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Reminder, if you're in the US, the FTC says your eye doctor must give you your prescription after your exam. If a doctor refuses to do so, they can face legal

• fma 8y ago
  Did my vision exam last week at Costco. The Costco optometrist is independent from the eye glass department, which is owned by Costco and you need a member ID to buy from. The prescription had PD on there. When I used to do target or lens crafter... I had to ask.
  • themodelplumber 8y ago
    I went to a local business a while back, where the optometrist was about 2-3 years away from retirement. I didn't want to offend them but politely and clearly stated that I would like to get my prescription. Still, they made a big act about parading me through their small collection of frames, and even suggested a few they thought I should try on. Just to humor them for a bit, I put on a pair and they made me look like I was wearing something from the Kim Jong Il lineup. The office assistant, who reminded me of the secretary from Ferris Bueller's Day Off, gave me VERY high compliments on them. I could barely hold in my mirth after looking in the mirror and had to pretend my wife was calling so I could dodge out of there and get the laughs out in my car.
    • jimmydddd 8y ago
      The sad thing is that it appears that (in the US) for optomtrists, the eye exam is just a loss leader for the eye glass purchase in the "store" they also own. I assume my eye dr. went to college, medical school, and then some additional training (2 more years?). He does a very comprehensive eye exam, and my VSP insurance only pays him around $70 for the exam.
      • wgerard 8y ago
        Just a clarifying point: Optometrists are different from Ophthalmologists. Ophthalmologists are medical doctors (i.e. they have an MD), optometrists are not. Optometry also involves post-graduate training, and results in an OD (Doctorate of Optometry). In the type of store you're talking about, it's much more likely you'll see an optometrist, not an ophthalmologist.
      • todipa 8y ago
        Such a waste of an education for a job that can be done by someone less trained. The only constraint is regulatory. I get my eye exam checked every year for other more serious and complex diseases so I think there is a role for the more trained medical professionals but these exams need to be disentangled from the expensive professionals. That is the way to bring the costs down to a fraction of what they are...
        • outworlder 8y ago
          Is it, though? My ophtalmologist wouldn't only perform measurements to see if my prescription had changed. She would do a proper eye checkup. Retina, pressure and a host of other things. It wasn't expensive. Of course, it was also not in the US. You are only there once a year at most, so it is an opportunity to catch things before they go wrong.
          • cgy1 8y ago
            I have had the same experience in the US. An assistant rather than the ophtalmologist is the one that does the vision test (I guess it's called the refraction?). The assistant then dilutes my eyes and after that is when the ophtalmologist comes in to do the checkup for my eyes for issues.
  • byproxy 8y ago
    Wal-mart also has optometrists that will give you your complete prescription for (last time I checked) the same cost as an eye-exam at Costco. Been my go-to for the last few years.
    • bluGill 8y ago
      Both Wal-Mart and Costco have fully independent optometrists: they lease the space and equipment and are not employees. (sometimes state laws don't allow this in which case they are employees)
      • Scoundreller 8y ago
        I think it's the other way around. Most states don't allow optometrist clinics to be owned/controlled by non-optometrists. When they do, Walmart/Costco may find it worthwhile to own/operate the clinic themselves.
        • bluGill 8y ago
          You could be right. The information I was able to find said otherwise, but that may well have been biased.
  • mtnGoat 8y ago
    I second this, Costco is great for eye exams. No upsells.
• cableshaft 8y ago
  As you mention, measuring PD yourself (with a friend) isn't hard. There's articles and videos online about it. I've seen that left off a couple times, and I just ask one of the people up front to just measure it for me and tell me what it is. I usually buy my main glasses from them anyway, and just say I'll get sunglasses or computer glasses online (which is when I use Zenni), so that helps, but even without mentioning that, I haven't gotten any pushback when I've asked for it.
  • wenc 8y ago
    It is somewhat hard to get right. I did it with a marker and old glasses, and I still got it wrong (and couldn't return the glasses that I ordered).
    • kazinator 8y ago
      Ah, but no it isn't! See kazinator's dead accurate, no-friend-required method here: https://news.ycombinator.com/item?id=13092902 https://news.ycombinator.com/item?id=13092902
      • Buttons840 8y ago
        Clever. Seems obvious in retrospec though. It reminds me of collimating a telescope with a laser or your eye. You basically look down the optics of the telescope and you should be staring into your own eye, or if you use a laser the laser should be reflected by the mirrors exactly back into the emitter.
