How do you decide how much prism to prescribe in the fastest and most accurate way? When do you decide to RX prism for a pt that has never had it ? When would u recommend sending them to neuro instead? Please share ur thoughts i’m genuinely curious to how different docs prescribe prism.

Just have some questions if anyone is let me know

Hi, opthalmology resident (not in the us) struggling with a case: M19 can only sustain clear vision for 2seconds, has mydriasis but normal pupillary light reflex and normal near reflex. Could his accomodative fatigue be the reason? and is it even ill sustained accomodation if he can only sustain accomodation for 2s? for more details: no medciations, neurological exam normal, EEG normal, no other clinical findings mydriasis is bilateral and equal for both eyes, NPA: 10cm, PRA:-3 (deteriotes to -2 to -1.5 after 30s), NRA:+2.25, BAF: 2cpm (difficulty with minus and performance deteriorates after 30s), MEM:+1.00 OD and OS, cover test:4 eso (near), Divergence amplitudes (near) : 14pd, convergence amplitudes(near):50pd, Any help would be highly appreciated and thank you!

How soon after graduation were you able to start practicing in California? I graduate in May and don’t care for a whole lot of down time. Thanks

Tech here with a followup question. Many of the patient's I see have a bad habit of liking the minus. I myself am aware of the fact that overminus needs to be avoided and generally as a rule of thumb I try not to go more than 1 diopter away from starting point, whether thats from a recent prescription or new autorefract numbers.

I've been told that every other -0.25Diopter has to be earned by reading another line. At what point at I supposed to test this? In the middle, right after doing sphere and before jumping into axis/cyl? Or should it be after the entire refraction? My confusion then lies in the fact that for balancing +-0.5D cyl with +0.25D sphere might end up changing the sphere we were planning on testing.

I really just need a clear cut step by step explanation of tech refraction including JCC and how to deal with older or more pathology patients who incessantly keep saying '2' despite minimal visual acuity improvements.

I’ve seen a bunch of posts on this forum about ODs wanting to step away from direct patient care. I don’t feel this job is right for my personality and I find it so hard to deal with entitlement/rude patients. Although my positive patient interactions far outweigh the negative, I take the negative so personally and feel on edge for months worrying about who’s gonna snap next. It’s exhausting.

But when you’re so deep in, it’s hard to walk away completely. I have no idea what else I would do. I’m looking for some advice on non clinical roles and switching to part time optometry. Or jobs where there is little to no refraction. Thanks.

For various reasons and recent developments over the years I’ve decided I would like to get rid of my Florida license. I don’t want to pay the inactive fee because it requires not only paying but also keeping up with all the Florida in person only CE which defeats the purpose of being inactive as it still requires me to fly over. I still practice in another state far away.

I’d like to figure out if my board scores will expire if I give up my license. I’m thinking it’s a yes but advice online and through the board is mixed.

I scribe and do billing and coding for an optometrist and I find the more I learn about optometry, the easier my job is. I'm still trying to learn more about Visual Field testing and Visual Field defects and their patterns. What's a good resource to learn about this?

How do you find the white to white measurement on the zeiss iprofiler? I haven’t found any videos or manuals for it.

I've come into the opportunity to inherit a small optometry clinic. There's one exam room, and the other visiting OD is willing to stay on, and potentially take more days.

It seems like a wonderful opportunity to serve the community, but I'm not an OD myself. My question is: How would I attract ODs to apply to work at the practice, and, as ownership, what could I provide them that could set the role apart from others? (aside from good pay!)

Is working at a low-key private practice more desirable than corporate optometry?

Thanks in advance.

Does anyone know of any reasons for an Optometrist to buy an Oculus Quest for work? I am thinking of vision training reasons or to research how the device would go for certain patients. Maybe to develop a visual fields or visual acuity app. Any ideas or reasons would be appreciated.

I spent 5 years training to become an optometrist (4 years of optometry school and 1 yr of residency). I love how our profession can change lives, but I feel like it is a lot more work than what was advertised to me as a student for how little the job pays. Not only do you need to go through several rigorous and expensive years of school, you also need to pass three parts of board exams (EACH part costs over $1400 this year). The fees behind these board exams have been increasing astronomically with no reasonable explanation and more people have been failing over the years and needing to retake. Other health professionals certainly don’t pay this much for their boards, and their jobs actually pay way more. It is also interesting how our licensing fees are so high.

