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Thread: Trouble with Nose Pads

  1. #1
    Master OptiBoarder OptiBoard Silver Supporter Jubilee's Avatar
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    Trouble with Nose Pads

    I have a patient that picked up her glasses in June. She had some trouble with the frame sliding and the pads being "too hard" to I put her in a pair of silicone pads.

    4 months later she come in, complains her nose hurts, the pads are digging in, and she can't stand them.

    Another associate adjusts the frame and she says it is better. Comes in a week later complaining that it really isn't better and the pads are hurting her.

    Other associate thought maybe the silicone was "gripping" too much, and put her in acetate... again she complains they are too hard.

    We have put her in Vylon, and lately the Biofeel cushioned pads. Three of us have adjusted her frames, and the nose pads just gently lay on the nose...whole pad front is flush against the nose.

    She normally points to her right side when she complains. Last time I noticed there was a red spot and asked her if maybe a blemish or sore is causing a problem, since any weight on the sore spot would make it feel worse. She claims that this isn't possible, and the spot is caused by the nose pads. I adjusted them so the pressure would be in a different spot, and she just called saying that she can't wear the glasses cause it hurts.

    I told her we would try a strap bridge and see if it helps to distribute the weight more across the entire bridge of the nose.

    What else am I missing here? I have never had someone have a problem with multiple types of pads or my adjusting of them....

    Cassandra
    "Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland

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    I had a patient like this a few years ago. This is not so much a nose pad issue as it is a personality issue. This type of person is hyper-sensitive and anything makes them crazy. They feel discomfort that really isn't there because they are always aware of every little thing. I adjusted and readjusted my patient, tried all types of pads and then finally and gently said to her "there is nothing more I can do". I had in a Sillouette Minimal Art so weight was no issue either. She finally conceded and stopped coming in all the time. I still see her when she needs a little tweak here and there but the daily onslaught is over. You have to be honest with them or you will drive yourself nuts too.

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    Bet you got the temples bent in behind his ears, putting pressure behind the ear and on the nose. Properly adjust temples so there is no tension between ear and nose. Temples should not be bent in enough to hold on the back of the ear.

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    Master OptiBoarder OptiBoard Silver Supporter Jubilee's Avatar
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    The temples gently rest about a mm behind the ear. They do not touch. That is one of the things we have checked, cause she'll tell me they are digging in behind her ear, and they are not even touching! She finally stopped complaining about that 2 visits ago..

    She won't take "We have done all we can do"...

    She is thinking it is the frame. Told her the only thing I could remake her in was a plastic frame w/o nose pads and we would have to re-edge her existing lenses. I would give her a 30% discount on frame.

    Lenses are an autograph in 1.6 w/AR. She is a fairly high hyperope. However compared to her last pair of glasses these are lighter. While her previous lenses were poly, they were a much larger frame.

    She is wearing an AK 9027 50 eye.

    Cassandra
    "Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland

  5. #5
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    Honestly, it sounds like buyer's remorse. If she has said or implied that "it's the frame," you and I know that doesn't make any sense. Another person could wear the same frame and be fine. (assuming it's a proper fit, which I'm sure it is.) It really sounds like she needs an adjustment in her head! lol
    The only thing I've found to work with this type is to do the remake (cheaper than adjusting them every day for the rest of your life!) or order in some new pads (like crystal, sounds like you've tried the cushion ones) that look and feel different than everything she's seen. Get her excited about them by explaining how certain you are that this will solve the problem. (It's like a sugar pill, but for your nosepads!) Sometimes that works like a charm!

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    My thoughts exactly....

    Quote Originally Posted by EyeFitWell View Post
    Honestly, it sounds like buyer's remorse.
    But I'll bet she'll take more sugar in her coffee and love a different pr. of glasses!!:shiner: Chris..

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    Master OptiBoarder Cindy K's Avatar
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    Have you closely observed how her old glasses fit (assuming she felt they fit well)? Many of those people with both genuine and imagined discomfort are greatly helped when I've had the opportunity to see the alignment of their old specs, and adjust the new ones as near as possible to the old. Some folks just dislike the feel of anything on their nose, and will focus so much of their attention to this area.

    Also, regarding the red mark she had-- any chance the metal of the frame is touching her skin close to the pad? I've seen this many a time, where the irritation is actually due to a reaction, and in a couple cases to the degree that the person would rub their frame then rub what came off the frame onto the skin, and it produced this effect.

    Just my two cents.

  8. #8
    Happy Halloween k12311997's Avatar
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    I had a patient who had a lot of trouble with nose pads. After trying everything I could think of I asked on optiboard someone, I forget who, recommended titanium nose pads from Hilco, they worked like a charm.

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    Thumbs up Silicone pads..........................