      • sabujp 8y ago
        it won't work if the mirror is tilted or bent, so make sure you get a flat mirror on a flat surface (e.g. use a level)
        • kazinator 8y ago
          If the mirror is bent, a level will not help. A level is useful if orientation relative to gravity is important (something has to be horizontal or vertical, like a cabinet, counter, or picture). That isn't even remotely relevant here. You could do this measurement while staying at the International Space Station. Even cheap mirrors from a dollar store are more than good enough for this, as long as they are glass. Most plate glass glass is made by floating melted glass on a bath of molten metal (which is heavier). The molten metal, if undisturbed, provides a perfectly level surface. Just don't use a plastic mirror, or a cheap polished metal one, not to mention a magnifying mirror. Even fairly noticeable distortion will not matter at the distances involved in this measurement. Let's say that your mirror is so horribly warped over the tiny ~65 mm pupillary distance that the pupil-to-ruler lines of sight are an entire degree away from being parallel. The measurement will then be off by about 1.7% of the distance from your pupils to the ruler. If you get your eyes within 15 mm of the ruler, the error is only about 0.25 mm; below what you can resolve with that ruler. If the mirror is fair, but tilted, the effect is negligible because the lines of sight remain parallel. The measurement is diminished according to the cosine of the tilt angle. For a rather significant five degree tilt, it will be only around 0.25 mm short.
• wlesieutre 8y ago
  They also can’t require a membership to get an eye exam, so if you don’t want the pressure to buy glasses there, Costco is a safe bet. They’ll give you your prescription and literally wouldn’t sell me glasses even if I wanted them, since I wasn’t a store member. I did have to measure my own IPD though, which I did with a ruler and a mirror. EDIT: another reply notes that they did get their IPD at Costco, so this might vary by location. As they mentioned, the optometrists are independent.
  • walrus01 8y ago
    Fun costco fact, in Canada and in many US states you also don't need a membership to use their pharmacy. And also in many US states where they sell alcohol they legally can't require a membership to buy it.
    • wlesieutre 8y ago
      I think that’s the case here in Connecticut for alcohol, though I’ve not gone and checked.
      • crankylinuxuser 8y ago
        I know for a fact that Indiana is a state that cannot put membership barriers on alcohol. I first saw a sign declaration in Sams Club stating that. When I went to the front desk, it was much gnashing of teeth to get the manual override for "alcohol exception". And then they demanded I do the mandatory member search. Members agree to. I'm not a member. I dont consent to searches. Maybe it makes me an asshole ; they're free to make it truly member only by removing alcohol. And also as another note, any alcohol sales in Indiana must be offered to all legal-to-purchase people. You cannot say "10% off with a kroger card". That's just as illegal as requiring a membership card.
        • RandomTisk 8y ago
          What is a "mandatory member search"?
• deleted 8y ago
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• CarriersSuck 8y ago
  Your PD is not actually part of your Rx. That's why it's normally not included. Your Rx consists of a OS Rx and OD Rx.
  • deleted 8y ago
    [deleted]
  • geoelectric 8y ago
    No, but the law has a handwavy bit about "everything needed to get prescription lenses," which ostensibly would include the PD at plain reading since you can't make the lenses without it and it's based on medical information. Your stance vs. that one is the crux of the debate. https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=797d7708fd092b6eed36927a1f783a4f&ty=HTML&h=L&r=PART&n=pt16.1.456 https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=797d7708f... > (g) A prescription is the written specifications for lenses for eyeglasses which are derived from an eye examination, including all of the information specified by state law, if any, necessary to obtain lenses for eyeglasses.
• dawhizkid 8y ago
  biggest scam is that glasses/contact prescriptions only last a year in the US
  • ddingus 8y ago
    That's maybe Fair given the potential rate of change.
    • kazinator 8y ago
      You can go decades without a change, or a significant change (more than half a diopter).
      • ddingus 8y ago
        Yeah, and others may go months, or years too.
      • bluGill 8y ago
        Significant change isn't just the RX, it is other things that can go wrong in the eye as well. IF caught early it can be corrected, otherwise you may not notice until you are half blind.
