Eye exams

[yakdriver]

Be very careful when you get an eye examination especially if you go to a big group practice or chain. My friend had an exam and the doc said his pressures were slightly elevated so he put him on some glaucoma medicine. Well he put that down when he went in for his medical and now if he ever wants to fly again he will have to spend thousands of dollars for tests and jumping through the FAA hoops. He is so discouraged that he is quitting flying. He did go to my optometrist later who is also a pilot and he said there was no way they should have put him on any medication as his pressures were just at the higher end of normal. But a lot of these places will prescribe tests and medications just because they will get paid by the insurance. This is happening more and more in medicine these days so you have to remain vigilant. Don

 

[James331]

Indeed.

 

[Henning]

He should have just gotten some traditional glaucoma medication.

 

[James331]

He should have just gotten some traditional glaucoma medication.

Or not jumped on the medication band wagon

 

[Henning]

Or not jumped on the medication band wagon

Stupid is as stupid does.

 

[Jay Honeck]

Thanks for sharing this. Eye exams aren't the kind of thing one normally expects to be scammed, but with insurance money at stake, anything is possible.

 

[yakdriver]

Problem is that most people will do whatever the doctor says without thinking. With a lot of doctors receiving kickbacks from the drug companies always ask a lot of questions like "do I really need this drug?" Or get a second opinion. Don

 

[Henning]

Thanks for sharing this. Eye exams aren't the kind of thing one normally expects to be scammed, but with insurance money at stake, anything is possible.

This is the result to expect when society mandates the greatest profit above all.

 

[weilke]

Your friend should worry about going blind, not how much it costs to get a medical.

I suggest he seek a consult with a glaucoma specialist.

 

[Matthew]

My eye guy is a pilot. He takes good care of me.

 

[James331]

FYI most of the healthy old folks I meet in my work, ones who are alert and or orintated, who live lives, they are the ones who aren't on medications, put only good stuff into their bodies and are active.

The ones with issues, who are knocking on deaths door, or who live lives that livestock wouldn't even want to live, tend to have a brown bag filled with RX garbage.

The smart money is on finding WHY you have the problem and fixing it's cause vs medicating it.

My BP is high, so is my cholesterol, I'll slap myself into line, suck it up and change what I shove in my pie hole, get a bike and start riding to work.

My BP is high, so is my cholesterol, I'll take some ACE inhibitors and Niacin, hey that's what doc in the box recommended.... and keep on living my sloth life.

Guess who lives longer and has a better QOL

 

[Henning]

FYI most of the healthy old folks I meet in my work, ones who are alert and or orintated, who live lives, they are the ones who aren't on medications, put only good stuff into their bodies and are active.

The ones with issues, who are knocking on deaths door, or who live lives that livestock wouldn't even want to live, tend to have a brown bag filled with RX garbage.

The smart money is on finding WHY you have the problem and fixing it's cause vs medicating it.

My BP is high, so is my cholesterol, I'll slap myself into line, suck it up and change what I shove in my pie hole, get a bike and start riding to work.

My BP is high, so is my cholesterol, I'll take some ACE inhibitors and Niacin, hey that's what doc in the box recommended.... and keep on living my sloth life.

Guess who lives longer and has a better QOL

You are mistaking correlation for causation. The deaths door and prescriptions go together regardless causation. A healthy old person isn't going to be on a bunch of crap because they are healthy as well.

 

[DrPappy]

Just joined the site, but thought I would put my 2 cents in since I happen to be an optometric glaucoma specialist. Glaucoma is not always so much of a black and white issue. Pressures in and of themselves are not diagnostic. There are a myriad of tests we run (or at least I do) to determine if a patient has glaucoma. Even then, some of the diagnosis and management calls rely on the doctor's best judgment, taking into account all of the test results as well as the life expectancy of the patient.

