# Optical Forums > Canadian Discussion Forum >  When does a RX expire????????

## Mrmessi

In ontario when does a RX prescription expire???

The reason i ask because each doctor writes their own expiry date. Some state 6 months, 1 year or 2 years. They make life difficult when trying to get a rx faxed over from their office. Obviously they want to bring the client back in their office.

So again according to the college of physicians and surgeons of otnario when does a rx prescripton expire????

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## MikeAurelius

speaking solely for myself, my script hasn't changed in over 10 years. (I get checked every 2 years).

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## Joe peshi

According to the opticians SOP never you just need to advise the Px that they should get a full exam every 2 years

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## optical maven

There is no expiry date for any spectacle Rx.  In fact, changes or no changes, have often no correlation (but not always) to ocular health.    That's why just autorefracting someone does a disservice and is potentially vison threatening in the long run.  That's what HPRAC concluded in the recent review and reaffirmed that stand-alone refraction is detrimental to ocular health.

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## design786

Would it be unethical if rX's actually had expiration dates? It seems like an interesting idea to implement. Virtually everyone would benefit.

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## edKENdance

> Would it be unethical if rX's actually had expiration dates? It seems like an interesting idea to implement. Virtually everyone would benefit.


 
...and when someone walked into your store with old glasses you could rip them off their face and smash them under your foot.  :bbg:

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## design786

> ...and when someone walked into your store with old glasses you could rip them off their face and smash them under your foot.  :bbg:


Like I said, everyone benefits!

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## uncut

> In ontario when does a RX prescription expire???
> 
> The reason i ask because each doctor writes their own expiry date. Some state 6 months, 1 year or 2 years. They make life difficult when trying to get a rx faxed over from their office. Obviously they want to bring the client back in their office.
> 
> So again according to the college of physicians and surgeons of otnario when does a rx prescripton expire????


Most of the prescriptions I see do not have an expiry date on them.  The ophthalmological ones that do, are simply because some of the medical conditions are temporary.  All optometric prescriptions do not fall under the guidelines of the college of physicians and surgeons of Ontario.  You will need to direct you question at the Optometric college.   They might be able to answer your question, or perhaps an Ontario optometrist might be able to answer.

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## Ory

> On the conclusion of the examination, the optometrist may determine that the
> refractive result should have a fi nite life span. That determination is based upon
> the optometrist’s assessment of the patient and application of clinical judgement
> based on the knowledge of the patient and typical growth and development of
> the eyes and vision system. When an optometrist specifi es a ‘fi ll before’ date on a
> prescription, information is communicated to the patient so the patient understands
> why it is not appropriate to fill the prescription after the specified date.
> If an optometrist determines that vision correction is required, he or she will issue a
> prescription as part of the assessment without additional charges, regardless if the
> ...


Linky
So there is no fixed rule on expiry as there is in many states.  I think a 1 or 2 year expiry could be easily upheld when pointing to generally accepted standards for frequency of eye exams.

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## LandLord

what's wrong with buying glasses 2 years after an Rx was written if the refraction hasn't changed in 10 years?

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## NCspecs

I've had countless experiences in the past where I or a coworker have filled an older Rx and a pt had come back saying "Something is not right" and it has nothing to do with my or their measurements. 

In my experience I don't think it is too much to ask people to be refracted (especially if they have yearly benefits to utilize their exam coverage) before getting a new pair of glasses. Yes, your refraction may not have changed in 10+ years but you could have had a multitude of situations occur; There may have been ocular trauma, you may be diagnosed with diabetes, you may have had a stroke, you may have even changed your rx for other maladies. I like to have a much information as possible about the pt before I make a pair of glasses; otherwise I'm just as lazy as an online retailer.

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## Geirskogul

So Canada doesn't have expiration dates.  To a stater, this is mind-blowing.

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## LandLord

Canada has expiration dates that are usually not observed by opticians because an optician asks enough questions that an expiry date isn't necessary.

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## Shwing

I thought we beat this to death about 5  years ago.  However, according to the Canadian Ophthalmological Society, their recommendation for an exam for a healthy 'normal' person between the ages of 18 and 45 is...




once every Ten (10) years.

I could source it for you, but I am soooo tired of "expires in 6 months" I just ignore what the OD writes and educate the patient.  Deal with it.

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## Shwing

Sorry, LandLord.  Ignore the very last remark.  You nailed it  and I was being snappy reacting.

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## NCspecs

> Canada has expiration dates that are usually not observed by opticians because an optician asks enough questions that an expiry date isn't necessary.


 
So if an Optician asks the right questions and finds that the pt's medical history necessitates a new refraction does that mean you stop working up the order for glasses and request they have a new refraction done? I'd have some very annoyed pt's if I insisted that they have a new exam in the middle of placing their order. I'm always a "measure twice, cut once" kinda gal. I don't believe in just throwing up my hands and calling it done if a pt is unhappy with their glasses. Yes it is my responsibility to ask questions and suss out the pt's need even when they themselves don't know, but I also think that using outdated information is a disservice to my client.

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## Geirskogul

My head just exploded.  Half of my day, and half of, what it seems, EVERY optician's day, is spent sending people back to their doctor because their glasses rx or contact rx (especially contact rx) is expired.  The federal government says that states may set their own expiration dates, up to 2 years max for each.  A state that doesn't have rules defaults to the federal rule of 2 years for specs and 1 year for contacts, no ifs, ands, or buts.  I'd love to have the refracting freedom to set them up with a new rx, but in unlicensed states I would need an OD or MD for that, so if they come in just a day over rx expiration I have to send them away!

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## fjpod

> My head just exploded.  Half of my day, and half of, what it seems, EVERY optician's day, is spent sending people back to their doctor because their glasses rx or contact rx (especially contact rx) is expired.  The federal government says that states may set their own expiration dates, up to 2 years max for each.  A state that doesn't have rules defaults to the federal rule of 2 years for specs and 1 year for contacts, no ifs, ands, or buts.  I'd love to have the refracting freedom to set them up with a new rx, but in unlicensed states I would need an OD or MD for that, so if they come in just a day over rx expiration I have to send them away!


Are you sure about the federal law that says eyeglass Rx's expire in two years if the state is silent??

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## Geirskogul

I'm at work, so I can't get onto FTC or FDA.gov, but I do know that the Fairness to Contact Lens Consumers Act REQUIRES an expiration date to be written on contact lens rxs, and a CL rx is invalid without one.  That is for every state, even those that do not require an expiration for glasses.  The max expiration date for CLs as stated on the FCLCA is 2 years, but I'm sure that I saw another reference while browsing the FDAs website for glasses.  I'll edit when I find it.  

I do know that states can set any expiration date limit ABOVE what the FDA sets (some states have 5 year max, others 2, one state has a 3 year date I think) but if the state doesn't set a limit, it is supposed to default to the 2.  That doesn't stop doctors from filling expired or "no expiration" rxs, though.  There are a kajillion loopholes as well: for instance, Idaho says that Gas Perm rx's must be AT LEAST one year, soft contact lenses AT MOST one year, and spectacles AT MOST 2 years, and that the doctor is REQUIRED to write an rx expiration date, or the prescription isn't valid.  However, neither the FDA, FTC, or Idaho have any legislation on neutralizing and manufacturing a pair of spectacles from an old set without a prescription on hand.  Sure, there is a sentence on there that says specs must be made with a valid rx, but that doesn't stop private shops from neutralizing a pair of specs and making duplicates, as there is no specific wording on that.

