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I was halfway done administrating non-contact tonometry (a.k.a. air puff test) when a 30-something man asked, “This is safe, right?”

To which I replied, “Well, yah. A small percentage of people could faint, but…pretty safe.”

To be fair, I have never had anyone faint after the air puff, but I have had two different men almost faint (lightheaded, sweating, nausia, paleness) after Goldmann applanation tonometry and corneal foreign body and rust-ring removal.

It helps to be prepared for the vasovagal response, so I have on hand an ammonia-based respiratory stimulant and Sunny Delight sugary punch.

Tags: @optotrician, Airpuff, fainting, optometrist, patients

Our Walmart Vision Center has a life-size poster of a tough-looking beared guy from Duck Dynasty. Someone thought it would be fun to put a Walmart name tag with the name “Willie” on it.

It’s strange having Willie in the optical because you see him out of the corner of your eye and you instinctively have to look over at him to see who’s there, but the then you feel stupid because you’ve already told yourself a thousand times before that Willie is just a cardboard picture.

The other day, an optician saw a lady trying to talk to Willie and asking a question. Of course it was only for a few seconds, but it was a couple seconds longer than most people would talk to a cardboard picture.

The VC manager decided to take the name badge of Willie after that. Now most people just come over and have a picture taken with cardboard Willie.

Tags: @optotrician, commercial, frames, Jokes, optometrist, patients, Wal-Mart, WalMart

Guy with thick accent (Indian?) holding up $9.99 sunglasses: Do you have anything cheaper than this?
Optician: Over in jewelry there are more sunglasses.
Guy: Yes. Cheaper?
Optician: I don’t know for sure, but probably a few might be cheaper.
Guy just stands there.
Optician pointing to jewelry: Over in jewelry.
Guy: Where?
Optician: Look right over there. Jewelry.
Guy: Sunglasses?
Optician: Yes, a different selection over in jewelry.
Guy: Cheaper?
Optician: You’ll have to look and see.

I did an eye exam almost 3 years ago. The patient paid their copay. A couple weeks later the insurance paid the rest, a whopping $15. Almost three years later the insurance said their payment was made in error, so I have to remit to them a check for $15 or else a future EOB would have $15 deducted.
Whatever, they can deduct it, but I ain’t sending a check. Do they expect me to send the patient a statement for $15 for an exam from three years ago? Never mind the patient has probably moved, and even if they haven’t, they will probably shrug off the statement like I did from the insurance.
A month later the insurance takes $15 from one of my EOB payments. Luckily I don’t bother billing the patient because a week later, they sent me a check for the same patient’s three-year-old visit!
Make up your mind, insurance company!
[UPDATED: Today BCBS sent me ANOTHER letter saying that they overpaid me for this patient when they repaid me! Eat poop, BlueCross!]

I had a patient who has a really big head and his regular size glasses were making an indented, red scar in front of his ears. Of course I recommend the largest style frame we have called FatHeadz. He finds one he likes, and it fits his head perfectly. The optician enters the order, but the lab calls and says they can’t make it. It turns out he has a small PD; therefore, they don’t make a lens blank large enough for his combo of large frame, small pd. Poor guy.

Tags: @optotrician, insurance, jewelry, pre-auricular scarring, sunwear

There is a different vaccine nurse at the table in front of the V.C. every day!

I observed a guy with the biggest mustache I’ve ever beheld. Imagine walking around with a dresser comb under your nose all day. Then, later the same day I saw another guy with what is now the biggest mustache I’ve ever seen! Just think of a blond Yosimite Sam.

It is my experience that youth who have trouble with the NCT and dilation drops tend to be unsuccessful at learning to insert contact lenses. But a teenage boy surprised me recently when after 20 minutes of trying, I had him take the contacts home to practice. He returned for a followup being successful!

This week I had a day where 100% of my exams were contact lens patients! Crazy! (It’s usually ~50%.)

Tags: @optotrician, contacts

Older female to college-age male: “You are a menace to society. You need to get married.” (I think she was quoting Brigham Young, but it turns out no one can substantiate that quote.)

Loud Lady at Flu Shot table: “No, I can’t take flu shot, but she nayd tetanus and diphtheria. Is thayt included in the flu shot?” (It turns out the flu shot nurse also does other vaccines.)

Tags: @optotrician, single, vaccines

Is there anything I can do to not get that gunk buildup by the nose pads?
An ultrasonic cleaner will take out the gunk. To help it not build up, try cleaning your glasses daily under the sink with dish soap that doesn’t contain lemon.

Yesterday I didn’t have to bill a single insurance. I love no insurance days.

New phones chirp like the phones in IHS used to. They also chirp louder and more frequently if no one picks them up quickly.

Lately people are confusing the non-contact tonometer with dilation. “Okay, I’m going to put some drops in your eyes to dilate them.”
“Didn’t we already do that with the puff of air?”
“No, that was just an eye pressure measurement.” (I already explained that when doing it, BTW.)

AlwaysCare website is down, probably due to hurricane Isaac since the call center is apparently in Baton Rouge. Earlier in the day, the website just timed out. Later it has this message: “AlwaysAssist website is currently having technical difficulties.. Please check back later to access any information. Thank you for your patience. For immediate assistance, please call [toll-free and local numbers] in Baton Rouge. ”

Of course all circuits are busy when you try to call that number. I think it’s ridiculous that they don’t have redundant servers across the country available. I guess these hurricanes inconvenience everybody…

Tags: @optotrician, air puff, eye drops, insurance, patients, phones

Optoblog revolutionized optometric blogging with eye doctor-related comics and poetry. Now we have “@ the Optotrician” which contains quick anecdotes and conversations that actually occur at a vision-center/eye-clinic/optical/eye-doctor-office.

This is à la Love the Liberry blog that I discovered when it was linked to by Mental Floss the other day. It’s so awesome that I’ve already read the archives back to 2007.

By the way, if you would like to be a contributor to optoblog, please see this page.

Without further delay, here is the inaugural post of @ the Optotrician:

Teenage Girl: Hey does anyone have a dime? Do you have a dime?

An asian male (from Asia), 20s, doesn’t want the full glasses power I found written in his Rx. He wants less so his eyes don’t get worse. I explain it’s debatable whether that would help, hurt, or make no difference for his future glasses magnitude, but he insists. I am fine with it as long as he is legal to drive. I show him a +0.75 shift, and he is satisfied with that.

What’s the deal with optometrists in India not prescribing cylinder? I’ve seen several Indians (from India) that have 0.75 diopters or more of astigmatism, and their glasses from last year are spherical.

Guy in 20s: Can I charge my phone here?

Man walks right past sign posting prices of eye exam. Asks optician, “How much is an eye exam?” This happens thousands of times a day.

Tags: @optotrician, Jokes, off topic, optometrist, patients