New eye doctor. Bad experience.
April 2, 2016 2:59 PM   Subscribe

I can't tell if this doctor is just a jerk, or if they committed a legitimate violation.

YANMD/YANML. This is Virginia, USA.

I've had high myopia and have been wearing rigid gas permeable (RGP) contact lens for twenty years. Long story short, I couldn't afford to see my current optometrist because he doesn't take insurance. I couldn't afford to pay out of pocket so I made an appointment at a place that was in-network for my health insurance

Now. I consider myself an assertive person, but the events at this appointment caught me totally off guard.

The first part of my exam was done by the optometric assistant (henceforth OA).

After the OA did my medical history/chart exam/intraocular pressure test, I notice her walking toward me with something in her hand while saying "Okay and now we're going to dilate your eyes!"

No advance notice given. I was not prepared for having my eyes dilated the rest of the day. I quickly threw my hand up and said "Wait, wait, wait. Is this necessary?"

OA's response: "Uh... well. Yes. Dilations are necessary."

Me: "No one informed me that I would be having a dilation done today. I'm not mentally or emotionally prepared to leave here and spend the rest of my day with my eyes dilated, and I also don't have anyone to drive me home if it impacts my vision to the point of not being able to see when I'm driving."

Her: "Well, your vision is really bad. You should always have a dilation when your vision is this bad."

Me: "Okay. But I've been to many, many vision exams throughout my life and I was always informed before the exam if I wanted a dilation. In fact, at my last annual exam, I asked my optometrist if the dilation was necessary and he informed me that based on my age, vision, and other medical history, a dilation would be overkill and that while it's a useful diagnostic he didn't see it as necessary. He gave me the option to decline and I signed a paper to decline the dilation. Other than my myopia, I don't have any other known vision symptoms (like floaters) or diseases. Again, I did not plan or prepare to have my eyes dilated [aside: this was on a hella bright, cloudless day, to boot] and I would like to decline."

OA: "Someone told you that you don't need to get your eyes dilated? That's very bad practice, that person is wrong. You should have your eyes dilated every single year."

Me: "But it is optional, not required, correct?"

OA: [after a long pause, where she looks confused about what to say] "...No. It is not optional. You have to get this done."

Me: [silent]

OA: [speaking very quickly] "'s not an option but yes you can decline it if you want to but that's at your own risk, I guess you can decline it and you can just sign the paper."

Me: [feeling overwhelmed, slightly confused, and also annoyed] "Look, fine, I'll do the dilation. If you really insist it's necessary then fine."

OA: [victorious expression on face]

Me: "This doesn't cost extra money, does it?"

OA: "Nope! Insurance ALWAYS pays for dilations- " [starts putting dilation drops in]

I surrendered because I didn't want to argue anymore. The OA was aggressive and I just wanted to move on. (Note that I have had my eyes dilated many times in my life, so this was not the first time at the dilation rodeo.)

Immediately after she puts in the dilation drops she has me remove my contacts, and the optometrist finally comes in. At this point the dilation drops had been in my eyes for all of two or three minutes. My vision was still adjusting.

The optometrist sweeps in and says, "Hi I'm Dr. Schmoptometrist, so I understand your other optometrists have been telling you that you don't need your eyes dilated? Well that's wrong and don't ever let anyone tell you that because you need your eyes dilated every single year! Don't EVER let ANYONE tell you you don't need your eyes dilated!"

I was overwhelmed by how hyper and aggressive she was, so I just said, calmly, "Thank you for the information."

She then swings the phoropter in front of me to start the eye exam. This is where I was shocked. She starts with my right eye, asks me to read the letters, and asks me which lens is clearer - 1, or 2? 2, or 3? I tell her right away, "Um... I can't see. My vision is really, really blurry. I keep blinking and I can't really see any of the letters."

She says, "Just keep going. 1 or 2?"

Me, even more uncomfortable because I feel like there's no way possible that this lens exam could be accurate since I can't see with my eyes dilated and blurry, "Uh... um... [struggling, blinking a lot to try to get my eyes damp enough for my vision to hopefully get less blurry] uh... this is still all really blurry... I guess 2. 2 looks better than 1, I think." At no point did the doctor ever acknowledge that I said my vision was blurry. In fact, she kept silent other than telling me to "just keep going" after my initial protest, and asking me "1 or 2?"

