[AMA] I Am a Young Optometrist Working in a Childrens Clinic. Ask Me Anything

LKappaPasterino on 01/06/2018 - 13:57
Last edited 05/06/2018 - 19:34 by 1 other user

How's it going. I'm an Optometrist that's been out working for a couple of years.

I'm currently working in a clinic that is primarily for children, but we do see patients of all ages as well. I also visit primary schools where we perform free eye examinations to see whether children are able to see well in class.

I have been very fortunate to work in a clinic which that co-manages patients from other medical and ophthalmology clinics. Hence, we often get referred interesting cases for us to assess. I would be happy to answer any questions, clear up any possible misconceptions about eyes (within reason of course). I also have knowledge about spectacles, but that's far from being anywhere near comfortable knowledge.

Ask me Anything

Edit: Thanks for the overwhelming response! I'll try to answer as many as I can. Because there are so many questions, please search through the post to make sure your own question hasn't been answered. Please also take my answers with a grain of salt (particular your own ocular health questions), it's best that you ask your own optometrist about them, as I know very little about you and your background.

Introduce Yourself

closed Comments

      • Nicoletta on 04/06/2018 - 11:17

        My husband had vitrectomies at age 30/31. He is now 40 and is always the youngest in his surgeon's office by about 30 years!! He's had subsequent cataract surgeries as a result of the vitrectomies (an expected side effect).

        His floaters came on overnight, in both eyes, and were severe. Most likely caused by his severe myopia. He waited two years and they did not improve, so he hunted down a surgeon who would perform a vitrectomy on someone his age.

        He is so happy he took that path - he couldn't just "live with it" like he was told by the opthalmologist he first saw.

    • uggugg on 04/06/2018 - 17:59

      How long did your floaters take to completely disappear? I've had floaters in both eyes now for about 20 months as a result of a PVD (posterior vitreous detachment). While the floaters are no longer as severe as they were at the very start, they are still quite visible if I bother to look at them.

      I feel the only thing that has changed is that my brain has adjusted to it and most days I don't even notice them but some days are rather bad, particularly outdoors in the bright sun, and I wish I didn't have these floaters any more.

    • Keef on 05/06/2018 - 18:07

      I think you answered your own question "post-op cateract surgery"

      Mine are due to Epiretinal Membrane - damage to tissue and I guess the floaters are old blood?

  • weirdthin on 02/06/2018 - 13:12
    +1

    What’s your funniest “kids say the darndest things” moment from your practice? :)

    • KappaPasterino on 02/06/2018 - 18:15

      Many kids come in and blantly say that they want glasses because either their family or friends wear them. So i spend a decent amount of time educating them about that haha

      • Scrooge McDuck on 03/06/2018 - 14:09
        +9

        Do you give the same response to hipsters?

  • DamonT on 02/06/2018 - 14:20

    Hi and thanks for doing this.
    Do you have any advice for a parent bringing their toddler in for their first check up? Mine certainly has a thing against strangers touching him or giving him directions (he'll likely do the opposite). I've also tried getting him to wear a pirate eye patch for fun, but he's not buying it…
    TIA.

    • KappaPasterino on 02/06/2018 - 18:04
      +1

      Bring your toddlers favourite toys. Some clinics don't have a play area for children, and may make them particularly nervous.

      If your child is particularly shy, I'd recommend doing an exam yourself, so your child can see what's going on. I often get toddlers to sit on their parent's laps, and would perform exams and put glasses on them to show them there's nothing to be afraid of.

      Our jobs as optoms is to also make the consultation as smooth as possible. Leave most of the work to us.

  • DarthAntz on 02/06/2018 - 14:24

    What the worst, preventable eye condition you have seen in children? Anything common?

    And when you have children, or if you already have children, what sort of eye/vision related care to you enforce and encourage as a parent?

    • KappaPasterino on 03/06/2018 - 21:19

      The #1 cause of reduced vision is uncorrected prescription. For parents its quite difficult to detect this because children often don't understand the concept of "blurry vision" or what it means to see clearly. I always recommend parents to get their child's eyes checked at ages as early as 2-3, as vision plays a significant part in cognitive development.

