Vision care, 2017 edition
January 25, 2017 11:15 AM   Subscribe

Bespectacled MeFites, what are your recommendations for vision care in 2017? We are an average family of 3 in the U.S., which is to say we have two adults with moderate age-related vision changes, a kid with moderate vision issues, and no vision insurance coverage. More specific questions below but all suggestions/tips are welcome.

1) Quality-wise, chain/mall stores or individual practices? I know the answer used to always be "individual" but is this still true in 2017, especially with the new digital exams such as LensCrafters Clarifye which claim to be super accurate without doctor's input? Our primary goal is a good prescription but it seems that all ophthalmologists and optometrists are trained and able to detect potential eye conditions, especially with the newer tools available.

In regard to technology especially, I suspect that franchises and chains would tend to be more uniformly up to date, while individual practices would tend to hold on to old technology longer?

2) Price-wise, smaller practices seem to cost about twice as much as the chains. Barring serious conditions such as diabetes or cataracts, is there really a difference worth paying for? There are lots of posts saying that the exams are "more thorough" at private practices but last time I took my kid to a highly recommended private doc, we were in and out really fast and he barely even looked at my son.

3) What is the magic word combination to ensure that you will get a real, accurate prescription that can be filled online? Last time I tried to get my own prescription from my (private) doc, I got it without PD (pupillary distance), and when I asked for it, they made me ask several times and acted confused. A few months later, I asked for a prescription with PD for my kid (different doctor/office) and there seemed to be confusion again, and then when I took that prescription to Costco, the optometrist there said there was no way it was a realistic PD and had to re-measure my kid.

4) Do kids need specialized doctors? If yes, why and what to look for?

And how often should I get my kid re-examined? His doctor gave me a hand wavy "once a year or so" but my son grows out of his shoes twice a year and his clothes every season, so doesn't that mean his head is changing size as well?

5) Is there any real difference in quality between the lenses you get at an individual practice, at a chain store, and online?

What are the best websites, as far as quality and selection, for adults and kids?

Thank you in advance for all your recommendations!
posted by rada to Health & Fitness (17 answers total) 12 users marked this as a favorite
I can't answer your child-specific questions, but I'm very happy with the glasses I get from Zenni Optical. I've also successfully learned my PD by going into a Walmart eye center during slow business hours and politely asking for it.
posted by Faint of Butt at 11:34 AM on January 25, 2017 [2 favorites]

I am not an eye doctor; I have worn glasses for over 40 years.

I love my individual doctor and optician, and have had only bad luck with chains.

Little kids do well with specialized doctors who have tricks to get them through the exam, but older kids are fine with standard ones. I don't know what age it switches at, but my daughter saw a children's doctor when she was four, and my doctor when she was 10.
posted by The corpse in the library at 11:44 AM on January 25, 2017 [1 favorite]

Get the eyes examined by an ophthalmologist, buy the glasses, contact lenses, etc. at Costco.
posted by mygoditsbob at 11:45 AM on January 25, 2017 [1 favorite]

Best answer: Costco is generally very affordable for eye exams--you might want to call because I think technically the optometrists are independent and might vary some--but they were also totally cool about giving me my whole prescription, PD included. Walmart was also cool about giving me my prescription including PD, but the exam was more expensive than Costco. Costco gave me a printout of the prescription without my even asking for it, which got them bonus points, although again, that might vary by location.

I can't speak to kid-specific stuff, but as an adult:

I have grown quite attached to getting my glasses from Warby Parker, which is relatively affordable, but kind of depends on you being into their aesthetic. I have not noticed any discernable difference in lens quality except at Zenni, and Zenni really is super cheap; they were slightly more inclined to scratch, I think, but not so much so that they weren't worth it. My primary problem with Zenni was that the frames felt cheap and didn't fit as well. But I think I'm harder to fit than most people and many folks seem to like them.

My reason for not actually just getting frames from Costco is that the selection was quite limited--it might be perfectly adequate for kids and adults without my apparently-giant head.

I don't think I'd try to spend more on the exams unless I started getting prescriptions that seemed inadequate through the cheaper route.
posted by Sequence at 11:46 AM on January 25, 2017 [2 favorites]

For 1) I've gotten the best results from Lenscrafters. I need trifocals with a sort-of tricky prescription, and Lenscrafters has been the only place that was able to get it right. I've tried the online discount places and even the local big-box wholesale stores that have an optical department, and none of them have even come close.

As for 2) when I was a kid my parents took me to some guy who they also went to church with, but this was in the early 70s and there wasn't even a mall in my town yet. I have an acquaintance here who goes to a smaller practice, and I think she pays an arm and a leg and maybe some fingers on the other hand for pretty basic glasses. My glasses from Lenscrafters are fairly expensive due to the prescription, but they get them right every time and they're still less that what my acquaintance pays.

