2-Week "Adaptation" period?

[Robert Martellaro]

I receive daily some of the worst refractions you have ever seen. Maybe its a LI thing.

But I suspect it isn't.

It happens too often, that's for sure. There are two ODs that I count on for clients who need an excellent refraction. They solve problems that are unsolvable by other doctors, and do so without creating new problems. They make me look like a miracle worker, but it's truly a team effort with everyone at their best- lab, optician, and the doctor.

It's rushed medical vision care. And Techs that are less than fully skilled.

Some are missing really easy stuff. No reason for that.

So I approach every Rx with suspicion. And I feel most should too.

Trust, but verify. I've refused to fill some RXs (sending the client back to the doctor for a recheck before the Rx is filled!), and if that Rx fails, on to a second opinion. Indeed, a very unpleasant situation for all, although my neck seems to have the most exposure.

[drk]

You gotta know who you're working with, for sure.

[eyeguy21]

In short, Number 2, except it's not that the patients brain learns to correct poor image information. To oversimplify it the brain just learns to ignore poor image information. The difference with PAL's is that the brain may need to learn to ignore information from a different area of the lens than what they were currently used to and this is where the adaption period comes in.[/QUOTE]

Love this response. Oversimplify away.

[eyeguy21]

Trust, but verify.

I knew a great man that used to say this very thing Robert.

[uncut]

Diopterman

Let's talk.

I receive daily some of the worst refractions you have ever seen. Maybe its a LI thing.

But I suspect it isn't.

It's rushed medical vision care. And Techs that are less than fully skilled.

So I approach every Rx with suspicion. And I feel most should too.

Feel free to disagree. I can actually see the point of feeling that an ECPs self worth is tied up in his gatekeeping.

My gatekeeping is simply applied differently. The Rx primarily. The eyewear secondarily.

I hope we can meet in person one day soon.

Barry

Amen, Brother Barry! I am having to practice defensive dispensing more than ever, for the reasons stated above. I often joke with the clients that we have to be the Norton or Macafee or Kapersky antivirus for them!

Safe dispensing!
uncut

[One science]

I've heard some Opticians specify a minimum of 2 weeks use for a patient to try a new PAL lens.

I'm wondering what others think about this, and if it has any basis in scientific fact.

It seems to me there are 3 possible outcomes:

1) the patients body (eye/lens/muscle/etc) actually change shape so that the optical image is painted differently on the back of the eye. Seems unlikely.

2) the patients brain learns to correct poor image information (outside the sharp corridors of the PAL). Sounds not only unlikely but impossible.

3) the patient just learns to deal with a bad lens. I think this is what the real hope is for the Optician; that the patient just gives up and finds ways to deal with the poor image, by things such as bending their head around, carrying a 2nd pair of glasses, getting help from friends, etc.

So I'm wondering what other opinions are.

More importantly, what is the scientific basis for the "2-week" period, meaning point us to actual studies that show the results have a basis in physiology.

Thanks for other opinions and facts.

I knew that is needed a one month period and i think this has nothing to do with psychology. Not in here. This is a concrete science, not a "maybe" one.

Regarding the 3 possibilities i agree with the 3rd one, is more likely.

[One science]

I don't think I was clear enough about option 3 (the patient just gives up and finds ways to deal with the poor image).

I am not talking about "adaptation" in the sense of a patient becomes "comfortable" with their new lenses.
I mean it in a totally different sense, and I'll say it again: poor image.
That does not mean at all "comfort". It means how well the lens resolves image details in different zones.

I also do photography, and there is no such thing as the camera "adapting", or learning to be "comfortable".
There is actual science and physics involved in the optical image, and I won't buy a lens without studying the MTF chart for it, because I want to know how it optically performs.

Now I've talked with many patients who do "adapt" to their new lenses, and find they work just fine for their typical activities.

However, I am talking about something completely different.
I will even give an example "hoping" this makes it more clear (yes this is for TLG):
I have seen opticians and vendors claim that the distorted image outside the intermediate corridor will improve and the corridor will appear wider to a patient after a week or two of "adapting". Yet I've never seen a patient who could actually resolve more detail after adapting.

So once again, where is the science and the physics?

I would expect an actual *measurable* change, such as being able to resolve more LPI in a resolution test chart, yet I have never seen this done.

So far, it looks like I'm the only one who's looking for this type of facts and data, but I'm hoping I'm wrong.

End of rant...

Ok, now you pointed some things, some good things.

[One science]

They also tend to have extremely poor listening skills and very little ability to acknowledge the fact that someone else may have superior expertise on any subject about which they imagine themselves knowledgeable.

Unfortunately there are some people like this. Couple of friends had to deal with unprofessional people that put ego before the professionalism. It's sad that this happens.

[One science]

Perhaps the "two week" adaptation period is linked to the experiment conducted by Stratton in the late 1800's where glasses were worn that caused the wearer to see the world "upside down". After a few days, the brain inverted the image so that everything appeared "rightside up". It took a few days for the image to invert again when the wearer discontinued using the glasses.

Just sayin'

This sounds a bit dangerous for the eyes, it may affect them, but what don't we do in the name of science?