SINGLE VISION & PROGRESSIVE LENSES
BEFORE ORDERING LENSES
Proper frame adjustment, pupil height and pupillary distance measurements are essential in order to ensure good performance and easy adaptation. Fitting errors are the primary cause of rejection of lenses by patients, even for the most sophisticated lenses on the market.
WHEN DELIVERING TO THE PATIENT
When delivering the glasses to the patient in their final form, it is important to check whether pupil heights are aligned with the fitting cross, for both single vision and progressive lenses. Asking the patient to try the new pair of glasses before removing the stamps and doing the next quick test is recommended.
CHECKPOINTS FOR A CASE OF PROGRESSIVE LENS REJECTION
STEP 1: MOUNTING CHECK
- Check frame adjustment. It can be hard for the patient to find the visual areas if the frame has been misadjusted for any reason.
- Use the appropriate centering chart to mark the fitting cross and engravers on the fitting chart.
- Verify whether the fitting cross is aligned with the patients’ pupils. Redo the job if there is any error you are not able to correct using the nose paths. If you can correct the error and problem persists, continue with step 2.
- Continue with step 2 if the fitting cross is aligned perfectly.
STEP 2: IDENTIFY THE REJECTION CAUSE
- The cause can be related to lateral distortion, general discomfort, insufficient reading vision, compromised intermediate vision or visual acuity lost. Carrying out additional steps is recommended, depending on the case.
STEP 3: ADDITIONAL TESTS
- The refraction may be incorrect i the patient has a visual deficit at distance. Repeating the visual exam is recommended in this case.
- If the patient demonstrates a clear visual deficit at the near vision, make sure he/she is able to find near vision properly and train him again. In this case, redoing the visual exam is recommended in order to check weather the Rx is correct. Discarding a possible near binocular anomaly would be recommended if the Rx is indeed correct.
- If the patient experiences general discomfort due to a peripheral unwanted astigmatism and it does not disappear after one week of use, a softer lens design should be offered in order to improve later comfort.
- It is desirable to create a new pair, selecting a shorter corridor length, if the patient has near visual discomfort because he has to go to low to read.
- If the patient demonstrates a clear visual discomfort for intermediate, train him/her to find it properly. If the patient is looking through the intermediate area but feels the visual field is too narrow, you offer him an office lens as a second pair for doing intermediate activities.