For 3) I'm not sure, since I use the eye doctors there at the store, so no help there.

With 4) I know I see lots of kids getting exams at the mall stores, go I'm guessing they don't have any reason to see a specialized doctor. Talking to my sister and sister-in-law, their kids, ages 14, 9, and 7, go every year unless there is a presenting reason to go earlier.

Looking at 5) all I can say is that the lenses I got at the mall store weren't even an option online, and the people at the big-box store had to order them in at an extra cost. Looking at the quality (literally), the lenses from the mall store were much better.

As for online stores, I can't say. My experience with them was sub-par, but I know a lot of people think they're great.

One thing to consider - even though I don't have vision insurance, Lenscrafters gave me some kind of discount just because I had BCBS. If you have just regular insurance, see if there is someone who gives a discount based on that.
posted by ralan at 11:51 AM on January 25, 2017 [1 favorite]

I get my glasses from Zenni, Coastal, or Bonlook. Coastal has frames as low as $35 (sometimes less) and lots of sales. Zenni and Coastal have kids frames.

I'd go to an ophthalmologist or optometrists office. I don't have good vision insurance (or I didn't with my last plan since I "had perfect vision HA!) and it wasn't too expensive for the exam. They were perfectly willing to give me my PD in the office and even grabbed my husband's when I asked. That's just my experience as a new glasses person who wants cheap frames.
posted by Crystalinne at 11:53 AM on January 25, 2017 [1 favorite]

1 & 2) The only times my prescription has been wrong, filled incorrectly, or for contacts that just won't work for me were at chains. I've also gotten good service from them, but I felt so railroaded the last time somebody put me in contacts that didn't work for me that I found an independent doc my wife and I both love (oddly enough, the Yelp reviews of this guy match our experience). Also even if they do some sort of automated thing I think they're still required by law to confirm the prescription before they sign off on it.

3) If you trust your doctor, say at the time of the exam (important) that you want them to do your PD so you can make sure it matches when somebody else measures it. I discovered after two years of rotating my head juuust a little bit that the chain place had measured my PD wrong, and my first pair of progressive lenses never quite fit. So if that's happened to you, you can say so. That said, I only get my prescriptions filled in person now, and now that I've had the experience of incorrect PD I would immediately know that it was wrong if I got another pair of glasses like that.

4) When I was a kid my mom took me to a pediatric eye doctor, and when I finally convinced her to take me to her doctor instead it turned out I could have been seeing him for a few years before that. I don't know what the recommended age range for specialized pediatric care is, though.

5) Depends what you mean by quality. Almost any lenses you get are going to be filled by one of a small number of big labs, so the big issue is the finishing and fitting. If you need progressive lenses the big deal now is that they are all "back side surfaced," and every brand of lenses has its own designs and patents. You may find that the lens brand preferred by one doctor is different than the one dispensed somewhere else, and/or that you prefer one design over another, but you can probably just accept whatever they're selling unless you don't like what you get.

Because I need progressive lenses and I've had bad fit issues in the past, I buy my glasses in person at a place I trust to get the fit right. If you don't need progressive, or you're an easier person to fit, maybe buying online will work for you.
posted by fedward at 11:56 AM on January 25, 2017 [1 favorite]

I go to a local eye doctor and found it a way superior experience to going to any chain I have ever gone to.

But I absolutely swear by Zenni and buy all my eyeglasses online. I have a tricky progressive prescription and they've nailed it every single time. I've purchased multiple pairs of eyeglasses from them in just the last few months because of how cheap they are. My last pair cost about $40. Yes, their quality is cheaper but you can buy eight pair for what I paid when I last went to LensCrafters. So when your kid breaks a pair, you just hop online and replacements are on the way.

And lastly, you might want to Google the term 'Luxottica monopoly' to learn more about this giant company that owns most of the chains, a huge chunk of the manufacturing, some of the vision insurance industry and more. I refuse to give them any more of my vision dollars. Your mileage may vary.
posted by lpsguy at 12:14 PM on January 25, 2017 [4 favorites]

I go to a local eye doc for my prescriptions and eye health visits. But I buy my glasses from Zenni and have had no problem—and I need progressives and I have a wicked astigmatism in one eye and practically none in the other. If your eye doctor is giving you the runaround for PD, it's because they know that means you're not buying from them and they want to make you rethink that. Of course they know what it is. When I was carrying eye insurance I bought one pair from them, but still got the PD so I could get others online. I dumped my eye insurance because buying from Zenni is so much cheaper than the ones I could get partially paid by my insurance. Getting them online means I can get lots of different colors and shapes, and I like that.
posted by clone boulevard at 12:20 PM on January 25, 2017 [1 favorite]

Best answer: The bit you need to get your prescription filled online is your pupillary distance. This is not part of the standard Rx form that says what type of lens you need for each eye - it measures how far apart your eyes are. A good eye doctor will provide this if you ask, a shady one will say no because they want you to buy the glasses from them only. I highly recommend local eye doctors over chains for your eye exam.

