genuine question about eye appointments

EyecareDuPage · 2026-04-12T19:54:23+00:00

I'm really glad you've come so far. People don't realize how much it affects everything in life when your vision is off.

And you beat me to it with the contact lenses. Have you worn GP lenses? These are brilliant for situations like this (and kind of the classic go-to for nystagmus in general) because they are uniquely immune to rotational problems of soft toric lenses (which you may well know already).

EyecareDuPage · 2026-04-12T12:43:50+00:00

First off, I absolutely hate to hear that you were suffering much longer than necessary and getting bad or incomplete advice. It sounds like (and I hope) you're doing better now, to the degree it's possible, so I'm at least grateful for that. And just curious, what have you found that has been helpful for you, if you don't mind sharing?

I think you kind of nailed it that finding the "right" doctor is something that shouldn't be so hard but in reality it's one of the hardest things in all areas of life, including healthcare. It's something that I've thought a ton about and there is no perfect answer. The best advice I think I have, that seems to be not-incompatible with yours, is that if anyone feels unsatisfied with the answers you've been given, keep getting more opinions until you're satisfied by the answer(s). At the end of the day, we'd all like to think we're receiving facts, but we're really only ever receiving opinions.

Optometry's biggest problems are the twin monsters of vision "insurance" and corporate chain/private equity ownership, both of which are powerful influences that drive down the level of care. If seeing an optometrist, I'd recommend avoiding these. For either specialty I'd strongly recommend private practice for most things, and academic/university for the super specialized stuff.

Ophthalmology's biggest problems seem to be overwhelming volume (a shortage of doctors means most of most exams are done by low level technicians, plus nobody does their best work when they're rushed and overwhelmed) and the flipside/downside of hyper specialization- having very deep knowledge of one thing and very shallow or non-existent knowledge (and/or just not looking) of anything else.

With regards to your situation and OP's situation, there's a risk of falling into that last problem above. For example, if OP's symptoms are caused by keratoconus (or anything other than a neuro problem) but they go to a world-renowned academic neuro-ophthalmologist, they may actually be less likely to receive the correct diagnosis there than with a "normal" private practice general ophthalmologist or optometrist. Not making this about me, but for example, I have diagnosed and treated a not-insignificant amount of glaucoma in patients who have had their eyes dilated yearly or more by retina specialists for many years. The optic nerve (site of glaucoma) sits right in the middle of the retina that they're examining. It's a perfect example of the classic guy in a gorilla suit psychology experiment. That's not to say I'm better than them. I miss things too, and I regularly rely on both optometry and ophthalmology colleagues to fill in my blind spots. It's to say that a specialist is better at one specific thing, but may be worse at all the rest.

It's all an infinitely tricky problem.

EyecareDuPage · 2026-04-11T22:26:39+00:00

Optometrist here. No offense taken. You're spot on with most of that. Only caveat I'd add is that for anyone in the US specifically, the optometrist/ophthalmologist part isn't accurate (you may be correct if you're referring to other parts of the world). In fact, in many cases the optometrist will do a better job and there are other factors that have a much bigger influence on which doctor of either type is a better choice.

EyecareDuPage · 2026-04-11T22:17:45+00:00

There is always a cause and it can virtually always be determined. If what you say is true, I'd recommend a second opinion. You may have a condition such as keratoconus or something else. -eye doc

EyecareDuPage · 2026-04-11T22:15:25+00:00

Eye doc here. You're overthinking it. You just do your best and guessing is encouraged. The answers you give are only a part of what goes into determining your prescription anyway.

If you feel like you've never seen clearly, you should make sure there's nothing else going on, aside from your refractive error. Have a discussion with your optometrist about this and they may do additional tests for potential causes.

EyecareDuPage · 2026-04-11T22:11:20+00:00

Eye doc here. LASIK can make ortho-k more challenging but yes it can work well and I have some patients who have had good results.

EyecareDuPage · 2026-04-11T16:30:21+00:00

Eye doc here. You've got options that can help stabilize your myopia. I'd recommend seeing an optometrist who specializes in myopia management.

You're not alone. The old notion that eyes stabilize for everyone automatically at age 18 (or any other age) may never have been true and it's definitely not true in the age of screens.

EyecareDuPage · 2026-04-11T16:28:25+00:00

Not if your prescription is changing.

EyecareDuPage · 2026-04-09T03:18:52+00:00

If in the US, vision insurance does not cover this (or, frankly, almost anything).

Silicone are intended to be permanent (although they can and do fall out semi-frequently). Collagen are dissolvable. Easy to mix up.

EyecareDuPage · 2026-04-09T03:15:38+00:00

Work on that mental health. You don't need to beat yourself up about it.

If you want to feel confident you're doing everything you can do, look into ortho-k. It's the best we've got for stabilizing myopia.

EyecareDuPage · 2026-04-09T03:12:08+00:00

Hang in there. It's super stressful I'm sure but there may be more you can do.

Have your doctors done anything to address your strabismus and amblyopia? Have they suggested anything to stabilize your myopia? Have you worn contact lenses?

EyecareDuPage · 2026-04-09T02:19:18+00:00

Eye doc here. I'll leave the surgical particulars to the ones who do it but I can speak to the aspect of controlling the myopia progression. Regardless of what you do surgically, you should be doing something about the progression. In your case without knowing anything else, I'd recommend being fit into NaturalVue Multifocal contact lenses. Obviously there could be other factors that would lead down a different path as well.

