitting at Walmart for around $100, or what it costs to get 3 months worth of my contacts. Maybe contacts shouldn’t be prescription items, but the simple fact is that they are. And if a doctor writes you a prescription for something, and it turns out to be harmful to you because of something an exam would have picked up, guess whose ass is grass? Ain’t yours. ---
**Author:** ![CutterJohn](https://avatars.discourse-cdn.com/v4/letter/c/91b2a8/32.png) [@CutterJohn](https://boards.straightdope.com/u/CutterJohn)\ **Post date:** [March 18, 2009, 10:07am UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/55 "2009-03-18T10:07:19Z")
I still have yet to understand the need to get a ‘prescription’ from an optometrist for eyeglasses. Contacts, sure. Those can have nasty side effects, and not everyones eyes can handle them. Eyeglasses, however, are far simpler. A trained technician should be able to operate that little machine and send the order off. I do pretty much that every time I adjust my binoculars, though on a simpler scale. Prescription for contacts? Sure. Prescriptions for eyeglasses are like prescriptions for shoes. ---
**Author:** ![Balthisar](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/balthisar/32/2825_2.png) [@Balthisar](https://boards.straightdope.com/u/Balthisar)\ **Post date:** [March 18, 2009, 12:25pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/56 "2009-03-18T12:25:43Z")
> [@CutterJohn](#): > > Eyeglasses, however, are far simpler. A trained technician should be able to operate that little machine and send the order off. I do pretty much that every time I adjust my binoculars, though on a simpler scale. Several years ago I was surprised to learn that optometrists were, in fact, even post-grad graduates! We’d always gone to an ophthalmologist for anything having to do with the eyes except for glasses. The optometrist was just kind of a technical worker. I realize now as an adult that there’s more to it than that, but I still have a lot less professional respect for an optometrist compared to an ophthalmologist. ---
**Author:** ![Cheesesteak](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cheesesteak/32/3694_2.png) [@Cheesesteak](https://boards.straightdope.com/u/Cheesesteak)\ **Post date:** [March 18, 2009, 12:40pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/57 "2009-03-18T12:40:24Z")
> [@CutterJohn](#): > > I still have yet to understand the need to get a ‘prescription’ from an optometrist for eyeglasses. > Prescriptions for eyeglasses are like prescriptions for shoes. People need glasses because their eyes are malfunctioning. When organs don’t work right, you need to see a doctor. If you put eye correction in the hands of Al Bundy, because it’s cheap, many people will wind up with horrible eye problems, not only from undiagnosed disease, but from the wrong prescription. Plenty of people wear the wrong size of shoe, hell I’ve heard that a solid majority of women aren’t even wearing the right size of bra. I have no doubt that the majority of non-prescription eyeglasses would be incorrect for one reason or another. ---
**Author:** ![badbadrubberpiggy](https://avatars.discourse-cdn.com/v4/letter/b/57b2e6/32.png) [@badbadrubberpiggy](https://boards.straightdope.com/u/badbadrubberpiggy)\ **Post date:** [March 18, 2009, 1:03pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/58 "2009-03-18T13:03:58Z")
> [@RickJay](#): > > I second and third those who point out that, for health reasons, an eye exam is just smart. But, that aside, if you just need lesnes, you can order contact lenses online. Why do you need a prescription? Most (all?) online stores verify prescriptions with your eye doctor. [Contactlenses.com](http://Contactlenses.com) will call your eye doctor to make sure the prescription is current, and they won’t fill it if it’s not. ---
**Author:** ![sailor](https://avatars.discourse-cdn.com/v4/letter/s/a587f6/32.png) [@sailor](https://boards.straightdope.com/u/sailor)\ **Post date:** [March 18, 2009, 1:17pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/59 "2009-03-18T13:17:35Z")
> [@CutterJohn](#): > > I still have yet to understand the need to get a ‘prescription’ from an optometrist for eyeglasses. Contacts, sure. Those can have nasty side effects, and not everyones eyes can handle them. Eyeglasses, however, are far simpler. A trained technician should be able to operate that little machine and send the order off. I do pretty much that every time I adjust my binoculars, though on a simpler scale. > > Prescription for contacts? Sure. > Prescriptions for eyeglasses are like prescriptions for shoes. An optometrist _is_ a trained technician. He is trained to do that job adequately according to American laws and regulations. If you want one with less training just come to China. You’ll love it here. Don’t complain if your eyes go bad due to incorrect treatment though. Or about poisonous additives in the food. It’s all part of raw, unregulated, liberalism here. ---
**Author:** ![anson2995](https://avatars.discourse-cdn.com/v4/letter/a/c77e96/32.png) [@anson2995](https://boards.straightdope.com/u/anson2995)\ **Post date:** [March 18, 2009, 5:41pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/60 "2009-03-18T17:41:39Z")
> [@CutterJohn](#): > > I still have yet to understand the need to get a ‘prescription’ from an optometrist for eyeglasses. Prescription for contacts? Sure. > Prescriptions for eyeglasses are like prescriptions for shoes. But of course, you _can_ buy eyeglasses off the shelf. They’re called reading glasses. [Previous page](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619.md?page=2) [Next page](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619.md?page=4)