I keep thinking, "Er, none of these are really good lenses right now because I can't see from the blurriness - hopefully we'll keep going until it improves..." and then she abandons my right eye and moves on to the left. I've never been to an optometrist who sped through the contact lens exam so quickly. It always takes 5-10 minutes per eye.

After she burns through my contact lens exam lickety-split, she pulls out the mega flashlight and checks out my dilated eyes for retina issues, and there aren't any. (Surprise.) Then she goes to her computer and starts typing, doesn't say anything. I feel confused and uncharacteristically meek - too shocked and intimidated to say anything. Eventually she tells me the front desk will order my contacts and they'll call me when they come in.

At the front desk they tell me they'll call me when the contacts arrive and when I come in they'll make sure the contacts are the right prescription. I hear them say this but I don't really think much about the comment at this point.

So, I get home, and an hour later it dawns on me that:
- Whenever I've had my eyes dilated, it was always done at the very end of the exam. Dilation drops were never put in until after the contact lens part of exam, which makes sense because it makes your vision unusually blurry.
- No optometrist has ever spent so little time on the contact lens part of the exam. That's always been the longest part. It has usually had me wondering "Is this over yet?" but I still appreciate the precision and thoughtfulness put into the exam.
- This is the first time I've had an optometrist not give me my prescription at the end of the exam.

Now, I realize that they were ordering the contact lenses for me on site, through their contact lens provider. But after researching FTC regulations and the Contact Lens Rule, my understanding - and correct me if I'm wrong - is that is they are prepared to sell me contacts (to me, calling in a prescription and ordering contacts is being 'prepared to sell'), then the contact lens fitting is 'complete' and they have to furnish the prescription to me.

I immediately felt conflicted because I think they obtained a shitty, inaccurate prescription from the exam, but I wanted them to give me the prescription because I was so unhappy with the experience and wanted to just order the contacts from another contact lens provider. Why? Because I don't think my insurance company covers more than one eye exam a year, I can't afford to pay for a full blown RGP contact lens exam out of pocket, and any contact lenses would be better than the ones I'm currently struggling with. I want the prescription so I can just get some contacts to hold me over for the next few weeks until I can go back for another exam for a more accurate prescription.

So, here I am, not knowing if I should be mad that they did a shit job examining my eyes for contact lenses, or mad and demanding they release the prescription to me so I can take my business elsewhere. These two things are basically in direct opposition of one another.

I call their office the next day and say, "Hi, can you please call my prescription in to ________. The receptionist (after putting me on hold twice - I think she was new) proceeds to tell me that I have to come back in to be seen again. I ask why. She says so they can "Teach me how to put them in."

I about lost it. I told them I'd been wearing RGPs for twenty years, as the doctor should know from the vision history I provided, and I did not need to be taught how to put them in. I told them they needed to come up with a better reason than that. They put me on hold. Then they came back on the line and said that the doctor simply had not signed off yet on the prescription so they could not fax it anywhere else. I told them that they were supposed to give me a copy of the prescription after the exam, and that I didn't understand why they would order contact lenses for me if the doctor was not satisfied with the results of the exam they did. I told them I wasn't coming back and they needed to fax the prescription before I filed a complaint with either the FTC or the state board of optometry or both. They said they'd speak with the doctor and call me back.

The next morning I get a call from the clinical director. She said that the doctor could not sign off on my prescription because they needed to fit the contacts on me first. I said that there's always a possibility the contacts may not be the right fit, but that every other optometrist has always given me the prescription immediately after the exam and told me to come back if the contacts don't seem right after about a week or there are serious issues. I told her that what she was telling me was absurd and I couldn't accept it. The clinical director then proceeds to tells me, "It is your fault [direct quote] because you did not know what brand of RGP contacts you are currently wearing. The doctor has to make sure that your eyes will accept the brand of contacts she ordered." First time hearing this! Also, my last optometrist never asked me what brand of contacts I already wore; likewise I never had a problem with whatever brand he requested on the prescription.

