Points Of Contact For a Zyl Frame On a Patients Nose?

[Lelarep]

During my education I was taught that a Zyl frame with no defined nose pads should touch a patients nose in 3 places, the two lateral surfaces of the nose, and the bridge of the frame should contact the superior surface of the nose, but not bear much to any of its weight there, just touching. I was taught that if the bridge of the frame does not contact the superior surface of the nose, it means that bridge is too small, and the patient should chose a different frame since it will prevent proper fitting. However, most people these days I see wearing Zyl frame have contact on the lateral surfaces and no contact with the bridge on the superior surface of the nose. The other day I saw an optician with a lot of experience fit a teenager with a frame where the bridge was so narrow, compared to the patients nose, that the bottom of frame just barely touched the lateral surfaces of the nose, and the bridge sat a good ~1/2" above the superior surface of the nose.

Was I taught old/incorrect information, or is it that these days there is less concern regarding the 3 point of contact than there used to be with regard to proper fitting?

[Tallboy]

I was taught like you, but some frames do fit in kind of a modified "keyhole bridge" type of fit, I like those go... if the RX is light and the lateral surfaces look like they are resting on the correct part of the nose. I haven't been burned too much doing this. I strive for the fit you are speaking of though.

[jpways]

The way I was taught only varies slightly, but not insignificantly, from your method. You should have full contact on both lateral sides with no visible gaps. On the superior surface of the nose, it shouldn't rest completely on the nose, as this is a sign that the bridge is slightly too big, nor should it have a large gap. The gap should be large enough that you can see light passing through, but not so large that you can see the skin between the patient's eyes, as that bridge is too small, unless it's a keyhole bridge.

Whenever I see a gap as large as you describe I wonder which website they bought the glasses from.

[Lelarep]

...Whenever I see a gap as large as you describe I wonder which website they bought the glasses from.

Ha, I think the same thing.

[Hayde]

Really good thread. I'm with Tallboy, keyholes get a little more latitude. Otherwise, I officially 'advise' the gapless fit (superior and lateral). If a patient leaves with a gap, they did it remembering they did so "against counsel" and so no restyle privileges.

[PartTimer]

Really good thread. I'm with Tallboy, keyholes get a little more latitude. Otherwise, I officially 'advise' the gapless fit (superior and lateral). If a patient leaves with a gap, they did it remembering they did so "against counsel" and so no restyle privileges.

Exactly. Always told "gapless." The worst is being a poor employee in a corporate setting and having to restyle them, anyway. Probably my favorite so far was a petite woman insisting on a 56 eye. Made no contact with either side of the nose. Temple had to bent almost to cable temple styling. She asked my opinion, I told her she looked like she was wearing her dad's glasses, and she bought them anyway. Two months later...refund request.

In other news, I recently had a patient bring me some wood frames that fit terribly. Fentoshop. Anybody familiar with these/sorry for attempted hijack. The poor nasal fit reminded me.

[Browman]

The way I was taught only varies slightly, but not insignificantly, from your method. You should have full contact on both lateral sides with no visible gaps. On the superior surface of the nose, it shouldn't rest completely on the nose, as this is a sign that the bridge is slightly too big, nor should it have a large gap. The gap should be large enough that you can see light passing through, but not so large that you can see the skin between the patient's eyes, as that bridge is too small, unless it's a keyhole bridge.

Whenever I see a gap as large as you describe I wonder which website they bought the glasses from.

Or chain. I cut my teeth under an OD at a chain outlet and while I received probably slightly better training than most get (thanks to an experienced coworker) I had to learn about zyl fitting on my own. I've seen plenty of chain outlets whose opticians went with the "if it looks nice it fits" ethos of framestyling.