      For the second question. No i don't have kids, and now that I've spent so much time with them, I don't think I'll be keen for my own ones anytime soon. Australia and the rest of the world, young children seem to be hit with a wave of myopia (short-sightness)and vision issues relating to focusing and eye teaming. It feels like a lost cause, but I'd get my kids to spend a lot of time outside playing sports. Studies have shown more time spent outside = less risk of myopia. We haven't found a cause for this focusing and teaming problem, but I suspect its related to computer and digital device use (so don't take this as advice).

      • froggym on 04/06/2018 - 20:04

        My optometrist told me to get any kids I might have tested as early as possible because of how bad my eyes are and the history of vision problems in my family.

        I saw one theory that said the recent myopia epidemic could have something to do with a lack of exposure to natural sunlight rather than computers or other devices. Something in sunlight helps our eyes develop properly, maybe it makes us release a certain hormone.

        • KappaPasterino on 04/06/2018 - 21:09

          YES! that's one of the proposed theories.

          I believe they're finding short sighted people for a study in Perth to further test this theory. Reason why they're doing in Perth is because it has one of the highest amounts of sunlight in the world.

          It would be interested to see what those studies show

        • mysti on 05/06/2018 - 22:05

          I think the study you're referring to is the Sydney Myopia Study, which found that exposure to high light intensity (i.e. light outdoors) will aid in the release of dopamine, a retinal neurotransmitter which regulates eye growth (to extrapolate a bit further, release of dopamine slows the rate of eye growth, so the eye is less long, therefore less myopic). There have been animal studies on dopamine and myopia (where they induced myopia in chickens by filtering the light entering one eye… Poor chickens); I think there are also large population trials conducted in China and Taiwan based on this theory.

          The research attributing near work like reading and devices have always been a bit inconsistent, but genetics do play a factor. Usually only in extreme cases where parents are high myopes though, or were myopic from a very young age. I have also heard low dose atropine drops has shown promise in slowing myopia progression. But most paediatric ophthalmologists will have to conduct tests over a number of visit to determine there is definitely progression before they will prescribe it to kids.

          Just curious, are your eyes bad because of myopia, or from other eye-related issues?

  • dc4207 on 02/06/2018 - 20:01

    Shouldnt kids under 12 years old not wear glasses as it can change the shape of their eyes?

    • KappaPasterino on 03/06/2018 - 21:04

      A common question which is asked by many parents.

      Forunately, the answer is no, wearing glasses does not physically change the shape of their eyes. The reason people may think so is that spectacles magnifies or minifies the image of the childs eyes, thus giving the appearance of an enlarged or smaller set of eyes.

      • Ozpit on 07/06/2018 - 09:32
        +1

        Wouldn't a more accurate answer be that children's eyes continue to change shape, including after being prescribed glasses, until they are adults (after which they may continue to change but usually more slowly). As the eye shape changes (and I don't mean in external appearance), a new prescription is needed. So, when the eye shape of a child who wears glasses changes, the child/parent may blame it on the glasses, when the shape was always going to continue changing, hence the need for a new prescription.

  • lainey13 on 03/06/2018 - 00:26

    My prescription has been steady over the last 5 years however recently I've noticed I cannot focus properly on things close to my face while wearing my glasses (for short sightedness, since I was in Grade 3). Is it because my glasses aren't right, or because my eyesight is degrading? I know when you hit 40s they will do that anyway, but I'm only 34 and it's happened very fast very recently :( With glasses off I can do my usual staring up close at objects, I've had -6.5 and -5.75 for ages now.

    • KappaPasterino on 03/06/2018 - 21:35

      If you tend to stare at a lot of up close material (aka computers at work, or mobile phones), this is a very common symptom and thats because you're straining your eyes a bit too much.

      I'd suggest talking to your optometrist about multi-focal glasses or Anti-fatigue lenses (if they offer it)

  • DardyMate on 03/06/2018 - 01:06

    Hi Kappa, I've been wanting to do an laser eye surgery for long due to wearing glasses ever since a young age! However, I'm scared what other possible complications may arise in the future.

    1) Do I need to be wary of anything when I have it?
    2) How long is the recovery?
    3) From seeing other videos, and from my friend's sister - they basically said you are "BLIND" and very sensitive to light for a couple of days and may take weeks. Is that true?
    4) Is there a chance LASIK wouldn't work or not restore a 20/20 vision?

    What other things do I need to know?
    Typically how much would it really cost? Seeing on Lions Laser Vision (I'm WA located) it's $3,250 per eye. Is that the right price or too high?