I told the clinical director that this sounds like it may be a violation of FTC/contact lens rule, and that if they did not fax my prescription to me or to my choice of contact lens provider by the end of the day, I would file a complaint to have the FTC review their procedure. I also said that I couldn't believe they dilated my eyes before the contact lens exam and that it made my eyes blurry and that it couldn't possibly be common practice. That's when the clinical director asked me how long I was an optometrist. I asked her how long she had been an optometrist, and she said, "I'm the clinical director." I said, "So what?" and she said, "So... [long pause] I'll be happy to set up a new eye exam for you with a different optometrist." I told her no, and I was not coming back. She said okay and to have a nice day and ended the call. Four hours later, they uploaded an electronic copy of my medical record to their online portal. Note that they'd already uploaded one the day before, but it was much less detailed. This new, more detailed medical record appeared to list the results of my contact lens exam, but I don't see how this could be considered a 'prescription' by anyone - it's just the medical record documenting my medical history, exam, test results and the doctor's plan of action.

I'm really upset about how this was handled. I later find out that this optometrist (and clinical practice) have several bad reviews online, citing how the particular optometrist is always rushing through the exams and text messaging on her phone (to be fair, I didn't catch her texting) and that the clinical practice bills absurdly high rates to insurance; they are also known for long delays in contact lens/glasses orders coming in. Given that my past eye doctors have only had me come in one time for an exam, given me my prescription on the spot, and told me to come back only if I have a problem with the contacts, I feel like they purposefully gave me a shitty initial exam so that I'd not only have to come back to make sure the contacts were 'correct', but so that when the first prescription didn't work out (because it was done poorly) they'd have a reason to order more and have me come in a second time. More appointments, more billing, more money. All for what I view as completely unnecessary things. I also feel like they could be strategically phrasing what they're doing so that it falls into some kind of legal loophole.

So, my questions:

1) I can't tell if this doctor is just a jerk, or if they committed a legitimate violation of the FTC rules regulating contact lens exams and prescriptions. Can anyone help me to clarify this?

2) Depending on #1, what should my next step be? (Given my financial and insurance circumstances, as well as the fact that I'm in moderately urgent need of new lenses?) I have no idea if I should keep pushing them to give me my prescription, file a complaint, give up and go somewhere else and hope my insurance will pay for more than one eye exam in a year, or what.
posted by nightrecordings to Health & Fitness (23 answers total)
Don't know enough specifics about the system, but the fact that you threatened to report them already and they didn't budge, tells me they're probably pretty comfortable with justifying their position on this.

Also, on the dilation aspect, I've always had my eyes tested both before and after dilation.
posted by ryanbryan at 3:24 PM on April 2, 2016 [2 favorites]

The FTC rule pretty clearly indicates that generally a prescription must be given, but after a fitting has taken place. When I've had fittings - and I've done fittings many times - the optometrist has always actually inspected the way that the contact has laid on my eyes and asked about comfort as the primary reason for the fitting. It's not unimportant to the process of getting new contacts, and they're acting in the law.

Per the FTC rule, and from my own experience, the exception is that you don't have to come back for a fitting if you're renewing the exact same prescription you used to have. Do you have your old prescription, and did they check against it? If it's the same prescription for the same contacts, you have an argument for demanding the updated prescription. If it's changed in any way, not so much.

The dilation thing, on the other hand, seems abnormally aggressive, even though it too is not an abnormal part of a vision exam.

I would be most concerned that they are rushing you through the exam in a condescending fashion. I would go back for the fitting, and if the fitting is OK, get the prescription and never go back. If the fitting isn't OK, tell them that you felt rushed during the last exam and had difficulties with the dilation, have them redo it. If *that* doesn't work out, never go back and leave a bad Yelp review, and discuss with your insurance to have the work re-done at a new optometrist.
posted by I EAT TAPAS at 3:53 PM on April 2, 2016 [3 favorites]

I have Eel's disease - retinal hemmoraging, so I see a retinal specialist. The assistant runs me through the chart, THEN dilates my eyes. I cannot imagine how it could work otherwise.
posted by rudd135 at 4:04 PM on April 2, 2016 [6 favorites]

I've always been asked if I want my eyes dilated. My doctor recommends doing it every other year.
posted by Ostara at 4:10 PM on April 2, 2016

My doc also recommends dilation in alternate years. And I'm extremely doubtful that any prescription this place makes would actually be correct for you, what with that dilation BEFORE the exam.