For example, this week I saw a patient in their early 20's who only has one eye due to a childhood accident, and now has high pressures and slightly reduced visual fields in the other eye. I will do more testing, but if I even detect the slightest hint of glaucoma, this patient is going to undergo some form of treatment because they have so many years of life expectancy ahead of them and no wiggle room because of their monocularity. However, I also see patients who are in their late 80's (and with both eyes!) that I might be comfortable just monitoring for any changes if that is what they want to do.

I cannot speak for every doctor, but I can say for myself that my decision making process weighs the pros and cons very carefully, and insurance reimbursement has zilcho to do with it.

 

[James331]

You are mistaking correlation for causation. The deaths door and prescriptions go together regardless causation. A healthy old person isn't going to be on a bunch of crap because they are healthy as well.

Not really, read my whole post, here's the nugget of epiphany for ya

My BP is high, so is my cholesterol, I'll slap myself into line, suck it up and change what I shove in my pie hole, get a bike and start riding to work.

My BP is high, so is my cholesterol, I'll take some ACE inhibitors and Niacin, hey that's what doc in the box recommended.... and keep on living my sloth life.

For many folks, HONESTLY changing their lifestyle will give them a better result than gettin a RX.

 

[Bob Noel]

Also be careful with the prescription - without really telling me why, my eye doctor changed my prescription to make my left eye good for near vision and my right eye good for distance. When I figured it out I changed it back and recommended that he be careful with pilots and FAA requirements.

as a reminder: see http://www.pilotsofamerica.com/forum/showthread.php?t=3445

 

[Everskyward]

Just joined the site, but thought I would put my 2 cents in since I happen to be an optometric glaucoma specialist. Glaucoma is not always so much of a black and white issue. Pressures in and of themselves are not diagnostic. There are a myriad of tests we run (or at least I do) to determine if a patient has glaucoma. Even then, some of the diagnosis and management calls rely on the doctor's best judgment, taking into account all of the test results as well as the life expectancy of the patient.

For example, this week I saw a patient in their early 20's who only has one eye due to a childhood accident, and now has high pressures and slightly reduced visual fields in the other eye. I will do more testing, but if I even detect the slightest hint of glaucoma, this patient is going to undergo some form of treatment because they have so many years of life expectancy ahead of them and no wiggle room because of their monocularity. However, I also see patients who are in their late 80's (and with both eyes!) that I might be comfortable just monitoring for any changes if that is what they want to do.

I cannot speak for every doctor, but I can say for myself that my decision making process weighs the pros and cons very carefully, and insurance reimbursement has zilcho to do with it.

Thanks for the input and welcome to POA!

 

[BillTIZ]

Also be careful with the prescription - without really telling me why, my eye doctor changed my prescription to make my left eye good for near vision and my right eye good for distance. When I figured it out I changed it back and recommended that he be careful with pilots and FAA requirements.

as a reminder: see http://www.pilotsofamerica.com/forum/showthread.php?t=3445

The doc should not have done that without telling you.
I'd find another doc.

 

[yakdriver]

Just joined the site, but thought I would put my 2 cents in since I happen to be an optometric glaucoma specialist. Glaucoma is not always so much of a black and white issue. Pressures in and of themselves are not diagnostic. There are a myriad of tests we run (or at least I do) to determine if a patient has glaucoma. Even then, some of the diagnosis and management calls rely on the doctor's best judgment, taking into account all of the test results as well as the life expectancy of the patient.

For example, this week I saw a patient in their early 20's who only has one eye due to a childhood accident, and now has high pressures and slightly reduced visual fields in the other eye. I will do more testing, but if I even detect the slightest hint of glaucoma, this patient is going to undergo some form of treatment because they have so many years of life expectancy ahead of them and no wiggle room because of their monocularity. However, I also see patients who are in their late 80's (and with both eyes!) that I might be comfortable just monitoring for any changes if that is what they want to do.

I cannot speak for every doctor, but I can say for myself that my decision making process weighs the pros and cons very carefully, and insurance reimbursement has zilcho to do with it.

