optoblog.com

Since October 16, 2020 I have had to take an extra step at the end of the exam to explain to patients they they need to sign a statement saying that they received a copy of their contacts lens Rx. Firstly, some people get a bit apprehensive when asked to sign any kind of legalese- as they should. Second, the question “why?” pops up when they’ve been wearing contacts for years and never had to do this rigmarole before.

So, obviously, the Contact Lens Rule was created to punish all optometrists for the sins of a few. No doubt that online retailers were behind this. You would think the proper way to handle a complaint that your optometrist didn’t give you a finalized prescription would be to tell your state optometry board and let them correct the issue as their rules dictate. But that wasn’t good enough for the Feds, so now we live in a county where the FTC has requirements for optometrists- although the punishment for not complying isn’t spelled out clearly.

So if we’re going to take away power from the states regarding their administration of licensed professions, then let’s just be consistent and have a national optometry license and tell the states that they can take their boards and throw them in the septic tank where they also think all the optometrists belong.

Tags: 1-800, Comics, contacts, doctors, Government, patients

There has been a lot of buzz about Bitcoin lately since it’s Dollar to BTC value has skyrocketed this last year and especially month. I heard about it way back in 2009, so I fiddled around with mining for a week or two. I visited a website that had a “Bitcoin faucet” which gave away 5 cents of Bitcoin (or 50,000 µBTC), so I had that in my wallet, but I pulled the plug since my 2009 laptop was way under powered to mine. So my 5¢ of Bitcoin sat in deep storage until Thanksgiving 2017.

Bitcoin was nearly worthless until randsomware came around which made people exchange dollars for Bitcoin to pay the criminals. It has also been heralded as a “Cryto-currency” and such, but I would like to argue that it is nearly worthless as a true currency and has been behaving more like a gold investment or other commodity investment.

When the exchange rate of BTC for $ was 11K, I decided it was worthwhile enough to find where I’d stored away my Bitcoin wallet. I found it okay, but my Bitcoin-Core app was so out of date that it wouldn’t connect to the Bitoin distributed network. After updating, I copied my wallet into the app, but I couldn’t make any transactions to an exchange account until my 2009’s 250 MB blockchain had been updated to the current 157 GB (!!!) blockchain. This took 2 weeks because it kept freezing, so I’d have to start it over and -reindex and -rescan and wait and wait because my 2017 laptop isn’t powerful enough I guess. The Bitoin Core-QT app also hogs the hard drive system resources (100%) even though the memory and processor power are barely used.

ANYWAY, it worked out great for me because during the next two weeks, 1 BTC went from $10K to $19K. After finally updating my block chain, I was able to transfer 4¢ of coin to an exchange account, but I didn’t realize that the miner’s fee is really important, so I tried to underbid, which led to my transaction not being processed at all. So I figured out how to abandon that transaction and then conceded to the recommended mining fee.

After bidding for a “4 hour fee” my transaction was finally confirmed 12 hours later, so I immediately cashed out when it was $18K/BTC. So everything worked out for me, but note how my story makes it obvious that BTC will never truly be a currency or money.

If I go to a pizza restaurant, I can’t pay with Bitcoin because the transaction would not be finalized in time before I’ve already eaten my pizza and gone home (unless it was a 1980s era Pizza Hut in which case you bring a bag lunch so that you won’t get hunger pains by the time your pizza arrives for dinner). Also, the shop owner isn’t going to want such volatility in the value of the currency being accepted.

Every time a consumer pays a shop owner with BTC, the consumer has to pay the transaction fee, which is opposite of the current plastic card model. And don’t forget that there is also volatility in how much one has to pay the miners to get a transaction processed in a reasonable amount of time (or if ever).

BTC is currently more of a gold or other speculative commodity rather than a true currency, so have fun investing rather than getting paid and spending. Actually, let’s start calling it a Crypo-Investment rather than a “cryto-currency.”