    • KappaPasterino on 04/06/2018 - 21:12

      1) read my other comment on LASIK. But in short, talk to your optometrist about it.
      2) Usually about a week.
      3) Yes, its true.
      4) Technically yes, but a good surgeon will give you a rough idea of the chances of that happening. Buts its quite uncommon.

      Hard to comment about price to be honest. But in other places its about 2.5-3.5k per eye, depending on the technique they use. So its not too high I guess

  • worrierwan on 03/06/2018 - 13:37

    What are your thoughts on ortho-k? Is it safe? Does it help prevent eye sight loss in children?

    • KappaPasterino on 03/06/2018 - 21:20

      Its' a great treatment, albeit expensive but I think its totally worth it in terms of long term health benefits and increased quality of life.

      Unfortunately, it doesn't prevent myopia progression, but instead reduces it.

  • [Deactivated] on 03/06/2018 - 13:38
    +1

    What's the pay like?

    • KappaPasterino on 03/06/2018 - 21:22
      +1

      Really depends.

      80-140k

      • itchyscratchy on 04/06/2018 - 09:53
        +1

        I have a few friends who are optometrists. From what they’re telling me, with the increase in optometry schools, there are a lot more graduates coming out now. New grads in metro areas are getting offers of around 70k these days and are going to decrease, from what I hear.

        • Wez93 on 05/06/2018 - 00:23

          A lot of grads are getting around ~65K now. I imagine very few would be making 120+K.

        • Levathian on 05/06/2018 - 11:55

          I would think that grads in cities with an optom school eg. Syd/Melb/Bris/Adl would be getting very average pay, though rural areas and regional cities would surely need to pay more to attract optoms?

  • ahly92 on 03/06/2018 - 13:50
    +2

    Was it your fist choice or was it your backup for Med/Dental?

  • Tidy on 03/06/2018 - 13:56

    If a child has Central Retinal Vein Occlusion, how likely is it they will fully recover and have normal vision? Do they undergo the same treatment as normal adults (injections, or laser, etc) or is there an alternative? From your experiences, how successful are these treatments?

    Do you have any CRVO recovery stories that can cheer me and my family up? My 11 year old nephew found out he had it last week. He can't see our faces with one eye when looking at us in the eye, only our hair and above that area :(

    • KappaPasterino on 03/06/2018 - 20:25

      I guess, it would like you to clarify that it is indeed a CRVO and not a CRAO (artety occlusion).

      CRVOs tend to have a much better prognosis and the reduced vision tends to improve over several months, but this is based on my experience with adults. So I can't comment, because it's extremely rare. A quick google check up only shows a few isolated cased studies on Academic papers, and even those don't talk about clinical research or treatment.

      Treatment tends to be injections, but it may not be the case, since the pharmacology of a child is significantly different to an adult and therefore may not produce the intended outcome.

      I'm sorry about your nephew, hopefully he'll be able to see you soon. Best wishes.

  • Purepwnage2 on 03/06/2018 - 13:57

    Thoughts on contact lenses?
    Been wearing glasses for 5 years and recently found it getting more bothersome e.g. playing sports, fishing.

    I am anxious about putting things into my eyes + infections.

    And cons I should know before getting contact lenses?

    • KappaPasterino on 03/06/2018 - 20:31
      +1

      If you plan to wear contacts for specific purposes like sports, I wouldn't be to worried about your concerns.

      Our job as optoms are to assess whether you're a suitable candidate for contact lenses. So book an appointment and spend time discussing with them.
      Infections are certainly a concern, but we only see them in careless and reckless patients who don't listen to our instructions.

      Its also normal to feel anxious about putting lenses in your eyes. This is an instinct that we teach you to control. I've only had one patient where I've genuinely not been able to get them to put in lenses themselves.

      I would also recommend you look up OrthoK lenses, which are night contact lenses which correct your vision like braces to allow you to see clearly without glasses or contacts during the day.

  • Kuhaku on 03/06/2018 - 14:13

    Optom student here, just wondering if its worth while working in a optemetry whilst studying, does it make a big difference (2nd year)in terms of what u learn in uni.

    • Kuhaku on 03/06/2018 - 14:14

      also i know its broad but expected grad pay per hour or package (generally speaking).