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## LandLord

wow, a lot of words dedicated to "when does an Rx expire?".  The answer is very simple: "it expires when you need a new one."

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## fjpod

> I'm at work, so I can't get onto FTC or FDA.gov, but I do know that the Fairness to Contact Lens Consumers Act REQUIRES an expiration date to be written on contact lens rxs, and a CL rx is invalid without one.  That is for every state, even those that do not require an expiration for glasses.  The max expiration date for CLs as stated on the FCLCA is 2 years, but I'm sure that I saw another reference while browsing the FDAs website for glasses.  I'll edit when I find it.  
> 
> I do know that states can set any expiration date limit ABOVE what the FDA sets (some states have 5 year max, others 2, one state has a 3 year date I think) but if the state doesn't set a limit, it is supposed to default to the 2.  That doesn't stop doctors from filling expired or "no expiration" rxs, though.  There are a kajillion loopholes as well: for instance, Idaho says that Gas Perm rx's must be AT LEAST one year, soft contact lenses AT MOST one year, and spectacles AT MOST 2 years, and that the doctor is REQUIRED to write an rx expiration date, or the prescription isn't valid.  However, neither the FDA, FTC, or Idaho have any legislation on neutralizing and manufacturing a pair of spectacles from an old set without a prescription on hand.  Sure, there is a sentence on there that says specs must be made with a valid rx, but that doesn't stop private shops from neutralizing a pair of specs and making duplicates, as there is no specific wording on that.


 You are correct about a CL Rx, but I don't believe there are any Federal rules about when a spectacle Rx expires.  Some states have rules, some say nothing.  You have to go by your state or Province.

Whether we like it or not, a spectacle Rx does not have the same status as a legend drug.  Perceptions about what it should be encompass the entire spectrum.  IMHO somewhere in the middle is the correct place.  Doesn't matter what we think.  Gotta follow the law.

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## Barry Santini

Expires is a word that connotes harm IMHO.

Using "expired" eyewear often does not yield harm.

????
B

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## kws6000

> Canada has expiration dates that are usually not observed by opticians because an optician asks enough questions that an expiry date isn't necessary.



Sure,like do you have a valid credit card....lol

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## kws6000

> My head just exploded.  Half of my day, and half of, what it seems, EVERY optician's day, is spent sending people back to their doctor because their glasses rx or contact rx (especially contact rx) is expired.  The federal government says that states may set their own expiration dates, up to 2 years max for each.  A state that doesn't have rules defaults to the federal rule of 2 years for specs and 1 year for contacts, no ifs, ands, or buts.  I'd love to have the refracting freedom to set them up with a new rx, but in unlicensed states I would need an OD or MD for that, so if they come in just a day over rx expiration I have to send them away!


Not if you do it the Landlord way...the rx never expires....anything to get the sale...lol

I love it when opticians get burned using outdated prescriptions...Especially when the patient blames it all on the optician for not getting an up to date rx...

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## kws6000

> Expires is a word that connotes harm IMHO.
> 
> Using "expired" eyewear often does not yield harm.
> 
> 
> 
> 
> 
> B



I agree, using an outdated rx generally doesnt directly cause harm,with the exception of allowing the patient to sidestep an exam which could detect sight threatening conditions....(which opticians generally dont concern themselves with... )

I can see the appeal of being a "site testing  optician"....generate rx's in house...bag the sale...and no concern or responsibility wrt eye health...or  having to worry about so called ethics or a pesky college overseeing your activities to protect the public....




The rx expiration is essentially stating that past that date, the numbers arent considered to be accurate ,and are to be used at your own risk...

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## kws6000

> I've had countless experiences in the past where I or a coworker have filled an older Rx and a pt had come back saying "Something is not right" and it has nothing to do with my or their measurements. 
> 
> In my experience I don't think it is too much to ask people to be refracted (especially if they have yearly benefits to utilize their exam coverage) before getting a new pair of glasses. Yes, your refraction may not have changed in 10+ years but you could have had a multitude of situations occur; There may have been ocular trauma, you may be diagnosed with diabetes, you may have had a stroke, you may have even changed your rx for other maladies. I like to have a much information as possible about the pt before I make a pair of glasses; otherwise I'm just as lazy as an online retailer.



I have seen numerous cases of greedy opticians getting burned that way....Around here ,a lot of opticals will fill any rx,regardless of its age and source,as well as fit contact lenses to anybody with an rx ,regardless of suitability...as long as they have the money....

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## Geirskogul

I don't know why Barry and others use the satirical argument of "oh your eyeglass rx is expired I'll go to your house and take all of your old glasses so you don't hurt yourself."  I find nothing wrong with using an older Rx, but if the doctor has put an expiration date on there, I'm going to assume that he wants to update the refraction by that time.  Most do it for money, but there is the occasional honest doctor that does it because the patient is a raging diabetic or something, and it could be outright dangerous to have them drive with the old rx.

If I were in Canada, someone came in with a 'no expiration date' spec rx from 15 - nay - 5 years go, I would be wary of filling it.  It is legal, yes, but if the patient feels all gung-ho about getting their new -2.00 SPH Rx glasses and gets in a car wreck because they need -3.50 -1.00 x100, then I have a hunch the patient would want to blame me.

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## kws6000

> I don't know why Barry and others use the satirical argument of "oh your eyeglass rx is expired I'll go to your house and take all of your old glasses so you don't hurt yourself."  I find nothing wrong with using an older Rx, but if the doctor has put an expiration date on there, I'm going to assume that he wants to update the refraction by that time.  Most do it for money, but there is the occasional honest doctor that does it because the patient is a raging diabetic or something, and it could be outright dangerous to have them drive with the old rx.
> 
> If I were in Canada, someone came in with a 'no expiration date' spec rx from 15 - nay - 5 years go, I would be wary of filling it.  It is legal, yes, but if the patient feels all gung-ho about getting their new -2.00 SPH Rx glasses and gets in a car wreck because they need -3.50 -1.00 x100, then I have a hunch the patient would want to blame me.



But thats the advantage of being an optician...Big deal...so the customer blames you ....Other then that,what recourse does he or she have?

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## Chris Ryser

> *wow, a lot of words dedicated to "when does an Rx expire?". The answer is very simple: "it expires when you need a new one."*


 
Nice, sweet and very logic

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## Geirskogul

> But thats the advantage of being an optician...Big deal...so the customer blames you ....Other then that,what recourse does he or she have?


Have you taken a look at the United States' (il)legal system?  It doesn't help that other countries are just gunning to copy it.

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## kws6000

> Have you taken a look at the United States' (il)legal system?  It doesn't help that other countries are just gunning to copy it.


Who wants to copy it?....Not Canada...

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## Geirskogul

> Who wants to copy it?....Not Canada...


Not the Canadian people, no.  Not the Canadian government itself.  I'm talking lawyers, lobbyists, policymakers.  There's too much money to be made for the rich in the US system, sadly.

