How To Have An Enjoyable And Effective Eye Exam

By Dr. Lachionte’ Culpepper, OD, MS

WHO AM I?

I am Dr. Lachionte’ Culpepper the Founder, Owner, and CEO of The Eyes Have It, LLC (TEHI). TEHI has been in business since 2008 and has been rebranded as a mobile concierge eye care company. I also fill-in for some of my colleagues at my leisure. I am licensed to practice full scope Optometry which includes the diagnosis, treatment, and management of eye conditions and diseases. I am also certified to provide Iridology as well as Corneal Refractive Therapy (CRT) services.

WHY SHARE THIS INFORMATION?

The purpose of this information is to be used as a reference and does not stand alone as medical advice in any situation or circumstance.  It was written in response to my experience as an Optometry student and as a Georgia licensed Optometrist.  With almost 15 years of patient care working as an Optometric Student, employed Optometric Physician, a contracted independent Optometric Physician, a brick and mortar owned Optometric Physician, and now a mobile concierge Optometric Physician I’ve been exposed to common problems surrounding visits to eye care facilities and the need for a more positive experience for everyone involved. The following solutions represent a general overview of some things to consider in an effort to add positive value to your experience when visiting an eye care facility.

STEP 1: WHO ARE YOU?

So you’ve decided you need an eye exam. Do you reach for the phone or hop on the web to browse first? No. The best thing to do is to decide how you want your visit to be. What kind of person are you? What are your likes and dislikes?

Think about why you need an eye exam. How many complaints do you have? Would you rate EACH of your complaints as mild, medium or severe? Thinking on these things will help you determine the amount of one-on-one time you feel you need to spend with your doctor…5 minutes, 10 minutes, 20 minutes, over 20 minutes.

If your answer is 5 minutes, a doctor who sees patients in a big box retail setting may be the best fit for you. These doctors are usually are W2 employed. When I served patients in these big box retail settings I had very little control of the appointment and walk-in schedule and no control of the doctor hours the office will operate. Because the prices of the exams are minimal (not set by the doctor), these big box companies must service a very large volume of patients per day to stay in business since the prices are so low. Also this type of setting is very fast paced. This is why I had an average of 5 minutes to spend with patients. After you have done your self-check (you have already thought about why you need an eye exam, how many complaints you have, the rating of EACH of your complaints, and you have determined the amount of one-on-one time you feel you need to spend with your doctor…5 minutes, 10 minutes, 20 minutes, over 20 minutes to make you satisfied) and you feel that this type of setting is not what you need, strongly consider the next two options.

If your answer is 10-20 minutes, a doctor who sees patients in a small retail setting may be the best fit for you. When I served patients in these small retail settings I was 1099 contracted and had complete control of the appointment and walk-in schedule, and the doctor hours the office will operate. Even though I represented TEHI, my office was inside a store. I had more time to spend with each patient than when I was seeing patients in the big box retail setting. I set my fairly priced exam fees and saw considerably fewer patients. When I had my leases in these stores I spent an average of 20 minutes per patient. After servicing them I escorted them to the retail setting which I had no control of. After you have done your self-check (you have already thought about why you need an eye exam, how many complaints you have, the rating of EACH of your complaints, and you have determined the amount of one-on-one time you feel you need to spend with your doctor…5 minutes, 10 minutes, 20 minutes, over 20 minutes to make you satisfied) and you feel that this type of setting is not what you need, strongly consider the next option.

If your answer is over 20 minutes, a doctor who sees patients in an office owned by him or her is the perfect setting for you. The office is not inside of a store. When I had my brick and mortar I made and enforced all facets of my private office. I had complete control of the appointment and walk-in schedule, doctor hours the office will operate, and retail area. I had more time to spend with each patient. I also provided more types of eye care services because of no time constraints.

I have worked in all of these settings and each has their pros and cons. After all, it’s really about personal preference. As our lives and value systems change so do our relationships and leisure activities. What we do to gain income is no exception. So it is very common for some doctors to work in more than one type of setting during different days of the week.

STEP 2: TO DILATE OR NOT TO DILATE. THAT IS THE QUESTION

As Optometrists we generally have 2 main goals for each patient depending on the exam type:

  1. Find the best glasses and/or contact lens prescription for the most comfortable and clearest vision.
  2. Confirm or deny the evidence of any diseases or conditions manifesting in the eyes.
  3. Effectively manage and treat these conditions or refer the patient.

Sometimes we can accomplish these goals by not dilating the patient. Other times dilation is necessary. If dilation is necessary it could add about an hour to your doctor visit and you could have blurry vision for up to 6 hours after the drops are instilled into your eyes (dependent on a patient’s normal pupil size, reaction to light, reaction time to dilating agents, and potency of dilating agents used during time of drop instillation).