I am tired of patients who think you only exist to give out glasses prescriptions and don’t take your medical advice seriously. Also tired of large corporations and private equity making optometrists see an unsustainable number of patients every day. I don’t think that the job fairly compensates optometrists, and this applies to nearly all modes of practice I have looked into in a high cost of living area. I have seen corporate places wanting their doctors to skimp on proper medical advice and care to maximize the number of patients that are seen. I also dislike that more and more practices require optometrists to work weekends to maximize profits and guilt you into it because you are a new grad (and some do not pay you more than your regular weekday rate). Many of the places I have looked offer no PTO and rarely have I seen a place pay more than $550 per diem in a high cost of living area. I see other health care professionals make at least double of what optometrists make (and no, I am not referring to surgeons or anesthesiologists) and with better benefits. My employer tells me that my 10 days of PTO is “generous,” but I don’t think it is enough. Several of my colleagues need to work multiple part time jobs and sometimes are not even offered basic necessities like health insurance. I find it ridiculous how insurances also reimburse so little for our services and how they determine what is “medically necessary” when they have no medical training. You can disagree with me all you want, but I really think there is a problem with the lack of transparency in our wages and our “work life balance.”

I am sure this frustration is universal in other health care professions as well. I just feel like optometry is underpaid and under appreciated compared to other health professions. I do sincerely love the good that the profession can do for patients, but I feel like the “work life balance” and pay are not what I was expecting. I am sure optometry paid much better in the past, but seeing how employers are not willing to raise wages and insurances do not reimburse more for our services despite of inflation makes it very problematic.

I have had people encourage me to join academia or industry, but I have seen many of these positions require more higher education credentials (a masters or a PhD) or lots of travel. I do not want to pursue more schooling for this purpose nor do I want to be traveling so much for work. I have seriously considered industry and have some connections that helped me get a taste, but I am not sure that the frequent travel life is for me at this time. I am also not interested in moving out of state (neither for higher daily rates nor for working for R&D for J&J in Florida, for instance) because I have already moved a lot and now I want to start a family. Also moving to a low cost of living area away from all my family and friends to make more is a lot easier said than done.

Please let me know if anyone has successfully transitioned out of the profession and/or found a way to rekindle the passion for optometry while being better compensated. Thanks for your time.

Hello everyone,

Does anyone have any tips and tricks to clean volk lenses? I use my superfield most of the time and it really tends to get dirty especially after patients with eye makeup 🥲 or any tips so I could avoid getting them dirty so quickly 😅

TIA!

I saw a job posting at a hospital about this. It says optometrist can apply. Does anyone actually know any optometrists that do this type of work?

Thank you.

Want some take on your guys opinion. Got a private practice job offering with base salary of 145k. 1099 employee which pretty much means no benefits but will cover malpractice, CE, licensing, and match 401k. No PTO and 6 sick days. About 10minutes drive from my location.

If you take on 300,000 dollars in debt at 7% interest and want to pay it off in 10 years, you have to make ~3500 in monthly payments. An entry level position affords you ~168,000 today. After taxes, monthly take home is about 10,000. 10k-3.5k=6.5k or 78,000 a year. If rent is 2,000 then you have 54,000. Let’s throw on a 1,000 car payment. 42,000. Really nice food + eating out. 34,000. A vacation? A really really nice vacation? 24,000. I have 24,000 dollars I don’t know what to do with. Invest? Use the dividends to help pay off my debt faster? Get it done in 9 years instead? What am I missing here? What’s so bad about the debt? I’m seriously wondering, I’m a college student who’s never had to worry about bills.

I have 2 positions being offered: the first as an ophthalmologist assistant for a practice I’ve never worked at, that will pay for further education & licensing; the other, retaking an optician role for a practice I worked at previously, who told me at that time they would assist with my becoming licensed & never followed through (I worked there for 4 years). Curious if anyone has experience in both roles/if one is in any way more beneficial than the other (financially, career-wise, benefits of certifications for each job, etc)

Im about to acquire an optical practice in Australia. The practice is over 25 years old and the 70 year old optometrist is ready to retire

Yes, I have done my due diligence to the best of my ability. Accountant and business coach say it looks good and I’m getting a fair deal.

