Reordering one PAL lens vs the pair

[AuspiciousOptician]

I need help explaining to a patient and my coworkers why it is not the greatest idea to reorder one PAL lens vs the pair. We have a patient who had some change to her OD but not to her OS since her last annual exam. She was adamant about not purchasing a pair of lenses, since she only needed the one lens. I was always taught that we do the pair to reduce potential horizontal prism issues. I found a way around not having to charge the patient or our lab charging us for the OS lens. Any tips on explaining the technical aspect of this would be great! Thanks in advance for your help!

Heidi

[Java99]

You're right, you need to know the amount of prism thinning used on the original pair to be able to match it with the replacement lens, or you have prism issues.

Why would you want the lab not to charge you on a new order?

[CME4SPECS]

You don't need to explain anything technical to her...be an optician and measure the prism, so that you can order the lens correctly.

[Uncle Fester]

But there is no technical reason you can't.

Oh- And welcome to Optiboard! Please take your newbie initiation as a rite of passage.

(PS- You were taught wrong)

[Randle Tibbs, ABOM]

The lab has every right to charge for the "other" lens, they have the cost of material and labor. If you are procuring lens vouchers to "cover" the cost, it doesn't cover the labs cost for labor, only material. I do at the same time understand your predicament, especially if you're working with dispensers with little or no knowledge, take the information you learn and glean from this forum to help them. if ordering just one lens, be sure to order from the same lab that made the original pair and even reference back to the original invoice. You can successfully measure prism at the PRP of the lens.

[AuspiciousOptician]

You're right, you need to know the amount of prism thinning used on the original pair to be able to match it with the replacement lens, or you have prism issues.

Why would you want the lab not to charge you on a new order?

Java99,

The patient was insistent on only ordering and paying for one lens. I had the other lens replaced under scratch warranty instead. So no charge for us or the patient.

[AuspiciousOptician]

Thanks for the help! I did use the same lab and I did reference the original invoice #. Since my patient has had some issues in the past, I didn't want to take any chances with just ordering one lens. Also, she was adamant that she would not be ordering if we wouldn't do just one lens. She has 3 pairs she needs updating and I wanted to accommodate my patient the best way that I could.

[AuspiciousOptician]

The lab has every right to charge for the "other" lens, they have the cost of material and labor. If you are procuring lens vouchers to "cover" the cost, it doesn't cover the labs cost for labor, only material. I do at the same time understand your predicament, especially if you're working with dispensers with little or no knowledge, take the information you learn and glean from this forum to help them. if ordering just one lens, be sure to order from the same lab that made the original pair and even reference back to the original invoice. You can successfully measure prism at the PRP of the lens.

Randle, the nonglare we sell in my office has a two year scratch warranty. I didn't use any lens voucher to cover the cost, simply asked the lab if that was an option and they said it was. They charged me for the lens we changed the Rx on and with the return of the scratched left lens, there was no charge for that lens being replaced under scratch warranty.

[Randle Tibbs, ABOM]

Thanks for the help! I did use the same lab and I did reference the original invoice #. Since my patient has had some issues in the past, I didn't want to take any chances with just ordering one lens. Also, she was adamant that she would not be ordering if we wouldn't do just one lens. She has 3 pairs she needs updating and I wanted to accommodate my patient the best way that I could.

If the patient has multiple pairs, ask if she can do without one for a few days, this will allow the lab to match the new lens to the old. I would recommend changing only one pair to start with and make sure she has no difficulties. If she does well with the new Rx, then send the other two pair in to the lab. PS., I hope you didn't think I was chastising you for finding a way not to charge the patient, it's just that I have worked on the lab side and know that all dispensers do not understand the labor costs involved in operating labs.

[AuspiciousOptician]

But there is no technical reason you can't.

Oh- And welcome to Optiboard! Please take your newbie initiation as a rite of passage.

(PS- You were taught wrong)

Uncle Fester, I will admit that I come from 8 years of retail (box optical chain) experience and have been working in a private optometry office for just over a year now. There are miles of differences between what I knew and learned while working there in the early part of my career and what I have learned and have exposure to now. I have only been licensed for 3 years and nearly all that I know was taught from classes and books and a few other opticians (all that work within the corporate structured retail optical world) and most likely suffer from the same lack of technical knowledge. I visit Optiboard often looking for tips and help for my technical questions and will definitely continue to do so. I don't think I was taught wrong per se, but maybe not taught in full?

