# 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:** 4
**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, 6:04pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/61 "2009-03-18T18:04:03Z")
They are also not very strong, and don’t require direct contact with the tissues of your eye. If you need something stronger than OTC reading glasses you need to see an optometrist or ophthalmologist. ---
**Author:** ![gigi](https://avatars.discourse-cdn.com/v4/letter/g/a587f6/32.png) [@gigi](https://boards.straightdope.com/u/gigi)\ **Post date:** [March 18, 2009, 6:07pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/62 "2009-03-18T18:07:14Z")
> [@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’m always amazed that my father, who squeezes a penny till it begs for its life, got my brother and me contacts when our eyes were stable enough, around 14 or 15. IBM paid for glasses but as far as I know he had to pay for the lenses himself. Incredibly fortunate for us. ---
**Author:** ![Eureka](https://avatars.discourse-cdn.com/v4/letter/e/74df32/32.png) [@Eureka](https://boards.straightdope.com/u/Eureka)\ **Post date:** [March 18, 2009, 6:22pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/63 "2009-03-18T18:22:27Z")
> [@Broomstick](#): > > They are also not very strong, and don’t require direct contact with the tissues of your eye. If you need something stronger than OTC reading glasses you need to see an optometrist or ophthalmologist. And OTC reading glasses don’t correct astigmatism. I’m severely nearsighted with significant astigmatism. I may go for years without getting an eye exam and a new prescription/pair of eyeglasses–because I’m lazy/cheap–but when I get new lenses, I like skinny lenses, and I find having a thorough eye exam reassuring. ---
**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, 6:51pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/64 "2009-03-18T18:51:47Z")
> [@Eureka](#): > > And OTC reading glasses don’t correct astigmatism Right, and that was my point. You can diagnose and treat yourself if you want. Caveat emptor. If you have complex vision problems, or want stuff that’s going to be on your eyeballs, you need to consult a licensed expert. The OP’s point is “i have a valid prescription, just give me my lenses.” I think the response is “that prescription isn’t valid forever.” Just like antibiotics. ---
**Author:** ![Rucksinator](https://avatars.discourse-cdn.com/v4/letter/r/898d66/32.png) [@Rucksinator](https://boards.straightdope.com/u/Rucksinator)\ **Post date:** [March 18, 2009, 11:33pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/65 "2009-03-18T23:33:45Z")
My eyesight started getting bad (nearsighted) around 13, and got progressively worse (-2.75) until about 30. Then it levelled off. I had 2 or 3 exams with the same prescription. Was without insurance for a while, so didn’t get an exam for about 3 years… just used the supply of disposable contacts that I had. Then… > [@NinjaChick](#): > > I wear contacts. I need some form of corrective lens in order to really function, and contacts work better. I discover I am running low on spare lenses, and need to order more. This means I need to make an appointment with an optometrist. (same story). I still saw just fine with my contacts. I still saw bad without them. After the exam I was told that my prescription went from a -2.75 to -1.25. [I was also told not to wear 2-week contacts for 2 months at a time (which was how 1 year’s worth of disposable contacts lasted me about 5 years), as this could make my eyes suffocate and go blind.] [/anecdote] ---
**Author:** ![cromulent](https://avatars.discourse-cdn.com/v4/letter/c/b4bc9f/32.png) [@cromulent](https://boards.straightdope.com/u/cromulent)\ **Post date:** [March 19, 2009, 12:00am UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/66 "2009-03-19T00:00:24Z")
> [@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. Thanks. This is encouraging! Originally posted by **Balthazar** : > [@](#): > > 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. Well, I’m not going to try to argue my way into any more “professional respect,” but I would keep in mind that the education of optometrists, as well as their scope of practice, has changed significantly in the past 30 years. There are many optometrists out there who medically manage glaucoma, for example, or treat eye infections of various types. It’s not simply about glasses or contacts (although I don’t think someone who spends their days really putting a lot of effort into finding the perfect refractive prescription is doing anything they should be ashamed of – it’s not always as simple as some people in this thread make it out to be.) The main difference nowadays between optometric and ophthalmologic scope is surgery, which optometrists don’t do. ---
