Question
I have been wearing prisms for about 40 years. My initial physician speculated the double-vision and lack of depth perception was experiencing was due to a head injury in childhood, but this isn't for sure. He said the injury was near the optic nerve.
Every doctor I've seen since followed through with prisms after seeing the double vision in their exams.
The current prism is a 3.
In my most recent exam. with new doctor, I mentioned I was experiencing sporadic double vision, so imagine my surprise when he didn't seem to detect my double vision, nor did the prescription call for prisms. When I mentioned this, he had the eyeglass maker next door check my glasses, then he added the prism.
I can't help but feel something went wrong. It seems to me that 40 years of prisms shouldn't be eliminated without mentioning it to the patient.
Did the doctor miss something, or have I miraculously been cured?
I intend to dispute his bill, but I'd like to know if it's just my imagination and lack of expertise.
As an update, I have telephoned and written to this doctor and he has not replied to my inquiries. I did pay half his bill of $170.00.
Answer
Actually the need for prism is easy to miss in a routine exam. I don't believe most doctors do all the available eye muscle functioning tests on every patient every time because such testing rarely turns up anything that is relevant to the handling of the case. It becomes much more important to check everything related to possible eye disease or dangerous conditions that could need immediate referral. The need for prism is much less definite and prescribing prism is more an art than a science.
In fact, if you don't specifically point out that you have needed prism in the past, you may easily wind up not getting it. It is even hard to miss prism in an existing pair of glasses when reading the prescription off them.
I would not be too hard on the doctor for not picking up the need for prism. It did get added back to your glasses, right? So no harm was done.