    • hondapikachu on 03/06/2018 - 17:16
      +1

      Im a 3rd year optom student (QUT) and work at an optom practice! Working in an optom environment and learning everything involved with spec/contact lens dispensing is pretty cool and is useful in the ophthalmic and dispensing units you cover in your course. If you haven't already had a job before, it can help with building your people skills for when you start clinic and see actual patients. You could also try applying for a job at an ophthalmology clinic if you prefer the therapeutic part of optom compared to refraction.

    • KappaPasterino on 03/06/2018 - 20:35
      +1

      As Hondapikachu has recommended, I highly recommend it.

      There's a lot which you will never learn in the clinic and uni, particularly people skills and the business side of optometry. It also provides you a good foot hold to getting a job in the future, because many students will get jobs in the clinics. Thus it will make it **much harder* to make yourself look good in front of a potential employer if you don't have a job

      Plus, there's the casual money which you will get to pay for those expensive expensive equipment.

  • Scrooge McDuck on 03/06/2018 - 14:16

    How risky are high-G sports to eye health?

    • KappaPasterino on 03/06/2018 - 20:35

      If there's anything I've learnt in optom.

      Don't bungie jump and play squash.

      They can cause problems such as retina detachments, broken lower orbits

      • Scrooge McDuck on 03/06/2018 - 20:38
        +2

        I do imagine it would be quite difficult to connect with the ball while rebounding chaotically on a tether.

    • xyron on 04/06/2018 - 15:17
      +1

      Seriously read this as high G-spots the first time. Thought that someone must have a seriously high g-spot to put their eyes at risk…

      • Scrooge McDuck on 04/06/2018 - 15:22

        You're not alone. I read it that way, and I wrote it! Phrasing possibly influenced by my subconscious mind.

        Either way, safety glasses are recommended when using high pressure nozzles near the face.

      • JimB on 05/06/2018 - 14:38

        I've been told you can go blind if you do it too often.

        I always assumed it was about masturbation, silly me, now I know they were referring to bungie jumping.

  • Wweezy007 on 03/06/2018 - 15:24

    What do you know about nystagmus and or spasmus nuntans. Have you encountered cases of these things.

    • KappaPasterino on 04/06/2018 - 19:20

      Frankly I haven't encountered many Nystagmus. But what I can say is that has a wide variety of causes (genetics, neurological).

      And none for spasmus nuntans

  • chickenwings on 03/06/2018 - 16:09
    +3

    another optom student here and curious to know how influenced the retail side of things are for an optometrist. Is it getting to the point where it's becoming like pharmacy and optometrists have to start pushing glasses onto people? Are there jobs that we can put patient care first?

    • KappaPasterino on 03/06/2018 - 20:51
      +2

      Great question!

      Sadly, I do feel that with recent changes in the optometry regulation, I feel that some optometrist get taken back by how influential the retail aspect of optometry can be on them. It is my personal opinion that despite these recent changes, optometry will never become like pharmacy.

      Some optometrist are getting pressured to force spectacles that are not needed, and this is quite unethical.

      And YES! There are plenty of jobs which strongly focus on patient care rather than sales, even in corporates such as OPSM and Specsavers. Independents tend to be pushy, but by no means are they clean. This is inherent in our field where retail is combined with clinical health.

      My advise is to really spend time looking for dispensing job (if not already) which really focuses on ocular health, or other specialties that other practices don't offer. Take your time. You will always have opportunities to work. But you will never have opportunities to develop those rarer skills.

    • Wez93 on 05/06/2018 - 00:29
      +1

      Please don't lost hope! Optometry won't end up like pharmacy, in my opinion, because we're a service based as well as retail based profession. The industry may or may not change to a more service based profession with the more competitive market retail-wise. However, you can definitely see more service based things we can do outside of just your run of the mill eye test e.g. dry eye management, paeds, specialist contact lenses, myopia control, etc.

      At the end of the day it comes down to YOU. I've worked in independents, and corporates. I've been in dodgy independents which don't even know what good eye care is and I've actually ended up in a corporate which puts eye care way before retail. My boss actually recently questioned how ethical one of my dispenses were to make sure I wasn't ripping my patients off. I've also been in other corporates where they pushed KPIs like crazy. It might take a few moves, but i'm sure you'l find something that suits you.