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## eye2

> I agree, using an outdated rx generally doesnt directly cause harm,with the exception of allowing the patient to sidestep an exam which could detect sight threatening conditions....(which opticians generally dont concern themselves with... )
> 
> I can see the appeal of being a "site testing  optician"....generate rx's in house...bag the sale...and no concern or responsibility wrt eye health...or  having to worry about so called ethics or a pesky college overseeing your activities to protect the public....
> 
> 
> 
> 
> The rx expiration is essentially stating that past that date, the numbers arent considered to be accurate ,and are to be used at your own risk...



REALLY! So if I have a patient come in and as I'm talking to them they state there rx seems fine, I can just ignore where it says expired and just fill it? Are you kidding me? How many pharmacists would be put in jail for doing expired rx's. And what if you filled an expired rx and the person ends up with a bad case of corneal edema because the fit changed? Come on OD are you serious! :hammer:

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## chip anderson

1) Rx expires whenever your board of optometry has convinced the legislature it should expire _for the good of public safety._  Public safety not really being the motivation behind such edicts, but it's the one you will get from the politicians and O.D.'s
2) Whenever the prescriber says it does on the Rx.

Chip

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## fjpod

I would think opticians, and optometrists, would do the right thing when a client is considering purchasing new eyewear, where the cost may be significant, and more than a year or two or three have elapsed since the last time the eyes were checked.

I would consider it unethical to encourage someone to spend hundreds of dollars without a checkup.

I often wonder why some supposed experts go on and on about being accurate in the fabrication of eyewear down to the last degree of axis, and the last eighth of a diopter, and lambast low abbe lenses, yet they would encourage a client to spend hundreds without checking whether a refraction has changed by half a diopter and five degrees over the course of two or three years.  Tsk tsk.

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## kws6000

> REALLY! So if I have a patient come in and as I'm talking to them they state there rx seems fine, I can just ignore where it says expired and just fill it? Are you kidding me? How many pharmacists would be put in jail for doing expired rx's. And what if you filled an expired rx and the person ends up with a bad case of corneal edema because the fit changed? Come on OD are you serious! :hammer:


You could do as you see fit...at your own risk if there are any complications...I wont work with expired Rx's...

Standard of care for pharmacists has no bearing in the optical business...

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## Barry Santini

> I would think opticians, and optometrists, would do the right thing when a client is considering purchasing new eyewear, where the cost may be significant, and more than a year or two or three have elapsed since the last time the eyes were checked.
> 
> I would consider it unethical to encourage someone to spend hundreds of dollars without a checkup.
> 
> I often wonder why some supposed experts go on and on about being accurate in the fabrication of eyewear down to the last degree of axis, and the last eighth of a diopter, and lambast low abbe lenses, yet they would encourage a client to spend hundreds without checking whether a refraction has changed by half a diopter and five degrees over the course of two or three years. Tsk tsk.


Yes, good point!  I agree!

That's why some of us Opticians wish to refract.

B

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## kws6000

> I would think opticians, and optometrists, would do the right thing when a client is considering purchasing new eyewear, where the cost may be significant, and more than a year or two or three have elapsed since the last time the eyes were checked.
> 
> I would consider it unethical to encourage someone to spend hundreds of dollars without a checkup.
> 
> I often wonder why some supposed experts go on and on about being accurate in the fabrication of eyewear down to the last degree of axis, and the last eighth of a diopter, and lambast low abbe lenses, yet they would encourage a client to spend hundreds without checking whether a refraction has changed by half a diopter and five degrees over the course of two or three years.  Tsk tsk.



Easy...they want to bag the sale on the spot...

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## chip anderson

What actually happens to the patient after 1yr., 2yrs.,  5yrs., that couldn't happen after 6 months, or 6 weeks, or 60 years.  Expiration is strictly a gimick to force the patient to get a new eye exam.   While this may occasionally (I mean per thousand patients) disclose an unsuspected problem or Rx change, it's  no guarantee against them.   We go far enough _advising_ patients to have a bi-annual exam.  If the patient wishes to go against that advise and can't see well out of his glasses, what's wrong with saying: "I advised you to get a new exam.  Now it's up to *you* to get a new pair of glasses and/or new lenses in the ones you just purchased."
We don't _force_ people to have a physical, or a heart check up or whatever.
What's the matter with you people that you think you or your God given Government can force people to do things?

If there is hope, it lies in the proles.   :  Emanuel Goldstein

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## kws6000

The biggest crying about rx expiry dates that Ive seen are by greedy opticians who will do anything to get the sale on the spot...

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## kws6000

> What actually happens to the patient after 1yr., 2yrs.,  5yrs., that couldn't happen after 6 months, or 6 weeks, or 60 years.  Expiration is strictly a gimick to force the patient to get a new eye exam.   While this may occasionally (I mean per thousand patients) disclose an unsuspected problem or Rx change, it's  no guarantee against them.   We go far enough _advising_ patients to have a bi-annual exam.  If the patient wishes to go against that advise and can't see well out of his glasses, what's wrong with saying: "I advised you to get a new exam.  Now it's up to *you* to get a new pair of glasses and/or new lenses in the ones you just purchased."
> We don't _force_ people to have a physical, or a heart check up or whatever.
> What's the matter with you people that you think you or your God given Government can force people to do things?
> 
> If there is hope, it lies in the proles.   :  Emanuel Goldstein


Actually,there are a lot more previously undiagnosed eye health problems and rx changes than what you have stated....

In the event that the expired rx that you use doesnt work,as per your example,good luck not having the customer blame you...

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## chip anderson

Seems to me the greatest protest I have heard is from patients (consumers) who's _Doctor_ won't give them a copy of thier Rx without a hassel and insist that they buy at least a year's worth of whatever product thereby insureing that the Rx probably won't be filled anywhere except the good _Doctor's_ shop before it expires and they must return to him for another.
The Rx isn't a vaciene for small pox, diptheria or polio for which one could make an argument that one must have to protect the rest of the public at large.  It's not even something to protect the public from themselves as supposedly helments and seatbelts (which I also have a *lot* of trouble with also) are.   It's just to force the patient (consumer) back into the examination chair whether he thinks he has a problem or not.
If this were truly the case then the exam would be manditory (which some elements of the politburo will go for) and it would be illegal for this patient go on wearing a pair of glasses over two years old.  Think of it, your next money grabbing plot, automatic expiration on existing glasses, must be turned in at the end of 730 days may not be worn a day longer.

Chip

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## LandLord

> The biggest crying about rx expiry dates that Ive seen are by greedy opticians who will do anything to get the sale on the spot...


I think you mean poverty-stricken opticians who can barely pay the rent because the greedy optometrist down the street puts unnecessary restrictions on an Rx.

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## fjpod

> Yes, good point! I agree!
> 
> That's why some of us Opticians wish to refract.
> 
> B


But if it's been two or three years, (and that's what we are talking about here, not one year expirations) don't you think a client should have an eye health checkup as well?  Suppose they are 59?  Or suppose they are 16?  Suppose they have diabetes?  Would you feel comfortable selling new glasses without the benefit of a full checkup?

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## LandLord

> But if it's been two or three years, (and that's what we are talking about here, not one year expirations) don't you think a client should have an eye health checkup as well? Suppose they are 59? Or suppose they are 16? Suppose they have diabetes? Would you feel comfortable selling new glasses without the benefit of a full checkup?


Yes, over 2 years must have an ocular health assessment. One year, not unless there is a good reason.