        • jrockway 8y ago
          That's true of everything, though. Your grocery store doesn't say, "sorry, you haven't been to the dentist in 6 months, we can't sell you food", even though there are many dental issues that can be life-threatening if not treated and eating food makes it worse. It's not their business to care.
  • xxpor 8y ago
    That varies by state. My NJ prescription lasts for 6 years IIRC.
    • joecool1029 8y ago
• bunderbunder 8y ago
  Nit: An optometrist is usually fine if all you need is a refraction. It's when you're dealing with something that requires medical intervention (glaucoma, pars planitis, etc.) that you need to shell out for an ophthalmologist. An optometrist can still catch that stuff, but will need to refer you for treatment.
  • checkdigit15 8y ago
    This is a good point and also worth pointing out (in the US at least) that most ophthalmologists will be covered under your medical insurance not your eye insurance (if any) because they are medical doctors. I was getting my contact lens exam/fitting recently and the optometrist wanted me to get something checked later by an ophthalmologist. He said it was probably nothing to worry about but made it clear that it was outside his scope of expertise to diagnose or make medical recommendations.
    • leeoniya 8y ago
      my wife is an optometrist. it's amazing the stuff she finds. she's found brain tumors and literally saved people's lives by referring them early to a neuro-ophthalmologist when they came in just to update their prescription. many latent systemic problems are also clearly visible in the eye: hypertension, diabetes, etc.
    • amalcon 8y ago
      > This is a good point and also worth pointing out (in the US at least) that most ophthalmologists will be covered under your medical insurance not your eye insurance (if any) because they are medical doctors. Make sure they code it correctly! I once had a rather large bill because the ophthalmologist's office accidentally billed me under a "routine" code that my medical insurance didn't cover. It took several hours of phone calls with the insurer and the ophthalmologist to get it corrected.
  • poopchute 8y ago
    Just echoing this, (Canada) my optometrist caught my glaucoma early using that machine that shoots a burst of air at your eye. He referred me to an opthalmologist who said there isn't any damage yet but gave me a prescription for some eye drops that reduce eye pressure. I'm only 27 and don't have any other medical issues, so it was a but of a surprise
• sftwds 8y ago
  It doesn't hurt to ask! The last time I got my eyes examined was at some cheap lenscrafters-type store which had a promotion for 2 pairs of glasses and an eye exam for ~$60. The PD wasn't on the prescription, but the doctor made the measurement after I asked about it. There was a very limited selection of glasses that were available for the 2-for-$60 promotion, and they really tried to upsell me to more expensive frames and lenses. Luckily I was able to resist their sales attempts and bought a nice frame and lenses from Zenni Optical. I keep one pair of the cheap glasses at my office and the other in my car. As an aside, being able to get inexpensive glasses online has been a huge improvement on my life. I remember growing up when I only had a single pair of glasses (and a "backup" which were with my previous prescription). I had to be very protective of my glasses, and getting a scratch on the lens meant that I was stuck with it until my prescription changed. Now I can get my favorite glasses from Zenni for $25, so I have backups if the lenses get scratched or the frame get bent. I also have prescription sunglasses for the first time! No more dorky clip-on shades!
  • andai 8y ago
    Can confirm, can order like 8 pairs for what 1 used to cost me. The things we can do nowadays!
  • bergesenha 8y ago
    Around here the store has some cheap frames they use for advertizing. The problem is they look like something a crazy old aunt would wear, with wild coloring. If you want anything like normal glasses you have to pay for the expensive brands. It’s really sad seeing institutionalized and less fortunate people wearing those cheap glasses...
    • notyourday 8y ago
      > Around here the store has some cheap frames they use for advertizing. The problem is they look like something a crazy old aunt would wear, with wild coloring. That would make you all the rage in a hipster circles.
