Yes! It's so infuriating. I usually go to Chinatown where they will sell you contacts without an exam or prescription.
I asked my optometrist once why a prescription was necessary to buy glasses or contacts, and why prescriptions expire so quickly, and she gave me the reason offered in the article: that it forces people to be screened early for treatable eye diseases. But I can't think of any other area in healthcare where your care is held hostage unless you pay them for some unrelated diagnostics you don't want. It's hard to see it as anything other than a cynical ploy to extract money from people.
>I can't think of any other area in healthcare where your care is held hostage unless you pay them for some unrelated diagnostics you don't want.
Ha!! Many woman feel this way about birth control! It's held hostage until you get a pap smear. Yearly pap smear, mind you, evidence and recommendations to the contrary be damned. This is despite the fact that cervical cancer screenings have zero to do with safety of birth control.
Just to be clear, cervical cancer screenings are very good! Especially so when done at evidence based intervals. But birth control can be safely prescribed without it, yet many health care providers require a pap test before they prescribe birth control.
I think the recommendation from USPSTF is every 3 years. If a provider is forcing yearly examinations on you without a good reason (i.e. suspicious findings on the path report) then I would consider talking to your provider or finding a new one.
My dentist pushes a periodic "comprehensive/full panel" xray. More than the usual, and claimed the justification was in case I have jaw cancer or something serious (non tooth/gum) related problem.
I asked what about all the rest of the bones in my body?
Or to get a blood test to see what kind of blood type you are, it’s not even enough to go to a primary cRe doctor and then get a lab ordered. They will try to resist telling you! Supposedly there is “no need” for you to know that information, and you can’t simply take a blood test from a lab without a PCP ordering it. Try it!
Luckily there is a loophole when you donate blood.
Or you can do your own lab, but I wouldn’t recommend it.
My regular eye exam caught early stage glaucoma. I go to follow-up screenings yearly to track progress, but it's entirely correct to say that going to my optometrist to get my updated prescription probably saved my sight.
All that being said, I always ask for a copy of my prescription so that I have it in my wallet just in case. I've been abroad when my glasses broke and having that on-hand made getting an emergency pair of glasses very simple.
edit I get my glasses at Costco, probably $120 all-in.
In Germany they usually just give you a little credit-card-sized card with your glasses that has all the information about the lenses (and thus your prescription) on it.
I think many people don't hear this enough. Eye exams can catch things and since a lot of the people I know get a good 4~6 years out of their glasses it makes since to get an exam when replacing them. Sure, exams might cost time/money but most people just don't hear the story of going to get a new pair of glasses and being saved from xyz eye condition story enough. I live outside the USA now and to get contacts you need a recent eye exam to purchase them. I think this works out good because the country I live in has a high number of contact users and I feel it ensures better health for the great amount of those who need vision correction.
Someone who isn't me has forged eye prescriptions with Photoshop to get around this problem to buy contacts and glasses online. I don't know in how much legal trouble he could get, but I think many people can understand.
I have severe allergies that occasionally requires epinephrine... without an annual checkup doctors typically won’t give me a prescription. I’ve similarly been hospitalized for asthma, same deal with an inhaler.
I had to really hunt to find a doctor who would give me a prescription without an annual checkup.
Legally they can’t. If you have a steroidal inhaler, you’ll need to be evaluated every few months to ensure the steroids are hitting your lungs instead of blood stream.
Came here to post this same experience. I have terrible asthma and allergies that are completely controlled by the typical prescription medications that any lay person would select after a few minutes of googling, but I can only receive access to them for up to one year without going back to a doctor.
The result is I often run out at inopportune times so I try to hoard / ration medication to avoid that situation.
I can see the case for it, I mean, I don't go into a car dealership and approve or deny which parts are to be replaced or which procedures are necessary. I have no basis for knowing.
If you have a digestive disease your Dr may refuse to fill your prescription if your last colonoscopy was more than ~2 years ago. Even if you have a less serious condition.
(I'm providing another example, but I agree they shouldnt withhold care.)
Something that I don't understand (and I haven't lived in the USA to know): when you get tested for something, you don't walk away with the results? They are kept in some system that only the MD who asked for them have access ??? You are unable to give the results to some other doctor, asking for a second opinion?
In the US, lab results are nearly always sent to the doctor who prescribed the tests, not to the patient. (And most tests cannot be requested without a doctor's order.) Some doctors are good about sharing the detailed results with their patients while others are not.
You can ask your doctor to send the results to another doctor (more often you just tell the new doctor to request them from the original doc). By law you are entitled to a copy of your medical record yourself but with many doctors it is surprisingly difficult to get them to do this. I have heard of cases where it took many weeks and the threat of a lawsuit.
