Saw Dr ****** in Tampa -- shocked by cost of tests!

[savino]

He gave me two kinds of antibiotic ointment one to put on during the day and one during the night. I applied these appointments to my eyelids and lashes for 5 days. I don't remember the names off hand but I can try to look them up on my prescription records anyway it really helped a lot.

[jadavispcfl]

Dr. ****** Specializes in Solving Difficult Problems

I went to see Dr ****** in Tampa, a f/u to seeing him about 5 years ago. He told me a number of tests would have to be done before he could make a diagnosis. The nurse said the tests would cost about $2000, none covered by insurance. One of the tests she said was to test for mites -- that test was $450. They pull some eye lashes and look under a microscope -- $450??? I left the office -- whole thing seemed weird. Anyone else have that experience?

As a long time patient of Dr. ******'s, it's hard for me to understand this reasoning. Dr. ****** specializes in solving difficult dry eye and corneal problems. I don't think too many people who have had a heart attack complain about the bill of their doctor. In the same vein, for some of us, he has been a life saver. To put in bluntly, I was a total wreck with my dry eyes. I had seen other doctors in my home town for three years and just kept getting worse.

I have gone through his test procedures, and he found problems that no one else even knew about. I have been probed 3 times. This past time I had an improvement of lipid flow of 175% after a one month follow up. How many patients can say that about their dry eye treatments?

Dr. ****** does not do LASIK surgery like so many others. Instead, he is there to treat people who have been damaged by this procedure. He is vital to the dry eye community.

If we are ever going to get past treating dry eye with warm compresses, eye drops, and special lenses, we need someone who is thinking outside the box and really trying to beat this disease.

[Gram]

I am DR. ******s patient, I too had the mites test. You are correct it was $450. There is no one in the florida area that treats dry eye to the same degree, I will try and keep posted. Had the Amniotic tissue transplant first in left eye . Upper lens first, easy, second in lower eye, that has left me with a feeling of something in my eye, a blurring, or "web across the lower half, Making reading frustrating. Dr. not able to pinpoint what is causing it. I wonder if the tissue in the second surgery is too thick or was sutured a bit low? Do not have an answer as yet. Holding off for other eye until this clears.

[grant555]

no one is disputing hes a good doctor. but i agree there is absolutely no justification to charge $450 to pull an eyelash and look at it under a microscope...except that he knows he can get away with it.

[Max52]

no one is disputing hes a good doctor. but i agree there is absolutely no justification to charge $450 to pull an eyelash and look at it under a microscope...except that he knows he can get away with it.

I'd say it's more a case of supply and demand. He's in demand...good on him..bad for us

[Gram]

My question concerns the post op blurring of the second AMT surgery on the lower part of the left eye. So far, no one has shared my experience of a slight "web or blur" in that eye and Dr. ******'s willingness to do the procedure on the right eye. Do not wish for that to occur in that eye.

[Gram]

Who is your eye doc that did your probing?

[alb1967]

As a long time patient of Dr. ******'s, it's hard for me to understand this reasoning. Dr. ****** specializes in solving difficult dry eye and corneal problems. I don't think too many people who have had a heart attack complain about the bill of their doctor. In the same vein, for some of us, he has been a life saver. To put in bluntly, I was a total wreck with my dry eyes. I had seen other doctors in my home town for three years and just kept getting worse.

I have gone through his test procedures, and he found problems that no one else even knew about. I have been probed 3 times. This past time I had an improvement of lipid flow of 175% after a one month follow up. How many patients can say that about their dry eye treatments?

Dr. ****** does not do LASIK surgery like so many others. Instead, he is there to treat people who have been damaged by this procedure. He is vital to the dry eye community.

If we are ever going to get past treating dry eye with warm compresses, eye drops, and special lenses, we need someone who is thinking outside the box and really trying to beat this disease.

can you please tell us what things he was able to find out about your disease that no one else was able to do ? I know that everyone is different and this disease is so individualistic but in the long run we all suffer from a lot of the same things.