Have you contacted your provider and told them all this? Pretty sure they won't want to be paying this over-billing bully and her crew of junior bullies.
posted by easily confused at 4:19 PM on April 2, 2016 [5 favorites]

I recently had my eye exam, which included a contact lens examination. The doctor gave me a sample pair of soft contacts in the proposed prescription to wear, then I came in for a quick check about 2 weeks later to make sure they were fitting properly and comfortable, I could see well while doing my daily tasks, etc. This second visit did not have an additional fee. They did not give me a copy of my prescription until after the second check. (I can see how this might parallel your "we'll order you a new pair and come back to try them" experience, since they're not likely to keep sample RGP lenses in stock to check for fit.)

In the past, I've always gone to places like Pearle Vision where they just give you the prescription immediately after the initial exam and don't ask you to come back unless you have problems. Dilation was always offered, but I usually turned it down in the past because I had to drive immediately after the exam. None of the providers ever pressured me to do it.
posted by belladonna at 4:30 PM on April 2, 2016

They put dilation drops in your eyes w/o having you remove your contacts 1st ? That doesn't sound right.

FWIW I've had glasses since I was 7 and dilation has always been part of my opthamologist visits.
posted by brujita at 4:43 PM on April 2, 2016

Thank you for the responses so far. I want to clarify a couple of things and then I promise I will shut up:

- I am very sympathetic to the fact that patients are inclined to not always understand why a doctor is doing something, and that there are good reasons for many of the things that are done during an examination. When people complain about doctors I tend to give the doctor the benefit of the doubt and consider their side first. But this exam had red flags all over (to be honest, I left out several other red flags, because my post was already way too long). I felt manipulated and uncomfortable. This patient-doctor interaction was unlike any other one I've had in my life, it blew my mind how half-assed it was.

- I am 110% aware of the benefits and necessity of dilation. That is not my question. The point is that they were unbelievably pushy about the dilation, to the point of being bizarre. I also don't understand how the prescription could be accurate when it was taken while my vision was blurry. I told the doctor that my vision was blurry and it was impacting my ability to see through any of the lenses they put in front of me and she ignored me and kept going. There was zero effort made by the optometrist to listen to me. Communication is key. She can't see what I'm seeing. She has to listen to what I'm telling her in order to know if it's the right lens for my eyes. And she didn't listen. The only reason I didn't protest more or ask "What the hell, lady?" is because I was completely shocked and in disbelief. Like I had been manipulated into believing that she'd just given me a legitimate exam. Rushing me through it gave me little to no room to protest.

- Going back is not a solution; I want nothing more to do with this place. The bridge is burned and there is no rapport.

- The part of the FTC/Contact Lens Rule that I'm confused by is this (see link): "What if my patient asks for a copy of the contact lens prescription before the lens fitting is complete?"
The Act and the Rule do not require that you provide the contact lens prescription to the patient before the fitting is complete. If you are prepared to sell your patients contact lenses, however, you cannot refuse to give them a copy of their prescription on the grounds that their fitting isn’t complete. If you’re willing to sell them the lenses, that means their fitting is complete, and you must give them a copy of the prescription. I recognize that the possibility is strong that I am beanplating this, but I feel like this is open to some interpretation and could go either my way or the doctor's. If they're ordering lenses for me, they're ordering merchandise that they plan to sell me. I don't understand how one optometrist gets to say "We're ordering lenses and then you have to come back and have them fit first before we'll give you the prescription" while the other optometrists I've been to have said "Okay, here's your prescription, once you get them and wear them please come back if there are any issues." She seems to be using "the fitting isn't complete" to get me to come back and order lenses from them. I think she knows that if she says the right things to explain her actions, she can get away with this by slipping through a loophole. I realize it's splitting hairs, but I'd be interested to know if this has been played out in the courts and if there is established case law interpreting it one way or the other.

