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FEAR AND LOAFING: LACK OF FOCUS (Optometrist)

Is it easy to assume that our reporter will make a spectacle of himself?












"One or two?" I ask Las Vegas resident Andreana Gray. "Which do you like better?"

I'm referring to two lens options on the phoropter refraction measuring device I'm operating. Gray has already made clear her choice of the room's two optometrists.


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  • "Dr. Malik, you're going to check me out after, right?" the 19-year-old asks.

    Dr. Ed Malik began my training at Eyes & Optics, 2261 S. Rainbow Blvd., an hour ago by introducing me to his Nidec Epic 2100 computerized refractor system.

    "The infrared light comes out of here and calculates their prescription," said Malik, who also owns a Caesars Palace shop called Oculus. "And it automatically moves the lenses into place, so I can sit here comfortably, rather than standing up and reaching over."

    Many optometrists in the valley still use old-school phoropters, which make wearers resemble Jeff Goldblum in "The Fly."

    "They're cheaper," Malik said. "But they're harder to work, they take longer, and patients don't like them as much."

    These sound like good points to me. But I came here to practice optometry, not operate computers. I requested a phoropter.

    "Suit yourself," Malik said.

    Malik is one of 268 optometrists practicing in Las Vegas, according to the state board of optometry. (According to salary.com, they earn a median income of $110,458 per year.) He's also the latest in a long line of eye care professionals I've come to know too well. As a child, I had amblyopia and -8 diopters of blurriness in my left eye, which put me somewhere between Mr. Magoo and the guy in "F Troop's" lookout tower. In 1999, I underwent Lasik surgery. This freed me of the choice between glasses so thick that bugs fried in my wake or contacts that played hide-and-seek inside my eyeball corners. It also helped fulfill my need to be at least $5,000 in debt at all times. (Last year, Malik gave me the great news that, in one or two years, I will get to be at least $6,000 more in debt because I am the youngest patient he has ever had with age-related cataracts. Woo-hoo!)

    Malik walked me into another room, which is a longer one to accommodate its antiquated screen projector. (An eye chart is built into the Nidec.)

    "This is the most important thing you need when you're an eye doctor," he said while holding up another marvel of old-school technology: Altoids, first introduced 200 years ago.

    "I can't tell you how many times people tell me, 'That surgeon you sent me to sounds really smart and awesome, but man, he stinks,' " Malik said.

    Immediately, something appeared wrong through the binocular indirect ophthalmoscope strapped to my head. It was a foreign metallic speck protruding just below my patient's right eye.

    "Do you want me to take my nose ring out for the pictures?" Gray asked.

    Malik, 48, who grew up in Boston, eyed another career before vision. Since age 7, he has played rock drums. He has been a member of what he estimates to be his 50th band since 1985. The Melancholics have played the House of Blues, The Joint and First Friday, yet Malik has never given the group his full-time attention.

    "The rock star thing was attractive," he said, "but I decided not to do that. I figured, 'I've got to learn something else or I'm gonna be playing drums for the Circus Circus trapeze artists.' "

    At first, that something else was surgery. It was while attending medical school in Reno, however, that the University of Nevada, Las Vegas graduate discovered just how long five years of residency after four years of postgraduate school was starting to seem.

    "I didn't want to do it," he said.

    The name of the profession Malik settled on comes from the Greek words opto, which means vision, and metria, which means boring job.

    "Actually, I find it exciting," Malik said. "I think we're one of the last remaining medical professions where someone can tell you what's wrong, and in 10 minutes you can figure it out. In most medicine, it's, 'I don't know. Let's do a million tests and scare you to death and see you in a month.'

    "Besides that, it's interesting," Malik continued. "It's a little medicine and it's a little rock 'n' roll."

    If the connection between optics and rock seems fuzzy, Malik intends to clarify it with a window display in his third store, which is in the planning stage. The display will feature reproductions of glasses popularized by rock stars including Buddy Holly, John Lennon, Ozzy Osbourne and Elton John. Its title? Specs, Drugs & Rock 'n' Roll.

    "You're not going to get a different reading," Malik tells me.

    The Nidec measured the astigmatism in Gray's right eye at -.25. But I just don't trust computers. I saw what HAL did to that astronaut in "2001: A Space Odyssey." I dial the phoropter's astigmatism cylinder up and down.

    "Which is better," I repeat, "one or two?"

    Earlier, Malik taught me to not only listen to the answer, but count how long it takes.

    "If the patient gives an answer right away, they're confident," he said. "If it takes a couple of seconds, they're not sure."

    The "one or two" game is the soundtrack to one of Malik's recurring nightmares, by the way.

    "I'm usually clothed when I'm doing the test," he said, "but I do have that dream."

    Gray answers "two," and she answers immediately. That means she clearly prefers -.5 to -.25.

    That makes me a quarter of a diopter better than a $100,000 computer. And the lenses I'm operating with are cloudy.

    "Good work," Malik says, adding that his examination of Gray will conclude with a manual double-check as well.

    "There is no machine that can tell us what someone's vision is without negotiation," he says.

    Hear that, HAL?

    Malik rolls his own eyes as I prance around his office, boasting of my optometrical prowess and granting unauthorized raises to his support staff.

    "I'm going to have to increase my malpractice insurance," he says.

    Watch video of Levitan practicing optometry at www.lvrj.com/columnists/Corey_Levitan.html. Fear and Loafing runs Mondays in the Living section. Levitan's psrevious columns are posted at fearandloafing.com. If you have a Fear and Loafing idea, e-mail clevitan@reviewjournal.com or call (702) 383-0456.

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    Note: Comments made by reporters and editors of the Las Vegas Review-Journal are presented with a yellow background.

    WEL wrote on October 16, 2008 01:31 PM: MAXIDEX WARNING

    I had eye surgery and in the post-op pack was MAXIDEX(dexamethasone) drops by ALCON LABS.

    Two days later I was BLIND

    Use Google and enter EPOCRATES MAXIDEX REACTION to verify


    GEORGE wrote on May 06, 2008 03:31 AM: Pat,try www.eyeglassfactory.com. There are other sites on the internet that you can find with a search for eyeglasses. You select the frame type you want and send them your prescription or an old pair of your glasses. Single vision glasses are $40 and bifocals $79 plus $5 shipping.


    pat wrote on May 05, 2008 12:19 PM: Where do I find the internet options, George??


    GEORGE wrote on May 05, 2008 04:20 AM: Optometry is a racket.Most of the work of an optometrist can be performed by a machine. The machine can measure your eyeball and give you a prescription for eyeglasses if you need one. Optometrists only add to the expense of the process. They are licensed by the state and make it illegal for others to do their work. If you buy eyeglasses through an optometrist, you are paying a high markup which goes into the optometrist's pocket. Glasses which cost about $200 at the optometrist's can be bought on the internet for about $40.