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## finefocus

> Actually,there are a lot more previously undiagnosed eye health problems and rx changes than what you have stated....
> 
> In the event that the expired rx that you use doesnt work,as per your example,good luck not having the customer blame you...


Of course the patient is not going to say "my fault, my problem". They will say "these glasses you sold me don't work".
Also, why do we worry about hyper-accurate lens designs if the Rx is suspect? Why worry about ANSI? An old Rx has likely changed by ANSI tolerances, so who cares? This business of precision is pretty over-rated, don't you think? Hell, we might as well start using offshore cheapie labs.

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## chip anderson

How often per  thousand patients scheduled for a routine exam and refraction is "significant pathology" found?

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## kws6000

> But if it's been two or three years, (and that's what we are talking about here, not one year expirations) don't you think a client should have an eye health checkup as well?  Suppose they are 59?  Or suppose they are 16?  Suppose they have diabetes?  Would you feel comfortable selling new glasses without the benefit of a full checkup?



Most of the opticians that Ive encountered would have no problem selling glasses/contact lenses to anyone walking in the door as long as there is an rx (date not important)  and the customer has the money....Its all about the money with these guys...

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## kws6000

> How often per  thousand patients scheduled for a routine exam and refraction is "significant pathology" found?



Define significant....I would say that I encounter clinically significant cataracts,contact lens overwear problems and macular degeneration in about 20% of the people I see...Which opticians dont have the skills to diagnose or manage...

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## kws6000

> I think you mean poverty-stricken opticians who can barely pay the rent because the greedy optometrist down the street puts unnecessary restrictions on an Rx.



Not my problem....Opticians would consider any restrictions on the rx as unnecessary if they cant bag the sale....

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## kws6000

> What actually happens to the patient after 1yr., 2yrs.,  5yrs., that couldn't happen after 6 months, or 6 weeks, or 60 years.  Expiration is strictly a gimick to force the patient to get a new eye exam.   While this may occasionally (I mean per thousand patients) disclose an unsuspected problem or Rx change, it's  no guarantee against them.   We go far enough _advising_ patients to have a bi-annual exam.  If the patient wishes to go against that advise and can't see well out of his glasses, what's wrong with saying: "I advised you to get a new exam.  Now it's up to *you* to get a new pair of glasses and/or new lenses in the ones you just purchased."
> We don't _force_ people to have a physical, or a heart check up or whatever.
> What's the matter with you people that you think you or your God given Government can force people to do things?
> 
> If there is hope, it lies in the proles.   :  Emanuel Goldstein



Chip,I love seeing people , who are having problems seeing  ,after they have purchased glasses/cls from guys like you who have used an expired rx....

Guess who they are angry at ,and wont buy from again???.....These people are usually easy sales for me,and generally wont deal with another greedy optician...

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## uncut

> Chip,I love seeing people , who are having problems seeing ,after they have purchased glasses/cls from guys like you who have used an expired rx....
> 
> Guess who they are angry at ,and wont buy from again???.....These people are usually easy sales for me,and generally wont deal with another greedy optician...


And of course....in your *omnipotent capacity* you are able to pinpoint the *exact* time their vision changed....just before they had the Rx duplicated ..........................................riiiiiight!
 :angry:

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## Barry Santini

> I don't know why Barry and others use the satirical argument of "oh your eyeglass rx is expired I'll go to your house and take all of your old glasses so you don't hurt yourself." I find nothing wrong with using an older Rx, but if the doctor has put an expiration date on there, I'm going to assume that he wants to update the refraction by that time. Most do it for money, but there is the occasional honest doctor that does it because the patient is a raging diabetic or something, and it could be outright dangerous to have them drive with the old rx.


Your point is well taken. Just goes to my arguement that the current paradigm encapsulated in an eyeglass correction is insufficiently robust to describe all one needs to know.

_Especially now, in the era of online fulfillment of Rx eyewear._

I've always said vison is fluid. But I'll bet my license right now, that most "expired" SV Rxs, made with a properly fitted digitally-enhanced SV FF lens, will be more satisfactory to most patients, than an modestly updated Rx made with stock lenses and without care in proper lens placement. This is my experience. The bottom line is that most people need to have at least 0.50D change, or cyl/axis changes of note, before they "see" a difference.

BTW, using your example, a simple acuity test would easy prevent letting someone reuse a correction that far off. Then, a refraction is definitely called for.

Barry

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## Barry Santini

> The biggest crying about rx expiry dates that Ive seen are by greedy opticians who will do anything to get the sale on the spot...


Agreed, as long as, within the United States, the refractionist complies with the FTC Rx Release law, and hands the Rx to the patient RATHER than the optician in their dispensary. It's about freedom of choice, not vendor or trade journal-sanctioned manipulation. IF they wish to fulfill the Rx in the examiner's store, that is *their* choice. But they MUST be given the choice. That's what the law in place to ensure. My clients, who are "directed" or "captured" by their examiner's office, will state very clearly to me that they won't go back to that examiner.

So much for improved "capture" rates.

BTW, I NEVER fulfill an Rx for a client if their last exam is over 1 year ago, unless *they* insist...meaning I advise them that a refraction alone is NOT an eye health exam, and if they skip the full exam, and just have a refraction, they are doing an disservice to the welfare of their vision.

But it is still an individual choice. Just like OTCs.

Barry

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## doglas

i dunno, greedy opticians? i've being dealing with this, "expires in 6 months-year" for a long time....what a joke, when you say greedy there is no optometrist on the planet that is more greedy then my still practicing father, are they all like this, well i don't know, but the optometrist office down the street from me does the highest volume in b.c. for sales, & what you might ask what my feed back from all my customers talk about? it's the extreme pressure they put on the customers (especially the elderly,this one really gets me) to purchase their extremely inflated eyewear, the way they get steered into the back room by high pressure sales....so, how does the reasonably priced optician combat that?  well, i'll tell you how, by sight testing, this so called greedy optician is going to be giving this service to the public for free, & i would suggest that all optician do the same when the other provinces allow it...it opens a lot of doors,  also here in b.c. it is suggested that the public between 19-65 get a eye health check, every 3-5 years. we can also sight test anyone once you have a prescription from the ophthalmologist, which states "please refract patient" since the eye health has looked after, & all this patient now needs, is just a sight test, & the ophthalmologist just doesn't want to do this, that is where again, a refracting optician comes in

----------


## Oedema

Here's a suggestion: Forget about sending $15,000+/year to eyelogic, find a friendly OD and set him or her up in your office at a fraction of the cost.  You save money, an OD makes money, you get to keep all patients of all ages in house, and maintain a greater sense of credibility.  Lots of OD's in the lower mainland looking for an opportunity like that.

----------


## Doug

> Here's a suggestion: Forget about sending $15,000+/year to eyelogic, find a friendly OD and set him or her up in your office at a fraction of the cost.  You save money, an OD makes money, you get to keep all patients of all ages in house, and maintain a greater sense of credibility.  Lots of OD's in the lower mainland looking for an opportunity like that.


I'd have to agree Odema. Easiest way to satisfy your patients and yourselves is to work together.

----------


## kws6000

> And of course....in your *omnipotent capacity* you are able to pinpoint the *exact* time their vision changed....just before they had the Rx duplicated ..........................................riiiiiight!
>  :angry:



It doesnt matter...the new specs/cls didnt meet expectations....from the customer's perspective the optician messed up...

