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Thread: Crooked frames

  1. #1
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    Crooked frames

    Canvasing for personal experiences of those willing to share.

    1) ...for multifocal patients with notable asymmetry in ocular heights: what's the most crooked you've been willing to adjust a frame to cater to their insistence on the tilt of the eyeglasses tracking the line defined by their eyes?

    2) What was their cylinder correction?

    3) FT, PAL, or other?

    4) Did you rope the lab into tracing the pattern off angle to preserve a vertical reading gaze/PAL channel/intended cylinder axis?

    5) Did you pull it off? Or did it bite you and become a learning experience?


    Thanks for sharing!

  2. #2
    Manuf. Lens Surface Treatments
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    Redhot Jumper there was a rule to fit the by the patients chosen frame first .....................

    When I learned optics, and its practical side there was a rule to fit the by the patients chosen frame first, so it would fit the face at its best, even if one ear or one eye was higher than the other.

    Only then you would take the measurements to place the lens features at the right place. That could result in uneven placed placed optical centers and or reading segs but ended, by being a perfectly fitted job for those cosmetically uneven faces.

  3. #3
    One eye sees, the other feels OptiBoard Silver Supporter
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    Quote Originally Posted by Chris Ryser View Post
    Only then you would take the measurements to place the lens features at the right place.
    Yup, pre-fit first until physically, cosmetically, and optically optimal (hint: make sure both you and your client agree what cosmetically level looks like), then measure the pupil/fitting cross/segment heights as well as the monocular IPDs, pantoscopic tilt, vertex distance, and dihedral angle.

    Hint: for segmented multifocals, show your client why you are placing the segment line unequal in the frame so that there are no surprises at dispense.

    Best regards,

    Robert Martellaro
    Science is a way of trying not to fool yourself. - Richard P. Feynman

    Experience is the hardest teacher. She gives the test before the lesson.



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    Master OptiBoarder rbaker's Avatar
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    Listen to Chris and Robert and you can't go wrong.

  5. #5
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    Without a doubt!

    All of the above is good stuff, but the question stands:

    'What's the maximum rotation within the facial plane to which you've been able to 'agree' is "level"?
    Stipulating we know to take advantage of the good advice above, 'What additional measures did you take because of that rotation,'
    and 'How did it turn out?'

    PMs are great if the tale is too horrifying for public digestion! Either way, your experience is appreciated.

    I don't have such a story myself, other than to say I've discovered how much rotation is too much for me to agree to go along with just to avoid such a potential horror story. But I'd value some colleague input to double-check my thinking.
    Last edited by Hayde; 03-27-2017 at 10:49 AM. Reason: grammar

  6. #6
    Manuf. Lens Surface Treatments
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    Blue Jumper facial plane to which you've been able to 'agree' is "level"?

    Quote Originally Posted by Hayde View Post
    \

    All of the above is good stuff, but the question stands:

    'What's the maximum rotation within the facial plane to which you've been able to 'agree' is "level"?

    Whatever it takes to make the frame look acceptable on the patients face, ...........acceptable by patient, his wife and kids and whoever, they are the ones that decide now.

    When that is done you worry about the lens placement.

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    Ghost in the OptiMachine Quince's Avatar
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    We have a patient (PAL wearer) that likes to adjust her frames herself and then come to us to 'fix' them. She has very asymmetrical eyes. Last time, I worked with her, she brought me a plastic frame that she bought in Florida and wanted drastic panto added. I ended up breaking the frame. It was a Lilly Pulitzer, which we carry, so it wasn't as much of a nightmare to replace, but still quite inconvenient for all parties.

    She has been told time and time again that she needs something with nosepads so we can better fit her, but she doens't always get her glasses from us. We have had some luck utilizing stick on nosepads, though it is far from ideal.

    Couldn't tell you too much about her script off the top of my head, but I know we pre-fit when we can- and when we can't she destroys her frames trying to get them 'perfect'. We have never had to order anything off script to fit the adjustment, that I know of. I comp when necessary, obviously.

    -Not sure if it fits the criteria, but it's as relatable as I could get!
    Have I told you today how much I hate poly?

  8. #8
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    Quote Originally Posted by Chris Ryser View Post
    Whatever it takes to make the frame look acceptable on the patients face, ...........acceptable by patient, his wife and kids and whoever, they are the ones that decide now.

    When that is done you worry about the lens placement.
    Thanks Chris, your answer seems to me pretty categorical. If a patient wants a 10-20 degree slope, you're still comfortable putting them in multifocals?

    If so and it's now time to worry about the lens placement, how do you intend to satisfy ANSI's 2-degree margin of error for horizontal segment tilt?

    Or is your answer more qualified than I interpreted of your last post?

  9. #9
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    Quote Originally Posted by Quince View Post
    We have a patient (PAL wearer) that likes to adjust her frames herself and then come to us to 'fix' them. She has very asymmetrical eyes. Last time, I worked with her, she brought me a plastic frame that she bought in Florida and wanted drastic panto added. I ended up breaking the frame. It was a Lilly Pulitzer, which we carry, so it wasn't as much of a nightmare to replace, but still quite inconvenient for all parties.

    She has been told time and time again that she needs something with nosepads so we can better fit her, but she doens't always get her glasses from us. We have had some luck utilizing stick on nosepads, though it is far from ideal.

    Couldn't tell you too much about her script off the top of my head, but I know we pre-fit when we can- and when we can't she destroys her frames trying to get them 'perfect'. We have never had to order anything off script to fit the adjustment, that I know of. I comp when necessary, obviously.

    -Not sure if it fits the criteria, but it's as relatable as I could get!
    Thanks for your anecdote, Quince! Didn't have my eyes on panto, but you made me think of something new--so it's exactly what I was looking for! Does adding panto have something to do with some symptom stemming from her uneven eyes?

  10. #10
    Ghost in the OptiMachine Quince's Avatar
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    Quote Originally Posted by Hayde View Post
    Thanks for your anecdote, Quince! Didn't have my eyes on panto, but you made me think of something new--so it's exactly what I was looking for! Does adding panto have something to do with some symptom stemming from her uneven eyes?
    I wouldn't use her as a good example for what would work for the average patient. She is obsessed with adjusting her glasses to the point that she got her doctor to give her a line-up chart...

    Glad I could add something potentially useful though!
    Have I told you today how much I hate poly?

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