BTW, John C. Dvorak has two words for you, “Beanie Babies!“

Tags: Bitcoin, currency, investing, investment, money

The drug companies report to CMS regarding how much they spend on each doctor for marketing, research, etc at the website openpaymentsdata.cms.gov, so feel free to search your own name. You can also search by the company making payments: (Alcon, J&J, Coopervision, Allergan, etc.
You can see my numbers here.

2015 Me: 59.27 Mean OD: 735.78 Median OD: 135.78
Mean physician: 3271.25 Median physician: 160.38
2014 Me: 36.81 Mean OD: 637.37 Median OD: 127.46
Mean physician: 3382.39 Median physician: 168.37
2013 Me: 86.06 Mean OD: 429.08 Median OD: 94.72
Mean physician: 1583.47 Median physician: 111.25

What I notice immediately is that the mean and median numbers are WAY different, so there must be a few doctors out there making TONS of cash from the pharmas and medical manufacturers.

Also…why are MY numbers so low??? What’s up with that!? I guess I don’t get invited to as many free lunches as the mean and median optometrist.

From what I can tell by searching eye doctors that I know, Alcon had a huge marketing push in 2015. And also Alcon beats J&J and Coopervision in the free lunch dept.

Also note how the median optometrist is just a big ball-o’-nothin’ compared to the mean other doctors.

Back when I worked at Walmart, I overheard the following conversation:

A guy wants to buy contacts but doesn’t have his Rx on him and his doctor is in another state. Walmart optician explains the Rx can be faxed to us since we need the written Rx and not just the contact boxes.
Optician: Was the exam done at a Walmart?
Guy: No, it was at an actual eye doctor.

Read more @ the Optotrician posts.

Opt School or a house?
Electricians make more cash.
Too late to drive truck?

As a mid-career optometrist still 20 years from any kind of retirement, I often wonder if I made the right decision. I’ve had to do some electrical work on my 1960 house (because that’s the kind of house an optometrist can afford) and really enjoyed it. Also I really like driving, so I probably should have been a trucking electrician or an electrical trucker.

If you liked this one, read more Optoblog poetry.

Tags: career, Jobs, optometrist

I was an Indian Health Service optometrist for two years, but my dad was one for 34, beginning in 1971. I believe he was the first PHS-IHS optometrist to join and then serve a full 30 years. (There may have been others that actually retired before him, but they had previous military time-in-grade.)

One of his contemporaries was Dr. Les Caplan, OD, MEd, FAAO. Dr. Caplan is an award-winning optometrist of historical significance. He was the first optometrist assigned as the Clinical Consultant for Optometry to the director of the Indian Health Service. Back in the early 70s, optometrists were barely being integrated into the IHS healthcare system as real eyecare physicians, so Dr. Caplan traveled around the country to help make this monumental transition, paving the way for increased scope of practice for optometrists in all modes of practice.

In June 2015 at the AOA meeting in Seattle, there was a presentation sponsored by the Optometric Historical Society that Dr. Caplan gave, and I got a hold of his presentation. The powerpoint file was 128 MB, so I condensed it to an 18 MB PDF, which you can view here with Dr. Caplan’s permission.

On page 39 there is a picture of some wetlands viewed through an airplane window. That is actually a 5 minute silent video filmed in 8mm that shows highlights from Dr. Kaplan’s trip to Alaska in 1971.

Anyone interested in Indian Health Service optometry should go through the entire presentation. It is also of significance to anyone interested in optometry’s advancement in scope of practice.

To learn more about the AOA’s optometric history initiative, read this.

There is an award given to PHS optometrists named after Dr. Caplan.

Tags: History, Indian Health Service, Organized Optometry, Scope of Practice, Travel

[scrippet]Title: The Air Puff
Author: David J. Langford
Contact: editor@optoblog.com

Fade in.

INT. – OPTOMETRIST PRE-TEST ROOM – DAY

DR. LANGFORD, an optometrist that smiles like a clown, tosses his clipboard on the adjustable table behind three items of ophthalmic instruments. He lowers the table as JANAE, pretty and wholesome, sits down on the stool on the other side of all the machines.