----------


## fjpod

So anyway, basically we all have to abide by the laws and regulations of our State or Province...which ranges from no limit, to a year or two.

Moderator...I think we've beaten this to death.  Why not close it down.

----------


## uncut

> It doesnt matter...the new specs/cls didnt meet expectations....from the customer's perspective the optician messed up...


Unfortunately...we all look bad when that happens, and guess what?  The general public has difficulty discerning who is optometrist and who is optician.  I'll bet you operate under the usual banner of "EyeEyeEye DrsRUs and also stuck an ad under Opticians in the Yellows, too.

----------


## DragonLensmanWV

Maybe we should all bow to kws, as apparently he knows it all. When do you think an Rx should expire, kws? Only when you can blame an optician for it?

----------


## optical maven

If you recognize a spectacle correction as a prescription, and therefor requiring professional requirements to presribe, then an expiry must be included.  If there is no medical requirement, then no presription is required.   For those who are advocating that position, are also advocating for no prescibing requirements for spectacles or contact lenses and are in favour of internet sales, as no risk of harm is present.

----------


## Barry Santini

Trial Framing the Rx in situations where it's efficacy may be suspect *always" helps to separate the wheat from the chaff.

FWIW

B

----------


## fjpod

> Trial Framing the Rx in situations where it's efficacy may be suspect *always" helps to separate the wheat from the chaff.
> 
> FWIW
> 
> B


I don't blame you for doing so.  Prescribers that are not within your dispensing location "just don't get it", for the most part, because they are not paying the lab bills.

----------


## Barry Santini

The weak-link where an immediate decision from a trial-frame evaluation may lead one astray is when the client cannot differentiate better/sharper from familiar/more comfortable. This is but one example where arriving at what is best for an individual's vision is not always predictable the first time at bat. So with a certain percentage of remakes invariably in the mix, i feel the more time an ecp practice devotes to trying to arrive at meeting the client's needs, the more they differentiate themselves from practices that don't...whether online or down the street.

My $0.02.

B

----------


## drk

Interesting discussion, Canadians plus others.  

I think we have to decide whether optical care is part of the overall health care community.  If so, then there's one course of action, and certain consequences.

If optical care is separate from the health care system, then there's another course of action and another destiny.

What do you think...is optical care an integral part of vision care and eye care, or is it more about selling products?

----------


## kws6000

> Interesting discussion, Canadians plus others.  
> 
> I think we have to decide whether optical care is part of the overall health care community.  If so, then there's one course of action, and certain consequences.
> 
> If optical care is separate from the health care system, then there's another course of action and another destiny.
> 
> What do you think...is optical care an integral part of vision care and eye care, or is it more about selling products?



It doesnt matter what my personal thoughts are,,,,the marketplace has already decided that optical care is retail....and about selling products...

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## kws6000

> Maybe we should all bow to kws, as apparently he knows it all. When do you think an Rx should expire, kws? Only when you can blame an optician for it?



1 year is reasonable....

----------


## kws6000

> Unfortunately...we all look bad when that happens, and guess what?  The general public has difficulty discerning who is optometrist and who is optician.  I'll bet you operate under the usual banner of "EyeEyeEye DrsRUs and also stuck an ad under Opticians in the Yellows, too.



Not quite....I actually come out of this looking good....Im not the guy who should have known better than to have used an expired rx.....

In the customer's eyes the optician just wanted the sale....

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## Barry Santini

> It doesnt matter what my personal thoughts are,,,,the marketplace has already decided that optical care is retail....and about selling products...


There are lot's of other businesses that sell products, but differentiate themselves through service, advice, repair, warranty and customer loyalty/word-of-mouth.

Eyewear has just arrived there.  Contacts have already become commoditized, but that hasn't put legions of ECPs out of the business of professional care and fitting them.

B

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## cwinma

Well in Mass. on a spec RX some docs say 1 year others 2 years, we honor 'their' expiration date. Now if a patients does not have their RX and we neutralize existing glasses our office policy is to ask date of last exam and if over 3 years old we will not fill.

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## kws6000

> There are lot's of other businesses that sell products, but differentiate themselves through service, advice, repair, warranty and customer loyalty/word-of-mouth.
> 
> Eyewear has just arrived there.  Contacts have already become commoditized, but that hasn't put legions of ECPs out of the business of professional care and fitting them.
> 
> B



Yes and no....The *******ization of the cl end of things has resulted in a downward spiral in cl fees and dispensing volume....Eventually ,you will likely see more ecp who stop working with cls because the hassles arent justified by the diminishing fees...


Chip should be able to chime in here about the downward spiral of cl related income...

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## chip anderson

Actually the CL business has practically died for independent fitters at least.  Now the industry has changed and prescribers have increased fees to the point that they now get as much as we were getting plus the cost of lenses in thier "contact lens exam" fees.   Many are forcing or inducing  the patient  to buy a year's supply (on a year only Rx.)  But as far as the independent fitter we now only see:  Old patients who are intensely loyal,  very difficult fittings (keratoconnus, corneal transplants,  rediculouly high cylinders and patients that for one reason or the other the presciber doesn't want to fool with.
Used to fit about five new patients a day, now if things go well I see this many new ones in two weeks.    And those are often people that several other people have failed to be able to fit.   Gone are the teenage myopic females that used to be our _bread and butter._
Unfortuately as an independent fitter one can't charge outrageous exam fees (we used to make a good living on replacements) or ensure that everything the patient can get with that Rx must be obtained for us.   And then Softlens fitting is so simple that a near zero expertise level is required, so the prescriber gets the teenage myopes.

Chip

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## uncut

> Actually the CL business has practically died for independent fitters at least. Now the industry has changed and prescribers have increased fees to the point that they now get as much as we were getting plus the cost of lenses in thier* "contact lens exam"* fees. Many are forcing or inducing the patient to buy a year's supply (on a year only Rx.) But as far as the independent fitter we now only see: Old patients who are intensely loyal, very difficult fittings (keratoconnus, corneal transplants, rediculouly high cylinders and patients that for one reason or the other the presciber doesn't want to fool with.
> Used to fit about five new patients a day, now if things go well I see this many new ones in two weeks. And those are often people that several other people have failed to be able to fit. Gone are the teenage myopic females that used to be our _bread and butter._
> Unfortuately as an independent fitter one can't charge outrageous exam fees (we used to make a good living on replacements) or ensure that everything the patient can get with that Rx must be obtained for us. And then Softlens fitting is so simple that a near zero expertise level is required, so the prescriber gets the teenage myopes.
> 
> Chip


Ahhh yes......the venerable, inexplicable "contact lens exam fees".   I know how to handle this question when it comes up with my own fittings, and how to coach existing fits in handling the situation.  How does one explain, when asked "Why was I charged more for my routine eye exam, just because I wear/wore contact lenses?".

----------


## chip anderson

Ah but you don't understand the doctor will sometimes even consult a chart for *the fit*,   actually read the* corneal measurements* off the auto refractor, and if he's real concientious give them a pair of trial lenses that he gets from his free *trial set* he got from the  manufacturer.  No follow-up later of course.  Think of good doctor's*  Time* in doing all this.  And if this doesn't work, the patient couldn't wear contacts or had _contact lens intolerance_.

