Clincal Case 01

[npdr]

The Rx is OD +6.50+0.50 axis 90 and OS +7.50 SPH. The intention was to have the patient see at optical centers. What corrective actions would you do?

[chip anderson]

A: Adjust nose pads
B: Probably shorten and bring temples in to hold on side of head behind ear.
C: Convert to cable temples if all else fails.

Of course being me, I would have put the kid in contacts and adjusted the glasses just for P.M. use.

Chip

[Judy Canty]

I'd switch nosepads to a strap bridge pad set and re-adjust to fit. Replace, or convert temples to cables and adjust as well.

[Clive Noble]

The Rx is OD +6.50+0.50 axis 90 and OS +7.50 SPH. The intention was to have the patient see at optical centers. What corrective actions would you do?

With this Rx I would guess that tha Pt has worn glasses before.

I would ask to see how his old specs sit, they are probably slipping down his nose and he is looking through a point about 10mm above datum.

Ascertain if this is his normal, see how the new frame slips, maybe he really like them like this and is comfortable.... then make the new ones with centres high up.

At the same time, as has been suggested, make the temples as comfortable and snug as possible.

That's my two penn'oth

[npdr]

Thanks. By the way, I'm a non-dispensing optometrist. Your suggestions are helpful for me to inform the involved dispensing optician

[Shwing]

Mandate the dispenser successfully complete an accredited program for ophthalmic dispensing.

Or fire them...

[Diane]

Select a frame that fits. One that has the bridge centered as well as center positioned temples rather than at the top would help this patient. That alone would allow for more on center vertical positioning.

Make sure the nosepads are not so thick as well. You may find that in selecting a center positioned bridge and temples, that you could also decrease the bridge size. This is a poor fit for this child. It doesn't appear that it was dispensed, since I don't see any lenses, but...if it was, and the lenses were removed for photo purposes, shame on the dispenser.

Contact Lenses...

Just my thoughts.

Diane

[CME4SPECS]

It's a real simple fix. The pad adjustment is not done by squeezing them closer together.Curl them downward and it'll raise the frame nicely.
Can you people that said to convert the temples to CC really see that the frame has skull temples? Skull temples will hold well if properly adjusted!

[chip anderson]

CM:
You must make allowances that every young male child (and many females) will have those nosepads completely flat against the lenses by the time he gets to the car from your office. In this event a slightly tensioned cable temple might make some compenstation for this, especially with a high/medium plus Rx.
I have often wondered why the nose pad struts on children's glasses aren't so strong that only we can bend them (some are close and some are so wimpy that they seem to flatten under thier own weight).

Chip:cheers:

[Happylady]

I swear I only see half a nosepad on the one side.

[FVCCHRIS]

I swear I only see half a nosepad on the one side.

Definitely looks like 2 different pads to me too, not that that's the problem. I would consider ditching those round pads in favor of a standard D-pad though..Chris..

[Jubilee]

I love the oval symmetrical pads personally. Or strap bridge. If we needed to pull the pad arms lower to keep the pad placement on nose the same, but raising the frame, then I would use an oval symmetrical pad, if a strap bridge can be used without having the "strap" across the brdige show, then I would use the strap bridge.

The nose pads currently aren't adjusted well, one side is digging in, and the other is just resting on top. They are shifted if you will to the one side.

Seems to be a lot of panto with the bottom nearly if not actually touching the cheeks.

I agree that it looks the the frame was bent out and down.