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Eye Care Archive (Expert Forum)
Difference between prescriptions
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Difference between prescriptions
by JenSch, Mar 16, 2006 12:00AM
My 2 1/2 year old daughter was recently diagnosed with severe farsightedness. We decided to get a second opionion with a Ped. Opth. who is supposed to be one of the best in the country. These are results:
First Doctor - OD - +6.50, -.50, 180 OS - +7.0
Second Doctor - OD - +5.25, +.25, 90 OS - +5.25, +.25, 90
Also, what blew me away was the fact that the second doctor said that the prescription in the glasses that we had filled did not match that of the first doctor's prescription! He said it was a OD - +5.25, +.50, 90 and OS - +6.25 in the glasses. I went back to the optician who gave us the glasses (a chain store) and they insist that it is correct. THey are very nice and are willing to replace them or give me the new doctor's prescription. They also said that if there were an error, that this would have been a huge difference in the optics. So either the second doctor or the optician is very wrong!
These are my questions:
1) How could there be such a difference in prescription between the first and second doctor?
2) I thought I trusted the second doctor until he said that the prescription in her glasses was incorrect. How could one of the top PO 's in the country make such a mistake / accusation???? Is it possible that his machinery was off? Was he just in a rush?
3) Which prescription should I choose for my daughter? She hasnt been very cooperative in wearing these glasses. They usually come off after 20 minutes to an hour.
Thanks so much for your opinion!
Jen
First Doctor - OD - +6.50, -.50, 180 OS - +7.0
Second Doctor - OD - +5.25, +.25, 90 OS - +5.25, +.25, 90
Also, what blew me away was the fact that the second doctor said that the prescription in the glasses that we had filled did not match that of the first doctor's prescription! He said it was a OD - +5.25, +.50, 90 and OS - +6.25 in the glasses. I went back to the optician who gave us the glasses (a chain store) and they insist that it is correct. THey are very nice and are willing to replace them or give me the new doctor's prescription. They also said that if there were an error, that this would have been a huge difference in the optics. So either the second doctor or the optician is very wrong!
These are my questions:
1) How could there be such a difference in prescription between the first and second doctor?
2) I thought I trusted the second doctor until he said that the prescription in her glasses was incorrect. How could one of the top PO 's in the country make such a mistake / accusation???? Is it possible that his machinery was off? Was he just in a rush?
3) Which prescription should I choose for my daughter? She hasnt been very cooperative in wearing these glasses. They usually come off after 20 minutes to an hour.
Thanks so much for your opinion!
Jen
Doctor's Answer
by Forum-OD-MP, Mar 16, 2006 12:00AM
i feel badly for you. i apologise for some of the difficulties you have had with my profession. its embarassing.
okay here we go...
1) how could there be such a big difference in rx between the 2 doctors? the main reason is b/c this is an art, not a science. patients think that they have some rx in their eyes and we eye docs measure that rx and its a hard, repeatable science. truth is every person has a "range" that they see well thru, and if you went to 5 different eye docs you'd get 5 slightly different rx's. no one would be way off, but its also doubtful that any of them would be identical. there is about 1D difference between those two rx's in the right eye and about 1.5D difference in the left.
2) how could there be a difference in the actual rx as measured by the PO and the optical shop? well there are a bunch of possibilities, and i bet there is some sort of combination going on. there could be differences in the equipment used to measure the rx, and differences in user technique used to measure the rx. plus there is the conversion factor...one rx is in "minus-cyl" form but the PO rx is in "plus cyl" form... to be honest i dont know why the rx's dont match but you're right, someone is incorrect.
3) which rx should you choose for your daughter? its sad to me that you feel like you have to choose. but i'm going to give you my opinion: in general in most young hyperopic patients, especially those who are esotropic which i ASSUME your daughter is (one or both eyes point IN)...the more powerful rx is probably the safer one. if the more powerful one was incorrect and overcorrected her making her distance vision blurry its really not that big of a deal. however if the less powerful one was incorrect and she was still undercorrected and ESO (turned in) even with the glasses on, that *is* a big deal. i'll take distance vision blur in a pediatric patient over constant esotropia EVERY TIME. every single time.
as for how to get your daughter to wear them...its really, really difficult. i'm sorry but you have to be mean. FORCE her to wear them. this is a big deal. she could permanently lose vision if she hasnt already. plus when she gets school age (i forget how old you said she was) she will have a VERY difficult time if you dont hash this out before then.
good luck. wouldnt hurt to get a *3rd* opinion...
okay here we go...
1) how could there be such a big difference in rx between the 2 doctors? the main reason is b/c this is an art, not a science. patients think that they have some rx in their eyes and we eye docs measure that rx and its a hard, repeatable science. truth is every person has a "range" that they see well thru, and if you went to 5 different eye docs you'd get 5 slightly different rx's. no one would be way off, but its also doubtful that any of them would be identical. there is about 1D difference between those two rx's in the right eye and about 1.5D difference in the left.
2) how could there be a difference in the actual rx as measured by the PO and the optical shop? well there are a bunch of possibilities, and i bet there is some sort of combination going on. there could be differences in the equipment used to measure the rx, and differences in user technique used to measure the rx. plus there is the conversion factor...one rx is in "minus-cyl" form but the PO rx is in "plus cyl" form... to be honest i dont know why the rx's dont match but you're right, someone is incorrect.
3) which rx should you choose for your daughter? its sad to me that you feel like you have to choose. but i'm going to give you my opinion: in general in most young hyperopic patients, especially those who are esotropic which i ASSUME your daughter is (one or both eyes point IN)...the more powerful rx is probably the safer one. if the more powerful one was incorrect and overcorrected her making her distance vision blurry its really not that big of a deal. however if the less powerful one was incorrect and she was still undercorrected and ESO (turned in) even with the glasses on, that *is* a big deal. i'll take distance vision blur in a pediatric patient over constant esotropia EVERY TIME. every single time.
as for how to get your daughter to wear them...its really, really difficult. i'm sorry but you have to be mean. FORCE her to wear them. this is a big deal. she could permanently lose vision if she hasnt already. plus when she gets school age (i forget how old you said she was) she will have a VERY difficult time if you dont hash this out before then.
good luck. wouldnt hurt to get a *3rd* opinion...
