Two in the Bush...ing

So here's the sitch.
I have a patient that typically wears grooved rimless frames, and likes a more minimal look. With this in mind I lead them towards a drill mount (silhouette). They like them, its a good look. They decide to order them. The chassis goes to the lab and come back, and the patient picks them up, frames are adjusted, everything is great. 4-5 days later the patient comes back in and they can't stand to wear them because of the bushings.

Has anyone had patients mention that they are unable to wear their glasses due to seeing the mounting for drill mounted frames? I'm curious if I need to start mentioning this when going into a rimless frame for the first time. Only reason I ask is cause they made it seem like it was my fault since I didn't mention they might notice them.

Thanks in advance for any advice!

It's a real deal, but no different than people who go from a rimless to a plastic frame and see the eyewire.

Or they see the flashy colors on the inside of the zyl frame.

Or they see around the edge of the smaller glasses.

Bottom line: the nervous system is set up to detect changes. There's a change. Their vision notices it. It always goes away.

I put my rimless mounts on, occasionally, and I notice it. Big whoop.


Your demeanor is everything. You have to act like you've seen this a million times before, and to not worry. Tell them it takes a month, wear them, and if there are still problems yada, yada, reassurance, yada.

We had 3 locations that blew through over 400 Silhouettes’ a year. Maybe, maybe 1 in 90 would mention it (at the most) usually initially after pickup to 1-2 days later. I’d tell them, and taught staff, to tell them it’s common to notice a new “picture frame” to see the world through. Metal, plastic any different shape or material they’re habituated to can be noticed. I’d assure them that their brain will get used to it, give it 2 weeks, if they still notice it and want to go with another style of frame, we’d be happy to remake it into any frame they wish (same price range) at no charge….I’d also let them know, that out of the thousands of Silhouettes we’ve sold over the years, we only had 4 patients that opted for a different frame. ( And that is true! for that particular reason)

But I always pointed out the quality and comfort of the frames, I wore them myself.

Never tell a potential client to “look” for some kind of potential “ you might see that!”. You’ll never sell a rimless compression mount the rest of your life…

Wow! Doc posted before me, didn’t see. Great minds think alike….or, is it deviant ones that think alike?..

I used to tell these people to wear a watch or a ring on the wrong wrist/finger for an hour or two. Of course it drove them crazy for a short while, but they usually tuned it out pretty quickly - but in any case, they forgot about the mounting.

But....Chemistrie....Ya.
Never had a single patient complain about seeing the bushings. Ever. We have had more complaints re myopic rings due to the edge polish.

These patients are rare with drillmounts. I literally just had a guy two days ago who absolutely hated the Silhouette he ordered because of the bushing. BUT. He also had an extremely narrow pd. The brain will eventually disregard the anomaly in their vision. Kinda like how our brain blocks out our nose. The problem is getting the patient to be....well....patient lol. But again, rare response. Like 1 in a 100

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Originally Posted by optical24/7

Wow! Doc posted before me, didn’t see. Great minds think alike….or, is it deviant ones that think alike?..

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I liked your post better. You have that "influencer" thing down pat.

I have had that 1 time in a 20 year career, performed the usual counseling session, brought them a cup of coffee and a snack, by the time they gave me their life story, they no longer noticed the bushings, in fact, they just bought their next pair, making it number 8, in about 10 years.

I'll tell them that:
"Your eyes in the peripheral are very defensive and anything new is causing the unconscious to notice it and make you want to look at it in case it is something more than say the bushing (or a new smaller, or plastic frame) and needs to be avoided."

"Eventually the conscious and unconscious recognize it's there all the time and suppresses it."

"You can't will it to happen- it just does."

While saying this I'll hold my right hand up and away from my right eye so it's a little in my peripheral when I say "unconscious" and my left hand up in the left eye peripheral when I say "conscious" and bring them together and down when I say "suppress it" as a visual calming, reinforcement.

And again- like drk says- a calm and cool and no big deal attitude is essential.

If they come back again I use this analogy:

"Let's say if I were to put some electrodes in your brain and hooked them up to a monitor and then told you don't think of a tree what image do you think will appear on the monitor?"

Done right it lets them realize they're obsessing and that's the problem.

When they complain of peripheral distraction through usually larger frames and/or new rx's I'll use a car analogy.

"Did you ever notice how when you first try to park a new car it takes awhile to get a feel for spacial relations yadda yadda" that is not really exact but seems to reassure them most of the time so they will take the sage advice to just wear them for a couple of weeks until it resolves on its own.

Only once. I might also add that Silhouette sometimes has different sized bridges. Something to keep in mind in case they can't adjust to their new "invaded periphery".

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Originally Posted by Optical Roy

I have had that 1 time in a 20 year career, performed the usual counseling session, brought them a cup of coffee and a snack, by the time they gave me their life story, they no longer noticed the bushings, in fact, they just bought their next pair, making it number 8, in about 10 years.

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Did the snack involve mushrooms?

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Originally Posted by Uncle Fester

Did the snack involve mushrooms?

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With a touch of Prozac!

Quote:

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Originally Posted by Uncle Fester

………..

If they come back again I use this analogy:

"Let's say if I were to put some electrodes in your brain and hooked them up to a monitor and then told you don't think of a tree want image do you think will appear on the monitor?"
….

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If the patient has the right personality, I use an old joke analogy;

”Have you ever heard the joke about the patient that goes to the doc and says, “Doc, my arm hurts when I do this”. And the doc replies, “Well then, don’t do that”…

I agree with everyone that has said just reassure them that it’s not that unnatural to notice it at 1st, but, it will go away with a little wear time. Remind them of the reasons they went rimless, and that you’ll stand behind the product if they are the 1 in 1000 that just can’t get over the bushings.

There is a lot of great feed back and analogies in here. I had a feeling the general consensus would be that it would be a few and far between kind of thing, I think the patient just got me a bit frazzled and flustered. Thanks for the advise and feedback everyone!

It's normal, and I would remind them that there is less in their periphery than if there was a big chunky plastic frame. Occasionally you'll get someone who notices the progressive markings in the lens and says they are bothered by them. Most people never even notice them.