    • NeedMoreTea 8y ago
• kazinator 8y ago
  However, you can easily measure your own pupillary distance exactly down to the millimeter with a ruler and a mirror. https://news.ycombinator.com/item?id=13092902 https://news.ycombinator.com/item?id=13092902
  • corw1n 8y ago
    Only problem is, if you look to close in the mirror, your pd changes because your eyes rotate to focus on the shorter distance. If you are closer then 1 meter to the mirror you should compensate. Up to 2,5 mm per eye if ur at 40 cm distance.(20cm from mirror)
    • kazinator 8y ago
      There is no such problem. Each eye stares at itself in the mirror. (Not necessarily at the same time, if the procedure is done as described.) Those two lines of sight are parallel if the mirror is true, regardless of distance to the mirror. There may be a different problem: though parallel, those two lines of sight may not be exactly perpendicular to the ruler/mirror. This is not going to make a huge difference. Suppose the mirror/ruler is rotated five degrees off relative to the plane of your pupils, which is quite a lot. For an pupillary distance of 65 mm, this introduces only a 0.25 mm error on the low side: basically the measurement shrinks by the cosine of 5 degrees which is 0.996. Pupillary distances are typically given to the millimeter. > If you are closer then 1 meter to the mirror you should compensate. If you're 1 meter away from the mirror, you won't be able to read the ruler, at least if you're doing all this because of near-sightedness. :) This technique is best if your face is right up to the mirror. If you press your forehead to the mirror so your head doesn't move, that's probably best. If you're far sighted and can't read the ruler from that close, then you have to back off. If you can't read the ruler at any distance, you may have to do this with contact lenses on.
• wnevets 8y ago
  >That said, I don't think the FTC stipulates what information must appear on the prescription. Many docs leave off your PD (pupillary distance), which is a necessary measurement if you're buying online. Fortunately, there are a variety of easy ways to take this measurement yourself after the exam, although if you're really concerned about precision, you'll want the doctor's measurement. at that point just visit a better eye doctor.
• patorjk 8y ago
  This kind of blows my mind. A few years ago when I went to the eye doc, they refused to give me my prescription, I had to buy glasses from their store in their office. Last year when I went, they gave me my prescription at the end, without me asking. It felt really nice and at the time I figured they were doing it to create a better relationship with their customers. Now I wonder if someone knew about this rule and reported them. Kind of curious how long it's been in effect.
  • sudosteph 8y ago
    I just got my eye exam done this morning, and I agree it really does make a way better experience. I think it's a state-level law thing. Here in WA State it's illegal for a optician to refuse you a plain eye exam or refuse to give you your prescription information, including pupillary distance: https://app.leg.wa.gov/rcw/default.aspx?cite=18.195&full=true https://app.leg.wa.gov/rcw/default.aspx?cite=18.195&full=tru...
    • traek 8y ago
      It's not, it's a nationwide thing enforced by the FTC. WA and some other states have stricter laws which include pupillary distance. https://www.ftc.gov/tips-advice/business-center/guidance/complying-eyeglass-rule https://www.ftc.gov/tips-advice/business-center/guidance/com...
      • sudosteph 8y ago
        Good to know. But judging by the current messaging on the site that where you're supposed to send those complaints for that... I don't think there's much enforcement going on right now. https://www.ftccomplaintassistant.gov/ https://www.ftccomplaintassistant.gov/
        • zie 8y ago
          Considering the US govt has been partially closed for over a month now, it's probably a fair statement that NO enforcement of this is going on right now. :P
• xahrepap 8y ago
  I told my doctor up front that I don't plan to ever buy eyewear from them because I don't feel comfortable buying a prescription from the prescriber. They were very accepting about it and they've been quite respectful to my wishes.
• jdblair 8y ago
  My doctor did leave the PD off the prescription, but I just called the office and asked for it. To their credit, they looked it up for me in their records.
• deleted 8y ago
  [deleted]
• acomjean 8y ago
  Eye exams are important. I have a cordial astigmatism in my left eye, I would not have know about without it. The eye glass seller in longwood boston will measure your pupil distance, and check that your online glasses match the prescription when you get them. He charges a small fee for this.
  • wwasilev 8y ago
    Would that be Longwood Optical?
    • acomjean 8y ago
      yeah. I like the glasses I got there but the owner was a little overbearing. Although I like it when they help curate the frames.
• criddell 8y ago
  A few years ago after an exam, I asked for my prescription and they handed it over with no complaints. I asked for my PD measurement and was told that is free with the purchase of glasses. I offered $20 for just that measurement and they wouldn't do it.
• LorenPechtel 8y ago
  I don't think the doctors normally measure the PD, they leave that to the ones who cut the glasses. That really does cause problems for doing it online, though.