Ostensibly, the reason for this state of affairs is so a patient can have a professional help explain and interpret the results.
I can go online and get all of my test results including graphs that show change. X-ray reports. The only thing not online is surgical notes, but I easier got copies of them. This is from the UCLA healthcare system. Also Quest labs has online results to patients. This is in CA. My brother-in-law, could not get results from tests in Virginia to get a second opinion. Perhaps it varies by state.
I had the option of having all test results emailed to me. I had the results of my physical before my doctor did. This is a result of modern medical information systems.
> But I can't think of any other area in healthcare where your care is held hostage unless you pay them for some unrelated diagnostics you don't want.
Certain medications require regular testing (example I'm familiar with is Orkambi for Cystic Fibrosis, and regular liver screens are required due to potential side effects), and the prescribing doctor won't renew those prescriptions otherwise.
That's less true now than it used to be, but it's worth remembering that the AMA killed universal healthcare in the US... in the 1950s! They were specifically worried about doctor's wages and fees going down.
I've been wearing my "good enough" glasses about twenty years now. I know what the perfect vision feels like (I can get 20/10 easily with "right glasses") but that is just too much for me. I just can't live with that, everything is way too sharp. Glasses that give me 20/20 but no more make me feel much better. I always order online nowadays, and never have been subjected to this American "you need prescription/license (= pay) for this" way of dumbing things down.
In general, degrading quality of vision is most likely a symptom of something. Needing reading glasses when you age is the only exception, that is just normal.
The US version reminds me of the bad kind of Java.. `GetGlasses` must implement `AbstractMedicalProcedure` with mandatory `waitAroundForAppointment`, `getOpaqueBillFromShittyWebsite`, `checkIfCoveredByInsurance`. `GetGlasses.get()` takes ONLY `AbstractOfficalPrescription` as input, which of course you CANNOT construct directly from the left and right lens power - must go to an 'OptometristFactory`. Probably like 200 lines atleast.
Meanwhile everyone else is like:
#pass in left_power and right_power directly if you know them.
def get_glasses(powers=None):
if not powers:
powers = eye_exam()
(left_power, right_power) = powers
return add_frame(make_lenses(left_power,right_power)) #make_lenses takes optional args for rarer eye conditions
When I was in China I wanted to get a cheap pair of prescription glasses. So I did, in an underground subway mall. Took 30 minutes. They (definitely not an eye doctor, more of a small shop owner) used a small handheld device to measure my prescription and then told me to come back in 30 minutes after I had chosen frames. I paid $40.
Ditto. In Beijing there's a multi-story building full of stores selling glasses. I walked around until someone spoke to me in English, they used a gizmo to automatically measure my prescription. I picked out a brand name pair of frames. The salesman told me to come back in an hour.
Voila a cheap (~$40US) spare pair of glasses.
A former optometrist of mine once gave me a 5 minute lecture on how I must buy my glasses from him because he makes no money from doing exams.
Cry me a river... guess ya should have gone into dentistry.
This pseudocode reveals another truth: it can be surprisingly hard in many places to get lenses for rarer eye conditions. If you have e.g. mild astigmatism (actually extremely common!), you can expect to be persuaded to leave it uncorrected.
Yeah, that expired proper prescription wasn't for toric lenses like I (supposedly) had decades ago. That first time they didn't even tell me the lenses had to be inserted at some correct orientation, and I don't remember seeing the marking on the lens, either... though they did tell me the lenses would cost a bit more. What was the point?
> it can be surprisingly hard in many places to get lenses for rarer eye conditions.
Indeed, ZenniOptical sunglasses simply don't come in m prescription. It flat out tells me to select their regular frames and pay for the tinting. Between my astigmatism and my prism in each eye I'm fairly limited.
Or it just gets expensive. Last Friday I was curious about the new Oculus but hate how VR headsets like my friend's Vive shove my glasses into my face or just simply don't fit and looked at inserts for it, the cheapest I could find from the companies that manufacturer the lenses were 98$ per eye.
It is even worse with strong astigmatism. I have over 3 diopter according to multiple wavefront aberrometer and photokeratoscopy measurements, but the opticians always want to put a 2.5 or even 1.5 cylinder, because they do not believe it can get that high.
I have it, recently got glasses and it annoys me that in my peripheral vision and while moving things get a little distorted. Glasses without astigmatism correction seem like a valid choice.
Oh, it's worse than that. With an app and a phone with a high-res screen, a simple device[1] (BOM of a few dollars) could give you spherical and cylindrical numbers. Nice for the developing world and, err, other nations with impaired health care systems.
