I got this letter from another doctor about a patient I referred

[wizer]

Names of others changed to protect privacy.


Read it fast...no, FASTER!

Hi Steve,
 
I recently examined Eric Jones for VT and I faxed you a report about him.  He is not a clear cut case so I would prefer him to have a ct scan.  I faxed a raport to his pediatritian to see what they think.
thank you for your referrals

Nancy
 
The first read through I thought she wrote "he is not a clear nut case".

Anyone else see it that way too?

Just curious.

[GoodWitch]

Not me, sorry. I didn't see it that way. But I can see where someone could!

[theWiz]

Maybe some new reading glasses?

Just a thought.   8)

[wizer]

Maybe some new reading glasses?

Just a thought.   8)

I DO need reading glasses. I gotta get over to my buddy whose an eye doc too. He gave me my last eye exam, it's been a couple of years. I think it's bifocal time. It's possible to examine yourself but not the best way to go.

[GoodWitch]

I DO need reading glasses. I gotta get over to my buddy whose an eye doc too. He gave me my last eye exam, it's been a couple of years. I think it's bifocal time. It's possible to examine yourself but not the best way to go.

My glasses are progressive bifocals. I read better without them! (I'm very, very nearsighted.) My right eye is shot from the surgery, but with my left, unaided, I can see incredibly well up close. The focal point is further away than it used to be, though! I estimate it's about 8" now - used to be about 4".

[wizer]

My glasses are progressive bifocals. I read better without them! (I'm very, very nearsighted.) My right eye is shot from the surgery, but with my left, unaided, I can see incredibly well up close. The focal point is further away than it used to be, though! I estimate it's about 8" now - used to be about 4".

"Progressive Bifocals"

That's an oxymoron..because Bi-means "two", as in "two focal points". Progressives have an infinite number of focal points.

The dioptric value of your Rx in meters is the recipricol of the focal distance in meters.

For example a myope (nearsighted person) with a contact lens Rx of -2.00, has a clear focal point 1/2 meter (or about a foot and a half) from their eyes.

What surgery?

[GoodWitch]

"Progressive Bifocals"

That's an oxymoron..because Bi-means "two", as in "two focal points". Progressives have an infinite number of focal points.

The dioptric value of your Rx in meters is the recipricol of the focal distance in meters.
For example a myope (nearsighted person) with a contact lens Rx of -2.00, has a clear focal point 1/2 meter (or about a foot and a half) from their eyes.

What surgery?

LOL I don't quite get that. "Progressive" just means there's no visible line of demarcation - so someone looking at me won't be able to tell they're bifocals. My aunt wears progressive tri-focals - now THAT would really drive me nuts!

Surgery - Trabeculectomy, 1994.

[wizer]

LOL I don't quite get that. "Progressive" just means there's no visible line of demarcation - so someone looking at me won't be able to tell they're bifocals. My aunt wears progressive tri-focals - now THAT would really drive me nuts!

Surgery - Trabeculectomy, 1994.

Nope.

Progressives...have a gradual change in power between the distance part of the prescription at the top of the lens, and the maximum reading prescription towards the bottom. It's like a ramp, with the power changing gradually, with no distinct gradations.

Bifocals...have only two distinct focal points, usually distance and reading, but they can also be "intermediate distance" on the top, and reading on the bottom. They usually have a distinct line which is the demarcation between the two lenses, and usually are shaped like a tear drop; but there are a few other types, less commonly used. There are also "blended" or "round" bifocals with no line or a nearly invisible line, but they are still bifocals with two, and only two, zones of vision.

Trifocals, have 3 distinct lenses, far, middle, and close, and have 2 lines in the lenses that are clearly visible.

There is no such thing as a "progressive trifocal lens".

There is no such thing as a progressive with only two focal points.


Your surgery..it messed up your eye? Or the glaucoma messed up your vision and the surgery was unable to prevent it? That's more likely..if the surgery screwed up your eyes...that's not only unusual but you might have a strong case for a lawsuit there. Just say'en.

[GoodWitch]

Nope.

Progressives...have a gradual change in power between the distance part of the prescription at the top of the lens, and the maximum reading prescription towards the bottom. It's like a ramp, with the power changing gradually, with no distinct gradations.

Bifocals...have only two distinct focal points, usually distance and reading, but they can also be "intermediate distance" on the top, and reading on the bottom. They usually have a distinct line which is the demarcation between the two lenses, and usually are shaped like a tear drop; but there are a few other types, less commonly used. There are also "blended" or "round" bifocals with no line or a nearly invisible line, but they are still bifocals with two, and only two, zones of vision.

Trifocals, have 3 distinct lenses, far, middle, and close, and have 2 lines in the lenses that are clearly visible.

There is no such thing as a "progressive trifocal lens".

There is no such thing as a progressive with only two focal points.


