what do you say to farsighted patients

[mscoco]

i've gotta ask:
hyperopic and presbyopic patient picks up new glasses, first time wearing anything for distance, and of course the first thing they always say is 'i see better without them, why do i need anything on top if i can see just fine'. of course also happens with someone who just became more farsighted. at this point i'm just annoyed, some get it, some don't, what do you say to explain the need for adjustment time or for 'the prescription on top'? what do you say?
anyone got a great link to explain to patients?
thanks!

[uncut]

Welcome to da Forum.....mscoco!

Short(passing by the terminal, and couldn't help myself)answer:

Yes, you can and will be able to see well, without them in the distance, as normal. These are to help you with near activities, and within the room, without having to remove them. It may be more convenient to leave them on, if you choose to do so!

[gmc]

“This is the power you need to see clearly at distance. The natural lenses inside each eye can create some of the power on their own but when they do, they can overwork and create eyestrain and potentially headaches.

This is the correction that looked clearest to you when you were in the doctor's chair. Your eyes aren’t used to your glasses supplying this much power yet. Your eyes and brain will most likely adapt to the stronger power over a few days. Most people adapt easily, but a few don’t.

If it’s then necessary for the doctor to cut the power back a bit to allow your eyes to do part of the work, we will make lenses to the new prescription for you at no charge."

[AngeHamm]

“This is the power you need to see clearly at distance. The natural lenses inside each eye can create some of the power on their own but when they do, they can overwork and create eyestrain and potentially headaches.

This is the correction that looked clearest to you when you were in the doctor's chair. Your eyes aren’t used to your glasses supplying this much power yet. Your eyes and brain will most likely adapt to the stronger power over a few days. Most people adapt easily, but a few don’t.

If it’s then necessary for the doctor to cut the power back a bit to allow your eyes to do part of the work, we will make lenses to the new prescription for you at no charge."

Perfect.

[curtains1]

I like Gary's answer.
What I say is very similar. When people pick up progressives for the first time I also give them instructions on getting use to progressives or multifocals that explains that time is needed to adjust, along with other tips. On the sheet it also says if you have tried them for approximatly two weeks and can not adjust please contact the office.
They can bring it home to read it over and it re-enforces everything.

[mscoco]

uncut: if i know that rx gets them to 20/20, i guess i'm just really wanting them to start wearing them fulltime.
gmc: i explain that same thing to them, just use different words. i'll try yours and see if that works better.
thanks to you both!

[Randle Tibbs, ABOM]

Welcome to da Forum.....mscoco!

Short(passing by the terminal, and couldn't help myself)answer:

Yes, you can and will be able to see well, without them in the distance, as normal. These are to help you with near activities, and within the room, without having to remove them. It may be more convenient to leave them on, if you choose to do so!

depending on the Rx and the prescribers intentions, I agree with uncut.

“This is the power you need to see clearly at distance. The natural lenses inside each eye can create some of the power on their own but when they do, they can overwork and create eyestrain and potentially headaches.

This is the correction that looked clearest to you when you were in the doctor's chair. Your eyes aren’t used to your glasses supplying this much power yet. Your eyes and brain will most likely adapt to the stronger power over a few days. Most people adapt easily, but a few don’t.

If it’s then necessary for the doctor to cut the power back a bit to allow your eyes to do part of the work, we will make lenses to the new prescription for you at no charge."

I do take issue with the last part of this quote, if not careful you are inviting the patient back unnecessarily for a re-refract and putting doubt in the patients mind. I do believe the patient needs to feel they are welcome to see the dr. if they are not satisfied.

[rbaker]

As granny used to say "you can lead the horse to water but you can't make him drink!"
Some people require an hour and a half to watch 60 Minutes. If the patient doesn’t want to wear the glasses that’s his choice, you have fulfilled your side of the equation. Thank him and go about your business.

[uncut]

uncut: if i know that rx gets them to 20/20, i guess i'm just really wanting them to start wearing them fulltime.
gmc: i explain that same thing to them, just use different words. i'll try yours and see if that works better.
thanks to you both!