Chip

----------


## Oedema

> Ahhh yes......the venerable, inexplicable "contact lens exam fees".   I know how to handle this question when it comes up with my own fittings, and how to coach existing fits in handling the situation.  How does one explain, when asked "Why was I charged more for my routine eye exam, just because I wear/wore contact lenses?".


I don't know about you, but I certainly appreciate being paid for my time and expertise when dealing with contacts.  Even if I'm not making changes there is extra work and thinking that goes into the exam for a contact lens patient. 

But thats part of the problem with contacts, so many practitioners (fitters and OD's alike) giving away their service and knowledge that many people will balk at CL related service fees.  For this reason I personally don't feel inclined to try and build this part of my practice.  Pittance for fees, whiny patients that return endlessly; no thank you!

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## chip anderson

Oedema:
The point is:  A _contact lens exam_ is strictly a routine eye exam with the words "OK for contacts on the Rx".  This is the doctor saying: The eye is healthy enough for contact lenses.  Something that any routine eye exam should reveal, no extra time, or whatever required.
Now many practioners, if they will release Rx at all charge an extra $80.00-$150.00 for the same exam allowing the patient to belive that some sort of additional services have been performed.   Now all this assumes that the patient will be referred to a competent optician contact lens fitter who will do his on K readings, fitting, follow-up and evaluations.
The only addittional effort the doctor need expend is putting "OK for contacts" on the Rx.
Chip

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## Oedema

That is not my idea of a "CL exam," if they can get away with charging $80 for write "ok for contacts," all the power to them.  I'm guessing this is an ophthalmologist?  But why is that even necessary for you to fit contacts?

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## chip anderson

I know how, which is more than I can say for all but a handfull of the hundreds of prescribers I have known. Also there are still a rare few eye doctors that feel thier talents should be used exclusively practicing medicine and surgery. I do realize that most of them are now businessmen, but there are still a rare few that are ethical left out there.
Some even feel that the time they would spend selling contacts could possibly save or restore and eye that they would not have seen if they were wasting thier time in the optical business.

Chip

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## sugarpopspete

> In ontario when does a RX prescription expire???
> 
> The reason i ask because each doctor writes their own expiry date. Some state 6 months, 1 year or 2 years. They make life difficult when trying to get a rx faxed over from their office. Obviously they want to bring the client back in their office.
> 
> So again according to the college of physicians and surgeons of otnario when does a rx prescripton expire????


Our office doesn't write expiry dates.  We have, however, been refused the rx from other offices that DO write expiry dates.  Annoying for the patient, who just wants to purchase glasses, and finds no problem with their 3-yr-old rx.

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## Oedema

> Our office doesn't write expiry dates.  We have, however, been refused the rx from other offices that DO write expiry dates.  Annoying for the patient, who just wants to purchase glasses, and finds no problem with their 3-yr-old rx.


They should not refuse to release the Rx to you, even if it has expired.  According to the college of optometrists they should release the Rx with "expired" written or printed on it.  I don't really feel like its the OD's job to police the enforcement of expirations, release it, and if there ends up being a problem, well then, told you so.  :Rolleyes:

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## eye2

> 1 year is reasonable....



Very easy to accommodate. Just have Doc. Put right on rx expiration date, problem solved. Unfortunately you have places that will disregard that and still fill it. I know of one right here in NY!

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## Barry Santini

> Very easy to accommodate. Just have Doc. Put right on rx expiration date, problem solved. Unfortunately you have places that will disregard that and still fill it. I know of one right here in NY!


yeah...me!

B

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## chip anderson

I have one group of OMD's that does not have this on the Rx they give this to the patient but if copied, duplicated or sent by Fax or E. Mail (even from them to the optician) it comes out with EXPIRED written all over it.    Created a problem when one is trying to get a duplicate to send to the insureance or other third party payers.

Chip

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## DragonLensmanWV

> I have one group of OMD's that does not have this on the Rx they give this to the patient but if copied, duplicated or sent by Fax or E. Mail (even from them to the optician) it comes out with EXPIRED written all over it.    Created a problem when one is trying to get a duplicate to send to the insureance or other third party payers.
> 
> Chip


That's high security paper. Like this:
http://www.highsecuritypaper.com/fea...enmessage.html

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## eye2

> yeah...me!
> 
> B




Sorry Barry you guessed wrong!

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## eye2

> I have one group of OMD's that does not have this on the Rx they give this to the patient but if copied, duplicated or sent by Fax or E. Mail (even from them to the optician) it comes out with EXPIRED written all over it.    Created a problem when one is trying to get a duplicate to send to the insureance or other third party payers.
> 
> Chip



Funny how insurance companies review expired and other optical places will just disregard it and use it.

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## chip anderson

The problem with this "high security paper" is it shows expired the day it's written if copied, faxed or e.mailed.   Where I have a problem is with Rx's for prosthetic eyes.   The only reason we ever need an Rx for a prosthetic eye is to collect from the insureance or other third party.   Don't really need Rx to provide one to the patient, just to get money out of third parties.

Chip

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## Barry Santini

Rx Expirations dates for eyewear "formulas" are just another blatant example of attempts to *control* the client. Plain and simple.

In my mind, this can be lumped in with the industry-wide advice to engage in the intra-office prescription "hand-off."

CL expirations are another thing altogether.

OMO

B

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## optical maven

If there is no expiry date on an Rx, then who is responsible to the patient when they claim they were unaware their 3 year old Rx may not be accurate.  Does it become my liability to replace the lenses when the person says they should have been informed?   I had this happen before I included a disclaimer on the Rx as to the potential inaccuracy of an old Rx.  Sorry, but it is in the patients, prescibers, and dispensers best interest to include at least a disclaimer as to the potential inaccuracy after a certain period of time.

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## chip anderson

If one goes in and asked to have a dress made at size 4 and refuses to have measurements or fitting done.   Then picks up same an comes back later when she finds out she has gained weight and needs size 6.   Is the dressmaker responsible?  If so how much?  Does she need to take it back and refund?  Does she need to completely re-make the dress?   Does she need to provide free alteration?
How far is one *required* to go?   Is one *required* to do anything at all?   If one is supplying a product at the *customer's specifcation and the customer's direction* against the advise of the seller, who's responsible?

Chip

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## Barry Santini

Whose to say a 1 hour old RX is accurate?

Just what is "accurate'?

Better is what the person finds as "satisfactory"

B

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## optical maven

Last time I checked making glasses was a medical act.  That is why a license is required to prescibe and dispense.  By your comments I am assuming you are advocating a complete deregulation of dispensing and requiring the same educational standards as required to fit a dress.  Have you been lobbying you state regulators to require no licensure to dispense glasses?




> If one goes in and asked to have a dress made at size 4 and refuses to have measurements or fitting done. Then picks up same an comes back later when she finds out she has gained weight and needs size 6. Is the dressmaker responsible? If so how much? Does she need to take it back and refund? Does she need to completely re-make the dress? Does she need to provide free alteration?
> How far is one *required* to go? Is one *required* to do anything at all? If one is supplying a product at the *customer's specifcation and the customer's direction* against the advise of the seller, who's responsible?
> 
> Chip

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## chip anderson

Maven:
I actually lobbied in my state for licenseing for about 40 years.   The few times we approched this with something acceptable (this was back when OMD's for the most part didn't dispense and we had thier support, which we don't have now that OD's are qualified to provide follow-up care on post-surgical patients, we no longer have this)  the OD's (they actually had thier members on the legislative commitees) would tack something unacceptable (like we couldn't take PD's or seg.hts.) on it.   Gave up on fighting that windmill years ago.

