Tuesday, November 15, 2016

Coke Bottle Glasses

People are obsessed with this! I get 2 questions a day about them. "THESE GLASSES WON'T BE COKE BOTTLE WILL THEY?" No, they won't. Let's talk about coke bottle glasses: They pretty much don't exist in 2016. Yes, I'm serious. Everyone knows that the "worse" your prescription is, the "thicker" the lenses are. That's true, but it was a much bigger problem in prior generations when lens materials were limited to crown glass and CR-39. More recent materials, the use of flatter base curves and better frame fitting and lens edging equipment have made this much less of a problem. There are other factors as well: most high myopes are in contact lenses now, when they weren't prior to about the late 80's, so a bunch of the people who were wearing "coke bottles" before...aren't now. They're in contacts instead. Also, only high prescriptions were ever thick. I get people with literally a -2.00 Rx asking me if their glasses will be "thick". No! You'll never, ever be thick. The people with coke bottle glasses (the ones with high Rx's) started out very early. You can't get there from the lighter -2.00 Rx's. Going from -2.00 to -2.25 (or -2.50 or -2.75 or -3.00 etc etc etc) will never be "coke bottles". You need to get into the -8.00 range before we're talking notable lens thickness, and again most of those are wearing contacts anyway. Plus with the frame styles that are popular right now, any lens thickness not taken care of by high index lens material is usually hidden by the plastic frame. Basically you all are worrying about nothing! Almost nobody leaves our office with "coke bottle glasses" haha so you can rest easy!

Tuesday, November 1, 2016

The Case of the New Diabetic

Here's something I get every few months, and I got one yesterday. A newly-diagnosed diabetic gets put on medication and their vision vastly changes. This patient yesterday went from basically plano (prescriptionless) to +4.50 4 days after he starts taking blood sugar medication. Well that's a problem. So Rx him some glasses! Easy, right? To quote sports celeb Lee Corso: "not so fast my friend." He just got put on his 1st medication. There will be adjustments made to his medications in the 1st few weeks/months. Maybe some different medications and maybe some different dosages of the same medications. He flat out told me he was prescribed two medications but one of them "made him feel funny" so he stopped taking it and is going to tell his doc that he is only taking one medication at their visit next week. So what do we do? His Rx is VERY LIKELY to change again, probably as soon as next week when the doc either puts him back on the medication that made him feel funny or changes meds/dosages. Plus his insurance plan makes us use their outside lab - we won't be making his glasses, they'll be made in Maryland or wherever, and they take 2-3 weeks to come in. So if we made him glasses we run the risk of his vision literally changing before the 1st (of many?) glasses order even comes back from the lab. And do you think the insurance company is going to pay for us to change his Rx 1, 2, maybe 3 or more times? NO WAY. Ok so here's how I usually deal with this: I put them in contacts. I measure today's Rx, teach him how to insert/remove and take care of contacts, then load him up on trials. Then I tell him to come back if/when his vision changes after his meds have been changed. I re-take the measurements and change the contact lens Rx and give him more trials. Easy, cheap, fast and quickly adjustable. Then after his Rx and blood sugar has leveled out in a few weeks/months we can remeasure and Rx some glasses that we won't have to remake 5 times. Heck this guy was so impressed with the contacts he may just be a convert anyway.

Thursday, October 27, 2016

Let's Talk About the Texas DMV/DPS

They know nothing about eyes. Nothing. They know nothing about vision! Nothing. "Failing" the vision test (acuity) at the DPS/DMV is meaningless. It does not mean that you see poorly or need glasses. It means their test sucks. I'm serious. "Passing" the vision test at the DPS/DMV does not mean that you see well or have healthy eyes. Sorry. Because once again: their test sucks. It is horribly inaccurate and it often fails people who see fine and should easily pass, and it often passes people who see terrible and need glasses or have eye disease. IF YOU FAIL: go to an optometrist. IF YOU PASS: still occasionally go to an optometrist. Do not make any of your eye/vision decisions based on what anyone at the DPS/DMV tells you about your eyes or vision.

Saturday, October 22, 2016

New Progressives

This week I got my new tortoise shell Ray Ban glasses with Essilor progressives & Crizal coating, all custom measured by our Zeiss i-Terminal. Not only are they perfect but they were *instantly* perfect. No adaptation time, which is a 1st for me. This is my 4th pair of progressives and the previous 3 were weird at the beginning. Not these. These were immediately amazing. No headache, no eyestrain, excellent vision in all views. It's pretty amazing. I'm a new BIG FAN of the i-Terminal. www.greeneeyesbcs.com

Tuesday, October 11, 2016

LASIK Regression

I had LASIK in one eye in 2007 for high astigmatism (about 4.75 diopters). I knew when I did it that it would probably not eliminate the full amount (it didn't), but it would greatly reduce it (it did). I have been fairly happy. Now I'm 44 and presbyopic (need bifocals) and the last 3 straight years my astigmatism has been getting worse again. It's "coming back" or regressing. It's my experience that a LOT of these high astigmatism cases regress, and my own situation has borne that out. Pre-treatment I was -4.75 diopters of astigmatism or "cylinder" (cyl). Immediately post procedure I was -1.00 cyl, a vast improvement! 3 years ago I was -1.25, 2 years ago -1.75, last year -2.00 and today -2.50. So I'm back to half of my original amount of astigmatism. I'm not too bothered by it. I wear progressive glasses almost all day anyway because I need them for the computer and reading, so adding in the extra cyl is easy. It is interesting tho that I'm regressing. I wonder how much more astigmatism I'll get? For the record it has not been my experience that nearsighted LASIK cases regress much. They're usually fine. And I don't refer many high cyl cases (or far sighted cases or high myopia cases) so I don't have many patients experiencing this because I'm pretty conservative.

Monday, September 12, 2016

GREENE EYES: Dr. Mindi Greene & Dr. Michael Prince

greeneeyesbcs.com Optometrists, Optical Bryan, TX

Optometrist Dr. Michael Prince is now at GREENE EYES in Bryan, TX

It has come to my attention that when patients call my old office in Huntsville, TX looking for me some of the staff say they don't know where I went when I left. No matter! here is all the info again! Michael Prince, O.D. greeneeyesbcs.com 979-775-4900 979-775-4949 fax https://www.facebook.com/greeneeyesbcs/ 725 E Villa Maria Road Suite 1500 Bryan, TX 77802 In the Bryan Tejas Shopping Center Next to HEB at the corner of Texas Ave & Volla Maria