Of course, MIT patented it, and SV made it into low-order-hundred dollar devices, with mandatory annual per-person subscriptions, but oh well. Looks like there's a current indiegogo, fwiw.[2] Amazon reviews are mixed. At least it's apparently no longer necessary in the US to pretend it's not used to get glasses - yay progress.
French Ophthalmologist here. The part that describes how easy it is to obtain glasses without a doctor's prescription is totally false. People do need a prescription made less than 3 years ago (and optometrists do not exist here, you have to go to the doctor).
As an ophthalmologist, I may not be objective on this subject; however I can confirm that I find everyday health problems in people that "just want a prescription". This can be a simple cataract, as well as a diabetic retinopathy or a glaucoma.
I especially remember a 50 years old woman who had the habit to go to an optician, have her refraction measured, go to her family doctor and ask for the according prescription (with no eye exam).
After 10 years without seeing a doctor, I diagnosed her with an advanced glaucoma. She was almost blind.
Glaucome is the worst disease: totally asymptomatic and irreversible.
Checking your eyes at least every 3 years after 40 is usually a good idea.
You need a prescription only if you want the social security/insurances to pay for the the glasses.
If you pay for them yourself, there is no need.
Additionally, many opticians consider themselves and act as optometrists.
The thing I really hate is that even if you do get a prescription, most optometrists will try to leave out the inter-pupillary distance. This area is mostly governed by state law, not federal, and in my state they're explicitly required to provide that information upon request. I've always had to remind them of this fact before they'll comply. Then, the form on which they provide the prescription - unlike the one they use themselves - usually doesn't even have the space for that information. It ends up being written in the margin, usually unlabeled as one last act of defiance.
It has always seemed rather scummy. That's why I've been buying glasses online for several years, tweaking it a bit based on actual all-day wearing experience each time because a measurement taken at any one time of day is sure to be wrong at another. So it's better as well as cheaper. Just need to find a site that doesn't play the optometrists'game, because some do and some don't.
Americans can order contact lenses from abroad without a prescription, legally. I have purchased from the UK for about half the cost, with international shipping, compared to what any U.S. based seller wanted. Not to mention less hassle.
I do think it makes sense to get a checkup every few years, but the 1 or two year prescriptions optometrists want are absurd.
I work for a PE backed roll up in this space. And have some broad healthcare background. Margins are healthy, but the store fronts easily close without the product margins. That’s why the hard push to buy in store. It’s called capture rate in the industry.
In the US, much of the healthcare regulation like this has been to ensure widespread access to care. In this case, by an optometrist not an optician. Remember, historically and maybe even today, we’re a pretty rural and sparsely populated country and the government is giving doctors a reason to open stores in every tiny town. Not saying I agree, just that is what is at play. If reverse this, access will be reduced significantly and US regulators have track record of not liking actions that reduce access.
It's ridiculous. I've bought my contacts online from the UK for years now due to this. I know my prescription and I know it works perfectly. Just let me buy the damn contacts! Vision Direct is the company, and they always send candy along with. :)
Anyways, my "vision insurance" actually covers a certain $ amount yearly towards contacts, so I send them the receipt (in pounds) and they actually cut me a check. Same contacts brand and model I'd get in the USA.
I calculated it and using the insurance does indeed cost me less overall than buying the contacts straight. It's essentially just a discount program that hopes people will forget to use it.
The VA will give me eye exams and glasses but it's the only service I don't use because the lines are so long and the waiting area is so crowded. My wife and I go to Costco for the exam and glasses. If I remember right the last pair came to about 110 dollars, exam included. Only drawback is it takes about a week to get them.
Readit News
I asked my optometrist once why a prescription was necessary to buy glasses or contacts, and why prescriptions expire so quickly, and she gave me the reason offered in the article: that it forces people to be screened early for treatable eye diseases. But I can't think of any other area in healthcare where your care is held hostage unless you pay them for some unrelated diagnostics you don't want. It's hard to see it as anything other than a cynical ploy to extract money from people.
Ha!! Many woman feel this way about birth control! It's held hostage until you get a pap smear. Yearly pap smear, mind you, evidence and recommendations to the contrary be damned. This is despite the fact that cervical cancer screenings have zero to do with safety of birth control.
Just to be clear, cervical cancer screenings are very good! Especially so when done at evidence based intervals. But birth control can be safely prescribed without it, yet many health care providers require a pap test before they prescribe birth control.
edit: Here is a link to the recommendation https://www.uspreventiveservicestaskforce.org/Page/Document/...
Dead Comment
Happens to women too for birth control.
I asked what about all the rest of the bones in my body?
