What is an Evaluation like?

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What is an Evaluation like?

Postby Tempted » Tue Apr 01, 2008 1:45 am

Hi,

I had a lasik consultation and was wondering if the cornea measurements are accurate if I had just removed my contact lenses 2 hours before the measurements were taken. And the tests were done in 20-30 minutes. It seems like it was too quick. All they did was: getting the prescript from my glasses, have me look at an image that gets blurry, then clear (or the opposite), the eye exam, and the cornea measurement. And they told me I was a great candidate for Lasik after that.

Does this sound normal? I was expecting more tests to be done.
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Re: What is an Evaluation like?

Postby Pappy » Tue Apr 01, 2008 3:53 am

Tempted wrote:Hi,

I had a lasik consultation and was wondering if the cornea measurements are accurate if I had just removed my contact lenses 2 hours before the measurements were taken. And the tests were done in 20-30 minutes. It seems like it was too quick. All they did was: getting the prescript from my glasses, have me look at an image that gets blurry, then clear (or the opposite), the eye exam, and the cornea measurement. And they told me I was a great candidate for Lasik after that.

Does this sound normal? I was expecting more tests to be done.


Really cursory, did they do a scan of your corneas to check for irregularities, slit lamp examination?

It might be normal, I'm not really sure I've done I think 5 total consultations each ranged from an hour to almost two hours.
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Re: What is an Evaluation like?

Postby Tempted » Wed Apr 02, 2008 1:21 am

[quote="Pappy"]

Really cursory, did they do a scan of your corneas to check for irregularities, slit lamp examination?

It might be normal, I'm not really sure I've done I think 5 total consultations each ranged from an hour to almost two hours.[/quote]

I'm not sure what you call "scan of cornea" or the "slit lamp exam". I don't feel they did a thorough evaluation. I think all they did for me were just preliminary tests. They spent at least twice as much time selling me the surgery than they did checking my eyes.

Thanks for your response.
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Postby 6502programmer » Wed Apr 02, 2008 1:25 pm

The slit lamp exam is the one where there is a small, very bright, vertical slit that is shined into your eye. Usually, the optometrist will ask you to look at their ear while they're performing the exam. It is a microscope combined with a high power lamp. It's typically used to examine the cornea, but after the eye is dilated, it can be used to examine the internal structures too.

I went to two locations before settling on mine. The first, part of a large national chain, I was initially put off by the fact that the HIPAA document was printed on cardstock, and clearly bore the impressions of people who had filled out paperwork on top of it. Then, I was brought in to speak to the optometrist. There was no dilation and minimal time with the slit lamp. I was given a refraction (better or worse, better or worse, etc), a glaucoma test (a puff of air in the eye), a wave scan (look at the car as the tunnel moves), told I was a good candidate, and passed off to the sales staff. I know I had a high prescription, I know I was highly astigmatic, and I know I spent all my life as a fairly severe myope. I received a more in-depth examination every year as part of my refraction and contact lens fitting. As a pre-operative examination, I had expected A LOT more.

The second provider I went to is a local operation. I was led through a series of tests, some I recognized, a few I didn't. I was given drops that (apparently) both "paralyze" the eye and stop it from being able to focus and dilate it. My eyes were examined in-depth through the slit lamp. Needless to say, I was much more comfortable with the second.

If you had told them you were only out of your lenses for two hours, that might have had something to do with it. When I told the second provider I was only one week out, they told me that they could do a lot of the tests, but we'd have to repeat them later, after being out for more than two weeks. The first provider didn't really seem to care too much about that.
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Postby LasikExpert » Wed Apr 02, 2008 4:29 pm

In many practices the initial examination is really an evaluation to determine if you are clearly not a candidate. Only the basics are covered - just enough for the sales staff to disscuss with you the options and determine if you are actually going to want surgery. If you show an interest (and possibly pay a deposit), then additional tests are performed that may or may not exclude you as a candidate.

Other practices will go through all of the relevant tests in the first examination.
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Postby Tempted » Thu Apr 03, 2008 5:28 am

[quote="LasikExpert"]In many practices the initial examination is really an evaluation to determine if you are clearly [i]not[/i] a candidate. Only the basics are covered - just enough for the sales staff to disscuss with you the options and determine if you are actually going to want surgery. If you show an interest (and possibly pay a deposit), then additional tests are performed that may or may not exclude you as a candidate.

Other practices will go through all of the relevant tests in the first examination.[/quote]

You are right. They wanted a $200 deposit, what I am not planning to do. I am going to check out other places. I wish they took the time to do a thorough evaluation. Oh well...

Thank you.
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Postby Tempted » Thu Apr 03, 2008 5:40 am

[quote="6502programmer"]The slit lamp exam is the one where there is a small, very bright, vertical slit that is shined into your eye. Usually, the optometrist will ask you to look at their ear while they're performing the exam. It is a microscope combined with a high power lamp. It's typically used to examine the cornea, but after the eye is dilated, it can be used to examine the internal structures too.

I went to two locations before settling on mine. The first, part of a large national chain, I was initially put off by the fact that the HIPAA document was printed on cardstock, and clearly bore the impressions of people who had filled out paperwork on top of it. Then, I was brought in to speak to the optometrist. There was no dilation and minimal time with the slit lamp. I was given a refraction (better or worse, better or worse, etc), a glaucoma test (a puff of air in the eye), a wave scan (look at the car as the tunnel moves), told I was a good candidate, and passed off to the sales staff. I know I had a high prescription, I know I was highly astigmatic, and I know I spent all my life as a fairly severe myope. I received a more in-depth examination every year as part of my refraction and contact lens fitting. As a pre-operative examination, I had expected A LOT more.

