Remake because.........

[drk]

I think Mowmow is right on one thing: if the guy was *****ing about a relatively good progressive like a Natural, then another progressive isn't going to be successful, either, even Definity. Maybe an individualized progressive would work, but I've only done the Multigressiv and I was underwhelmed.

What Martello said is right, too. This guy needed an education, and he needed "profiling"

Having said that, Ryan, sometimes it's better to "fit them all with good glasses and let the chips fall where they may." like you do. I generally do that, unless a gigantic red flag waves in my face. Overall, the optimistic approach works. If you want remakes to be at 1%, then be super careful, and I respect that, but if you're aggressive, the winners will outweigh the losers.
I think the issue is with the rudeness and the Dr.'s lack of communication.

[Texas Ranger]

Ryan, having a chance to re think this, and read some other points of view, I was curious; you have a man who's worn a Natural, and this is his second multifocal rx? with a +1.00 add?, that just gives him a plano near rx? So, how old a person is he? We just do so few +1.00 adds...to see a +1.00 add on a persons second time rx is "unusual". now, you have someone he does not need glasses to read, at all...so they aren't going to like ANY multifocal lens. they just barely need the glasses for anything beyond 12 feet, but can't imagine why they'd even wear them in a close office environment..so, he's paid a lot of money for something that isn't very USEFUL to him...does he just WANT to wear glasses? Someone said that you could possibly refer him back to the rx doc for a 3rd exam before the redo, sounded like good advice..

[mowmow]

Texas Ranger also brings up some very valid points. The more we disect this one the obviouse it becomes that was probably a red hering from the onset. This reinforces my contention that you need to be extra careful when screening patients & dealing with the primo materials.

[Robert Martellaro]

Considering the fact he is currently wearing a Essilor Natural that he currently hates, he wanted the best available.

Ryan,

I didn't see this first time around. It sounds like your client was recently fitted with PALs and found them wanting. Unless you detected errors in the design and/or fabrication of his existing eyewear I would have told him that new lenses would be of no help.

Until a hyperopic shift kicks in, and/or there is an increase in add power, this client is not a good candidate for PALs, or possibly multifocals in general.

Robert

[Ryan]

My apologies to mowmow for not detailing the whole discussion with the patient. My post was originally just to vent some frustration about the situation. My frustration is that the patient was getting mad at us for a situation we didn't create. The patient stated he was seeing fine at first, I just think he is one of those that always has to get a recheck to feel 100% sure because he has had bad luck with the other fast food optical stores. My other frustration is the Dr. planted the seed of the material, poly to CR-39, with such a low power. Thanks for everyone's help on this situation, I will definitely let ya'll know how this turns out.

[RT]

Lost in this discussion is the fact that the lab that made the glasses exactly to the optician's specifications will get stuck giving out a free remake. If supermarkets worked like labs are expected to, they'd replace your groceries every time you burned the roast.

[hcjilson]

When I first came into the business 1959, it was common policy for the labs to do "Dr's Changes @ no charge. in the mid 60's they were done at 25% of original cost, and now I think its pretty standard to do it at half price. Not to get a jump on my competition, or to encourage "experimental refractions"....where can I get a remake for free?? :D

hj

[hcjilson]

Addendum:
While the lenses may be replaced at a reduced fee, you will find that most labs will still charge for the labor involved with drilling a 3 piece mounting......

[Ryan]

UPDATE:

Pt. picked up glasses Tuesday, he said he can see good . (He said the same thing the first time). He said plastic makes such a huge difference. (-0.25 sph -0.25 cyl) Sure, whatever:hammer: . Someone who dislikes poly must have informed him about how much better plastic is . So, anyway, he probably will be back in a few days for adjustments:idea: , so, we will 'see'. (no pun intended)

[chip anderson]

Don't always discount it when you get a complaint against a product or material you like. Withing the last week I have replaced my own lenses with 7/28 glass and it is a lot heavier. But I see a hell of a lot better and I have used most every progressive there is, know how to measure for same, etc.

Had one patient who (at -11.00) insisted on glass (had been plastic and high index plastic and very hight index glass as well as plastic). I wanted to help him as much as I could so I used high index glass. He was not happy. Delivered regular old ordinary crown glass today, patient much happier and if he doesn't complain of glare in the mirror due to flat front, (he had +2.00 base before) I am out of the woods.

Have had many patient's complain over the years of poly and used CR-39 (down Pete) which resolved the problem (Yeah, I know they improve it, just like they improve ARC every year and I'll let you know when I think it really gets were the claims for it say it is now.)

Point, no matter how convinceing the last lecture you had, how pretty the sales person, no matter how much we convince ourselves we like a material, when a patient complains, he may actually precieve somethng we don't.

Chip

[Texas Ranger]

Chip, I don't really suppose that we'll ever fit glasses providing better vision that with optical crown glass, period. but, there are so many issues with lens designs, safety, impact resistance, liability, etc. There are folks that seemingly have zero discernment when it comes to their glasses, they can wear different rx's, made of different materials, different base curves, 5mm off pd, either direction, without much complaint. folks come in wear pal lenses set 6mm above the pupil, been wearing them 2 years, have to "tip their head down to drive"...but they "got used to them" just like the "optician"(?) told them they would...als, there are those folks like Ryan's pt. who is "sensitive" to a 0.25, etc. we see axis changes of 10 degrees on a -2.00 cyl. and one pt loves it, another with the same change "can't see". Chip, remember in the 70's when they went to minus cylinder lenses. guaranteed, today, if we put our pts who've been wearing minus cyls, back in plus cyls, even if refracted in plus, they would likely not wear the glasses...all in all, when going away from what the pt is already wearing and is "happy" with, use caution, and advice the pt what to expect, at the time of the order, not later when you're trouble shooting what the problem might be...

