Think of troubleshooting as an opportunity for opticians to show off our technical knowledge!
First things first: Get the patient somewhere comfortable (and private if possible) to discuss their adaption and visual problems (helps to avoid the soapbox preacher).
WHY is the patient here?
- Ask specific questions, get specific answers
- When does this happen? Time of day/ What are you doing?
- What exactly do you mean?
- How does this relate to your distance vision?
- Can you give me an example?
- Are you saying…. Or…..?
- Do you have any health issues that can lead to varied vision?
- Is it unclear, uncomfortable, or both?
- OD, OS or OU?
- How many hours/day have you worn these glasses within the past 2 weeks?
- How did the old RX work for you?
LISTEN to the patient’s answers and ask as many follow up questions as it takes to get a full picture of what they are experiencing.
- What is the problem?
- Why is it happening?
- How are they FITTING? Vertex, OC etc..
- How can I fix it?
- Then FIX IT!
- Why did it work/ not work?
- Verify RX, SEG and PD
- Recheck SEG and PD
- Compare to backup glasses/old RX
Was there a change in cyl and/or prism?
Was there a change in base curve?
Was there a material change?
Did the patient have their exam with our OD?
What was visual acuity (VA) reported during exam?
What was old VA vs new VA?
What was old VA vs new VA
Characteristics of Minus Lenses
- Patients tend to like more minus
- Makes reading harder
- Reading area is typically farther away
- Edge thickness
Characteristics of Plus Lenses
- Patients tend to want less plus
- Makes reading easier
- Causes patients to bring reading materials closer
- Center thickness
- Affects both near/distance
- Affects patients are prone to oblique aberrations
- Patients tend to hate cyl change adaptations
- Sometimes cyl changes can cause objects to seemingly change shape during the graduation between different powers throughout a progressive lens
- Cyls closer to 180º are easier for patients to adapt to typically
High Index Characteristics
- Base curve is based on RX
- Not as clear away from the optical center (because of abbe value)
- Measurements have to be MORE accurate
- There are over 800 types of progressives!
- Patient changes RX based on how they hold their head
- Patient training is MUST- these lenses are all in how you use them!
- Remake lenses
- Adjust or readjust frames
- RX Check with original OD
- Patient education on the use of their new glasses and the importance of giving their eyes adequate time to adjust to the new RX
Your goal is to promote patient satisfaction, and to solve the problem without requiring OD involvement.