Rx checks – what are they and how do you deal with them? An Rx check is when a patient makes an appointment to come in because they are unhappy with their new prescription for glasses or contact lenses. They come to you for a resolution to the problem and it’s your job to make it happen. Simple enough, right? Wrong! Clinically, the Rx check is an art form. There are an infinite number of reasons why patients might be unhappy with their prescription. Being able to decipher and solve the underlying problem requires good communication, reasoning skills, and a great deal of patience.
The number one rule to remember is to “Listen”, says Matthew Cordes O.D., Chief of Optometry at The Villages VA Outpatient Clinic in Ocala, Florida. If a patient has taken the time to come in, make sure to listen carefully and address the issue. The following are steps to remember when a patient comes in and they are unhappy with their new correction:
Rules of Rx checks
1) LISTEN! (Take a thorough case history).
2) Take a new auto-refractor or retinoscopy reading.
3) Use lensometry to verify the prescription (Do the same if they bring in their old glasses that they like).
4) Take VA OU (with new and old…Who knows? They may prefer 20/30 vision over 20/20).
5) Repeat refraction.
6) Note any pathology that may be causing the problem.
7) Thoroughly educate the patient as needed.
Keep in mind an Rx check can take as long as a full exam. We have a tendency to think that checks are quick, however, if the patient is very unhappy it can take a while to figure out what the problem is.
Rx checks can happen with glasses as well as contact lens prescriptions. Ryan Hargreaves O.D. of Braverman Eye Center in Hallandale Beach, Florida says “With contact lenses it can be anything from dry eye related, switching of solutions, to compliance.” Contact lens Rx checks require an over–refraction as well as a thorough slit lamp evaluation. There are different things to consider with contact lenses such as the type of lens (i.e. Spherical, toric, or multifocal), the overall fit, and the patient’s compliance of recommended wear time.
Some Rx checks can be just a matter of patient education. Ocular pathologies like macular degeneration can greatly affect a patient’s vision. However, if they are not fully educated on the condition, the patient may think their glasses are the problem and will continue to come back until they understand their condition.
There are many different reasons why patients come back for an Rx check. To be able to master the art form of Rx checks requires asking the right questions and taking the appropriate steps to solve the issue to make the patient happy.