Bridge of the Nose Irritation with Nosepads

[kmjackson]

From time to time a patient will arrive with deep welts on their thin skinned nose that are undeniably in the area of their glasses. These patients, for no other reason than bad luck, are nearly always disasterous contact lens patients. If glasses are necessary (and you can't talk them into a monocle ;) ) what can you use to improve the situation. This is what I think I know on the subject:

1. Ensure nosepads are properly adjusted.
2. Use larger nosepads.
3. Do whatever is possible decrease weight of lens and frame.
4. I believe there are pads available to make kind of a sling between the nosepads to further distribute weight (if anyone knows of a product...).
5. A properly fitted adjustable bridge pad-less plastic frame may be better.

Please correct me and add your own wisdom on this subject. In my particular situation I am stuck with a selection of only 5 different frames (all metal with the same nose pads). (I am in the military.)

[chip anderson]

In addittion to "proper nose pad adjustment" there are other factors.
The size and a weight of the lenses.
Some "opticians" bend the temples down so much that they bind behind the ear, not only hurting the ear but causing the nose pads have much more tension against the nose.
The age of the nose and skin thickness. I'm sure a dermatologist could contribute some things about skin type.
The hardness of the nose pad.
The nose "type" skinny noses will feel 19 times as much pressure as those with wide flat noses, all other things being equal.

Chip

[kmjackson]

Can you recommend a large surface area soft nose pad? Or are there sling devices or something similar available to help in these cases? Could you recommend specific products?

[kmjackson]

Here is some info from All About Vision on this issue.

Q: I have developed what I believe is a sensitivity to silicone — my skin reacts to nose pads on my glasses, the skin becomes red and eventually (if not treated) will develop a blister-like sore. I have tried the "hard" nose pads, but they also irritate, though not as severely as the soft pads. Is there a source for non-silicone nose pads? — C.S., Canada

A: Great question! I asked Pat, one of our terrifically talented opticians. She said that vinyl nose pads are indeed available for people who are sensitive to silicone. She added that it is very likely your frame also needs to be readjusted to distribute its weight evenly, taking the pressure off your nose. She also pointed out that vinyl nose pads come in different sizes and shapes — yours may need to be altered to fit you better.

My thought is... try contact lenses. Your nose will appreciate you! — Dr. Dubow

[More info from Liz DeFranco, our technical editor who is also an optician: Optical supplier Hilco distributes "soft" nose pads that are not silicone. This type of pad is also commonly found on kids' glasses, where it appears to be a comfort bridge (one-piece, instead of individual nose pads), but is adjustable to fit tiny bridges. The material is also available for larger size adjustable comfort bridges and nose pads as well. All trained opticians should be familiar with non-silicone nose pad options.]

[kmjackson]

In the interests of answering my own question

As a result of some research I have elected to purchase these products from Hilco to see if they can resolve this problem.

Description:

Logic Strap Bridges - Adult Med, 4 pc

Details:

Silicone Bridge with our Dual Purpose insert

Part No:

25/902/0000






Description:

Logic Strap Bridges - Adult Lg, 4 pc

Details:

Silicone Bridge with our Dual Purpose insert

Part No:

25/903/0000






Description:

Logic Vinylon - 6 Pairs, 17 OVAL

Details:

All the benefits of our Logic insert in a durable Vinylon material

Part No:

25/816/0000

I don't know if they will work, or if they are the best solution but I will try to remember to keep this board posted. If someone has a better solution please chime in.

[CME4SPECS]

If the pads that the patient is wearing are silicone, switch to an acetate or vinyl pad. I see this quite frequently and the switch seems to take care of the problem. Terry

[Uncle Fester]

RE:Nosepads/elder skin, my Trick of the trade

Sometimes when I'm faced with your problem I'll first explain to the patient we need to do something radical to heal the sensitive (blistered) area before we try to fix the problem. I then turn upside down a new pair of nosepads (usually of a different material), adjust them so they fit (way in or way out-whatever) OFF the irritated area and have them wear them for a week or so to let things heal. A little talcom powder can help dry the effected area. Once the blistered area looks healed I'll reverse the upside down pad in the new material back to the proper position and suggest they come back sooner rather than later if an irritation again begins.
If they come back, then the problem is probably sensitive skin.
This is usually solved by insisting the patient let you fit them with a plastic frame that you know fits the bridge perfectly.
There's more I could suggest but it's late and time for bed!
Good luck!
Fester

[Judy Canty]

For those patients who seem to be sensitive to both hard and soft vinyl and silicon, I've been very successful with titanium nose pads.

[k12311997]

For those patients who seem to be sensitive to both hard and soft vinyl and silicon, I've been very successful with titanium nose pads.

now that's interesting, I don't think I saw them in the Hilco catalog?! where can you get them and do they help when the skin is just sensitive to the contact not the material?

[Judy Canty]

now that's interesting, I don't think I saw them in the Hilco catalog?! where can you get them and do they help when the skin is just sensitive to the contact not the material?

Hilco 25/824/0000 12mm Teardrop screw on
Hilco 25/825/0000 12mm Teardrop push on

Page 112 of the 2004 Hilco catalogue

Sometimes it's just the fact that the material "sticks" to the skin, especially the delicate skin of older folks. I've used the titanium pads for both allergic reactions and contact reactions. It's worth a try.

[chip anderson]

This is rare but some patients who have surgery, especially cancer surgery of the nose cannot stand the weight of anything on the nose in a concentrated area. In these cases I have taken a cast of the nose and made a soft silicone (medical grade) saddle bridge custom fitted to their nose. Thereby disapating the weight of both frame an lenses over a broader area and made the problme go away.Chip:idea:

[Chris Ryser]

Nosepads......................

Chip was right in his first posting.

So I can only ad a little history.

Nosepads have been around for many years. Also for many years until the late 1960's they also were quite small.

Opticians during these periods were trained to adjust nosepads, even if the heavy glass lenses had their full weight on those 2 tiny pads most people wore their glasses without problems. It was matter of being able to make a proper adjustment You have to know how to angle the pad, you have to know how and where to correct the angle when a customer walks into the store with red marks on the nose.

Ity looks like in modern times not much importance is given to this problem which was no problem in older times.