**Author:** ![Bob55](https://avatars.discourse-cdn.com/v4/letter/b/e9c0ed/32.png) [@Bob55](https://boards.straightdope.com/u/Bob55)\ **Post date:** [March 19, 2009, 12:34am UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/67 "2009-03-19T00:34:04Z")
> [@Balthisar](#): > > 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. My wife is an optometrist. Considering optometrists spend 4 years on the eye alone, and their main goal is to get you fitted into the correct eyeglasses or contacts, you should trust them and respect their abilities. An ophthalmologist’s income is from surgery (my wife interned with one who performed 50 lasiks a day, at ~$2k each I believe), he makes peanuts on eye exams and the majority use an autorefractor to determine your prescription (a computer). This will overcorrect, and your eyes will over time get lazy. An optometrist, on the other hand, will perform an accurate examination by hand. I would go to an optometrist for eye exams, but an ophthalmologist for the hardcore stuff like massive infections, corneal ulcers, serious loss of vision, lots of flashes, etc. Both have their strengths. To answer the OP, my wife confirms what others said - you may think your prescription is correct, but generally you’ve adapted to one that is not perfect for you. They also test for various diseases that you may not notice until the damage is done. My wife caught a pituitary adenoma in a patient (small brain tumor) and very well could have saved his life. ---
**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 19, 2009, 1:54am UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/68 "2009-03-19T01:54:04Z")
**Cromulent** and **Bob55** , no disrespect was meant to the profession. Like I said, _several years_ ago. The “respect” thing isn’t intellectual; it’s gut reaction until the brain kicks in, like any other prejudice. ---
**Author:** ![NinjaChick](https://avatars.discourse-cdn.com/v4/letter/n/71c47a/32.png) [@NinjaChick](https://boards.straightdope.com/u/NinjaChick)\ **Post date:** [March 19, 2009, 4:40am UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/69 "2009-03-19T04:40:30Z")
> [@anson2995](#): > > Right, and that was my point. You can diagnose and treat yourself if you want. Caveat emptor. If you have complex vision problems, or want stuff that’s going to be on your eyeballs, you need to consult a licensed expert. > > The OP’s point is “i have a valid prescription, just give me my lenses.” I think the response is “that prescription isn’t valid forever.” Just like antibiotics. (I know I should really let this go, but oh well.) Yes, but no one is prescribed antibiotics with any sort of reasonable assumption that they will continue to need to take an antibiotic every single day for the rest of their life in order to function. No, technically I don’t need contacts specifically (in fact I’m wearing glasses right now instead), but that’s the only way my vision is getting better than 20/50 or so; glasses just don’t do it\*. I don’t expect a lifetime prescription for penicillin when I have strep throat, but that’s because the point of the drug is to cure it. Contacts are just helping out with the symptoms, which aren’t going to go away or suddenly change overnight. Someone way up-thread mentioned that glasses prescriptions tend to be different from contacts, which I know, but the prescription for glasses is a full diopter stronger in both eyes than what it should be, so I’m pretty sure that’s wrong. I’ll have to stop by the office to pick up my new contacts, so I’ll just get it sorted out then. And within a few years I hopefully will have enough dough saved up for PRK surgery, even if it means putting off grad school a bit longer, so it’ll all be completely irrelevant then. \*Bonus factor: Don’t want your glasses lenses to be a solid inch thick and have eyes like mine? That’s another forty-fifty bucks for high-index lenses. ---