      • chickenwings on 06/06/2018 - 15:55

        oh wow thats really interesting to hear that corporate can be a good place for eyecare. what is the deciding factor that influences good eye care at an optical place? Is it the boss/franchaise owner or would it be the parent company?

        also, how do you start specialising? do you just apply for places that do this and learn from them?

  • EyyBanane on 03/06/2018 - 16:47
    +3

    Have you heard of Aooko?

  • moo on 03/06/2018 - 17:57

    If I am unable to wear contact lens for swimming,, what are my options short of gluing an old pair of lens onto my goggles?

    • KappaPasterino on 04/06/2018 - 19:20

      Just look up prescription swimming goggles, you can buy them online and many independents offer them

  • k15866 on 03/06/2018 - 18:39
    +1

    Is there a clear division between research and commercial interests? Given the highly lucrative nature of selling glasses, I have always felt the profession would try to do everything it can to prevent something free (eg. Eye exercises) from gaining traction. Do you think future research is driven to further / maintain this market?

    I have also heard specssavers funded/started a course in Melbourne (not sure on technicality). If this is the case, do you think there is enough scrutiny in the profession to ensure specs savers is not influencing the profession negatively thru teaching

    Or am i crazy?

    • minotaurian on 03/06/2018 - 20:05

      You're not crazy, I have heard this with regards to Deakin Uni. The big giants like Luxoticca and Specsavers who control roughly 70% of the market share combined, have great influence on this uni. I am worried future graduates will have a retail-centric mentality as oppose to clinical. Similarly, how health insurances has a strong hold on how we choose our healthcare and dental providers. We do not choose based on clinical merit and expertise, but rather, the "preferred" provider, which in some cases do not have our health in their best interests.

      • KappaPasterino on 03/06/2018 - 21:31
        +2

        Well said, and unfortunately i think it goes with other medical professionals as well.

        These companies make it significantly easier to work as an optometrist in their own system. Students, even in Deakin can opt not to work for Speccies. Honestly, it depends on how you conduct yourself as an optometrist. I've seen many optoms from my uni become disenchanted, and vice-versa I've heard of grads from Deakin excel to become great optoms.

        • minotaurian on 06/06/2018 - 20:36

          I understand where you're coming from. All of us as individual has the capacity to dictate our own future. However, future can easily be influenced by external factors, which somewhat relates to the controversial debate of nature vs nurture. Are we born a certain way or the environment can turn us a certain way? Obviously, it's neither, but a combination. I just fear the latter has more of an influence. If this was not the case, then why would big multinationals support allowing a larger intake of Optom students at this uni. They are definitely not doing it for the sake of it. It just reminds me of pharmacy all over again.

  • [Deactivated] on 03/06/2018 - 18:58

    Hi OP, I have Myopia, brought on at about 18 years of age. When overseas last year in Europe I noticed you can purchase '- rated' glasses for nearsightedness. Why don't we sell these in Australia? We sell the '+ rated' reading glasses. They fixed my sight perfectly. Is it an Australian law that prohibits these being available?

    • KappaPasterino on 03/06/2018 - 21:00

      Honestly I'm not sure. Australian Law is much more strict compared to other countries particularly with medical devices or treatment. But there are two possible reasons:

      1) Myopia prevalence is still not high enough that it makes it a commerically viable reason to make these glasses in bulk.
      2) It's a lot harder to know whether your -ve glasses are the correct one. For -ve lenses, you can use a lens which is a lot stronger in power and still find things clearer in the distance; but what you'll find is that objects up close may be more straining on your eyes.

  • spook290 on 03/06/2018 - 19:51

    Hi OP,

    Thanks for taking the time to answer so many questions, interesting to read through them.

    I've thought about getting laser eye but have been put off by the costs, the quotes I've received vary from clinic to clinic and by method.

    What would you say is the most cost efficient and best method for laser? Any particular clinics have a good reputation?

    • KappaPasterino on 04/06/2018 - 15:23

      SMILE and LASIK are the ones that usually have a particular good visual outcome, but I think the prognosis of any surgery is more related to the surgeon themselves. A good surgeon will accurately tell you what to expect in terms of vision, potential side-effects and in some cases tell you that refractive surgery is not a suitable option for you.

      I can't recommend any clinics because I don't know where you live and would like to remain impartial. Ask your optometrist for their recommendation. A good clinic will take the time to explain the process to you.

