It is partly what "opens the purse strings" but also what makes a given diagnostic and treatment protocol available.

30 years ago you could be what is called autistic now, and you would have probably been diagnosed Asperger's, or "mentally retarded" actual words of the diagnosis.

For the Asperger's you would probably have been sent on your way, with an 80% chance of divorce, a 20-80% depending on who you trust higher chance of suicide than your neurotypical peers, and zero help. If you were "retarded" you would go on disability and into a group home if your parents couldn't take care of you until you died.

With an autism diagnosis you get treatment, and if you get enough early enough, a 50% chance of being indistinguishable from your neurotypical peers by adulthood.

So, you are right. It is much more about money than scientific taxonomy.

But we made the rules.

If doctors are following them to get best outcomes for their patients, aren't they doing their jobs?

So it comes down to our medical system being a mess.

Curious, where are you pulling that "80% chance of divorce" statistic from?

Honestly the computers kids should have are the most barebones python and assembly beige boxes that can be found, and told they can play games when they can make them.

That's why I learned to code.

And beige boxes are WAY cheaper than Apple products (and make you do more with less)

You're missing the point that the current tech push is largely to get computers that can run the standardised testing bloatware being pushed down from the top of the system. Education possibilities are only a side benefit; testing is the goal.

Infants can see contrast. Including color contrast. Interpreting color is the bit they don't really have.

There is an interesting digression to be had about amblyopia and the difference between optic nerve presence and use here if you are into talking about it.

Anyone know if this is anything like B.f. Skinner's crib?

If you get any of essilor's scratch coats (or any of unity's they offer a warranty your optician may not tell you about (so he has more wiggle room, or he may buy without warranty to save money)

Thanks. I actually wear contacts most of the time--which is when I need readers. They're the ones that beaten up because I'm always taking them on and off and sticking them in pockets.

Yeah, can't get much cheaper than readers, unless you want to get a pair with glass lenses for very long term (much harder to scratch, can shatter)

Maybe I’ll get a prescription for readers next time. I got progressives last time I was at the doctor and love them for when I’m around the house.

Progs are pretty great. Some minor downsides, but comparing them to a lined bifocal... Depends on personal preferences.

Neat Sherlock Holmes Ian trick, at about halfway up your lens, near the nose, and temple, there are some laser etchings (your progressives) these should tell you what kind of lens they are and how much add power you have

Most offices who keep stock lenses keep cyl (astigmatic correction) up to two diopters in quarter increments in my experience.

The main limitation is usually material choice.

If people needed glasses "now" the local optician would not be a dying trade, and LensCrafters wouldn't have killed off half of their labs three years ago, while eliminating the one hour guarantee.

Davis optical also closed a load of their labs. Quick turnaround spectacles are seeing some changes.

Optician here with some relevant experience regarding the opthalmic space, recognizing that isn't primarily what the article is about.

For the most part glasses still have to be custom made to some extent.

That process has been getting more sophisticated (smarter edgers, free form surfacing everywhere) and faster processing times.

But getting the formula right on mail order is hard.

First you have limited information about and from the patient. You have a PD (pupillary distance) and all of these services, that I have seen only collect a binocular pupillary distance.

The lenses have to be, at the very least cut to shape to fit the frame selected with the optical center of the lens moved so it sits over the pupil of the wearer when they are in the "gaze posture" appropriate to the glasses

That is to say if they are distance glasses the pupils will be looking straight ahead, while using the glasses, but the person's eyes may be 3mm narrower than the frame selected, so before grinding the lens that 3mm must be taken out of the "middle"

If one eye was in two and the other was out eight though (very uncommon) you have a reject pair.

If the glasses were of high power and one eye was out 1 and the other eye were out 2, if we were over 14 diopters of correction we fail quality. But not because the glasses, how they fit the patient's face 2000 miles away.

Hey, UtilityDave, all of your comments are dead on arrival (I vouched for all of them, as they seem well within guidelines). You might want to email the mods to get that fixed, as the only sin it looks like you've committed is not using your account.

I mostly want to try to spread more information about this sector of the economy, it is interesting, and I really wish there were more competition.

Right now there are competitive garden walls if you want to use Zeiss, essilor, rodenstock, and Hoya lenses it is a nightmare to keep everyone current, and lab networks are very difficult to use for end user opticians let alone patients.

If you want to disrupt opthalmic dispensing

Start by making good EHR for offices with good product and lab network integration.

None of the big boys have gotten that or lims with solid legacy support going yet.

Maybe you're just tacking on a general reply to my comment, or maybe you misunderstood what I am saying. When I say "dead on arrival", I mean that your comments are "dead" in that no one can see them (unless they change a setting from default). YOU can see them, but no one else can.

That said, it looks like the mods have fixed it behind the scenes, as your last comment did not show up as "dead".

I was unclear. Thank you ( just woke up) thanks!