I agree....since fulltime wearers require less maintenance(fewer mishaps). That will happen only if the advantages of wearing them outweigh the disadvantages of leaving them in place, on the face!

I find that the result desired is often achieved by allowing the patient to discover the result, on their own.....they then own it!. For example, I over-emphasize the distortion on the periphery of multifocals, caution against driving, walking, ladder work, hiking, etc. and suggest that they only attempt these activities, with trepidation and fear. Viola!....a week later they often arrive wearing them, accomplishing all goals I subliminally set up for them....they've been driving, walking, ladder working, and hikin!

And yes, never set them up for failure or use the word "problem" or "redo" in any of my instructions, unless that is part of the original prescription?

[fjpod]

IMO, none of the explanations work. The truth is, if the patient cannot adapt to the effects of the Rx in a positive manner within a day, then the Rx is either too strong, or they really don't need it, or the visual advantages have not been demonstrated to the patient. Simply put, the patient should feel a positive effect as soon as they put them on.

As prescribers, we are trained to measure a patient's true refractive state...but, in the case of hyperopes, or even myopic presbyopes, this finding should rarely be used as the actual Rx. Prescribers that don't eat their own mistakes are the ones who are the worst at it. (That is the reason BTW, why I feel prescribing and dispensing should be under one roof for the good of the patient...but that's another story).

It is my experience that none of the "explanations" work. How intelligent does it sound to a patient when we say, "Oh, wear these glasses anyway, even though they are blurry, hurt your eyes, and make dizzy..."...and they're thinking, "Why would I want to get used to something that causes these problems and makes my eyes blurry when I take them off? How can this be good for me?

Of course, patients should be educated in the pros and cons of their eyewear, and how their eyesight changes over time. i am not saying keep them in the dark, but basically forget all the explanations,..get together with your prescriber and work out the right prescribing/dispensing formula so you don't have to make excuses.

[optilady1]

Here's what I tell patients. "Even though you feel like you see fine, while you were in a dark room with a bright white chart and perfect black letters, this Rx was determined to make you see the bottom row better. However, life doesn't happen in a small dark room. Wear them for a week or so, and if you find they are continuing to bother you, then go back to your doctor." This always works, because everyone gets it.

My suggestion is to have a little compassion. As annoying as these patients are, they are usually first time eyeglass wearers and their perception is that eyeglasses will make their vision better.

[Barry Santini]

Here's what I say:

"Nearsighted people can see near, not far."

Farsighted people can't see." Period.

B

[Happylady]

Whatever you say-say it BEFORE they put on the new glasses! If you tell someone that things might look slightly blurry/curved/tilted/closer/further or whatever before they experience it themselves they will be expecting it as a possibility and be excepting. They will be willing to try them.

If you mention it only after they notice it themselves they will think you are just covering your but* and won't be happy. And will be much less willing to try them.

[Happylady]

This is why I always note first glasses, first progressives/bifocals, and first strong minus correction(for contact lens patients who haven't worn glasses in a while) on their paperwork. If I am dispensing what I didn't sell, I ask if I'm not sure.

[opty4062]

Here's what I tell patients. "Even though you feel like you see fine, while you were in a dark room with a bright white chart and perfect black letters, this Rx was determined to make you see the bottom row better. However, life doesn't happen in a small dark room. Wear them for a week or so, and if you find they are continuing to bother you, then go back to your doctor." This always works, because everyone gets it.

My suggestion is to have a little compassion. As annoying as these patients are, they are usually first time eyeglass wearers and their perception is that eyeglasses will make their vision better.

And once again optilady gets a +1 from me.

[optilady1]

If you are lucky enough to sell the glasses to who you are dispensing them to, that's the best time to discuss this. I flat out tell patients there is a good chance they are going to hate their new distance at first. You have to be realistic with people. Being smooth and blowing smoke up patients butts doesn't put their mind at ease and they can usually see through it.