DR. LANGFORD
So…Jay-Nay? What brings you in for an eye exam today?

JANAE
Juh-Nae. Oh, just a check up.

DR. LANGFORD
Okay, then. Let’s start with this machine.

JANAE
Oh, no. Is this that puff of air thing?

DR. LANGFORD
Yeah. This one is not too bad.

JANAE
Really?

DR. LANGFORD
It’s the most gentle non-contact tonometer on the market.

JANAE
‘Kay…

Janae puts her forehead on the rest. The doctor clicks the button. The machine whirs, and we hear a PUFF of air.

JANAE
(high, almost squeal)
Oh!

She sits back and rubs her eye.

DR. LANGFORD
Ready for the next one?

JANAE
I guess…

The machine whirs again then PUFFS. Janae recoils the same way.

JANAE
(rubbing second eye)
I’m glad that’s over with. What does that machine do, anyway?

Dr. Langford tries to repress his wierd smile.

DR. LANGFORD
It checks eye pressure, which is important to know because if it’s outside the normal range, you could have a serious eye condition.

Janae blinks a lot.

JANAE
My eyes feel dry now.

DR. LANGFORD
Okay, let’s move on to this machine. It gives me a close idea of any glasses prescription you might need. Chin on the chin wrest.

She puts her head up to the autorefractor. It beeps and then-PUFF!!

JANAE
Ah! Hey! I thought we had already finished the puff of air thing!

DR. LANGFORD
Did that puff at you?

JANAE
Yes!

DR. LANGFORD
Huh, let’s try the other eye then.

She puts her head back to the machine, but the monitors shows that she’s squinting in anticipation.

DR. LANGFORD
Okay, for the machine to take the measurement, you’re going to need to open your eye wider.

JANAE
But I don’t want it to puff at me.

DR. LANGFORD
Just a little wider…

Janae’s eye opens just barely more and…PUFF!

JANAE
Ow! It did it again.

DR. LANGFORD
(holding up the print-out)
Well…it printed out these glasses prescription numbers, so it can’t be broken.

JANAE
But it blew air at my eye!

DR. LANGFORD
I’ll have a look at it later. Let’s move on to the last machine in this room.

He holds out a clicker for her to take.

DR. LANGFORD

It’s going to test your peripheral vision. Every time you see a flicker in your side vision, just click on the button. It takes about a minute per eye.

JANAE
Okay, that doesn’t sound so bad…

She takes the clicker from Dr. Langford and puts her forehead up to the machine. She SEES THE FLICKERING SQUARES on the screen.

JANAE
So when I see those dealies I just click?

DR. LANGFORD
Yup, but don’t move your eyes around just look straight ahead. Okay…begin.

She presses the clicker and- PUFF! She sits back.

JANAE
What the…

DR. LANGFORD
Keep clicking!

She gets in the the machine again. She clicks, and…

.MONTAGE OF GETTING PUFFED

PUFF! Janae clicks, puffs, and yelps over and over. Dr. Langford looks on with a sly grin.

INT. – OPTOMETRIST PRE-TEST ROOM – DAY

JANAE
Doctor, every time I clicked on the button, it gave me a puff of air in the eyes!

Dr. Langford looks at his display.

DR. LANGFORD
Oh, you know what? I had it set to the serial tonometry setting. Sometimes it’s helpful to take multiple readings to see what your eye pressure is over time. Oh well, no harm done. Let’s go into the exam room.

INT. OPTOMETRIST EXAM LANE – DAY

Janae enters rubbing her eyes and sets her things down. As the doctor enters, she looks in the mirror on the wall to see that her eyes are *bright red*.

JANAE
My eyes are really red!

DR. LANGFORD
Don’t worry, that will go away in a minute. Have a seat on that dentist-looking chair.

JANAE
I hope you’re right.

DR. LANGFORD
Of course I’m right.

He scoots a big Phoropher up to her head.

DR. LANGFORD
Now, which is better? One or two?