- I signed a form guaranteeing I would pay them/am responsible for the charges if insurance does not pay. If I ask my insurance to question the charges for the exam, then insurance denies it, I'll end up with this place billing me directly. It seems like either way, I'm going to have to pay out of pocket for a second exam, if not both.
posted by nightrecordings at 4:46 PM on April 2, 2016 [3 favorites]

I am extremely myopic and tend to schedule my eye appointments first thing in the morning on work days, and every time the doctor mentions dilation I tell him I have to go work in front of a computer all day. His response is always, well, come back at the end of the day sometime and we'll do the dilation then, it will still count as part of this exam for insurance purposes. I'm a terrible person and never go back for the dilation, which I'm sure is noticeable from my record, and I have gotten literally no shit ever about it. Your experience seems very bizarrely pushy to me, and I'd be upset about it, too.
posted by banjo_and_the_pork at 5:09 PM on April 2, 2016 [7 favorites]

I have a terrible time with things in/near my eyes (involuntary kicking is involved,) so I've only actually gotten dilation maybe three or four times out of at least fifteen to twenty eye exams (I have extremely bad eyes.) It's not ideal, but it's also not nearly as big a deal as this provider made it. And it always happens at the very end.

Having said that, I'm not sure this translates into a cause of action. Personally I'd complain to insurance and save up for the out-of-pocket exam cost at a chain; I certainly wouldn't trust the prescription they give you.
posted by SMPA at 5:45 PM on April 2, 2016

So sorry this happened. I would talk about this on yelp and social media far and wide.
posted by 2soxy4mypuppet at 5:48 PM on April 2, 2016 [4 favorites]

Before ordering contacts from someone else, go in and have them fitted by the prescribing office. That way if they SUCK, then you can make them take them back and go elsewhere for the exam.

You can call your insurance provider and tell them that you had an unsatisfactory experience with their optometrist.

Also, you're 100% right. My doc didn't dilate me at my exam, didn't need it.
posted by Ruthless Bunny at 5:59 PM on April 2, 2016

Not sure about the FTC rules, but I can tell you how my last eye exam went:

1. OA took some history, then sat me down at a computerized machine and gave me some exam (like looking for the red dot, etc.). Then he took a photo of my eye, as it was pressed up against the machine.

2. Optometrist came in and did the eye exam. He discussed dilation, then offered me a dilation-free exam using new technology. He also explained that my insurance will cover normal dilation, but not this new type, and the price (aka $35). I opted for the new one, even tho' I did have someone to drive me.

3. He also discussed how I used my glasses, and I got two prescriptions: one for long distance and driving, and one for mid-range work, such as using a computer or short-range tasks like chopping vegetables.

4. He did try to get me to buy eyeglasses there, by herding me to one of their eyeglass sales people, but it was later in the day and they couldn't make them same-day, so I said I'd just be taking my prescriptions with me and I got them, paid my co-pay plus the $35 extra, and left.

5. Went to Lenscrafters at the mall and got two pair of glasses. I am super happy with both of them, one is for computer work, and one is for watching TV and driving.

6. At no point did I feel pressured that I would *have* to have a dilation exam, old or new technology. And the eyeglasses thing was meh, I got my prescriptions and left, granted it was not contact lenses, ymmv.

Just wanted to give you a point of reference, that there is new technology out there, should you ever venture into a new place, you might want to ask about it first.

My experience was friendly and professional, and no one made me do anything. I am sorry you went through this, and you should seek out other eye doctors who will give you what you want. I have had bad experiences before, so I know where you are coming from. Not sure if it's even worth protesting, despite the bad experience and frustration, rather seek out a new place that will give you a better experience. And yes, I had to wait a while until my insurance paid for the new exam and eye glasses.
posted by Marie Mon Dieu at 6:00 PM on April 2, 2016 [1 favorite]

Yeah, I haven't had my eyes dilated for years - I pay for the high-res retinal photograph. Find an optometrist that will let you do this. It's worth the extra $35. I hate dilation.

And in three different countries, I've never walked out of an eye exam without my lens prescription in-hand. It's never been something they've refused or hesitated to give me.