[Jim Stone]

Not that it matters, but you won't get any of those products in 1 hr with AR.

Also, I notice that the largest per cent of drs remakes are progressives with a refit policy. Rarely ever do you get a flat top drs change. I think it's too easy to remake a progressive at NC. I think if the Dr has to buy the remake, they are a little more pursuasive for the patient to wear them a while. I think it is way past time to do away with the refit policies.

[Optigman]

This being my first post in this forum, I must say how pleased I am to find a venue that allows honest and open communication in our community. I have to agree with just about everyone here with the exception of some disconcerning comments or suggestions about chains. I have been a practicing Optician/Lab Manager/General Manager in Pennsylvania for 18 years. The first 9 were spent in a family owned business and then onto a large Opthalmology practice for several years and now with a leader in the industry.

Remakes are always going to be present in our business with respect to Doctors refraction errors. It is our responsibilty to communicate effectively with our patients to uncover their needs and expectations, taking into considerations of their previous eyewear and prescriptions. The .25 diopter changes are the most frustrating and if you ask me, the doctor makes this change because in part they are just as clueless as the Optician to what the patients real complaint is. In defense of the Doctor, patients are not always clear about their choices when in the chair, and to go a step further, their could be underlying medical problems such as undetected diabetes that could be contributing to their refractive errors and visual fluctuations.

I do work for a large chain, and yes there are incompetent people working for large chains there is no doubt. I have hired many employees claiming years of service to our industry in private practices who don't even know the basic mathmatical rules and or how to adjust a pair of eyewear behind the ears correctly. We as the leaders need to help educating our staff and peers for that matter in how to properly deliver our service to our patients.

As for the get 2 for $99, I agree, this is a crock and you get what you pay for. However, not everyones pockets are so deep, it is our responsiblity to also offer products at a price point for every budget, not just what we feel is always the finest available, (this does not mean that we should not offer them, we are obligated to give them choices). I loved the post about how you never see anyone walk into a shoe store and ask for the cheapest pair. How true is this in any office.

I really didn't mean for this to be a marathon post, I'm just glad to find a forum with interests and concerns the same as mine, even though I may be working for "the man". Thank you for your contributions, I plan to stop by frequently to learn from you, my peers.

[Texas Ranger]

optigman, glad to see your first post; I had the pleasure to spend some time at a B&B in Lancaster a few years ago, when we had the OAA convention in Philly, what a nice area...enjoyed your comments, so true.

[ikon44]

here in the uk , things are slightly different, as most clients tend to have their specs dispensed at the same place that did the sight test.If there is a remake issue it is all kept in house.
If a person does come in with an outside rx it is generally accepted that the prescriber is on the hook if their is a non tolerance to the rx.(assuming it has
been correctly dispensed).
It does create ill feeling with the client,because to them you are fobbing them
off even though you have taken their money.
It is best to do your utmost to avoid the situation in the first place.

Speaking personally, I am a contact lens optician, and therefore see a far higher propotion of outside prescriptions.
A lot of lens wearers do have high prescriptions, and will often ask us to do their spectacles as well.
Whenever i get a complex rx, I will tend to get the client in the chair, just to check it out.
I very rarely get a back vertex distance on even very high plus or minus prescriptions. This alone can cause around a dioptre of under or over correction.
I will always try and check their old rx, because if someone has gone from a 0.50 cyl to a 2 cyl, you can at least warn them what to expect when they put the new rx on.

Over the years this policy has saved me and the patient a whole lot of grief.
I must admit you cannot legislate for a non tol on an 0.25 rx. In my experience the people who complain about these small rx changes have got other issues i.e.
they got home with their new specs and found their partner hated them etc
sometimes you have to read between the lines to get to the bottom of what is really bothering them.
sometimes i think a degree in applied psychology would be a useful skill in our profession !

[ziggy]

With that little of a change stick them on a shelf for a week, heat the temples before you dispense them and send them on the way!! 95% will thank you , because the change has made such a profound diffrence in their V.A. just my two cents

[Rophod]

With that little of a change stick them on a shelf for a week, heat the temples before you dispense them and send them on the way!! 95% will thank you , because the change has made such a profound diffrence in their V.A. just my two cents

Ah the psychological exchange. It is amazing how well it works sometimes. Reinforces the fact that we deal with visual perception not just acuity.

[For-Life]

When I started working for my father I was not licenced so I could not legally do adjustments. So if a client was waiting for my father I would take the glasses, bring them to the back, tighten the screw, and clean them up. I would then give them back to the client and told them my father (I did and do refer to him by his first name always and not and never "Dad") would be with them in just a minute. They would then claim what I did made all of the difference and leave very happy. I think some people just want attention, and if you give it to them they will be happy campers.