**Author:** ![Turek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/turek/32/18782_2.png) [@Turek](https://boards.straightdope.com/u/Turek)\ **Post date:** [March 19, 2009, 12:29pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/70 "2009-03-19T12:29:51Z")
> [@NinjaChick](#): > > (I know I should really let this go, but oh well.) You really are tilting at windmills here. > [@](#): > > Yes, but no one is prescribed antibiotics with any sort of reasonable assumption that they will continue to need to take an antibiotic every single day for the rest of their life in order to function. No, technically I don’t need contacts specifically (in fact I’m wearing glasses right now instead), but that’s the only way my vision is getting better than 20/50 or so; glasses just don’t do it\*. I don’t expect a lifetime prescription for penicillin when I have strep throat, but that’s because the point of the drug is to cure it. Contacts are just helping out with the symptoms, which aren’t going to go away or suddenly change overnight. I take a maintenance drug every day. It relieves the symptoms of a condition I have. It doens’t cure it. Guess what? I have to go back EVERY YEAR to get my prescription renewed. Why? To make sure my condition hasn’t changed for the worse. For the doctor to prescribe the meds again without verifiying that fact would be irresponsible. ---
**Author:** ![cromulent](https://avatars.discourse-cdn.com/v4/letter/c/b4bc9f/32.png) [@cromulent](https://boards.straightdope.com/u/cromulent)\ **Post date:** [March 19, 2009, 12:40pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/71 "2009-03-19T12:40:15Z")
**Ninjachick** , my eyeglass prescription for my right eye is about a -10, and my contact lens prescription for that eye is about a -8.75. I would not assume the diopter difference means your prescription is incorrect. It may just be, as others have said, a result in the difference in distances between your eyeball and the two lens types. This can make a significant change in the prescription, particularly for high prescriptions, which it sounds as if you have. ---
**Author:** ![Solfy](https://avatars.discourse-cdn.com/v4/letter/s/848f3c/32.png) [@Solfy](https://boards.straightdope.com/u/Solfy)\ **Post date:** [March 19, 2009, 3:51pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/72 "2009-03-19T15:51:30Z")
> [@NinjaChick](#): > > (Someone way up-thread mentioned that glasses prescriptions tend to be different from contacts, which I know, but the prescription for glasses is a full diopter stronger in both eyes than what it should be, so I’m pretty sure that’s wrong. I’ll have to stop by the office to pick up my new contacts, so I’ll just get it sorted out then. The office should straighten out the confusion, but for the rest of those reading who aren’t going to the office with **NinjaChick** , it’s totally standard to have the eyeglasses prescription a full diopter stronger than the contact lens. It’s due to the differences in focal distance. Your contacts sit on your eyeball, while your glasses sit on your nose. Or, what \*\*cromulent \*\*just said. High index lenses are worth every penny.\* \*Full discosure: I work in the optical materials industry; high index lenses are one of the marvelous products that pay my mortgage. But then, so do regular lenses. More eyeglasses for everyone! ---
**Author:** ![StuffLikeThatThere](https://avatars.discourse-cdn.com/v4/letter/s/bc8723/32.png) [@StuffLikeThatThere](https://boards.straightdope.com/u/StuffLikeThatThere)\ **Post date:** [March 19, 2009, 4:18pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/73 "2009-03-19T16:18:19Z")
> [@Solfy](#): > > High index lenses are worth every penny.\* > > \*Full discosure: I work in the optical materials industry; high index lenses are one of the marvelous products that pay my mortgage. But then, so do regular lenses. More eyeglasses for everyone! I do not work in the optical industry, and I have to pay full price for high index lenses. They’re still worth every penny! ---
**Author:** ![justrob](https://avatars.discourse-cdn.com/v4/letter/j/a9adbd/32.png) [@justrob](https://boards.straightdope.com/u/justrob)\ **Post date:** [March 19, 2009, 4:42pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/74 "2009-03-19T16:42:39Z")
> [@NinjaChick](#): > > (The question popped into my mind because I just discovered that the glasses prescription he gave me is not just incomplete (lacking the pupil distance) but also completely _wrong_, correction-wise, so I’m possibly going to need to pay for another freaking exam so I can get glasses that I can actually see with.) **NinjaChick** I’ve never been to an Optometrist that didn’t have some sort of follow up visit to make sure the prescription was correct. I’ve also never had to pay for them to adjust a prescription that was off. ---