    • ricebubbles on 13/06/2018 - 22:06

      It would be helpful to go into a specialist refractive clinic to have a proper assessment for your eyes. Factors like stable script, corneal thickness all play a factor in the overall choice of the type of laser that you will end up having. If you are a contact lens wearer, make sure you leave them out for around 5 days (each clinic might tell you a different duration) to ensure that the "final script" for your eyes is most accurate.
      You wouldn't want to choose the type of laser depending on the cost. Consider the type of lifestyle you live; how active you are, swimming, high impact sports, or office job etc., and that will help the clinicians decide which would be the most suitable for you as the healing times do vary a bit.
      Keep in mind that you will also need to have follow-up post op appointments to ensure everything is healing nicely and outcome is as you expect (work flexibility/work environment).

  • thriftybunny on 03/06/2018 - 20:49

    Hi thanks for the AMA, I have fairly bad exophoria, normally it's not obvious to me because apparently my brain's used to it, I only use one eye to look at things if I'm really tired. Is there anything I can do? And what would happen if I don't do anything?

    • KappaPasterino on 04/06/2018 - 19:23
      +1

      Depend on the nature of your eyes, spectacles may help.

      Vision Therapy can help you consciously control your eyes a bit more and be aware of moments when your eyes do turn. It's quite a tedious process which requires commitment.

      Finally, if you're an adult, shouldn't be too worried. If it was a child, potential lazy eye may be a concern.

      • thriftybunny on 04/06/2018 - 20:00

        Thanks @kappaPasterino my optometrists were always reluctant with spectacles, reason being they would make my eyes lazy.
        With vision therapy do you mean the pencil push ups and 2 balls on a string?
        I am an adult, I just wonder if it will get a lot worse with age and whether I'll get double vision…

        • KappaPasterino on 05/06/2018 - 19:47

          If correctly prescribed, lenses will never induce lazy eye, especially in an adult.

          In the simplest sense yes, pencil push up and other similar activities; however research indicates that pencil push-up is a poor form of treatment. I'd recommend you talk to an optometrist or orthoptist that offers it, as there are a wide variety of exercises that they can implement according to your severity of your eyes.

          Double vision may get worse as a result of cosntant strain, but will rarely cause lazy eye

  • StarvingOat on 03/06/2018 - 21:39

    I wanted to visit a good Optometrist in Melbourne. Is there anyone you can recommend since Im new here or is there anything I need to look out for while browsing through them?

    • KappaPasterino on 04/06/2018 - 19:25
      +2

      I'd recommend looking for places that have specialties or certain areas of interests (children, contact lens). Usually optoms there are quite knowledgeable in the field more than the average optometrist.

      Look for places that have Optical Coherence Tomographies (OCTs), these places usually have optoms with reasonable knowledge about ocular health.

      • StarvingOat on 05/06/2018 - 03:27

        Thank you for your response

  • Thenarrator on 03/06/2018 - 23:58

    I wear glasses but I want start to wear contacts. I have very sensitive eyes. I cant even do eye drops without closing my eyes. I just let the eye drops seep through my eyes. I cant imagine myself touching my pupil. 1) Is it possible to change this at all? 2) are there people who just cant get contacts to work due to their sensitivity? 3) What is the best way to learn to wear contacts given these conditions? 4)would playing with phone while laying in bed worsen my prescriptions?

    • KappaPasterino on 04/06/2018 - 19:27

      Please refer to one of my previous answers in regards to contacts. But to sum it up, leave that job to us, we'll teach you to do it.

      And finally, there's no evidence to support that digital devices worsens prescription but it does strain your eyes.

  • jnathanc on 04/06/2018 - 00:16

    Hi OP,
    1. A family member was born with what I believe is called Retinopathy of Prematurity? To your knowledge is there any advances in technology that can help the eyesight?

    1. I can't remember exactly when this began, but when I look out of my right eye, seeing text at a distance is not clear, whereas my left eye feels relaxed and pretty clear. I've had a test done at the eye specialist which apparently the pressure reading in the right eye was quite a bit higher, what could be the cause of this?
      -this happened so of a sudden one day to my knowledge..

    Thank you

    • KappaPasterino on 05/06/2018 - 19:50

      Treatment for ROP is unfortunately limited at this moment. But my understanding is very limited, so anyone may correct me.

