On my most recent visit, February, 2000, he warned me that he'd gone further out with his methods - prescribing with the eyes closed! This almost turned me away, but in my mind I new what he was getting at - I can tell a bad prescription with my eyes closed - it's the light that falls on the eyelids, and the tiny amount that passes between them. With the eyes closed, you can focus on your response to the lenses with less distraction. Be warned, however, Sirota's rate is $175/hour and it took three hours that last visit. I expect he could have done it in two, and would have had he seen me more than every five years or so. Negotiate with him.