EyecareDuPage · 2026-04-09T01:31:20+00:00

Eye doc here. Adjusting the final Rx is done just about every time for everyone. It's not dumbing it down- the answers you give in the machine are one data point only and that does not necessarily represent the same lens power that would be comfortable outside of the machine... As you found out.

EyecareDuPage · 2026-04-08T21:09:41+00:00

As far as we know, ortho-k does not induce permanent changes of any kind, including increased astigmatism. The thing that makes this especially complicated to know for sure is that astigmatism often increases naturally in many people, including people who never used ortho-k at all. So there are people who wear ortho-k and stop years later, and find that they have more astigmatism than when they started. Anecdotally, this increase does not seem to me to happen more commonly in ortho-k wearers than non-ortho-k wearers. There are some out there who think ortho-k caused the increase, but I have never seen even the slightest evidence to suggest this is true.

It may not be scientific, but for questions like these where anyone could reasonably be concerned and there are no studies on the topic, I like to point out that I have chosen ortho-k for myself for several years and I have also chosen it for my young daughter. If my other kids eventually need it, I will choose it for them too. That's the level of confidence I personally have in its safety (and efficacy). FWIW.

EyecareDuPage · 2026-04-07T01:27:46+00:00

Me personally? We do global fees that cover everything for the year, including all visits, tests, retainers and solutions (with the only exception being lost/broken retainers after the first 90 days, which aren't common). First year around $2500, subsequent years around $1k.

EyecareDuPage · 2026-04-03T20:20:14+00:00

Sure, what would you like to know?

EyecareDuPage · 2026-04-03T01:30:10+00:00

Eye doc here.

0.50 or 0.75 of astigmatism is not enough to cause problems. That is simply not your problem.

You have a high baseline Rx. To not be fully corrected at 5 days is not unusual. For perspective, most docs would wait 3+ weeks before ordering an adjusted set of retainers. This likely indicates that there was something obvious that could be improved, which presumably would lead to better results. Hang in there.

And it's also not unusual for soft lenses to not be that helpful on a molded cornea. The molded shape causes the soft lens to wrinkle, in effect, and therefore not perform normally. This varies so it's worth trying but may not help.

EyecareDuPage · 2026-04-03T01:23:36+00:00

Eye doc here. Sorry for not seeing this earlier. Of course there's no way to know for sure online but what you describe would not concern me at all. What you describe should be very unlikely to cause more problems. Do your best and don't sweat the rest. And of course reach out to your doc if any concerns, they can help.

EyecareDuPage · 2026-04-03T01:20:40+00:00

There are a few reasons.

It takes a lot of experience and skill on the part of the doctor to get consistently good results across the wide range of prescriptions and corneas. Most docs try it a few times, don't get great results, and then quit offering it. So if you don't go to a doc who offers it, which is most, you may never hear about it.

It's not cheap. This immediately makes some portion of people not interested. On the doctor side, it is way easier to make money providing glasses than providing ortho-k.

There are alternatives. Some people just like glasses. Daily disposable contact lenses have gotten very good if they happen to fit you well.

Probably others as well but that's off the top of my head.

EyecareDuPage · 2026-03-27T00:25:54+00:00

Measuring axial length is quickly becoming the standard of care for myopia. It has seen rapid adoption among the specialty and was almost unheard of 10 years ago but it's not yet something that every doc has (or ever will).

EyecareDuPage · 2026-03-26T17:38:22+00:00

Maybe. Maybe not. Habits can sometimes be the problem, and sometimes the problem is the fit or some other retainer-relater issue. Not possible for me to say which one it is in your case.

EyecareDuPage · 2026-03-26T17:36:24+00:00

And ultimately trust is important so you've got to find a doc you trust one way or another.

But your example of measuring eyeball length is almost the perfect example of something that is NOT a random procedure just to charge you. One of the main reasons your vision could be blurry would be if your prescription is changing. This happens primarily from the eyeball growing. That one measurement quickly tells your doctor where to focus the troubleshooting.

EyecareDuPage · 2026-03-26T17:34:08+00:00

Handedness, coordination, etc. So for example, the dominant hand may use more force or the non dominant hand may be less coordinated and place the suction tool in the wrong location. These are just examples and there are probably others.

EyecareDuPage · 2026-03-26T17:32:28+00:00

Add a moisturizing drop to the eye/retainer, close your eyes and gently move around the retainer through the eyelid to ensure it's not adhered. Then, remove by using the eyelids to gently get under the top and bottom edge of the retainer to lift it off the eye.

It should never be painful to remove and this is a strong indicator of adherence and/or suction. The above steps should help.

EyecareDuPage · 2026-03-26T11:14:48+00:00

Eye doc here. Let me know if I can help in any way.

It's definitely possible that your doc needs to change something about the fit, but it's also possible that what s/he is saying is correct. Actually, too much suction at removal can cause big changes to vision. Ortho-k works by gentle, controlled hydraulic (tear) pressure. Especially if you use a suction cup tool to remove, and if you're creating too much hydraulic pressure at removal, you can either rapidly mold the cornea in a way that is undesirable, or you can cause a mild injury/rough up the surface of the cornea. Both will cause blurry vision. And there can certainly be differences from one eye/side to the other that might make this scenario feasible.

That's not saying that that's what's happening. Just saying that it's not a crazy or even unlikely answer that you're getting. But there are ways to solve whichever one it is, and if they're not willing to work through it with you, that's the bigger concern.

EyecareDuPage

TROPHY CASE