      It's quite normal to have one eye seeing things better than the eye, in the same way as most humans being dominant with one hand. Asymmetrical pressures is not too uncommon, and there can be a wide variety of causes. I'd advise you to talk to the specialist if you have any particular concerns. If the specialist did not take action, then its most likely asymmetrical but still within the norms.

  • greatlamp on 04/06/2018 - 07:24

    Hi, thank you for the AMA

    Is it difficult to work out the correct eye glasses prescription?

    I went to three different optometrists on the same day and walked out with 3 different prescriptions.

    I ended up ordering glasses using and average of 2 of the three, after comparing with my older ones (I keep all my prescriptions).

    • KappaPasterino on 04/06/2018 - 21:45

      Prescriptions are not hard to find, but sometimes it can be a bit of an art to find it since it relies on your personal responses. All prescription will be different because the amount of lens combinations are limitless, but the prescriptions should be quite close to each other.

      Honestly, I think you've done yourself no favour by visiting 3 optometrist on the same day. Fatigue can play a factor in finding a prescription and may be the reason why they're all different. Furthermore, you've order using an average of two prescriptions, which means none of those 3 optometrist are held liable for the new prescription now.

  • ben oost on 04/06/2018 - 08:17

    Medical student interested in ophthalmology here.
    What's your relationship with ophthalmologists like?
    What do you wish they would do better?

    • KappaPasterino on 04/06/2018 - 21:02
      +1

      Good luck with Medicine. Ophthalmology is one of the harder specialties to get in, but honestly will be most rewarding if you decide to become an ophthal. A quick 5 min cataract surgery can literally restore someone's life.

      We have a pretty good relationship with our ophthals, but that's also because we've spent considerable time talking to our patients and the ophthals to see how good they are. For some we do a co-management program where we alternatively monitor certain stable eye conditions such as glaucoma and macular degeneration on a 6 month basis. Another allows us to do post-op check ups. Overall the communication between the us and the ophthals are pretty decent.

      Apparently the relationship between ophthals and optoms used to be very bad. Things have gotten better when it comes to managing patients together, but I feel that are certainly still areas that need improvement. The practice of optometry sometimes gets looked down by a few ophthals as just being mere spectacle makers. I think this way of thinking is slowly changing as all fields of health are slowly becoming more integrated in order to help their patients.

      • kawinuyo on 07/06/2018 - 09:53

        I think you will find there are also bad relationships with a subset of optometrists who don't practice evidence based practice (behavioural optoms)…you'll get a bad rep for that too… Honestly I think most ophthals think mainstream optometrists are fine.. There are always a few who think they know better and screw up a patient which is then left for the doctors to fix which they don't end up knowing about cause the patient doesn't go back to that optom…. (but that is true for all industries, a few that think they know better than everyone else?)

  • myusername on 04/06/2018 - 10:06

    how much does laser eye surgery cost?

    i just got prescribed glasses as i'm short sighted.

    i was told my optic nerve ending is twice the size of the average person, the optometrist ran some other tests and said i've got nothing to worry about.

    just curious as to why it's so big?

    should i be concerned in the future?

    are these questions covered by medicare or my health insurance?

  • Slippage on 04/06/2018 - 10:15
    +1

    How do you actually test children's eyes? At what age do you think you get reliable results when testing kids?

  • peterw1 on 04/06/2018 - 10:23

    are the size of the letters in the sign to your clinic normal size or larger?

  • Baebs on 04/06/2018 - 10:51

    Hey, thanks for the AMA!

    In regards to the ugly rise of commercialisation with specsavers and overall rising uptake in optometry students around AU, are there any expanding areas in the field that would allow prospective optoms to separate themselves from the rest?

    Also did you opt for further training immediately after graduation before working with younger patients or ease yourself into the field through work experience?

    • KappaPasterino on 04/06/2018 - 21:36
      +1

      As much as I would like to bag out on Specsavers, I think all this movement is creating a positive change for our field and patients. Competition overall benefits the consumer or patient, and for optoms it pushes us to distinguish ourselves from each other.

      I think many Optoms have been become too complacent and comfortable, simply cashing in on their quick prescription checks for glasses, and Specsavers will make them run for their money. Australia has an ageing population so at least for this moment, the demands for more optoms are needed.