Chip

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## Barry Santini

To do eyewear well takes skill and training. To do it adequately takes almost nothing in the way of skill or knowledge. Hence, the growth of online.

And the risk of long-term sustained harm when it is done less-than well is very low.

So I'm against any position that trumpets a risk of harm greater than reality backs up. And so we'll just have to acknowledge that good enough is in fact good enough..not the best or near excellence, and not hide behind our license that, being done without, presents a great risk to the public.

As far as eyewear is concerned. OMO

B

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## eye2

[QUOTE=Barry Santini;381825]Whose to say a 1 hour old RX is accurate?
 Just what is "accurate'?
 Better is what the person finds as "satisfactory"


B thats all true, but if its written on the rx expired how is it your right to circumvent what the Doc wrote and use the rx? Same could be said for contacts also, do you also circumvent that issue as well? Can't have it both ways B. :hammer:

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## Barry Santini

Contacts no.  Eyewear Yes.  That doesn't mean that I would and routinely do ignore exp dates.  It's just that no person is *obligated* to return the the dr. who writes the expiration date. So I'm thinking it is more about "control" than health. So if the date is all about eye health\, then make the exam the determining factor...not the eyewear.  Duplicating eyewear has nothing to do with health.  Not having an eye exam when you should does.

There's a distinction here that also applies to contacts, since they are medical and in the eye

B

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## optical maven

So to some extent we are talking apples and oranges.  In Ontario presribing and dispensing glasses are only allowed by license.  In the US these laws appear to be different between states.  I have always and will always give a prescription, no matter how old to the retail store or patient.  But, I am still responsible to make the patient aware that the Rx may not be accurate after 1 year.   Should I say the Rx is good for life?  Will you redo the glasses, ad infinitum, if the customer cannot see?  If you advocate for no expiry date, then there should be no date on the Rx at all? 

If it is different after 1 hour as you blogged above, then there is a medical problem (eg unstable blood sugar), and for sure they shouldn't have that filled.  




> Contacts no. Eyewear Yes. That doesn't mean that I would and routinely do ignore exp dates. It's just that no person is *obligated* to return the the dr. who writes the expiration date. So I'm thinking it is more about "control" than health. So if the date is all about eye health\, then make the exam the determining factor...not the eyewear. Duplicating eyewear has nothing to do with health. Not having an eye exam when you should does.
> 
> There's a distinction here that also applies to contacts, since they are medical and in the eye
> 
> B

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## Barry Santini

In NY State, I can duplicate/copy a person's own Rx glasses.  If we agree this is no good, then we MUST ban all OTC and internet eyewear.

Either....or.

B

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## eye2

> In NY State, I can duplicate/copy a person's own Rx glasses.  If we agree this is no good, then we MUST ban all OTC and internet eyewear.
> 
> Either....or.
> 
> B




B what we were talking about was using an expired rx not neutralizing a persons specs to duplicate them. If the rx says expired I don't care what you do you can't use it. Now if you say you neutralized the persons glasses then yes that is allowed under NY law. But what if there is a case where you notice that said rx has expired and you ask doc to ok it even though it was not the original doc do you use it or not?

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## chip anderson

If the doc is a doc, he can prescribe anything he wants.   If he says use it, he is in effect re-newing the old Rx whether he was the origional author of same or not.  Of course, then if there's a problem, it's his problem.  But then we fill "no change" Rx's every day.

Chip

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## rdcoach5

Agreed. As far as no Dr OK, in my state, we can duplicate Rx

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## fjpod

In NY, there is no provision in the law for writing expiration dates on spectacle Rx's.  And I don't know of anybody who writes them because we know better.  What I do if somebody asks for a copy of an old Rx is, of course, write the old Rx date on the prescription, and gently remind the patient of how old it is.  I might do this if the Rx is one to two years old.  If it's a really old Rx, or I think this particular patient is likely to need a change because of a medical condition or past history, or the remaker or the patient is likely to get burned, or if I think I will get blamed for writing a wrong Rx, I write in the instructions, "exam recommended before filling this Rx".

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## Barry Santini

> B what we were talking about was using an expired rx not neutralizing a persons specs to duplicate them. If the rx says expired I don't care what you do you can't use it. Now if you say you neutralized the persons glasses then yes that is allowed under NY law. But what if there is a case where you notice that said rx has expired and you ask doc to ok it even though it was not the original doc do you use it or not?


Expired or not, if there is an emergency, and someone *needs* to see right noow, I'll prepare eyewear as close as I can from stock, and advise of the wisdom to get an eyeexam as soon as they can.

Medical...not optical.

Sue me.

B

----------


## eye2

> In NY, there is no provision in the law for writing expiration dates on spectacle Rx's.  And I don't know of anybody who writes them because we know better.  What I do if somebody asks for a copy of an old Rx is, of course, write the old Rx date on the prescription, and gently remind the patient of how old it is.  I might do this if the Rx is one to two years old.  If it's a really old Rx, or I think this particular patient is likely to need a change because of a medical condition or past history, or the remaker or the patient is likely to get burned, or if I think I will get blamed for writing a wrong Rx, I write in the instructions, "exam recommended before filling this Rx".





You are kidding right? You have not seen expiration dates written on a glass rx? I have seen it hundreds of times and mostly from OD's. And when is it prudent to except an expired rx and one that a doc gives a cursory ok but never examined the patient? REALLY! I can't believe any of you would go along with that, but then again "the root of all evil is the love of money" so maybe that's where we differ! :hammer:

----------


## fjpod

> You are kidding right? You have not seen expiration dates written on a glass rx? I have seen it hundreds of times and mostly from OD's. And when is it prudent to except an expired rx and one that a doc gives a cursory ok but never examined the patient? REALLY! I can't believe any of you would go along with that, but then again "the root of all evil is the love of money" so maybe that's where we differ! :hammer:


I don't follow what you are trying to get at.  Are you in NY?  Who writes Rxs without examining the patient?  Are you saying that an optician's financial incentive to make a sale supercedes what might be best for a patient?

----------


## chip anderson

fjpod:    As recent events show, Doctors will give written statements of illness without ever seeing the patient.   You can turn them into your employer (especially if it's the taxpayer) and get paid for the illness time off.   What keeps making you guys think education or license has anything at all to do with interity?
At present of the 50 or so OMD's in town, I can only think of one who will absolutely send a patient back to the optician that referred the patient.  At least without trying to manuver the patient into his optical shop or sell/fit contact lenses himself.        There is no honor left in the eye business at any level.

----------


## eye2

> I don't follow what you are trying to get at.  Are you in NY?  Who writes Rxs without examining the patient?  Are you saying that an optician's financial incentive to make a sale supercedes what might be best for a patient?



If you had read all the posts leading up to this you would have known what we were discussing. Re- read posts 96 and 100.

