Frame Sizing for laymen customers

Hello Everyone,

When helping a customer and you want to educate them what frames are the best size for them, do you ever use Small, Medium, Large, Extra large instead of describing What number the A Size is?

Do you have a system?

Small= 49mm or below
Extra Small= 48 and below
Medium= between 50-53
Large= 54-57
Extra Large 58 and above

Does anyone do this? Also would you change anything of the sizing above as a general template? I know this doesn’t include the total width of the frame that’s what we usually eyeball.

It's your job to know your inventory and show them what will fit well. A 50 eye frame can be quite small or quite large. I can see how you might use this as a frame of reference, but I am unsure of the necessity of "educating' patients beyond let me show you what fits.

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Originally Posted by tomases

It's your job to know your inventory and show them what will fit well. A 50 eye frame can be quite small or quite large. I can see how you might use this as a frame of reference, but I am unsure of the necessity of "educating' patients beyond let me show you what fits.

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I agree, not all customers want you to help them though, in those cases they will try frames on their own. So a guide which isn’t so technical to follow helps in some situations.

Due to covid, right now we pull frames for our patients. That sort of eliminates this conversation. Prior to covid, if I had someone ask and want to look on their own, I recommend certain eye sizes if they ask. If someone is petite, I would say to look for some that are labeled petite (some are and some aren't) or maybe tell them that it depends, but maybe look for around 48-50 eye. They're labeled and easy for a patient to see. I also say it's a guideline and you could have 2 frames in a 50 eye that fit differently due to the design. If they want to select a few, then I will help them narrow down and find the best fit.

I also will tell a patient if they find a frame they love and it's not the appropriate size, to still pull it aside and maybe I can find something similar in style that would work for them. It helps me get to know what they want and what their tastes are.

We have all had customers ask " what is my size?" as though they were buying a shirt or a dress, where there is one right answer. There is no one "right" size for anyone. I wear both a 42 eye P3 and a 56 eye chunky zyl, and they are equally correct. Now, shouldn't we put everyone in a low ED frame with only a few millimeters of decentration? Sure, but that's not the way of the world. If a -10.00 with a 55 PD wants a 58 eye aviator, we would have to say that's wrong, but it takes an extreme example like that to limit their choices. Should the overall size, endpiece-to-endpiece match the width of the skull at the top of the ears, so the temples don't converge or diverge when adjusted? Maybe or maybe not, depending on whether the customer likes the look. If a myope wants a larger eyesize, and are fully rpt. fully informed about the resultant lens thickness, why not? For hyperopes, a little more caution is in order, since additional center thickness is more trouble than edge thickness. All by way of saying that few questions have only one correct answer.

I lived through the 70's - 80's when the 90lb teenagers all wanted a 60+mm frame. Of course it was always a 6D Rx with few high index options. Now that's that the huge frames are back in fashion, I'm so glad I'm retired.

The older datum system was a more effective guide when fitting a frame.
the boxing system was a lab answer to non symmetrical shapes in the age of limited blank diameters .

Frame sizing is dependent not just on the eye size, but the DBL, as well. Also, take into consideration the total width of the frame. a 53/22 will fit almost as well as a 60/15. Dita and Laibach are good examples. The Laibach Washington is a 52/21, but the fit is like a much larger frame, due to the frame width at 140cm, which is about the same as a 58/16 Persol 2803.
The Washington will produce a thinner looking lens than the Persol.

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Originally Posted by lensmanmd

Frame sizing is dependent not just on the eye size, but the DBL, as well. Also, take into consideration the total width of the frame. a 53/22 will fit almost as well as a 60/15.

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Absolutely! Also keep in mind that the size listed may or may not be correct. I always have a PD stick on me when looking for specific sizes for this reason. But as lensmanmd stated, there is more to the puzzle. Not only does the DBL greatly influence, but also the style. Are the hinges a tension construction like Ovvo and ICBerlin or is it a rigid acetate?

I tend to avoid words referring to size. Just like with clothing, it can be considered offensive to the right individual. Now, if a fathead comes in referring to himself as such, I'll play along.

Based on responses would you than measure the frame from one edge to another to have a better understanding of size than just reference the A size?

Who benefits from a wider dbl vs a narrower dbl?

I tell people to look in the mirror and that for best size their eyes should be as centered as possible in the lens (horizontally). More lens to the outside of the eyes, frame is bigger than necessary, more lens inside frame is too small. Final fit is rarely that perfect, but I've actually been very surprised once I point that out how many people internalize it and successfully weed out bad size selections themselves. Sometimes, especially for large or small fits that will have narrower selection, I find a frame that is an ideal fit, explain why it is ideal for them, and then let them use that frame as a reference. Again I've been impressed how well most people heed that advice. It's fun to watch them hold the frames next to my reference frame and then nix them without even needing to try on.

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Originally Posted by DanLiv

I tell people to look in the mirror and that for best size their eyes should be as centered as possible in the lens (horizontally).

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More than about '4mm in' and we start to look cross eyed (esotropia). Not a good look!

Sometimes borderline small is necessary to reduce lens thickness and weight. Use good judgement to find the optimal balance between cosmetics and function.

Less frequently, we have to fit very close to on-center as required by the Rx parameters, the balance here should be tilted strongly towards function.

Robert Martellaro

DanLiv has great advice. Looking for a centered fit is a good way to go.

Along with that, I tend to bring up comfort, especially with any frames lacking adjustable nose pads. People will go back and forth between frames just going by style so I'll ask if one it more comfortable than the other and it surprises me how many people will respond with a definitive answer. Comfort should always be a part of the equation.

When I get a patient that wants to play the numbers game, I purposely pull 2 frames in the number they have been told in the past they need, say a 51, with very different bridge sizes and temple extension. Then I explain to them they should only use that number for a suggestion. Maybe a 49 will be a better choice in another frame or a 53. As long as their eye is as centered as possible.....obviously this is much more important with the higher scripts and higher astigmatism. They are usually very happy that I opened up more options for them. Unless they are engineers.....UGH Engineers are the WORST..:)

I tell people that glasses are like jeans - different styles fit differently, even when they are labeled the same "size."