We see an eye chart, and switching between one or two, WE DON’T NOTICE ANY DIFFERENCE.

JANAE
Um..

Black Screen

SUPER: 20 MINUTES LATER…

INT. OPTOMETRIST EXAM LANE – DAY

DR. LANGFORD
And now which is better, one or two? One or two?

JANAE
I don’t…uh..

Dr. Langford pulls the machine away.

DR. LANGFORD
Okay, it looks like you don’t need glasses still.

JANAE
All *that* just to find out-

DR. LANGFORD
Okay, one last thing, I’m going to look inside your eyes with my microscope.

He swivels a slit lamp over. It looks kinda’ like those other machines in the pretest room.

JANAE
Doctor, look…I’d rather not do this one.

DR. LANGFORD
Well, I need to look inside your eyes to complete the exam.

JANAE
But couldn’t you do it with something…else?

He pulls out an ophthalmoscope, an innocent-looking flashlight.

DR. LANGFORD
I guess I could use this.

JANAE
Let me see that.

He hands it over. She twists it apart, looks, and reassembles it.

JANAE
Yah, I guess that’s okay.

He takes it back and gets…uncomfortably close to her face.

JANAE
(pushing back)
Whoa, whoa!

DR. LANGFORD
With the ophthalmoscope, I have to get in close. You chose this one. Don’t worry. Nothing touches you.

Janae still has a defiant look of doubt.

DR. LANGFORD
Just a quick thing, and then we’re done.

JANAE
(a look that says don’t cross me)
Real quick.

DR. LANGFORD
Yes.

JANAE
It won’t hurt.

DR. LANGFORD
No.

JANAE
Fine. Get it over with.

He brings the “flashlight” in again, still uncomfortably close.

We SEE ALL THE BRIGHT LIGHTS that she sees.

And then… PUFF! She recoils.

JANAE
That’s it! I’ve had it!

She stands up from the exam chair.

JANAE
I’m not paying for this!

She starts to walk out.

A BLACK SPOT BLINDS her central vision and full view of the doorway.

Janae hits the wall. She holds her forhead.

JANAE
You are sick!

As she exits she has fire in her red, red eyes.

EXT. PARKING LOT – DAY

Dr. Langford strolls to his car. As he gets out his keys.. WHACK! A force of nature- a flash, which vaguely looks like Janae, body checks him onto the car. His limp body then slides to the ground.

Janae brings around the car a big air compressor on wheels. She holds open his eyes while pressing the trigger. Air whooshes his hair and then her aim corrects to his eyes.

JANAE
(as she alternates the aim between his eyes)
Which is better now, doctor? One! or Two!

Dr. Langford whimpers, eyes red. Now Janae has the weird smile.

FADE TO BLACK and ROLL CREDITS

INT. OPTOMETRIST EXAM LANE – DAY

Dr. Langford gets really close to Janae with an ophthalmoscope…and steals a kiss.

FADE TO BLACK
[/scrippet]

Tags: air puff, comedy, movies, patients, revenge, scripts

The phrase “apple of thine eye” is really a mistranslation. We should be saying “Little Man of the Eye” or “Little Doll of the eye.”
If you are the little man in God’s eye that means He is watching over you so closely that whoever looks at His eyes will see you in His cornea’s reflection.

The “On Top of the World” music video by Imagine Dragons is my most favorite music video of all time.  The video portrays a faked moon landing while referencing Stanley Kubrick and late 1960s pop culture.  It was written and directed by Matt Eastin and Corey Fox.  In addition to Imagine Dragons, it features the lead actor from Napoleon Dynamite, Jon Heder, and many from the cast of StudioC, BYUtv’s sketch comedy show.   Guest appearances also include Whit Hertferd, Marvin Payne, the monkey from Friends, members of New Electric Sound, and Robert Connolly from Fictionist.  Also appearing is Alex Sermon, wife of lead guitarist Wayne Sermon, and Aja Volkman, wife of lead singer Dan Reynolds and from the band Nico Vega.