----------


## eye2

Ok

----------


## jediron1

> In NY, there is no provision in the law for writing expiration dates on spectacle Rx's.  And I don't know of anybody who writes them because we know better.  What I do if somebody asks for a copy of an old Rx is, of course, write the old Rx date on the prescription, and gently remind the patient of how old it is.  I might do this if the Rx is one to two years old.  If it's a really old Rx, or I think this particular patient is likely to need a change because of a medical condition or past history, or the remaker or the patient is likely to get burned, or if I think I will get blamed for writing a wrong Rx, I write in the instructions, "exam recommended before filling this Rx".





Ya there is no written law but I have seen it dozens of times where a scrip is written mostly by OD's that down in the right hand corner it says expires on such and such date. So I ask the question again do you ignore like Barry and just use it or do you recommend eye exam and if they walk they walk? As I asked Barry before he basically said I just fill it. How do fill an expired rx with documentation? I saw an incident where an expired rx was used the optician went and asked the presiding OD if it was alright to use she said yes but she was not the initial OD and it's my understanding that an OD can't give an ok without seeing patient even for rudimentary exam which was not done! So how do you explain that? And that is what I was asking before. So what's your opinion?

----------


## Stonegoat

British Columbia has completely deregulated the dispensing of glasses and CLs.  This was done to accommodate internet vendors.  I think it's a shame that decades of work done by opticians in BC to set a standard for fitting and dispensing eye wear, and regulate their profession  has been undone.  With the new regulations, neither glasses or CL Rx's ever expire.  Customers so inclined can simply continue ordering their glasses online indefinately.

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## fjpod

> Ya there is no written law but I have seen it dozens of times where a scrip is written mostly by OD's that down in the right hand corner it says expires on such and such date. So I ask the question again do you ignore like Barry and just use it or do you recommend eye exam and if they walk they walk? As I asked Barry before he basically said I just fill it. How do fill an expired rx with documentation? I saw an incident where an expired rx was used the optician went and asked the presiding OD if it was alright to use she said yes but she was not the initial OD and it's my understanding that an OD can't give an ok without seeing patient even for rudimentary exam which was not done! So how do you explain that? And that is what I was asking before. So what's your opinion?


Look, I don't have an answer for everything.  Basically, an expiration on a spectacle Rx could mean one or two things.  The prescriber is being obstructionist or b), he/she is trying to warn you that there is good reason to question the efficacy of this Rx, which translates into "Don't blame me if you have to eat glass.  I warned you to get an exam first".

----------


## eye2

> Look, I don't have an answer for everything.  Basically, an expiration on a spectacle Rx could mean one or two things.  The prescriber is being obstructionist or b), he/she is trying to warn you that there is good reason to question the efficacy of this Rx, which translates into "Don't blame me if you have to eat glass.  I warned you to get an exam first".



FJpod what I was asking and jediron1 figured it out was can OD just give a verbal ok without being the initial examiner and with out even giving a cursory look? And on your other question that you said I have never seen an expired date, I work in and around western NY from buffalo to Syracuse and I can say for a fact that I have seen at least 100 rx's almost all from OD's that have an expiration date. The question was also raised but 
you didn't answer what if a dispenser took in an rx that read expired do you use it like Barry or do you recommend exam and if they say no they walk. What would you do?  :Rolleyes:

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## Barry Santini

> what if a dispenser took in an rx that read expired do you use it like Barry or do you recommend exam and if they say no they walk:


Well, in Canada, the recommendation is every TEN years for an exam if you are under 40, and "asymptomatic"

So maybe this every-year-thing is a US/cultural phenomenon, or maybe...just maybe...its a veiled manipulation to control these clients.

Again, the current Rx paradigm is insufficient.

B

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## optical24/7

> So maybe this year-thing is a US/cultural phenomenon, or maybe...just maybe*...its a veiled manipulation to control these clients*.
> 
> Again, the current Rx paradigm is insufficient.
> 
> B


This IS the reason. I've seen dozens upon dozens of different Dr's Rx's. Every single OD's Rx always has a 12 month expiration written on it no matter what the patients age or medical condition. Conversely, I've yet to see an OMD Rx with one.

Additionally, most of these patients I see that went to an OD were not given their Rx AND they (the patient) has to either go by to get a copy or they have to fax a signed release to have it faxed to us. I've never had an MD that made a patient send them a release.

 The funny thing is, is that when an office uses such practices it often backfires. The patient gets frustrated with that office and it's easy for me to refer them elsewhere next time.

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## jediron1

> Expired or not, if there is an emergency, and someone *needs* to see right noow, I'll prepare eyewear as close as I can from stock, and advise of the wisdom to get an eyeexam as soon as they can.
> 
> Medical...not optical.
> 
> Sue me.
> 
> B


I visited a few MD and OD sites and the feeling was that if it says expired you can't use it. Now if you want to go out on a limb and use it that's your choice. Also those sites said that the prescription must be given right after the exam with all other matters such as payment should be done before the visit or before exam starts.  :Rolleyes:

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## fjpod

> FJpod what I was asking and jediron1 figured it out was can OD just give a verbal ok without being the initial examiner and with out even giving a cursory look? And on your other question that you said I have never seen an expired date, I work in and around western NY from buffalo to Syracuse and I can say for a fact that I have seen at least 100 rx's almost all from OD's that have an expiration date. The question was also raised but 
> you didn't answer what if a dispenser took in an rx that read expired do you use it like Barry or do you recommend exam and if they say no they walk. What would you do?


If there are two or more ODs in a practice and a patient asks the one that did not examine him to review the record and write out a new Rx, the OD is legally able to do so.  

If I got an outside Rx from a patient and it was marked expired, I would make it very clear to the patient that I could not guarantee their satisfaction, and there would be no refunds or free remakes.  If it were a simple +/- 2.50 SV Rx, I would probably fill it.  If it were for a -9.00, I would let the patient walk.  It's a disaster waiting to happen.  I don't need that risk...and neither do they.  It's not all about making the sale.

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## DragonLensmanWV

> If there are two or more ODs in a practice and a patient asks the one that did not examine him to review the record and write out a new Rx, the OD is legally able to do so.  
> 
> If I got an outside Rx from a patient and it was marked expired, I would make it very clear to the patient that I could not guarantee their satisfaction, and there would be no refunds or free remakes.  If it were a simple +/- 2.50 SV Rx, I would probably fill it.  If it were for a -9.00, I would let the patient walk.  It's a disaster waiting to happen.  I don't need that risk...and neither do they.  It's not all about making the sale.


What? That's totally contrary to Chip calling all OD's greedy.

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## chip anderson

It also insuates that he doesn't trust other OD's ability to refract.

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## kws6000

> It also insuates that he doesn't trust other OD's ability to refract.


No...it indicates an increased likelihood of the rx being incorrect due to the passage of time...

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## fjpod

> It also insuates that he doesn't trust other OD's ability to refract.


 Got nothin to do with who wrote the Rx.  
Chip, you would fill a three year old Rx for-9.00/add 2.00?? (probably with high index and AR)??  Even if the patient was not in dire straits and had two pair of glasses??  You would not recommend an examination?

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## chip anderson

An exam of course.  Now if he had one broken pair, I sho would fill it, or give him some trial contacts or somethin.  However it's just an antsy patient with back up glasses, who needs it?  
 Now we shall get to the teenage princess with glasses who has run out of contacts and mother is keeping her out of school so no one will have to see her in glasses or have to know she wears glasses.  Remember she's rich and whole family are good regular high dollar customers.....

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