I have slightly high pressure that was detected 25 years ago. Went through a battery of tests for glacoma and nothing was detected. The pressures have remained exactly the same for the last 25 years.
They did not do any tests on my friend just said he had slightly elevated pressure and said take this medication (I'll try and find out what it was) he put it down on the form so was denied his medical and it is going to be extremely expensive and a long fight to get it back so he said hell with it. Don

 

[orange]

Problem is that most people will do whatever the doctor says without thinking. With a lot of doctors receiving kickbacks from the drug companies always ask a lot of questions like "do I really need this drug?" Or get a second opinion. Don

One of the problems is that with HMO's and POS's, doctors make very little per patient, so they have to see a lot of patients per day to make any real money. They can only spend very little time with each patient and are more likely to just prescribe something and move to the next one in the assembly line than actually take time to accurately diagnose a potential problem.

Also, they do get kickbacks. I saw a dermatologist for a skin condition (no it wasn't herpes..), and she prescribed some anti-fungal/anti-bacterial compound creme. She asked what pharmacy I use and when I said CVS, she said they won't cover it. But she said XXX pharmacy 2 blocks from here will cover it. WTF? I went to CVS and obviously, it was covered.

Like somebody said, sadly, too many doctors make our health decisions not by what's best for us, but what's most convenient and financially beneficial for THEM...

 

[flyingron]

I had a particularly bad Optho once that really scared me. I went to her because she was allegedly an expert in diabetic retinopathy (not for me, but my son is a diabetic). Her bedside manner is awful and she delegates nothing to assistants which means she's always in a rush to schedule 10 patients an hour. She scared me with claims of high IOP sending me digging through all the treatment stuff and FAA hoop standings.

I did some research. Much as with regular BP, IOP has a bunch of things that need to be done right. First, most people are diurnal, so the pressures are higher early in the morning typically. Some people are more so than others. Again, technique matters. If you keep poking at the patient because the flinch or whatever, you're going to get an erroneous high reading (doc #1 had this problem).

I switched to the other highest rated optho in the area (later this guy would go on to some infamy for doing his own LASIK commercials on the radio, but he's a great guy). With him, the IOPs were borderline but he did the full workup. I've had regular close examinations of the optic nerve, humphries visual fields, and some of the later automated tests like GDx and the last time there was a new one. Pretty much they've decided mine is stable.

There are some people on the boards (probably the red board now that I think) that are on the SI. The beta drops aren't particularly problematic as they're non-systemic. Fortunately, I've not needed to go that route (yet).

 

[Henning]

Not really, read my whole post, here's the nugget of epiphany for ya




For many folks, HONESTLY changing their lifestyle will give them a better result than gettin a RX.

I don't disagree, however that was not the issue or point. There are sloths around with fine BP and cholesterol numbers that are not on meds for cholesterol or BP. You made it sound like the prescriptions are the cause. The cause is there regardless, you do have a choice in how you deal with it, including allowing for a natural death. I do believe the side effects and consequences of all these drugs are worse than a natural death though.

 

[ARFlyer]

I scatched my eye a few years ago while out on the flight line. My normal doctor gave me some meds and told me to stay out of my contacts for six months.

Few weeks later my eye was red again and since my normal doctor was on vacation, I decided to go to my mother's university office. I had no less then three "very experienced" doctors ***** me out over sleeping in my contacts, even after telling them the real cause. A few days later my normal doctor called the university and went off on their so called "doctors"

The cause of my second redness? Pink Eye

Moral of the story? Even, so called "experienced", university doctors can miss the obvious and your results may not be true to your condition.

 

[silver-eagle]

There are good reasons for second opinions. Doctors rely on teaching and experience as we all do. What you might have might also not been in their teaching nor experience.

 

[flyingron]

There are good reasons for second opinions. Doctors rely on teaching and experience as we all do. What you might have might also not been in their teaching nor experience.

What do you call a doctor who finished last in his class? Doctor.
What do you call a lawyer who finished last in his class? Your honor.

 

[DrPappy]

What do you call a doctor who finished last in his class? Doctor.
What do you call a lawyer who finished last in his class? Your honor.

...and what do you call the pilot who just barely squeaked by his written exam? Captain.