I visited the location today and spied on the front doors as I had lunch. Traffic was pretty non existent. Admittedly I was only there for 40 minutes, but it had got me worried.

Now I am worried. What if this goes wrong? What if no one comes in?

I’m currently trying to incorporate ortho for patients. I only got 2 patients doing it now. My biggest concern is that I have patients developing imprints from where the lenses sit on their eyes. If these patients were to completely stop doing ortho k would those imprints go away? Would it turn into scarring ? I’ve seen patients with irregular corneas that use hard lenses lifelong and develop these imprint / scarring and they never go away, but they have to use these lenses to see . Just wanted to hear y’all’s thought.

I'm absolutely miserable in this career. What other careers do you recommend someone with our education and background go into?

I'm about $250,000 in debt and hope to get out ASAP. I can't justify our debt to income ratio, and I certainly can't justify seeing +25 patients a day any longer.

EDIT: The responses are concerning due to the fact that if anyone voices criticism of our field (cost/salary ratio, amount of schooling for our profession, AI progression, insurance cuts, etc.,) or shows any disinterest, they immediately get downvoted. The message is QUITE clear, praise your job or stay quiet!

Looking for opinions, examples, & pros/cons of best home devices that make tasks manageable for visually impaired people. For example, setting air fryers, coffee pots, etc. (Digital screens & small lettering are super hard to read.) Looking into Google Home, Alexa, smart plugs, etc. TIA.

Does anyone have any thoughts or opinions on working at Kaiser?

Hello, I’m a 4th year optometry student and looking into potential job opportunities would anyone have any insight into working for National Vision? Hate it or love it? I’ll be in the NY region.

Hello,

I am currently working corporate and was looking at potential opportunities in the area and came across MED. If you work for the company how do you like it?

Hi! I recently went to a CE conference and attended a lecture on normal tension glaucoma. It was a good reminder of ddx with NTG (I'm early in my career, have been practicing for 2 years now), but the lecturer said something that caught my interest. He stated that he believes treating when glaucoma isn't actually present is almost on par w/ not treating glaucoma. He did not mean like for instance missing compressive neuropathy, but as a general statement. He also stated he did not treat NTG unless he saw progression citing the CNTGS (without exactly explaining what constitutes progression for him), but at that point I feel like I would have missed out on years of not treating that could have POSSIBLY slowed things down? Just wondering if there is any additional input. I'm in a single doctor practice so I don't get many opportunities to talk with other docs so any education you have to offer is so welcomed!

4th year student on rotations and saw this in periphery. 27M NP, first routine eye exam, no visual complaints

Looks like a giant window defect/ RPE atrophy? Weird presentation since it’s in the periphery.

I’m considering (re)taking a full-time position as an optician (currently unlicensed/hoping to attain license in the near future) at an office I worked at previously (~4 years). The reason I ultimately left is because my then manager & HR coordinator seemed uninterested in giving me any information about going for my license, despite the fact that they claimed they would assist with this upon hire & despite my having asked several times during my last year about what I needed to do to obtain it. The disinterest had nothing to do with my job performance; I did well, was invested in my role & now they are very interested in rehiring me, even 3-4 years later. I’m just curious about what typical hourly rates are currently for unlicensed/apprentice opticians & for licensed (particularly in Virginia)- I’m being offered $15.50/hr & I feel like this might be a bit skimpy considering I have experience, although unlicensed, & the opportunity to take a full-time medical assistant position at a specialized eye care office which starts between $16-$18/hr AND guarantees they will invest in my becoming licensed (that is as a medical assistant, not optician; I suppose I feel like it’s sort of a waste of my previous experience in optical to not try to get my optician’s license before moving onto something else.)

Currently planning on moving back to my home city to join my dad’s small private practice. It has always been single doc 2-4 staff members since he started it. He won’t have full time work for me to begin even with him giving up a day or two right away so he can slow down and focus on the business side more to expand.

I’m currently in a corporate setting, with the chance of keeping some sort of virtual care position when I move or working part time in their local office depending on demand. At what point is it best to go all in on the private practice (which is my endgame) verse trying to keep part time work while I’m not full time in my dad’s practice?