    Quote Originally Posted by Jubilee View Post
    I have a patient that picked up her glasses in June. She had some trouble with the frame sliding and the pads being "too hard" to I put her in a pair of silicone pads.

    There is no such thing as nose pads being too hard. Nosepads have to be angled properly when adjusting the frame.

    If the frame slides downwards the angle of the nose is not anymore the same as in the place where the pads were adjusted. Therefore even soft silicone pads are not the solution.

    Temples have to be adjusted properly by opening up so that there is no pressure against the skull as this will make the frame slide forward and out of place. On metal frame you can bend them up at the hinge on plastic frame you have to use the file.

    Once this is done you bend the temple tips so that they follow the contour of the skull as well as the one of the back of the ear.

    If you follow this advise you can throw all the silicone pads in the garbage as you will never use them again, at least for this purpose.
    Chris Ryser
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    http://optochemicals.com............................. http://arcoatings.com

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    Master OptiBoarder OptiBoard Silver Supporter Jubilee's Avatar
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    unfortunately she doesn't have her old pair...she lost them

    the pads are flush against the nose w/o indenting the nose itself. When she came in yesterday, and I saw what the biofeel pads had done, they did leave a ring from where the extra cushion bordered at..

    Switched her to a strap bridge and adjusted temples so they rest gently behind the ear w/o pressing on the ear or skull.

    Of course when she checks to see if the glasses slide when looking down, she flings her head down like she had been hit or something.. so of course they move a bit.

    I have a child's strap bridge on order (can't believe I was out of those, nor where they in hilco kit I just received) since the strap doesn't actually touch the nose and rises above the bridge of the frame. I will also check into the titanium pads.

    Cassandra
    "Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland

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    Manuf. Lens Surface Treatments OptiBoard Gold Supporter
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    Redhot Jumper Its the angle of the pads......................

    Quote Originally Posted by Jubilee View Post
    I will also check into the titanium pads.
    Cassandra...........it is not the material of the pades, you could have pads from lead or from pure gold..................if the angle of the pads is not perfectly adjusted the whole weight sits on a small area and will mark the skin and then emit hurt, hurt hurt until the skin opens and you get a sore.
    Chris Ryser
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    DLO. NA.IC.I.T.PO

    http://optochemicals.com............................. http://arcoatings.com

  12. #12
    Bad address email on file OptiChick21's Avatar
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    Larger pads...

    Quote Originally Posted by Chris Ryser View Post
    ...if the angle of the pads is not perfectly adjusted the whole weight sits on a small area.
    This is very true, sometimes a larger nosepad does the trick, as it spreads the weight more evenly over a larger surface area. For people who have tough times with the pads I often try to go bigger and softer.
    Sounds like since she's a high hyperope, she may have a little extra weight up front in the lenses, possible weighing down on her "SUPER SENSITIVE" nose! The only problem here is that some patients don't like the look of big old nosepads, and I'm sure she'd be the one to complain about that too... they always want their cake and to eat it too. The strap bridge might work to spread the weight better, but not look too hot... :o
    Honestly, I agree it really sounds like she just doesn't like the glasses and wants to nay-say every fix you come up with until you are forced to remake new glasses for her... I've had many of these patients! Why don't they just say from the start "I changed my mind!!" Probably because they think they can get a free remake if there's something so-called "wrong" with the initial glasses! Good luck with this one!! :bbg:

  13. #13
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    It's probably not the nosepads at all. If she is a very high Hyperope, it's probably the weight of the lenses that are bothering her. (i see this a lot)Putting her in a strap bridge probably isn't going to help either. Same with a plastic frame(adding weight to the problem).How high is her rx? What about the frame? Is it a lightweight frame or not? If she really is that high of a hyperope, you may have to go with a thinner/lighter weight lens and lighter weight frame??????

  14. #14
    Bad address email on file OptiChick21's Avatar
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    Quote Originally Posted by Jubilee View Post

    Of course when she checks to see if the glasses slide when looking down, she flings her head down like she had been hit or something.. so of course they move a bit.
    LOL!!! :D I can picture it now...


    Quote Originally Posted by Jubilee View Post

    Lenses are an autograph in 1.6 w/AR. She is a fairly high hyperope. However compared to her last pair of glasses these are lighter. While her previous lenses were poly, they were a much larger frame.
    Maybe you could try remaking in a lightweight, aspheric polyc lens, like the 1.0 center thickness type. Might help the weight issue if nosepads won't...