The second provider I went to is a local operation. I was led through a series of tests, some I recognized, a few I didn't. I was given drops that (apparently) both "paralyze" the eye and stop it from being able to focus and dilate it. My eyes were examined in-depth through the slit lamp. Needless to say, I was much more comfortable with the second.

If you had told them you were only out of your lenses for two hours, that might have had something to do with it. When I told the second provider I was only one week out, they told me that they could do a lot of the tests, but we'd have to repeat them later, after being out for more than two weeks. The first provider didn't really seem to care too much about that.[/quote]

Thank you so much for the detailed answer. Anyhow, if they were planning to do a thorough evaluation, they would have/should have told me to not wear my contacts. I'm going to check out some other places. Thanks Again!
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Postby beingbobbyorr » Mon May 05, 2008 8:09 am

1) My personal rule was that I would make sure I was out of (soft) contact lenses for 1 week before any refractive surgery consult I went to.

2) I wouldn't do refractive surgery without seeing at least 5 surgeons, preferrably based on (a) recommendations from friends/coworkers, (b) "Best of <mycity>" type surveys, and (c) USAEYEs CRSQA. Part of seeing at least 5 doctors was to educate yourself, through experience, just who does thorough testing, who is patient with your questions, who has good bedside manner, who you're comfortable with, etc.,
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Postby LasikExpert » Wed May 07, 2008 6:36 pm

I have seen studies performed by business consultants to refractive surgeons that indicate the average person visits about three offices before making a final decision.
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Postby Remander » Sun Jun 01, 2008 8:54 am

I had the exam to see if I was a candidate, and I was. Some looking in machines for scans, cornea thickness check, etc. Standard stuff.

Then I told them I had a retinal tear years ago and wanted a darned thorough check to make sure there was no issue there before we went further. The Doc worked me over good, like no exam I've ever had, and eventually pronounced that I was good to go. I could tell he checked the heck out of it. It was "eye opening." This was all pre pre-op, before I committed to paying a dime, and there was no charge for it.

Here is the rest of the story: http://www.usaeyes.org/ask-lasik-expert ... .php?t=820

It turned out fine.
:D
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Postby kelso » Wed Jun 18, 2008 5:43 pm

I'm thinking about getting lasik and I heard the eye exam can be expensive so I just wanted to fill everyone in on my findings. I found this site [redacted], it's for [redacted] and with it you can get a free eye exam which seems like a pretty good deal. I'm going to schedule soon to see if lasik is the right way for me to go. Check out the site if you're thinking about it, maybe [redacted] is in your area. Seems like a great deal :)

Note: Commercial website redacted.
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Re: What is an Evaluation like?

Postby JustLooking » Thu Sep 04, 2008 6:28 am

Interesting. The doctor that I saw last week in New Orleans put me though a full battery of test at no charge, including the computerized Wave scan test. He came in to talk to me at the end of all the tests and told me that I qualified for Lasik.

After I told him that I wanted to go ahead with scheduling the surgery, they put some more drops in my eyes and repeated a few of the tests. After those repeated tests, he gave me an exam similar to what a regular eye doctor would give when you go to get glasses or contacts.

The majority of the tests were free to see if I qualified. After I agreed to get an "exam" the cost was 150.00 (for a couple of repeat tests and an eye exam). They subtract the cost of the exam from the final cost of the lasik if you agree to get it done. He does enough tests and scans for free to know if you qualify or not. The only reason to pay the 150.00 for the additional exam would be because you want to go ahead with the Lasik.
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Your Evaluation

Postby Cindy G » Tue Sep 16, 2008 2:01 am

That is about the same amount of time it took for them to tell me that I had thin corneas and was not a candidate for Lasik. If you decide to go through with the surgery they will do more in depth testing. If they don't I would be concerned.

I am going somewhere else for testing this week. This place did not even want to see me until I was out of contacts for a week. I had been wearing gas perms and didn't want to wear glasses for long, so they have me switch to soft lenses for 4 weeks and then to glasses for a week. By the time I have surgery, if I can have a surface ablation, I will have been out of contacts for 2 weeks.
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Postby JustLooking » Tue Sep 16, 2008 2:32 am

I had PRK last week, and they ended up doing the Wavefront test on the machine a total of three times. Once the day of my evaluation to see if I qualified for Lasik, and twice the day of my PRK. I did qualify for Lasik, but I decided that I wanted to to PRK instead.

I did Custom PRK. I think they would have done the Wavefront mapping test three times had I done Lasik, too.

I was wondering what would happen if the first test had not been correct for some reason. I guess they do it three times to make sure there are no errors. The last time was just minutes before I had the PRK procedure.

The place that I had mine done does dozens of people on each surgery day and they seem a little "rushed" sometimes, but they seem to have a good system of checks and balances to double check for possible errors.
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Postby LasikExpert » Tue Sep 16, 2008 4:32 am

JustLooking wrote:I was wondering what would happen if the first test had not been correct for some reason. I guess they do it three times to make sure there are no errors. The last time was just minutes before I had the PRK procedure.


It is actually more than that. Each time the machine is triggered it makes five evaluations. It disregards the highest and lowest and averages the middle three. That is the report you see. Your doctor did this three times, which means there were actuall 15 scans from which 9 were averaged 3 times to affirm consistancy.
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