VSP is pretty specific in terms of what they will and will not pay for. Most VSP patients don't want to spend much or any money more that VSP allowable. I also don't know how or if any optical would 'negotiate' a price. That might work in Europe or the Middle East but bargain and barter are not a part of American retail.
We don't push routine care down to the optometrists. Any patients that wants to see and eye MD ophthalmologist for routine care can. Some insurance plans mandate the exam be with an Eye MD as example diabetic. Some visual care plans for routine exam only cover optoms. If there is a medical diagnosis then patients can opt for an Eye MD using their health insurance.
An informed consumer can ask about the costs and advantages of different brands and types of progressive multifocal glasses. Few do. Our practice "stands behind" glasses RX filled at our dispensary or any commercial dispensary. Without charge we will check the glasses, if necessary repeat the glasses test and work with the optician to try and make the patient happy. HOWEVER we do not do that for internet glasses. We will not even adjust them. Some people are happy and have saved a lot of money, some people, especially when dealing with multifocal glasses (bi-, tri, no-line) are very unhappy. One of the biggest wastes of money is "anti-reflective" (AR) coating. All opticians (including ours) push them. AR is expensive, hard to keep clean and not at all durable. After a couple of years its mostly worn off and makes the surface of the lens look strange.
Thank you for the information. I have published a paper on the absolute high end of glasses which is called wavefront technology. Its very expensive and for most people is not worth the extra money. This is a link to the paper: http://www.omagdigital.com/article/Grinding_It_Out%3A_Wavefront_Spectacle_Lens_In_Clinical_Practice/805950/78197/article.html
JHagan MD
There have been no further tears. Though I've had occasional black speck floaters in BOTH eyes, the last dilated exam showed no issues with either retina. I have mild PCO in the right eye (the one with more recent cataract surgery and tear), but the retina doc doesn't want me to do anything about it until I pass the three month mark from the tear. So another retina exam in several months before I can go back to my anterior practice and try to get a YAG treatment scheduled, which I"m quite sure will take at least a couple of visits there. I'm not expecting huge improvements because the majority of my vision issues there are a result of the big greasy floater caused by PVD.
The more interesting stuff recently has been getting fitted for glasses. The super expensive (even after insurance) progressive glasses fit by the opticians in my anterior segment practice never worked right - I was much happier with the 1/10 the cost "spare" pair I had ordered online from Zenni. The optician spent some time adjusting the frames and I gave it another couple of weeks, but near and intermediate vision were paltry, making reading and computer work difficult.
He had fit me in what he claimed where the "latest technology," Zeiss Choice. I dug into research and determined that these were NOT the latest and greatest, and they were known for narrow intermediate/near corridors. I suggested a different Seiko lens, which is when I learned that my vision insurance dictated lens brands and Seiko wasn't on the list. So they then put me in what is actually a newer product from Zeiss, Individual 2. These are great - I now like them better than the cheap internet glasses, though not anywhere close to 10x better. I checked the relative costs of the two lenses and with the insurance price I paid I got not much of a discount at all with the Choice lenses, and much more substantial discount with the Individual 2 (they didnt' charge any more).
Lessons learned on buying progressive glasses: Price does not equal quality. Progressives bought off the internet (without a segment height measurement) at a huge discount can be prefectly fine, though if something does go wrong you're probably out of luck. When being fitted for glasses prior to all the surgeries, I'd just assumed I was being given something relatively standard - but that' snot true. Opticians push you toward what they want to see you in, maybe for good reasons, maybe for bad, but it's not transparent. THey don't want to give you the information necessary to make your own informed choice as to the brand/model they're fitting you in. Nor do lens manufacturers - it's very hard for a consumer to access any meaningful information at all on the differences between various types of progressive lenses.
My follow-up today revealed a horseshoe tear, was lasered. Ouch. The doc ise going to monitor very closely over the next few weeks as he thinks getting a tear after the Weiss ring separation is indicative of potential trouble. Oh, and while the blood has mostly disappeared from my vitreous, and I'm not noticing the Weiss ring so much, I have a very large and cloudy floater that does makes the vision in that eye quite difficult.
Spoke a little too soon. The PVD continues in my right eye. As I was playing a board game yesterday, I watched a long stringy black floater develop in real time - very disconcerting. The doc called me back quickly and saw me first thing today. The stringy floater has resolved itself into a ring (likely a Weiss ring) and my eye is blurry overall (he says it's blood, which hopefully should resolve). The good news is no new retinal tears. I go in again in a week.
It's all so frustrating. I know there's nothing to be done, but I really just want everything to stop. Since I've had every complication known to man so far from every issue, I'm keeping my fingers crossed I don't get a tear or an ERM in what was (?) my good eye.