Eye docs and optical professionals are constantly struggling with competitive online contact lens sales. Refusing to give Rx’s for contact lenses can make a patient frustrated, confused and a little angry as well it might be against the law: I recently read From The Student Doctor Forum, not to say it’s against the law not to give the Rx and they were questioning the optometrist.
Hey all,
I need some advice/opinion on my experience with an optometrist today. I am a resident in a different field so thought I would ask you guys.
So I went in for a routine eye exam and needed new glasses and contacts because my vision has slightly worsened since my last exam. The optometrist gave me the prescription for my glasses but then refused to give me a prescription for my contacts. Basically she gave me a pair of contacts from a particular brand and said i would have to follow up with her in 1-2 weeks to decide whether I want that brand and if her exam of my eyes would indicate it would be safe for me to use them. Only then would she give me a prescription for contacts for that brand. If I do not like those contacts, I would have to try another brand and follow up with her again.
Is this routine practice or am I missing something? I thought we were supposed to get our contact prescription and we can choose what brand we want to buy from. Also if I did get a contact prescription from her for the brand that I tried, can I use it to get the contacts from a different brand instead or are prescriptions written for a specific brand. Please help!
This is probably not the only patient that is confused about contact lens scripts and types. From what I read- The doctor or staff did not adequately explain contact lens types and prescriptions to the patient to their satisfaction. The doctor did not tell the patient hey, here is your RX, and you have a choice to get whatever type of contact lens you prefer. They may or may not fit, they may or may not be the best for your eye health, they may work the best for you, but it is your choice to come back to get the best possible contact lens for your prescription and the safety and health of your eyes.
I went to Optiboard and asked them how they handle patient Rx Requests:
- There is a difference not only between the Acuvue Advance and Acuvue Oasys, but between the Oasys and Air Optix. Basic measurements, such as base curve, diameter, thickness, and power parameters can differ. The actual material composition including wetting agents are different. What feels good and works well for the the 10 minutes in the office may not continue to do well a week out. The combination with patient/lens/solution could cause comfort issues in a few days due to high amount of protein deposits, etc.
- Its quite possible that even though your old lenses felt fine to you, the doctor saw some internal signs of irritation or overwear.. thus the desire to see if a different combination might be better.
- This is all part of the reason why there are extra fees involved with contact lenses. It isn’t simply tossing a dart at a brand and handing them out. There is some art and science to it, and extra steps above a routine exam. How come no one ever questions a follow up to see if a medication is doing its job, but do in regards to contact lenses? *sigh*
- I understand that your vision changed, and that you need spectacle and contact lenses, updated to your new power. What was the reason for changing to a different lens type/brand? Was it because of power limitations, lens discontinuation, pending presbyopia, overwear, oxygen deprivation , tear exchange, occupational needs, complaint about existing contact lens????? All of the factors listed above could be a reason for a refitting.
- All brands do not fit the same, just like a small T-shirt in one brand doesn’t fit the same as another brand, nor do they behave the same in your eye or environment as your present contacts(brand) do. I feel that there is some things left out of your observations about what transpired, or you didn’t like what you heard at your exam, or didn’t listen, or didn’t ask enough questions.
- Since the brand is part of the prescription, it is illegal for a contact lens seller to deliver anything other than the written product. Contact lens manufacturers and contact lens sellers lead patients into believing that they have the definitive choice in selecting their contact brands, but this is untrue. When you see an ad for Acuvue contacts, it is identical to what you experience when you see an ad for Vasotec. If you get a prescription for heart medication, you cannot use it to get a different heart medication. Contacts are no different.
- When the doctor writes or signs the space on the Rx that says “Brand necessary”, only the exact brand is acceptable. If the doctor signs without specifying “Brand Necessary”, a substitution is acceptable when the generic and the brand item are substantively identical. There are some rebranded contacts that are identical to those available as a name brand product and these may be substituted for the like item. It is not acceptable to substitute a lens that is not identical. For example: a patient may not purchase Acuvue lenses on a Soflens prescription. Does that make better sense?
I hope you got some ideas on how other eyecare professionals are dealing with patient requests for CL prescriptions
Resources
Federal Trade Commission- The Contact Lens Rule: a Guide For Prescribers and Sellers
Texas Department of State Health Services- Contact Lens Dispensing
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Great info, thanks