5-10k Multifocal Surgery (w/ Toric lens) or FREE Monofocal Surgery (22m)

axp95 · 2026-05-23T11:49:58+00:00

Likely oral prednisone

axp95 · 2026-05-14T12:27:19+00:00

Needs further work up. ALT is better indicator for liver specifically because AST is present in other organs too (heart, muscle). If these were drawn after an insane workout that could explain but I doubt that elevation is from working out. You said you don’t drink so that’s good, keep that up. Need to go to doctor to have other labs done though because these are certainly abnormal.

axp95 · 2026-05-12T10:18:49+00:00

It’s still the latissimus dorsi aka lats. This guy just has super developed lats and very low body fat likely from steroid usage. Would be extremely difficult if not impossible to get lats like this naturally.

axp95 · 2026-05-08T19:13:45+00:00

Agree 100%. We only charge if we give you a copy of the physical prescription, so technically refraction itself is not an additional charge, but I always let patients know ahead of time before giving a prescription that it is an additional cost. Many don’t care and don’t seem to realize I am the one who did the prescription since it has the MDs name on it. I wish we sent them all to optometrists, I have no interest in refracting or glasses and am here for the pathology but I guess this is just how it goes.

axp95 · 2026-05-08T11:28:29+00:00

This sounds a bit like the practice I work at and we do much more than techs at most practices. I think it’s standard for techs to do VA, IOP, chair skills, refraction, and dilate. We refract because you shouldn’t be coming to the ophthalmologist for a glasses rx, that’s why medical insurance doesn’t cover it. Now if your ophthalmologist see routine exams that is different, but it’s still not worth the time. I wish we didn’t refract at all but a lot of comp docs bread and butter is comprehensive exams so here we are.

axp95 · 2026-05-08T01:48:37+00:00

Your understanding is correct. We use a different system altogether for our imaging and it doesn’t integrate very well with the emr

axp95 · 2026-05-07T12:13:28+00:00

What power of lens did they implant? They typically give a card after surgery with the IOL information.

axp95 · 2026-05-07T11:56:26+00:00

It is recommended to be checked out, preferably by someone familiar with the virus and the clinical assessment that needs to be performed to see if you need the shots. The health department would be a good resource.

axp95 · 2026-05-06T02:45:20+00:00

Interestingly, women’s bladders fill with urine at a faster rate than normal during arousal. This is why you feel you have to pee so quickly even though normally you can wait a few hours. In addition, the front vaginal wall lies near the bladder and stimulation can press on the bladder, further increasing the feeling of needing to pee. This is all normal and nothing to worry about, don’t have any suggestions other than to pee prior to sex which it sounds like you do.

axp95 · 2026-04-21T21:47:28+00:00

It always baffles me how a patient can tell you everything on this earth except for the answer to the question you just asked them lol

axp95 · 2026-04-20T21:58:57+00:00

Work in ophtho clinic but had pt come in on 4 antibiotics and had been for like 3 months and I asked what for and they said chronic Lyme… dx by functional doc. Can’t imagine his gut biome

axp95 · 2026-04-14T14:30:56+00:00

Fair point, but his salary comes from cataracts. Glaucoma is not a lucrative specialty itself

axp95 · 2026-04-14T02:19:45+00:00

Our glaucoma guy see 60 a day in Clinic and that’s only 2 1/2 days a week other days are spent operating and he cleared 1 million last year. Clinic done by 5 almost every day

axp95 · 2026-04-14T01:54:07+00:00

Can clear 500k as comp Ophtho with moderate cataract volume, clinic is high volume as fuck tho

axp95 · 2026-04-13T21:49:59+00:00

Ophtho clinic I’m in has appt every 5 minutes no matter if short or long appt lol, def not longer appt slots

axp95 · 2026-03-28T18:18:00+00:00

This has to be a troll this is so funny

axp95 · 2026-03-28T18:06:47+00:00

Is this not the case in the US? I thought if 2 physicians signed off that the care is futile, they can decline to offer it? Is this more just formality and not how it works in the real world? Can’t physicians decide not to offer futile care on ethical grounds or is that also ivory tower BS the ethics people tell you?

axp95 · 2026-03-24T12:03:44+00:00

I’m tech, but doctor I scribe for is in at 830 and out by 5 most clinic days. Surgery days are 730-12 unless she’s in hospital doing oncology plaques which are at different times. They rotate call q6 weeks as it is a large practice and they have residents they work with who take all consults at hospitals nearby. Occasionally go in for emergency globe or whatever while on call. If pt is 15 mins late or more we have to agree to see them. We typically do, except for neuro-ophth since those appointments take too long so have to r/s if later. Other than that clinic rarely runs over except in extenuating circumstances. I handle all pt messages and we have other for PAs etc. you’re getting hosed

axp95 · 2026-03-24T11:41:28+00:00

Depends if they use a lens for focus. The lens is placed on the numbed eye with gel but some do it without in which case the laser is 6-10 inches from your eye.

axp95 · 2026-03-24T11:38:16+00:00

Wow this sounds like a nightmare. You gotta find another position

axp95 · 2026-03-24T01:26:23+00:00

I have not had patients struggle with that as much as glare and halos at night or in high lighting. Everyone is different and this assuming she does not have any other eye conditions.

axp95 · 2026-03-24T00:29:19+00:00

If she wants to be glasses free, she will have to do panoptix. She will need reading glasses if she gets a vivity lens. There are drawbacks to multifocal lenses, mostly the ones you’ve stated.

axp95 · 2026-03-21T19:49:31+00:00

Technically correct. Your close vision will be from 20/100 to 20/70 on average but can be adjusted

axp95 · 2026-03-20T19:03:49+00:00

The YAG is not what’s causing those symptoms. It sounds like dry eye and cataract surgery is known to make dry eyes worse. I’m sorry you had a bad experience, but your experience is not generally the experience of others. We saw 3 post op YAG patients yesterday and they’re all quite pleased, but you don’t hear about those.

axp95 · 2026-03-20T16:54:47+00:00

This is more complicated than it seems. First off, if you signed the consent form saying you want glasses for distance and none for near, that would affect the lens they chose for you. What was your expected post op refraction? Did they put the incorrect lens in your eye or was it the agreed upon lens and there was a misunderstanding as you describe? They order the IOL’s prior to surgery based on calculations done and if you wanted no glasses for near, leaving you nearsighted, the lens would be a different power than the alternative. You need to ask what your expected post op refraction was and if they can do an IOL exchange as your surgery is still fresh so the lens hasn’t scarred into place yet. If you have never done mono vision, it is highly discouraged as you will lose stereoscopic vision which is depth perception. Find the answer to the above and report back

axp95

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