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The following page has been changed by jonebreak: http://wiki.apache.org/httpd/jonebreak New page: 1. "I use my eye chart as a crutch." Many optometrists (who provide primary eye care) and ophthalmologists (M.D.s who can perform surgery) are adapting shrewder business tactics to keep costs down and patient traffic brisk. For instance: Walk into any eye doctor's office and you're likely to see the trademark pyramid of letters that's at the heart of every eye exam. But some doctors use the eye chart as the main â or worse, only â component of an eye exam. Everyone raises their hand. But vision is more than reading the 20/20 line. It shouldn't be confused with healthy eyes. A full checkup should include a glaucoma test, a check for near vision (in which you look at a target within reading distance) and dilation of the pupil, so that the doctor can look at the back of the eye to detect cataracts or age-related diseases. 2. "Glasses are my cash cowâ¦" Since optometrists and ophthalmologists rarely hand over eyeglass prescriptions without prompting, most people don't know that federal regulation requires eye doctors to release them so that patients can comparison-shop for glasses. And why would they? In order to offset the high overhead of managing a practice, doctors and optical retailers may jack up the prices of glasses they sell from 50% to 80%, estimates Harold Koller, an ophthalmologist in Meadowbrook, Pa. "Some of my friends say the annual profit of having a dispenser in their office is between $25,000 and $50,000. 3. "â¦and contact-lens discounters are my enemy." Contact lenses are another area where you can save a lot of money, given the chance. Mail-order distributors, discount chains and online retailers offer discounts of about 20%. And while some doctors will hand over the prescription if you ask, many don't have to: There is no federal law requiring doctors to release contact-lens prescriptions. In this case, the concern isn't completely about profits. [url="http://www.eye4care.com/blog"]Contact lenses[/url] can be more problematic â poorly fitting or irritating â for patients than glasses; once a doctor hands over that paper, he loses not only a potential sale, but also control, says Peter Ferguson, a spokesman for the New York State Board for Optometry. "What if something goes wrong? Could this somehow be turned around [to blame the doctor] if the contacts are defective?" 4. "Your kid may not even need glasses." In school yards across the country, "four eyes" is no longer an insult. Glasses are hot, and eye doctors are ready to cash in on the trend. According to Koller, outgoing chairman of the American Academy of Pediatrics' section on ophthalmology, children are more likely than adults to want glasses they don't need because "the people they idolize often wear glasses." (Blame that Potter kid.) But kids' glasses can run upwards of $300. 5. "I blur the truth about laser surgery." Lasik â the procedure that uses a laser to correct vision by reshaping the cornea â is all the rage with patients and ophthalmologists alike, and it's easy to see why. In the 15 minutes it takes your doctor to zap a laser in both of your eyes, he earns enough to buy a ticket to Honolulu. According to John Pinto, president of an ophthalmic management-consulting firm in San Diego, the typical Lasik practice earns a 30% margin on a procedure that costs the consumer, on average, $1,200 per eye. Furthermore, he says, in any given market of 1 million people, there will typically be about five doctors dividing up an annual $8 million pie. 6. "I learned Lasik in four days." Is four days enough time to learn how to operate on a patient's eyes? At least one Lasik course director thinks so. The following advertisement was found on EyeWorld.org, an online publication for ophthalmologists: "SUMMER SPECIAL!! Obtain Lasik skills in a four-day, complete training course and avoid the awful 'learning curve.'" Gabriel Child, director of the course in question, The Real Lasik Course, defends his program by saying that he has found no significant difference in complications between the procedures performed by newbies and those done by the teaching ophthalmologists. 7. "Surgery's wrong for you? Don't expect me to stop you." To Erik Petersen, a 25-year-old artist from Prescott, Ariz., laser surgery seemed like the perfect solution: He had never liked glasses, and his persistent dry eyes made it hard to wear contacts. Surgery, however, did little to fix his vision. As the doctor worked on his left eye, Petersen felt a sharp pain "that freaked me out" so much that the doctor couldn't operate on the other eye. It was a blessing in disguise. With his left eye, he now sees massive halos over objects, and every morning it "feels like it's glued shut." And since his vision in each eye is now so different, contacts are his only option. Other patients who should think twice about Lasik: anyone who's had a herpes infection, a lazy eye, or severe myopia or astigmatism. 8. "Sterile equipment? Nope. But hey, we washed it." Peter Brett, a 42-year-old oncologist in California, was horrified back in 2001 when he read an article from the San Francisco Chronicle about the eye center where he and his wife had both had laser surgery; supposedly, instead of sterilizing the surgical microkeratome blades, the clinic rinsed and reused them. Brett was so concerned that he and his wife were tested for Hepatitis B and C, as well as HIV. (All tests were negative.) In a settlement to an investigation brought by the Medical Board of California, the doctors in question admitted that the protocol was to rinse and reuse a blade on up to four eyes; the board concluded that the doctors departed from the standard of care and placed them on probation. 9. "Open your eyes and I'll be gone." Ever heard of "co-management"? It's a controversial trend in eye care in which an eye surgeon can share postoperative checkups with an optometrist â who, in turn, gets a cut of the surgery fee. This arrangement sometimes makes sense for patients, especially those who live in rural areas and have had surgery far from home. But it can also be disastrous, since the risk of complications â bleeding, infection or retinal detachment â are much greater in the first 10 days after surgery, says Alan Mendelsohn, president of Florida's Broward County Medical Association. "There's no other specialty in medicine," he says, "where a surgeon doesn't see his patients postoperatively." 10. "You're a guinea pig." Eye care is one of the most rapidly advancing areas of science, and the benefits to patients can be life-changing. In fact, it's quite easy to find an eye doctor conducting a clinical trial of some new, experimental treatment. Devices that aren't approved by the FDA for any use, however, require informed consent from all patients. Unfortunately, when it comes to fully understanding the risks, patients are often in the dark. ---- CategoryCategory