Making Of

Some great coverage regarding the making of the video includes:

• Costume/Fashion designer Lindsey Shores outlines in a Herald Extra Article the costumes, and her website has great photos from the shoot.
• A Salt Lake Tribune article has great behind-the-scenes info
• A Fox 13 TV article has a great feature and reports that co-director Corey Fox claims that there are over 50 hidden 1960s references in the video
• UtahValley360 article: “15 things you didn’t know about Imagine Dragons’ music video“
• iluminatiwatcher.com article on hidden symbols in the music video

Studio C and Matt Meese

Interestingly, many of the StudioC cast members are in the video, but not all of them!  Here is a list of Studio C cast members and their roles along with a link to their twitter accounts:

• Mallory Everton is a hippie.
• Jeremy Warner is another hippie.
• James Perry is the boom mic operator.
• Whitney Call is an assistant to Stanley Kubrik (or President Nixon?).
• Jason Gray is a Man in Black.
• Adam Berg is a TV-in-the-shop-window viewer.
• Natalie Madsen is another TV-in-the-shop-window viewer.

Curiously missing are Matt Meese, Stacey Harkey, and Stephen Meek.  It’s possible that with a tight shooting schedule that the three of them were out-of-town or otherwise disposed, but is that likely?  Sure, neither Stacey nor Stephen are  the creator of Studio C, so they may not have been asked to be in the music video.  (However, why not??!!!???   What is wrong with you guys?  Will Stacey and Stephen ever speak out about this injustice?)  Now, Matt Meese on the other hand created Studio C.  Why wouldn’t he be in the Imagine Dragons music video with almost all the other Studio C cast?

UPDATE: Read this comment by an anonymous poster who seems to know what he or she is talking about.

Well, it turns out Matt may be in it after all.  Take a careful look at this image.

I propose that the guy in the brown fedora wearing sunglasses is none other than Matt Meese! (UPDATE: The aforementioned anonymous poster says the Fedora Guy is Monson Hayes.)

Notice the face in question is baby smooth with faint lips just like these photos of Matt Meese trying not to laugh:

[UPDATED: IMDB now says, :(13 Nov 2013) Music video released for Imagine Dragons “On Top of the World” – Window Watcher”  I had previously been informed that IMDB said he was a Russian cosmonaut, which he clearly wasn’t.  Sorry about the much-ado-about-nothing.]

So I apologize to Matt Meese for accusing him of not being in the video when he actually was.  It’s possible that Stacey and Stephen were in the video but their scene was cut.  I would really like an explanation.  It’s curious that more people involved in the making of the music video haven’t blogged every detail about their involvement.  The only one to do so that I’ve seen is the costume designer (see link above).  Did they have to sign non disclosure agreements  or something?

Hot Topic

Imagine Dragons currently have four official videos. This narrative could be considered controversial because, well, just ask anyone, “Do you think we put men on the moon?”

You are likely to get strong responses for Yes and No, Continue Reading »

Tags: Imagine Dragons, Moon, Music, off topic, politics, Studio C

I posted on my practice website the information that I wrote for a patient handout on allergy eyes. There’s some new stuff in there reflecting the current research on intestinal flora and allergy symptoms.
See also:

• http://www.nature.com/nm/journal/v20/n2/full/nm.3444.html
• http://www.marksdailyapple.com/seasonal-allergies-treatment/
• http://www.marksdailyapple.com/leaky-gut/
• http://www.ncbi.nlm.nih.gov/pubmed/24690419
• http://www.ncbi.nlm.nih.gov/pubmed/3745938 (Asmtha, Eczema, Allergies are all closely related)

It appears that most of America’s health problems could be solved by ceasing the Standard American Diet and implementing the Paleo/Atkins/LowCarb diet. I’m betting research will someday show it helps with glaucoma, AMD, dry eyes, MGD, and many other eye conditions related to inflammation and blood vessel pathology.

Tags: allergies, eye drops, eye health, paleo diet, patients