None of us will admit it, but each optometrist has—albeit hidden from plain view—a dirty little secret. Hey, don’t drift into weird. That’s another column altogether, probably not suitable for this wonderful, serious medical publication. It may be better suited for the latest issue of Creepy Psychology Monthly…circulation 27.

It is simply a fact that we all have our favorite and least favorite patient types. In no particular order, I present a list of patients I find especially challenging: 

1. Kids. I love kids. I have a couple of my own, ages 40 and 41, and hope to retire before they need progressives. I also have six grandchildren, most of whom I adore, ages eight to 14—three boys and three girls—and I hope to retire before they need progressives, too. But kids can be challenging patients. First of all, they are mostly smarter than me and more than willing to remind me of that as they toy with me on their VAs and subjective answers when refracted. How do I know whether they can see whatever I show them? They apparently just want me to squirm. I kind of blame Paul Karpecki and Joseph Sowka, since they like to remind me that 20/20-2 VA could mean a brain tumor.

2. Dads. I love dads. I just told you I am one myself. But moms care if the kid can see. Dads only care about how much it costs. That is, unless it can make Johnny a better wide receiver. Then money is no object. I am quite tired of promising that these contact lenses will mean a full-ride in a D1 college when the kid is eight, 3’ 9” and 30 pounds ringin’ wet. Hopefully I’ll retire before the offers “come pouring in” as promised.

Dr. Montgomery Vickers

3. Those who proudly announce, “I used to work for an eye doctor.” Now, don’t get me wrong… working for an eye doctor is a worthy career, assuming the doctor is smart, kind and appreciative. But formerly working for an eye doctor does not mean you need to tell me that eye doctor told you 17 years ago to never wear PALs and that you will always be better than 20/20 in contact lenses. How come I’m always the one who has to explain presbyopia?

4. Family. Yes, my family, but much more than that, I’m talking about looking at my afternoon schedule and seeing five family members in a row. One hangnail and your afternoon is shot. Even worse—they may all show up! I suggest you refer to #2. It’s hard enough for dad to write that check for one kid; just wait until he sees the total bill for every member of his family at once! I can’t convince him they will all get football scholarships, although his wife seems sturdy enough, I guess.

5. Gamers. So what if they’re 2D myopes. Every single thing they ever look at is less than 30 inches from their greasy unshaven faces, and that’s just the girls. They are only in your office because that’s the price they pay for free room and board in mom’s attic. They will ignore every single thing you tell them. Could it be because of the earbuds? Even my best references to “Pong” leads to zero engagement.

6. Insurance maniacs. You know the ones, right? If they had an arrow sticking out of their chest, just before they bleed out, on their last breath they’d tell the ER doctor, “I only want what my insurance will cover.” Will that fit on a tombstone? Only if their prepaid funeral plan covers it. 

7. Patients who know how to do stuff. They can change out a breaker, fix plumbing, deal with a car making strange noises and still bag a deer every season. I really wish I was them. 

Reminds me of an old joke: a neurosurgeon hires a plumber to fix a toilet. The plumber works for 43 minutes and hands the surgeon a bill for $572. The doctor says, “I’m a neurosurgeon and I don’t make $572 in 43 minutes.” The plumber says, “Neither did I when I was a neurosurgeon.”

Man, I love my patients!

Dr. Vickers received his optometry degree from the Pennsylvania College of Optometry in 1979 and was clinical director at Vision Associates in St. Albans, WV, for 36 years. He is now in private practice in Dallas, where he continues to practice full-scope optometry. He has no financial interests to disclose.