I skipped it.
Luckily there is a loophole when you donate blood.
Or you can do your own lab, but I wouldn’t recommend it.
All that being said, I always ask for a copy of my prescription so that I have it in my wallet just in case. I've been abroad when my glasses broke and having that on-hand made getting an emergency pair of glasses very simple.
edit I get my glasses at Costco, probably $120 all-in.
I’ve been using the same prescription for about 6 years, it may be about time to see an optometrist and get my eyes checked out...
I had to really hunt to find a doctor who would give me a prescription without an annual checkup.
The result is I often run out at inopportune times so I try to hoard / ration medication to avoid that situation.
https://en.m.wikipedia.org/wiki/Medical_paternalism
(I'm providing another example, but I agree they shouldnt withhold care.)
In the US, lab results are nearly always sent to the doctor who prescribed the tests, not to the patient. (And most tests cannot be requested without a doctor's order.) Some doctors are good about sharing the detailed results with their patients while others are not.
You can ask your doctor to send the results to another doctor (more often you just tell the new doctor to request them from the original doc). By law you are entitled to a copy of your medical record yourself but with many doctors it is surprisingly difficult to get them to do this. I have heard of cases where it took many weeks and the threat of a lawsuit.
Ostensibly, the reason for this state of affairs is so a patient can have a professional help explain and interpret the results.
Certain medications require regular testing (example I'm familiar with is Orkambi for Cystic Fibrosis, and regular liver screens are required due to potential side effects), and the prescribing doctor won't renew those prescriptions otherwise.
Often they will say "it's for your own good".
In reality, it's just a cartel, extremely protected by government regulation.
For some reason, people think that the rules of economics don't apply when it comes to healthcare.
In general, degrading quality of vision is most likely a symptom of something. Needing reading glasses when you age is the only exception, that is just normal.
If you mean 'come with a written expiration date,' then mine never have and I would find this practice abhorrent.
If you mean 'really is no good in six months,' then your eyes are actually changing.
Meanwhile everyone else is like:
Voila a cheap (~$40US) spare pair of glasses.
A former optometrist of mine once gave me a 5 minute lecture on how I must buy my glasses from him because he makes no money from doing exams.
Cry me a river... guess ya should have gone into dentistry.
Never had anyone trying to convince me to leave it uncorrected.
Indeed, ZenniOptical sunglasses simply don't come in m prescription. It flat out tells me to select their regular frames and pay for the tinting. Between my astigmatism and my prism in each eye I'm fairly limited.
Or it just gets expensive. Last Friday I was curious about the new Oculus but hate how VR headsets like my friend's Vive shove my glasses into my face or just simply don't fit and looked at inserts for it, the cheapest I could find from the companies that manufacturer the lenses were 98$ per eye.
I have it, recently got glasses and it annoys me that in my peripheral vision and while moving things get a little distorted. Glasses without astigmatism correction seem like a valid choice.
Deleted Comment
Of course, MIT patented it, and SV made it into low-order-hundred dollar devices, with mandatory annual per-person subscriptions, but oh well. Looks like there's a current indiegogo, fwiw.[2] Amazon reviews are mixed. At least it's apparently no longer necessary in the US to pretend it's not used to get glasses - yay progress.
An optical trial lens set is another option.[3]
[1] https://www.eyeque.com/pvt/ [2] https://www.indiegogo.com/projects/smartphone-vision-tests-o... [3] https://www.amazon.com/s?k=optical+trial+lens+set
The dangers associated with not being able properly come to mind.
It has always seemed rather scummy. That's why I've been buying glasses online for several years, tweaking it a bit based on actual all-day wearing experience each time because a measurement taken at any one time of day is sure to be wrong at another. So it's better as well as cheaper. Just need to find a site that doesn't play the optometrists'game, because some do and some don't.
I do think it makes sense to get a checkup every few years, but the 1 or two year prescriptions optometrists want are absurd.
In the US, much of the healthcare regulation like this has been to ensure widespread access to care. In this case, by an optometrist not an optician. Remember, historically and maybe even today, we’re a pretty rural and sparsely populated country and the government is giving doctors a reason to open stores in every tiny town. Not saying I agree, just that is what is at play. If reverse this, access will be reduced significantly and US regulators have track record of not liking actions that reduce access.
Dead Comment
Anyways, my "vision insurance" actually covers a certain $ amount yearly towards contacts, so I send them the receipt (in pounds) and they actually cut me a check. Same contacts brand and model I'd get in the USA.
I calculated it and using the insurance does indeed cost me less overall than buying the contacts straight. It's essentially just a discount program that hopes people will forget to use it.