  • fencepost 8y ago
    PD is actually an automatic part of having that big mass of lenses up against your face and properly positioned for testing. If they don't have that adjusted properly you're not going to see much.
• loufe 8y ago
  I'm not sure if the professional designation changes country to country, but here in Canada an ophthalmologist would not be the person to give a comprehensive eye exam. That would be an optometrist. (source: optometrist parent)
  • wrycoder 8y ago
    Your parent had it backwards. An ophthalmologist is an MD.
• O1111OOO 8y ago
  > your eye doctor must give you your prescription after your exam In regard to the above quote, I wonder how effective or if anyone is familiar with: https://www.indiegogo.com/projects/eyeque-visioncheck-world-s-1st-automated-eye-test#/ https://www.indiegogo.com/projects/eyeque-visioncheck-world-... It essentially promises to not only cut out the doctor's exam visit but actually improve the prescription (since measurements are taken throughout the day). note: not affiliated but seems like an interesting product (if not now then certainly as the field of self-testing improves, example: https://tricorder.xprize.org/prizes/tricorder https://tricorder.xprize.org/prizes/tricorder)
  • teknico 8y ago
    Not affiliated either, just an amazed customer. Never needed glasses until I was in my late forties and had to start using reading ones. I bought the Personal Vision Tracker (the black one) on the Indiegogo campaign. It's not very easy to use but gives fairly consistent data if handled with care. I did not yet compare the device data with the ones from a doctor's visit. (The data for my right eye are slightly worse than for the left, and I have indeed not ideal results with standard reading glasses.) I bought prescription glasses on a UK site (I live in Europe) based on the device data. Both the reading glasses (short distance) and the computer glasses (medium distance) are perfect: I have not seen this good in years. Because of that excellent result I have also ordered the VisionCheck (the new, white one) on the Indiegogo campaign. It is purportedly easier to use, not gotten it yet. Meanwhile I had also got the Insight model (larger white one). That is for visual acuity and it confirmed that I have 20/20. Interestingly, it also showed I have a light form of tritanopia, which might explain past naming disagreements around colors between green and blue. Their product page: https://www.eyeque.com/pvt/ https://www.eyeque.com/pvt/
• koiz 8y ago
  About 6-7 months after an exam I went back to get my prescription/PD measurement because I wanted to order something online instead from local shop because of their insane prices and they outright would not give me the measurement. Likely knowing I didn't want to buy frames from them. They've been closed for years.
• hamandcheese 8y ago
  In almost every eye exam I’ve gotten the doctor doesn’t even measure my PD, but rather the glasses sales people once I’ve found a pair of frames I like.
  • ubermonkey 8y ago
    Yeah, this. The lack of PD on scripts is mostly about how labor has typically been divided, not a nefarious or bad-faith effort to force you into using the local optometry department. In years past, those optical departments were a major part of the ophthalmologist's/optometrist's business model. With the rise of big-box store optical, though, that changed. (And has now changed MORE with folks like Zenni and Warby Parker, etc.) For example, my late stepfather's business (he retired in '99) depended on that optical department, but for most of his career (and his father's before him) there WEREN'T places outside doctors' offices to get glasses, especially where I grew up. OTOH, the eye doctors I've used in Houston, where I've lived since the mid 90s, have generally not even HAD an optical department. Oh, and one more bit: ISTR that Warby Parker will do a PD measurement for you gratis if you visit one of their stores. You might even find glasses you like -- not as cheap as Zenni, but definitely cheaper than a traditional provider.
• fanzhang 8y ago
  A optometrist I went to did my eye exam for $90, and then I decided I wanted the prescription to get my own contacts. First, I asked, and they denied it. Then I literally had to pull out this law and they finally granted it. But they did everything they could to obstruct me. Literally they refused to scan it and wanted me to show up in person. Then while writing it, the doctor himself said "sad to see you don't support our business". (For people living in Boston, the place was Custom Eyes in Central Square.) I was surprised by the divergence between the law and how pissy the doctor got when I tried to exercise my rights.
  • akira2501 8y ago
    > the doctor himself said "sad to see you don't support our business". That I would want to question him about. Does he mean that the medical service is the loss-leader and that he gets a kickback off our purchase of eyewear?
  • vamega 8y ago
    Wow, I used to go there 4 years ago and liked the place. Never had trouble getting my prescription. So sad to see how that place changed.