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Comment by dsizzle | Hacker News Reader

Not sure why vision checks require a doctor at all. In the end, they're just relying on your responses anyway: "What's better: A or B"? In fact, I'd go further and say it doesn't even require another person.

I, for one, am glad to see this bill.

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>require a doctor

Just a note, but optometrists are "doctors" (because optometry is a doctoral degree), but not doctors in the colloquial sense, ie people with MDs who work in hospitals.

Ophthalmologists are the MDs that specialize in eye disease, and are the ones that treat infection and do surgery.

Optometrists treat infection and disease, and can work in hospitals as well. My fiancée is an optometrist who did her residency in a hospital and has worked in hospital systems.

Vision checks have also changed a lot in the last five years or so. I have a pretty strong prescription and always used to do rounds of reading charts and "A or B", and now there's a machine that scans my eyes and gets it very close to right, with an adjustment or two at the end.

12 years ago, I walked into a second hand eye glasses shop in India and they had one of these machines. It was amazingly effective. I felt duped by all the optometrist appointments asking me about A or B.

To me, the tradeoff of an expensive modern machine vs an cheaper iterative process seems logical. I think it's funny that a second hand shop has the fancy equipment... but they must know it sells glasses more effectively.

Here, the machine results are used as a starting point, validated by A/B but I don't know if the human part is effective or just theater.

Well, assuming the optometrist charges around $50 per hour, after 10 patients it would pay for itself. I assume the machine is simply cheaper, which is why it was used.

Duped, because they are doing it the old-fashioned way?

Because they are making theater to justify their cost.

Did the machine tell you if anything else was wrong with your eyes? Could it?

It could determine my index accurately. It couldn’t tell if I had symptomless eye cancer, however.

Eye exams are not easy or one size fits all. The machine does objective refraction, which is a different and more error prone method than subjective refraction. Also for multifocals you'll need a more tailored prescription. There's definitely progress in autorefractors though!

This machine is not new. I remember it being used to approximate my prescription when I joined the US Army almost 20 years ago.

They can now check ocular pressure without the puff!

That's amazing! The puff is soooo uncomfortable! Is the technology to do this widespread?

It looks like it is becoming more common place.

iCare Tonometer

That's like saying a family doctor will just ask you if you're feeling alright. I know optoms who have found parasites, diabetes, cancer... The complete disregard for an entire field of medicine in this thread is astounding...

*Edit, saw your comment about not referring to the entire checkup.

FWIW, a checkup for me is 1 part refraction, one part retinal inspection, one part corneal inspection, and one part automated refraction/pressure checks.

Only one of those parts can be done without a doctor or highly specialized equipment.

Right, I was only talking about that 1 part. (Wasn't suggesting there's no use for optometrists!)

I guess I'm a bit confused then - if it's part and parcel of a regular checkup, what's the value of breaking the refraction out into a wholly separate activity?

Your vision could change faster than however often you need your cornea examined or whatever. Or someone may not be able to afford a doctor's visit but know they need glasses (ignoring the question of whether it's right for people to not be able to afford an eye doctor's visit).

Extending your logic to other areas would end up with absurdities like needing a doctor to measure your waist size before you can buy clothes. "You should visit your doctor regularly anyway, what's the value of allowing people to buy pants without a prescription?"

The impact of an improper prescription - headaches, eyestrain, creating lazy eyes - are far worse than buying pants which are too big.

You're just as likely to get the wrong prescription with an optometrist -- they're relying on your self-report after all -- except it's harder to correct, because you need to go and make another doctor appointment to have it corrected (vs using the machine again).

Also, if someone feels they would get better vision correction working with a trained professional, I'm fine with that. I only object to _requiring_ a doctor's prescription to get glasses.

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