The other piece you need to successfully get glasses online is the size of the frames. Frames often provide mm dimensions from temple to temple, from temple back to the ear, and the width of the nose bridge. It can be hard to know what fits without trying it on. If you have not had glasses before, I recommend buying your first pair in a store after trying them on. Lift the dimensions from that pair and use it for future orders online.

Online ordering can be dicey -- its hard to know what level of quality you will get without feeling the frames in your hands. But that tradeoff comes with vastly reduced prices so it may well be worth it.
posted by cubby at 12:21 PM on January 25, 2017 [1 favorite]

I've worn glasses for 40+ years. I have a strong prescription and now trifocal/progressive lenses. I was concerned about using Zenni at first, but have used them for the last 4 years and they are great, my glasses come in spot-on. Mr jane, who tends to lose or break his glasses frequently uses Zenni too.

I do go to an opthamologist once every 2 years to check up on my prescription and have glaucoma testing. I ask politely for my PD and they have given it without a fuss.
posted by sarajane at 12:23 PM on January 25, 2017 [1 favorite]

Best answer: I don't know what the chains charge these days, but my optometrist charges around $75 for exams including prescription (printed and including PD), glaucoma check, etc., and would certainly refer us to an ophthalmologist if necessary.

And how often should I get my kid re-examined?

This might vary depending on growth spurts, so pay attention if your child is complaining and/or squinting. My son went through four prescription increases over two years (and one mm PD increase in that time), and our optometrist was not surprised at all, especially when she heard his drastically deeper voice at our latest visit, if you catch my drift. She expects his vision to continue changing as long as he's growing. By contrast, she checked the glasses I've had for over 20 years (I wear contacts) and said they're still correct for me, so I don't think her advice about my son's vision is a money grabbing tactic.

I buy my son's glasses from zenni because he loves the frames and the lens quality seems fine. I let the optometrist determine the best brand and fit for my contact lenses, then I order the exact brand and Rx from whichever website has a coupon code or promotion going.

I agree that anyone giving you a hassle about getting your PD is just bitter about not making that sale. Personally I'd leave a provider like that for fear they'd give an inaccurate PD out of petty spite.
posted by whoiam at 12:28 PM on January 25, 2017 [1 favorite]

The other piece you need to successfully get glasses online is the size of the frames. Frames often provide mm dimensions from temple to temple, from temple back to the ear, and the width of the nose bridge.
posted by cubby at 3:21 PM

True! But assuming you already wear glasses, this information should be imprinted on the inside of the arm. Zenni has online chat customer service that can help you figure out those numbers. I don't work for them or know anyone who does... I'm just a satisfied customer. :)
posted by whoiam at 12:34 PM on January 25, 2017 [1 favorite]

My health insurance covers one visit to an Ophthalmologist per year, and maybe yours does too? Ophthalmologist are real MD doctors, and having a doctor say "yep, your eyes are fine" means a lot to me.

Don't buy glasses from a store. Buy them from Zenni. It's really easy to measure your own pupillary distance.
posted by gregr at 12:38 PM on January 25, 2017 [2 favorites]

do not buy glasses from the store. i was in a jam and paid $300, plus the $200 my insurance chipped in, for a pair of glasses. i got almost the same glasses on zenni for $40. especially for your kid, buy them 4 pairs of funky fun glasses for $40 total. also check out coastal. and there are a couple other places i've had good experience with for less than 80$ a frame.

i have better luck with non-chain eye exams. they don't rush as much and seem more willing to explain things. but unless you need something beyond a basic script, i think pearle vision et al is fine.
posted by misanthropicsarah at 1:32 PM on January 25, 2017 [1 favorite]

Best answer: Oh as a general note for checking kids or yourself. You can print out eye charts online. Write a note in your phone when they did their exam then have them read the chart after a year or so WITH glasses and if it's worse than when they got glasses the year before then go in. I realized I needed glasses and had astigmatism from printing out an eye chart.
posted by Crystalinne at 1:50 PM on January 25, 2017 [3 favorites]

I have pretty strong myopia (-7.5) and have cost my parents a pretty penny in glasses since I was a kid. I got replacement glasses every 2 years because that's what our insurance covered; my vision sometimes deteriorated a lot in that time span though, so every year is probably better if you can afford it.
posted by serelliya at 7:51 PM on January 25, 2017 [1 favorite]

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