      Furthermore, the myopic epidemic is rising in Australia, so there will be more greater awareness about it, thus creating a market for optoms to focus on. For Specsavers, myopia control doesnt seem to interest them too much yet.

      Parents are also becoming increasingly aware of the importance child's vision. So for optoms like myself, it allows us to develop and hone our skills more towards these patients.

      Finally to answer your last question, I was fortunate to have work experience with children, and was lucky enough to be recommended to apply for a childrens clinic. But by no means did I have formal training specifically for children

  • OneHunn1t on 04/06/2018 - 11:22

    Best practices to reduce morning eye discharge, dry eyes and redness?

    Also is the morning eye discharge a contributing factor to eye redness?

    Thanks in advance :)

    • KappaPasterino on 04/06/2018 - 21:18
      +1

      There are many factors that can cause morning discharge (most common are dry eyes and allergies) so talk to your optometrist about ruling that out. Over the counter ocular gel is always a good star and I sometimes tell my patients to do a warm compress on their closed eyes before going to sleep. Make sure to clean your eyes thoroughly.

      Yes, it can. It can also be vice-versa too.

      • OneHunn1t on 06/06/2018 - 13:05

        thanks for the advice!

  • squashy on 04/06/2018 - 11:23
    +1

    Can you recommend a good pair of sunnies for kids? Babiators are nice but it's too expensive.

    • KappaPasterino on 04/06/2018 - 21:14

      Cancer council sunglasses are decent for toddlers and babies.

      Also pretty cheap too.

  • Donaldhump on 04/06/2018 - 11:28

    how do you see your future panning out

  • jleno on 04/06/2018 - 11:30

    Why are glasses soo much cheaper in Asia but so damn expensive in Australia? Surely most of them come from the same place so are we all being ripped off?

    • myusername on 04/06/2018 - 15:49

      "australia tax"

    • Wez93 on 05/06/2018 - 00:37

      As I explained similarly in another comment, theres no such thing as an optometrist in Asia (aside from Hong Kong, i believe). So its like walking into Kmart and buying a shelf. The have a product costs and a little bit of cost of running their shop, and thats your product selling price.

      Optometrists as professionals are not cheap, nor are the skill spectacle dispensing staff. I'd bet a good amount of money there'd be many more people buying glasses in Asia that don't work vs in Australia. So you're really paying for expertise and guarantee that you get good specs.

      I imagine economies of scale would play a roll, as well as "island tax", not to mention the high base wages in Australia.

  • h4zey on 04/06/2018 - 11:37

    Is watching tv/monitor so close bad for your eyes?

  • dsgfh on 04/06/2018 - 15:57
    +1

    Is a rousing game of peak-a-boo considered fun or cruel in your line of work?

  • dvd107 on 04/06/2018 - 16:02

    1. What's the salary range like in private vs corporate e.g. spec savers

    2. Is it much more lucrative to own a optometrist?

    3. What types of acute condition do you refer to the GPs or what conditions do GPs refers to you?

    • KappaPasterino on 04/06/2018 - 21:55

      1. Really depends on the location and practice. Corporates tend to have higher starting, but you'll be guaranteed to work your butt off for that salary. Privates are often lower, but the opportunities to have pay rises are greater.

      2. Not more than any other business I guess. All owners will be working themselves to make them run.

      3. I usually send patients to GPs when I suspect certain conditions like hypertension, cholesterol, nasty shingles or suspected STIs. GPS often send patients to me to remove metal or wood in their eyes, if they're ruling out tumours, and many red eye cases which can't be fixed with good old chlorsig

  • ireadtermsofuse on 04/06/2018 - 16:43

    Will my eyes crust if I don’t take these prescribed eye drops?

    • KappaPasterino on 04/06/2018 - 21:13

      Those drops are "prescribed" for a reason.

  • eathb on 04/06/2018 - 16:52

    Hi I wear two different prescription contact lens but one of them has torn and I've thrown it out. Since then I've been wearing only one lens and I feel I can still see pretty clearly. Firstly is this bad for my eyes and if not is it okay if I just buy lens for this one eye from now on and go with that?

  • serpserpserp on 04/06/2018 - 20:45
    -2

    Why do you identify yourself as a "young" optometrist? Are you ageist?

  • KenDiaMoi on 04/06/2018 - 20:47

    hery canm yuo chewck myu eyesdight

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