Monday, September 12, 2011

To Dilate or Not To Dilate?

Just so I'm clear, I went to three years of undergrad and four years of optometry school so I could be Dr. Melissa Rasmussen. I, as an educated and licensed eye doctor, recommend that everyone have a dilated eye exam every year. BUT, if you do not want to be dilated, for whatever reason your little heart desires, that is your right to refuse it. That DOES NOT give you the right to tell me that I am almost to the point of malpractice by dilating you on the front end of an eye exam (along with complaining about all the forms that need to be filler out, that our sink doesn't have a stopper[???], about how her old doctor just never could get it right!). A: Dilation affects your near vision, not distance. In essence, dilation drops temporarily paralyze the muscles that control the iris, or colored part of the eye. One drop makes the pupil bigger and the other keeps it from getting smaller when the light hits it or when you try to focus, hence the side effects of light sensitivity and near blur. By dilating you, I am able to view more of the retina than I would normally (the bigger the window, the more you can see) helping to detect retinal diseases like glaucoma, diabetic retinopathy, macular degeneration, etc. But it also insures a more accurate prescription, especially in most children. Children have the ability to focus through a tremendous amount of near blur. So, undilated, a child that is very farsighted, can actually read 20/20 at near and will show hardly any prescription. But by taking away their ability to focus, we are able to see their true prescription and prescribe glasses accordingly.

So, please, by all means, refuse to be dilated if you have had a bad experience being dilated, if you don't feel comfortable driving while dilated, even if you feel like it might make your glasses not perfect. But that does not mean I do not have a good reason for doing it on the front end of an exam. Usually, to be honest, most of the time we do it on the front end to save you, the patient, time! If I waited till after the glasses part of the exam, you would be in the office about an additional 20-30 minutes. And I know the LAST thing I want to do is spend more time at any doctors office. But you know, they would probably be the first to complain about how long the exam took! (Funny thing is, this particular patient ended up saying how happy she was that I was her eye doctor! Funny how things work out, huh?!)

Thanks for letting me rant a little! =)

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