Seeing what the patients sees

[Freebird]

How does one try and make sense of what a patient is trying to tell us what they see? I’ve had several patients come in and get a pair of glasses from us, often without even changing PAL types , only to suddenly claim that their reading area is too small, or that they’re “pulling,” or something similar.

Of course, when faced with this sort of situation, I ask them questions that to get them to reveal more about what they are seeing (without “leading” them to an answer). I make sure that tilt, face form, vertex distance, base curve, et al, are equal to their last glasses. Or, failing that, these factors fall within tolerable variances. Most times this fixes their issue.

But what if it doesn’t, and they still vow that the new problem persists? Has anyone taken measures on their own to try and see what the patient sees?

For my own part, I am only thirty, so I don’t need to wear bifocals of any kind yet. I have, however, when I ran my lab, taken some +1.25 add blanks and made plano lenses out of them, in an attempt to try and get an idea of what my patients see when they wear their progressives. It was an interesting experience, and gave me an idea of what patients may mean when they tell me certain things about their own glasses.

What do you all think?

Thanks!

[AngeHamm]

"Pulling" is my favorite term. I hear it at least twice a week and still have not the faintest idea what it means.

[Java99]

"Pulling" is my favorite term. I hear it at least twice a week and still have not the faintest idea what it means.

I have felt pulling personally when my cyl has had any change in axis. I mean 2 degrees, and I feel pull. I can see how this could be exacerbated in a PAL.

[GokhanSF]

"Pulling" is my favorite term. I hear it at least twice a week and still have not the faintest idea what it means.

"Pulling" can be caused by unwanted prism

[chip anderson]

That's why God made tranlsating lenses. It's really hard for some people to see out of a distorted lens.

Chip

[Crazy-bout-Optics]

"Pulling" is my favorite term. I hear it at least twice a week and still have not the faintest idea what it means.

"Pulling" can be caused by unwanted prism

So I've had a pair lenses made from Essilor. They are FF SV lenses -1.75 OU is my RX. Measurements were taken at the lab using their new measuring system. I believe these are Eyecode lenses.

My pd is 32.5 OU and from the lab they came back with an OS at 35.5. And this is when I realized the "Pull" patients complain of. And while I could see and things were relatively clear they were just not comfortable to look through.

Had them made back into actual PD and now they are just fine.

[NCspecs]

I did not fully "understand" the "fishbowl effect" some patients experience until it happened to me. I had never had an issue with any lenses until that pair. The panic I experienced made me realize just how scary it would be if I were a patient and I had spent a lot of money on a nice pair of glasses and I felt like my expecations were not met.

The work that went into finding a solution really made me appreciate the point of view of the other side of the dispensing table and how frustrating it can be when you don't get what you thought you paid for.