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    Quote Originally Posted by OptiChick21 View Post
    Maybe you could try remaking in a lightweight, aspheric polyc lens, like the 1.0 center thickness type. Might help the weight issue if nosepads won't...
    Optichick,
    I don't think they can do a 1.0 center thickness on a "high hyperope" even if it is poly! :finger:

  16. #16
    Optical Clairvoyant OptiBoard Bronze Supporter Andrew Weiss's Avatar
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    All the previous posts have listed most of the different things I would look for -- pad material, size, positioning, temple adjustment, etc. I have also found, however, that panto can have an effect on pad comfort. Even if the pad arms are adjusted to compensate, there is enough change in how the weight of the frame is distributed that it can cause problems. I've had patients go from discomfort to delight by readjusting the panto, even in frames as lightweight as Silhouette titans. Of course there are limitations here, especially with progressives.

    And I can also say, from my own personal experience, that there are some frames that just never feel comfortable no matter what I (or anyone else who adjusts them for me) do. I had a Tura frame years ago that looked great on and I couldn't wear for more than 2 hours without a headache. And I even have a Rodenstock drilled rimless mount, very lightweight and with Trivex lenses, that I can't wear for more than 4 hours without a headache. I truly believe there's nothing wrong with the frame or with me, and that it's just a mismatch.

    I guess I'm just one of those hypersenstive folks . . . ;)
    Andrew

    "One must remember that at the end of the road, there is a path" --- Fortune Cookie

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    Bad address email on file OptiChick21's Avatar
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    Quote Originally Posted by EyeFitWell View Post
    Optichick,
    I don't think they can do a 1.0 center thickness on a "high hyperope" even if it is poly! :finger:
    You're right, I wasn't thinking when I said 1.0ct. Guess it depends how high of a myope she is, but an aspheric poly lens would be nice...

    You don't miss a beat do you.

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    Just a little side note concerning hyperopes. Many, many years ago some frame manufacturers actually used to make temples of differing weight (same frame chassis) and styles to counteract the weight of the lenses. Oh, gone are the days.

    Also in a few desparate situations where the patient had skin or nose repair situations, I have actually made a mould of the nose and custom made a nosepad/bridge to fit that nose and dissapate the pressure.

    Chip

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    Quote Originally Posted by OptiChick21 View Post
    You're right, I wasn't thinking when I said 1.0ct. Guess it depends how high of a myope she is, but an aspheric poly lens would be nice...

    You don't miss a beat do you.
    The part I was teasing you about is that the lenses will be plus. She isn't a myope. She's a hyperope. So, you can certainly do a poly aspheric lens with an edge thickness of 1.0. But it would have a center thickness of more than that depending on the strength of the lens.

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    Master OptiBoarder OptiBoard Silver Supporter Jubilee's Avatar
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    She's a +3.00 with little cyl and a 2.00 add

    The frame is a not titanium or stainless...

    She went 3-4 months with no issues, and when she first picked up the glasses she loved how thin and light weight they are.

    The lab that I ordered them from can only get the autograph in the 1.60 material....and they are much thinner and lighter than what her older pair was.

    With the rx being 6 months old now, there is no way to get new lenses covered under any type of warranty...except for the AR which would be same lens material for same frame. I will not cover the cost of new lenses, and the frame itself is very classic. No bold lines/bold colors. Nice upsweep progressive friendly frame. It looks great, fits great.

    Chris..
    The way I was taught was that the nose pads should be flush with the nose so that the entire front surface is in contact, but not pressing against the nose. That is currently how I have them fitting. The front of the pad is touching the same as the back of the pad surface, with the top applying the same amount of pressure as the back......please advise me if I have been doing this wrong for 12 years and on thousands of patients.

    Cassandra
    "Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland

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    Redhot Jumper Temples out of whack...........................

    Quote Originally Posted by Jubilee View Post
    The front of the pad is touching the same as the back of the pad surface, with the top applying the same amount of pressure as the back......please advise me if I have been doing this wrong for 12 years and on thousands of patients.
    Cassandra
    Ifg the angle for the nosepads is right on, but the patient still hurts or feels uncomfortable on the nose, he or she probably hit their head against something and your templed are our of whack. This will shift the presssure more to one side, right or left as well as up or down.

    Have patient twist glasse with their own hands to show you how it would feel right and take it from there.

    And to all you other guy's...............who want to sell other lenses to cure the problem, as being weight.

    We used to sell glasses in any power...........in glass lenses and were still able to adjust a frame properly so it would fit and not hurt.
    Chris Ryser
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    http://optochemicals.com............................. http://arcoatings.com

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    registeredoptician Refractingoptician.com's Avatar
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    Last edited by Refractingoptician.com; 03-02-2007 at 01:17 AM.

  23. #23
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    LOL...Gary,
    It would have been more dramatic if you snapped them in half, threw them on the floor, and stomped on them. Then, point to the sign that says you're not responsible for breakages during adjustments. Hilarious!!!

    Ok, maybe I'm just delirious from all the last minute insurance folks...

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