**Author:** ![dangermom](https://avatars.discourse-cdn.com/v4/letter/d/e274bd/32.png) [@dangermom](https://boards.straightdope.com/u/dangermom)\ **Post date:** [March 19, 2009, 7:29pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/75 "2009-03-19T19:29:13Z")
I love high-index lenses! My correction is about a -12 these days (down from -14) and I got a better high-index lens a little while ago. Huge difference. I’m also loving my new daily wear contacts, which I’ve never had before–they’re so much more comfortable than the last kind. I probably only wear them 4 out of 7 days a week, though. I don’t plan ever to get any optional surgery, though; I’m just waiting for the inevitable early cataracts. I expect to require too much eye surgery to elect to get any I don’t actually need. We went out to lunch with an ophthalmologist friend the other day and he was telling me about all the great new glaucoma surgeries available and stuff. It’s very handy to have a friend in ophthalmology, I advise everyone to get one.🙂 ---
**Author:** ![Solfy](https://avatars.discourse-cdn.com/v4/letter/s/848f3c/32.png) [@Solfy](https://boards.straightdope.com/u/Solfy)\ **Post date:** [March 19, 2009, 7:43pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/76 "2009-03-19T19:43:01Z")
> [@StuffLikeThatThere](#): > > I do not work in the optical industry, and I have to pay full price for high index lenses. They’re still worth every penny! Ironically, I have to pay full price for mine, too. Although I’m finally getting a free pair of _mumble mumble_ glasses from work to celebrate a recent successful product launch. It’s about time. At -8 diopters (-7 for my contacts), I will never go back to regular lenses. ---
**Author:** ![Bosstone](https://avatars.discourse-cdn.com/v4/letter/b/22d042/32.png) [@Bosstone](https://boards.straightdope.com/u/Bosstone)\ **Post date:** [March 19, 2009, 8:14pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/77 "2009-03-19T20:14:16Z")
> [@Rucksinator](#): > > [I was also told not to wear 2-week contacts for 2 months at a time (which was how 1 year’s worth of disposable contacts lasted me about 5 years), as this could make my eyes suffocate and go blind.] :eek: Did you at least take them out and wash them? It doesn’t sound like it, if there was concern about suffocation. I like disposables because cleaning’s not necessary, but I’ve only worn a 2-week pair for 3 weeks at most. Right at 2 weeks they start getting irritable, and that third week is always a major annoyance. I can’t imagine going 2 months on one pair. ---
**Author:** ![NinjaChick](https://avatars.discourse-cdn.com/v4/letter/n/71c47a/32.png) [@NinjaChick](https://boards.straightdope.com/u/NinjaChick)\ **Post date:** [March 19, 2009, 10:22pm UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/78 "2009-03-19T22:22:08Z")
I wear lenses that are supposed to be good for one or two weeks, and (taking them out at night) I wear each pair for at least two months, at the suggestion of the ophthalmologist who first got me set up. As long as they’re comfortable and you clean them properly (which requires twenty seconds a day), the only reason to swap them more frequently is to spend more money. ---
**Author:** ![dangermom](https://avatars.discourse-cdn.com/v4/letter/d/e274bd/32.png) [@dangermom](https://boards.straightdope.com/u/dangermom)\ **Post date:** [March 20, 2009, 1:56am UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/79 "2009-03-20T01:56:11Z")
I guess that depends on your sensitivity or whatnot. I had that kind before I got the daily wear ones, and my problem was that they were great the first day, but got progressively more uncomfortable as they got older. I could only wear them about half a day at a time. But I have bizarro eyes ever since I became suddenly allergic to Acuvues. That’s why I like the daily wear–they’re always new, therefore always comfortable. I can actually wear them for a whole day! ---
**Author:** ![Rucksinator](https://avatars.discourse-cdn.com/v4/letter/r/898d66/32.png) [@Rucksinator](https://boards.straightdope.com/u/Rucksinator)\ **Post date:** [March 20, 2009, 4:22am UTC](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619/80 "2009-03-20T04:22:20Z")
> [@Bosstone](#): > > :eek: > > Did you at least take them out and wash them? It doesn’t sound like it, if there was concern about suffocation. I like disposables because cleaning’s not necessary, but I’ve only worn a 2-week pair for 3 weeks at most. Right at 2 weeks they start getting irritable, and that third week is always a major annoyance. I can’t imagine going 2 months on one pair. Yes, every night. The doc (who doesn’t sell contacts) told me that up to a month or so is fine, but beyond that, they get clogged up with (?protein?), and your eyes don’t get enough oxygen, and that trying to save a few bucks can lead to blindness way down the road. I’ll let qualified professionals comment and clarify. [Previous page](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619.md?page=3) [Next page](https://boards.straightdope.com/t/why-dont-optometrists-believe-their-patients/489619.md?page=5)