I've been wearing contact lenses for over 20 years, and short of a recommended change in technology/brand ten years ago, I have never been required to "come back in" to "fit" them. Granted, I wear soft lenses and I don't know how this compares to RGP ones, but they usually have samples in their office that they use to fit the same time they determine my prescription, and I walk out wearing those new ones.

What you experienced sounded incredibly sketchy. Whether or not it's illegal, I don't know, but I would complain about them on the review website of your choice, send a written complaint to them, and take your business elsewhere next time.
posted by olinerd at 6:33 PM on April 2, 2016 [1 favorite]

Also, I've paid out of pocket for an eye exam/prescription before, and it was under $200 including the $35 for the retinal photograph. It's not pocket change, but it's outrageous.
posted by olinerd at 6:34 PM on April 2, 2016

I agree with everyone else that the hard sell on the dilation makes zero sense, and that administering it to you prior to the exam itself makes negative sense. In addition, they really shouldn't charge you for the follow-up exam to check the lenses for fit (leaving aside their strange unwillingness to read your file...), although my optometrist generally has me in to make sure that I can still see where I'm going with the new prescription. Definitely complain to your insurance company.

Although I get the dilation every year, I've also had the retinal photographs, and they're worth looking into if driving is going to be an issue.

Granted, I wear soft lenses and I don't know how this compares to RGP ones, but they usually have samples in their office that they use to fit the same time they determine my prescription, and I walk out wearing those new ones.

Also, I've paid out of pocket for an eye exam/prescription before, and it was under $200 including the $35 for the retinal photograph. It's not pocket change, but it's outrageous.

Speaking as someone with similar eyes to the OP (hypermyopic, astigmatic) and also wears RGP lenses, RGP lenses a) have to be custom-fit to the eye, or else you will wind up screaming VERY LOUDLY and b) are much, much more expensive than soft contacts. $200 wouldn't even cover one of my contact lenses out of pocket...
posted by thomas j wise at 7:38 PM on April 2, 2016 [2 favorites]

Hmm, well... I kind of wonder how many people who are agreeing with you that your experience was strange are soft lens wearers, because I've worn both kinds, and RGP protocol is totally different than protocol for soft lens wearers.

Backing up, I am severely myopic, have needed corrective lenses since I was a child, and have family members with similar vision who have experienced retinal detachments. I have NEVER gotten an eye exam in which the optometrist treated dilation as optional, because it's a crucial way to examine retinal health. So that part didn't strike me as funky--reading through, I was absolutely nodding and saying, "Sounds normal" when you were describing how adamant they were about dilation.

Nor did their insistence that you get the RGPs fitted at their office strike me as particularly odd. I only recently (last few years) was able to switch to soft lenses because they finally make some that accommodate my degree of astigmatism -- and because those are standardized to a degree that RGPs can't be, I've gotten used to the luxury of not having fittings when I get my prescription filled. But for the majority of my life, i wore RGPs, and always had to come in for fittings for those.

(Soft contacts are so much more straightforward that you can really shop around and just order from whatever website stocks your prescription. It's so freeing!)

So, I guess I'm playing devils advocate here, insofar as your experiences don't strike me as odd in light of the twenty odd years I wore RGPs. But the way in which all this was handled doesn't seem great, and would in itself be reason for me to switch doctors, were I in your shoes.

(Moreover, other people in similar boats seem to have had different experiences, so now I'm wondering if I'm the outlier here!)
posted by artemisia at 8:03 PM on April 2, 2016 [2 favorites]

To clarify, the sub-$200 cost was for the exam and prescription, not for the lenses themselves.

I'm also severely myopic and have been since age 7, but I've never had an optometrist insist on dilation - they've always been happy with the retinal imaging. But yeah, I am a soft lens wearer.
posted by olinerd at 9:34 PM on April 2, 2016

I'm strongly myopic (-7 range, so still OK for soft lenses although I prefer glasses) and was told at my latest eye exam that the current recommendation is to dilate every year for strong prescriptions because high myopia is a risk factor for retinal detachment. It was conveyed to me as a recommendation though, which I'm sure I could have declined if I felt strongly about it.
posted by serelliya at 11:55 AM on April 3, 2016

tl;dr but my prescription is -10 and they always dilate me (and of course I hate it, because it's always on a sunny day. So now when it's over I nap in my car for a while, to readjust.)

