That, and they’re doctors, and they have a measure of responsibility for the health of their patients. They can’t trust that your vision is perfect, that your prescription doesn’t need a bit of tweaking. They can’t know that what you consider “fine” isn’t what someone else may not be happy with. They can’t know that you don’t have a problem that should prevent you from using contact lenses, or necessitate a switch of brand/type.
You said you’re “fine” and you want him to put his signature on a prescription for you. The doctor owns the prescription pad, and is responsible for everything that gets written on it. Doctors who pass out prescriptions without examining the patient aren’t well thought of, and for good reason.
Maybe contacts shouldn’t be prescription only for refills, but until that’s changed, the doctor has to do his job before prescribing them.
Some years ago I was waiting to have my eyesight checked in DC and I was asked to translate for a Mexican who spoke no English. The Optometrist said “tell him this is an emergency and he needs to get to an emergency room right away; take a cab directly from here; no delay” but the patient was incredulous saying he felt OK. The optometrist insisted forcefully several times but I have the feeling the patient did not want to or could not afford to spend money and just went home. I forget what it was exactly but it may have been a detached retina.
As noted above, and confirmed recently by my own frustrating experience, no one will fill a two-year-old prescription. Now, I’m not discounting the possibility of a conspiracy; I have little doubt that someone, somewhere along the way of making that policy, found a way to conflict their interests, but there it is until someone changes it.
Things you were told when you were a kid should always be assumed to be exaggerated, oversimplified or just plain wrong. It’s foolish to take them at face value when you’re an adult.
Every year for the past…27 years, I’d say, my eyes get a little worse, and I’m only 27. They definitely don’t level out, at least in my case, but if I were asked to judge for myself I wouldn’t think otherwise.
I normally get my eye exam in November, but I procrastinated last time until February when my supply of contacts ran out. I could see just fine and I tried to order another box of contacts at my old prescription, telling myself I’d get my eye exam in another couple of weeks, but they wouldn’t sell without a new scrip. So I got the exam and not only did my farsightedness get worse, needing a stronger scrip, but where before my eyes needed the same power lenses, now my right eye is weaker than my left. I got contacts under the new scrip, and it’s much, much sharper than before. Your eyes can compensate for under or overpowered lenses to a certain extent, but it’s not really healthy in the long term.
Similarly, they can indirectly identify diabetes, which is deleterious to ocular vessels before pretty much anything else.
ETA: Diagnosed diabetics have more frequent exams; IIRC my brother is required to be certified by both his medical doctor and his optometrist when renewing his driving license annually.
Up until relatively recently (mid 90’s, I believe) an optometrist was under no obligation to write a prescription good for even a year, nor release that prescription to you. So, it could be worse, but I also wholeheartedly agree that it seems like someone found the best way to line everyone’s pockets.
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?
In addition to verifying your current prescription (or writing you a new one), as already mentioned an eye exam can detect glaucoma or diabetes before overt symptoms come to the attention of the patient. There are various other conditions that can be found on exam, such as retinal cancer (which would be odd in someone your age, but not unprecedented). Also, it is my understanding that contact lens wearers can suffer from changes to the eyeball itself from poor-fitting or unclean lenses ranging from lesions to undiagnosed infections. Perhaps you have never been so unfortunate, but not everyone is so fortunate and the doctor doesn’t know you as a personal friend or relative so he has to treat you just like everyone else.
In other words, you need to have someone look at your eyes on a regular basis.
Prescriptions for non-controlled drugs are only valid for a year. Contact lens prescriptions are good for a year, depending on state. Eyeglass prescriptions can be valid for anything from 2 years to for ever, depending on your state.
Listen to sailor people. My wife had a detached retina, and it took three operations to fix it - almost. This is serious stuff, and doctors know it. If you start to see flashes, or if it seems like a black sheet is coming down over one eye, get to a doctor right away and don’t take no for an answer. Before the retina detached completely my wife let the specialists office she was referred to give her an appointment a month in the future, which turned out to be too late. When I started to see sparkles a year ago, I told the scheduler that I was going to see the doctor that day. When I reminded him or what happened to my wife, he agreed. (It turned out my sparkles were a normal part of aging.)
Rant off. Bottom line, you really don’t want to mess with your eyes.
My brother started glaucoma in his 20’s. My vision changed by 2 diopters in my 20’s (and now it’s changing back, as I get a little older). Also, I always make sure to get a thorough examination of my retinas done, since I fully expect mine to fall apart one of these days. Nowadays, they even can zap weak spots and prevent problems! (This is amazing to me–when my dad’s retinas detached in about 1982, he spent 6 months in bed, in the dark, and considered himself very lucky not to be blind.)
Patients often don’t notice when their eyesight is changing for the worse, even to a considerable extent. It’s not because they’re stupid, by the way. Going from 20/15 to 20/30 in one fell swoop is immediately noticeable, but having it happen gradually over a period of months is not. Similarly, narrowing of your field of view through a disease process such as glaucoma can happen so gradually as to be unnoticeable. There’s a reason why patients have to go through visual field exams, and aren’t simply asked “So, having tunnel vision?”
Even things you’d think were fairly obvious – such as significant central visual field deficits – can go unnoticed for a long time, simply because patients don’t close one eye and compare the view to the other, and you generally won’t detect monocular blind spots so long as visual information is available to the fellow eye. Consider that right now, with both eyes open, you’re certainly not aware of the significant blind spot created in the region of your retina where the optic nerve exits the eye.
(Is it crazy for me to be a little offended by all the “your doctor wants to buy a boat” comments? Maybe I’ll suddenly get incredibly greedy after I graduate, but most optometrists I’ve met, and certainly my professors, want what’s best for their patients, not simply to line their pockets.)
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?
Let’s not forget this. Putting a contact lens in your eye disrupts the corneal environment. Without monitoring, you could develop any number of eye problems. Keratoconus is controllable to some degree…if you’re in treatment for it. As mentioned above, glaucoma will sneak up on you too. Many problems are perfectly treatable when caught in progress. But many will be out of control before symptoms present.
I work for an ophthalmology practice which also employs optometrists. After 20 years in this business, I can honestly say that I wouldn’t waste my time with a doctor who wrote a contact lens prescription with more than a year before expiration. I also don’t trust doctors who don’t dilate your eyes. I can’t inspect my own retinas or optic nerves and whatnot. I want to know all my eye-guts are in great shape before I go covering them with a little piece of foreign matter.
A few years ago, a friend of mine found out via a routine eye exam that she has MS. There really IS more to an eye exam than just seeing clearly.
At our office, I am also responsible for the “training” of new contact lens wearers. I have a 2-page packet which I wrote and had cleared by a corneal specialist. Every new wearer gets this packet, and signs for it. Fewer than half of all people wearing contacts are taking proper care of them, and often, it’s because they were never taught how to do simple things, like rub them clean after every wearing period. I refuse to “go easy” on someone. I want every single one of my patients to be well-informed. Whether they choose to use what I teach them is debatable, but at least I send them out with solid information. I can’t believe what people will do to their eyes. blech!