Your surgery..it messed up your eye? Or the glaucoma messed up your vision and the surgery was unable to prevent it? That's more likely..if the surgery screwed up your eyes...that's not only unusual but you might have a strong case for a lawsuit there. Just say'en.

The surgery lowered the pressure - which was the point of it - so "technically" it was successful. But I haven't seen very clearly with that eye since, I have all kinds of problems driving in the dark because of refractions from headlights, and it always hurts a little. I signed something saying all that and much, much more "could" happen.

[theWiz]

I've been in progressives for ten or twelve years and never been happier.  My optometrist said I'd need a few days to adjust to them (after bifocals) but it was more like thirty minutes.  I've got focal lengths everywhere...one for the gauges in the car, one for the computer, one for reading, etc. 

If I had lots of money though, I'd put a window at the very top with NO correction, for very close work or some mechanical stuff on cars.  Inside of 8 inches my vision is perfect...

[wizer]

I've been in progressives for ten or twelve years and never been happier.  My optometrist said I'd need a few days to adjust to them (after bifocals) but it was more like thirty minutes.  I've got focal lengths everywhere...one for the gauges in the car, one for the computer, one for reading, etc. 

If I had lots of money though, I'd put a window at the very top with NO correction, for very close work or some mechanical stuff on cars.  Inside of 8 inches my vision is perfect...

Most people need a few days to adjust to progressives...for some, it can take longer..2 weeks, even a month or more. Some, never adjust, even with changes to deeper frames (to allow more room for the transition), and different brands. Some brands work better for certain individuals than others- there are "hard" and "soft" designs...the hard design has distinct transitions between the usable and nonusable parts of the lens..and the soft designs have more gradual transitions...however the "hard" types have more usable area. There are other differences as well. The newest progressives, known as "digital" progressives are "supposed" to have more usable area. The sales reps swear by it, of course. I'm not sure that they are all that much better. It's what the patients say that really matters.

Some people get their new progressives and it just "clicks". The adjustment is instant. That's what happened with you, and that's a good thing. There ARE progressives with a different rx in the top, for airline pilots for example..who need to see close up above their heads. Like you suggested, they aren't cheap.

[wizer]

The surgery lowered the pressure - which was the point of it - so "technically" it was successful. But I haven't seen very clearly with that eye since, I have all kinds of problems driving in the dark because of refractions from headlights, and it always hurts a little. I signed something saying all that and much, much more "could" happen.

You signed a waiver...saying that you agreed that all these horrible things could happen and the surgeon isn't responsible. Yeah, even with LASIK there are waivers. With ANY surgery there are waivers. It still doesn't excuse the surgeon from incompetence that results in injury to the patient. I'm NOT saying that's what happened with you.

[GoodWitch]

Wizer - I'm using the word "progressive" to indicate that there is no visible line of demarcation in the lens. That is how it was sold to me. In any event, the bifocal part makes things a little clearer up close but not nearly enough to be what I'd call "good". My distance prescription, I'm certain, is still the same. I have problems during exams since the machines used indicate no astigmatism in the right (operated on) eye, yet is is indeed there. I have to make the Dr. let me read the eye chart with my existing glasses and it I can read down far enough, LEAVE IT ALONE. I had one guy give me glasses with a weaker prescription in that eye and I couldn't see a damn thing. Pain in the neck.

[wizer]

Wizer - I'm using the word "progressive" to indicate that there is no visible line of demarcation in the lens. That is how it was sold to me. In any event, the bifocal part makes things a little clearer up close but not nearly enough to be what I'd call "good". My distance prescription, I'm certain, is still the same. I have problems during exams since the machines used indicate no astigmatism in the right (operated on) eye, yet is is indeed there. I have to make the Dr. let me read the eye chart with my existing glasses and it I can read down far enough, LEAVE IT ALONE. I had one guy give me glasses with a weaker prescription in that eye and I couldn't see a damn thing. Pain in the neck.

That's the difference between a good, thorough, eye exam performed by a competent eye doctor that is prepared for the unexpected, vs your routine run of the mill, flip the lenses back and forth and blindly come up with an
rx for the patient, doing it the same way for every patient regardless of their history. I see patients like this all the time.

Your the type of patient that "separates the men from the boys".

In Greece, they use a crowbar to separate the men from the boys, but thats another story.

[GoodWitch]

That's the difference between a good, thorough, eye exam performed by a competent eye doctor that is prepared for the unexpected, vs your routine run of the mill, flip the lenses back and forth and blindly come up with an
rx for the patient, doing it the same way for every patient regardless of their history. I see patients like this all the time.

Your the type of patient that "separates the men from the boys".

In Greece, they use a crowbar to separate the men from the boys, but thats another story.

LOL


Edited to add: I drive doctors crazy because I usually have a pretty good idea of what's going on, and I ask lots of questions. Particularly with mammograms, ultrasounds, and that sort of thing.