[grant555]

he checks everyone for five things: allergy (by giving you an allergy drop and seeing if you improve), bacterial infection (using lab cultures), mites (using a microscope), MGD (using an infrared light and camera to look at the blockage of the MGs), and ATD (using basically a more complex version of the schirmer test). He also checks for chalasis just using the slit lamp, and I have yet to hear from a patient who ****** has NOT recommended surgery for. That's not to say it hasn't helped people but it's far from certain.

One could argue that most of this could be discovered by any competent doctor in the country who has a focus on dry eye without the costly tests (i.e., cultures, mites, the IR camera, and Schirmer)

[alb1967]

well anyone can suggest an allergy drop. I do not see why mites cannot be seen upder a regular slit lamp microscope, but I guess they can't. But I still do not see why someone should charge that much to look under a miscroscope. MGD almost anyone can tell themselves by looking at their eyelids but for sure a good dr can just press on your lids to see your oil production. I have never been told anything about chalasis so I am assuming I do not have that. But yes I agree any Dr should be able to see (test) for all the above issues.

[waterbee]

Speaking of allergy drops for eye, would they make a dry eye problem worse if it wasn't an allergy?

[grant555]

very possible. one of the side effects of allergy drops is usually dry eye.

[jadavispcfl]

My Diagnosis

can you please tell us what things he was able to find out about your disease that no one else was able to do ? I know that everyone is different and this disease is so individualistic but in the long run we all suffer from a lot of the same things.

He first looked at my skin and mentioned that I had Rosacea. Rosacea can affect the meibomian glands and cause blepharitis. Next, my eyes were irritated and asked about allergies, which I have some. He performed the following tests: 1) The Schirmer Test to assess the amount of tears I was producing. 2) Fluoresin/TBUT to evaluate tear stability 3) Rose Bengal test to evaluate the health of conjunctiva epithelial cells. 4) tear clearance test to evaluate how effectively the eye removes old tears and replenishes with new tears. 5) Demodex mites test: may be source of inflammation of lash follicles. Dr. ****** found about 10 things wrong with me. I had MGD with about 3 glands working in each lid, many atrophied. He also found conjunctivochalasis, which was very painful. I Had trauma on my eyes every time I blinked. I also had overused vasoconstrictors and had a rebound effect of large veins in the corners of my eyes. I had blepharitis too, with enlarged eyelids. I also had pterygiums in the inside corners of my eyes.

Treatment was probing to get the oil flowing, flaxseed oil supplements, tear duct cauterization, and eye resurfacing. yes, it was expensive, but it gave me my life back. If could never thank him enough.

[jadavispcfl]

Dr. ****** Reaches out to Teach Others

[QUOTE=grant555;97993]he checks everyone for five things: allergy (by giving you an allergy drop and seeing if you improve), bacterial infection (using lab cultures), mites (using a microscope), MGD (using an infrared light and camera to look at the blockage of the MGs), and ATD (using basically a more complex version of the schirmer test). He also checks for chalasis just using the slit lamp, and I have yet to hear from a patient who ****** has NOT recommended surgery for. That's not to say it hasn't helped people but it's far from certain.


One could argue that most of this could be discovered by any competent doctor in the country who has a focus on dry eye without the costly tests (i.e., cultures, mites, the IR camera, and Schirmer)[/QUOTE


You seem to be very knowledgable about Dr. ******. Are you one one his patients? If not, why the put down? What I've experienced is that many doctors are not up to speed yet with dry eye. Dry eye, as we all know, has so many facets to it. I think we need to support the ones that are dedicated to educating their colleagues in managing dry eye. Dr. ****** has written a lay persons book, "Reversing Dry Eye Syndrome" that is a great help to any patient dealing with this. He has also written an article, "When Meds Are Not Enough", that explains his approach, and when surgery is the best answer. This article is helpful to teach his colleagues on his approach. There are many other examples, but these are two I like. I recommend anyone reading this to look these up.

[grant555]

yes I saw him. Again, my point is about the costs of the tests not whether he is a good doctor. I'm just saying I've seen several other knowledgeable doctors (there aren't many but some) who came to the same conclusions that he did but only cost me my $35 copay - instead of $2000.