[AuspiciousOptician]

If the patient has multiple pairs, ask if she can do without one for a few days, this will allow the lab to match the new lens to the old. I would recommend changing only one pair to start with and make sure she has no difficulties. If she does well with the new Rx, then send the other two pair in to the lab. PS., I hope you didn't think I was chastising you for finding a way not to charge the patient, it's just that I have worked on the lab side and know that all dispensers do not understand the labor costs involved in operating labs.

Randle,

That's precisely what we did for her. We started with her every day pair and will move onto her computer pals and her sunglasses next. She was able to part with her glasses for the time it took to make the new lenses, and will most likely be able to do the same with her other two pairs. I suppose you're saying I should trust my lab to read the prism in the OS to match with the new lens they are making. Her suns are tinted, not polarized, so we may have to remake the pair to avoid discrepancy within the tints. What are you thoughts on that?

[Randle Tibbs, ABOM]

Yeah, the tint does pose another problem. They do fade over time and matching is almost impossible so you may need to remake both pair in that instance. Trusting the lab? That depends on your past experience with them, but they should be able to archive the original jobs and duplicate them. I applaud you for lifestyle dispensing.

[Robert Martellaro]

I need help explaining to a patient and my coworkers why it is not the greatest idea to reorder one PAL lens vs the pair. We have a patient who had some change to her OD but not to her OS since her last annual exam. She was adamant about not purchasing a pair of lenses, since she only needed the one lens. I was always taught that we do the pair to reduce potential horizontal prism issues. I found a way around not having to charge the patient or our lab charging us for the OS lens. Any tips on explaining the technical aspect of this would be great! Thanks in advance for your help!

Heidi

Heidi,

Assuming an outside client, the primary concern is with identifying the PAL design and version number, if any, and the reflex color if anti-reflective coated.

In general, tints could be problematic, and might require a pair to get a perfect match. Otherwise, as stated above, if you measure the optics and use a first-rate lab, single PAL replacements are doable and should be on the table.

[RT]

So what happens now if the patient scratches a pair, now that you have used up the scratch warranty on the left lens?

[Uncle Fester]

I was always taught that we do the pair to reduce potential horizontal prism issues.

Heidi

It's the vertical prism that would be the bigger issue and is related to prism thinning which is a concern on higher plus lenses.

BTW- What is the old and new rx?

[AuspiciousOptician]

So what happens now if the patient scratches a pair, now that you have used up the scratch warranty on the left lens?

RT,

Our nonglare has an unlimited scratch warranty for 2 years.

[Pogu]

A good rule of thumb (aka bad habit) is if there is a variable you can't specify or control, only do a pair. You can specify prism, you can ask about AR reflex color, you can not make new transitions lens the change the same as a 6 month old one, etc. When you can get the patient a new lens under warranty and make sure it matches, that's good service.

[Pogu]

And to actually answer your question....
I think the problem is that your reason for not doing it is vague and quite frankly wrong*. To convince them you have to have concrete reasons, though they don't need to fully understand them. You must either come up with a set of guidelines on when a single lens is ok, and when its not; or have them consult you every time the situation arises. If you have good reasons and can explain them both your co-workers and the patients will accept it. Just yesterday I shot down a single lens for a husband (old LifeRx FT28) and accepted the wife's order for a single E-line. Confidence and explainable logic is the key to educating your coworkers, though it will always be herding cats.


*Prism in multifocals is not something out of control and mysterious, you measure it at the prism reference point and specify that reading to the lab. If there is prescribed prism this can a little complex, but that is the fun part isn't it?

[AuspiciousOptician]

Thanks Pogu! I appreciate your explanation.

[sharpstick777]

There was a time with early Transitions and crappy PALs people were told to order in a pair only, to reduce prismatic issues. But that time is past.

matching A/R is the only concern that remains, it should be noted that AR done on Tuesday will be very slightly different than AR done on Wednesday. Just inform your patient.

[sharpstick777]

Some of the older lens materials and hardcoats would yellow a bit too over time, but also, that is not an issue anymore.

[sharpstick777]

Hey Heidi, I am in Seattle too! There is a great Facebook group for Northwest Optical people, please find us there if you are on FB.

https://www.facebook.com/groups/nwoptical/