If you know for sure you would like to be dilated at your visit please bring a driver with you to your appointment and be prepared to wait additional time to complete your examination.

STEP 3: MAKING CONTACT

After you have done your self-check (you have already thought about why you need an eye exam, how many complaints you have, the rating of EACH of your complaints, and you have determined the amount of one-on-one time you feel you need to spend with your doctor…5 minutes, 10 minutes, 20 minutes, over 20 minutes to make you satisfied), you are now ready to make contact with a big box retail doctor’s office, a small retail doctor’s office, or a privately owned doctor’s office. Wait one minute!! Gather some information first. You will most likely need the following info:

~Your medical insurance card is used when your visit is not related to you needing glasses and/or contacts. Also, have available the name and date of birth printed on the insurance card you are using.

~Your vision insurance card is used when your visit is related to glasses and/or contacts only. Also, have available the name and date of birth printed on the insurance card you are using.

~Alert the office if you will be bringing a form that needs to be completed (a form from a school, department of motor vehicles, place of employment, insurance company, etc…) because some offices require additional days for the doctor to complete the necessary forms. Depending on the appointment schedule during the time of your visit you may or may not get your form completed so a return trip to pick up your completed form may be required.

~What is the PRIMARY reason for your visit? What concern do you feel needs attention first? Do you need to spend time with the doctor for an updated prescription for glasses and/or contacts (vision insurance card needed or pay out of your pocket)? Or for another reason (medical insurance card needed or pay out of your pocket)?

After making your appointment make a note to arrive at least 15 minutes before your scheduled appointment to fill out your paperwork. This helps the doctor to stay on time. From my experience the #1 flow breaker of doctor schedules is late patients so please arrive at least 15-20 minutes before your scheduled appointment to make your visit a pleasant one for all parties involved in servicing you.

STEP 4: VALUING YOUR VISIT: HOW IMPORTANT ARE YOUR EYES AND VISION TO YOU?

So you’ve checked in and completed your paperwork (including insurance if applicable). The next steps are pre-testing with the tech, your exam with the doctor, your selection of glasses and/or contact lenses (if desired), and your payment for all services rendered.

The tech is very important to the doctor. The preliminary tests help give the doctor a good starting point to assist you in ensuring your glasses and contact lens prescriptions will be as good as they can be. The preliminary tests also reveal potential issues with your ocular health. Pre-testing by the tech usually includes a brief case history, vision assessment (asking the smallest line readable), auto-refraction (a starting prescription), and ocular pressure assessment. There may be other tests done depending on your desires and needs, however, the above-mentioned things constitute a very basic pretest.

For an enjoyable and effective pretesting experience:

~make sure you are not straining to see as you are stating your answers during the vision assessment and position your head into each machine properly. The correct position is to put your head into the machine looking forward with your chin in the chin cup and your head pressed gently against the headband. Do not twist or turn your head. Keep it straight.

~also feeling tired/sleepy and conditions such as allergies, headaches, and sinusitis may prevent the doctor from obtaining the best prescription for you. When the health of the eyes are not well your vision can easily be negatively impacted in the form of intermittent or constant blurry vision even with your glasses and/or contact lenses on. It is not recommended to test for a glasses or contact lens prescription under these conditions. Allowing your eyes to heal will result in a better chance of the doctor obtaining the best prescription for you.

Your doctor will conduct a more thorough case history, refine the refraction to determine the best glasses and/or contact lens prescription for you, and examine your ocular health. For an enjoyable and effective doctor-patient experience:

~make sure you are not straining to see as you are stating your answers while your doctor is testing you for your prescription and position your head into each machine properly (the phoropter and the slit lamp). Long eyelashes are not recommended during the exam as they may result in an incorrect prescription.

~also sleepiness, tired eyes, and conditions such as allergies, headaches, and sinusitis may prevent the doctor from obtaining the best prescription for you. When the health of the eyes are not well, your vision can easily be negatively impacted in the form of intermittent or constant blurry vision even with your glasses and/or contact lenses on. It is not recommended to test for a glasses or contact lens prescription under these conditions. Allowing your eyes to heal will result in a better chance of the doctor obtaining the best prescription for you.

The selection of glasses and/or contact lenses (if desired) with the optical staff and finally the payment for all services rendered are the last 2 stages of your visit.  These 2 steps are self-explanatory. Please note here that some doctors require payment for services about to be rendered upon check-in (before seeing the tech and/or doctor).

I hope my past experiences and this general informational piece will help with your future eye care visits. As stated previously this information piece’s intended purpose is to be used as a reference and does not stand alone as medical advice in any situation or circumstance.  It was written in response to my experience as an Optometry student and as a Georgia licensed Optometrist. Feel free to email [email protected] if you find this piece useful.  Thank you for reading.

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