The assistant runs me through the chart, THEN dilates my eyes. I cannot imagine how it could work otherwise.

Agreed. I have lattice retina which runs in my family; probably I'll have a detached retina at some point, my older brother already has. They dilate in order to inspect the areas at the edge of the retina (with God's own headlight) and it's extremely painful for me but apparently must be done. They want every year but I always delay that appointment a month or two 'cause they never find anything.
posted by Rash at 12:43 PM on April 3, 2016

I have two initial reactions to that story.

1. I've always had my eyes dilated when I get my eyes tested every year. It is always done by the assistant after they have me look at the eye chart and before the doctor comes in. And they've never "warned" me about it either. I am 30 and this has been the case for as long as I can remember. And the dilation only lasts like an hour or so (not all day), so I think you maybe you overreacted slightly. (Worth noting I do have a thyroid disorder that affects my eyes, not sure if that's why they do it. But they also do a glaucoma test every year, so...) HOWEVER...

2. I do think they should've done the refraction test before they dilated your pupils, so that seems wrong. For me, it goes > assistant for initial eye chart/look in weird machine for dots > doctor for refraction > assistant for drops > doctor for inspection of my eyes. There's no way you could've done an eye chart test if the dilation drops started to kick in.

I once had a bad experience at an eye doctor. I was doing refraction and I felt the doctor never got it perfectly clear. So even though I was picking which one looked better when she flipped back and forth, she never got me to a point that I felt was clear enough. I regretted not saying, "Hey wait, that still wasn't sharp enough." But part of me felt that if she wasn't able to do that on her own, she probably wasn't very good at her job. Instead I just wrote a bad review online, and I was able to get another free exam from an eyeglasses place (since that bad one cost me my one annual eye exam I got through insurance).

In your case, I would call my insurance and find out if the visit you just had counted as your eye exam. If it did, I'd tell them the doctor did wrong - they did everything out of order, they refused to give you your prescription and it was a useless eye exam - and you need a new one and see if they can advise you. I obviously would not go back to that doctor's office again, no matter what.

As for FTC violations, no clue. But I think that is more of a revenge thing, and what should be your more immediate concern is getting a proper prescription. I'd worry more about getting everything sorted from an insurance standpoint, and then you can explore the FTC thing, but unfortunately, it's going to be your word against theirs, so I doubt you'll get very far.
posted by AppleTurnover at 1:54 PM on April 3, 2016 [1 favorite]

Sounds to me re the FTC rule that they are *ordering* the lenses but they aren't going to sell them to you until after the fitting. That's what the fitting is for, to test out the lenses they ordered so they can either re-order or sell them to you depending on outcome.
posted by Lady Li at 10:01 AM on April 4, 2016

I wear soft lenses, and I've had to put them on in front of the doctor, just so they could adjust if I had any problems, like the prescription ended up not being quite right or anything like that. That part sounds normal. The rest sounds kind of like a horror show.

I agree with I EAT TAPAS and Ruthless Bunny: you should explain to your insurance company that you were unsatisfied with the exam and that you don't think that the results of the exam were accurate due to their speed and the fact that you weren't prepared to be dilated. The prescription is probably worthless, so you wasted your time and money. Your insurance shouldn't pay it, nor should you be liable for it. They didn't do their job. You should definitely try, even if you think they'll deny your request. Complain to the Board of Optometry if you have to. I'm not sure why they did what they did, but you should definitely find another doctor. If your doctor hadn't been so hasty, you could have addressed the assistant's behavior, but it seems she was just as pushy and hurried.

This sounds a lot like an experience my husband had with his ENT, especially when getting his splints removed after his septoplasty last year. The assistant was nice, but the doctor was wham-bam-thank-you-ma'am and ripped them out (after they'd crusted to the inside of his nose with blood and mucus for a week) quicker than you could blink. It was disgusting. Absolutely no sympathy or bedside manner. In her case, I think she was rushed. She was the only doc in the practice and had tons of patients in the building when we went. Doctors need to learn to manage their time better and treat their patients as people. It's not an assembly line.
posted by serenity_now at 8:44 AM on April 6, 2016

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