We occasionally get a patient who has just purchased AR coated lenses, and they come back upset because they still see glare. What are some tips for troubleshooting this issue?
Thanks!
We occasionally get a patient who has just purchased AR coated lenses, and they come back upset because they still see glare. What are some tips for troubleshooting this issue?
Thanks!
Don't sell it as a glare reducer as much as a reflection reducer. Cataracts, dry eye, etc will still give glare.
Which AR are you dispensing? Does it happen with different brands or only one?
We use Crizal brands for the majority of our jobs.
Have you asked your patients if they mean glare as in reflected glare from surfaces, or glare on the lens.
Side note, I absolutely hate this industries propensity to make up names for things like "No-Glare coating" and confuse the public. We already had a perfectly good name that described exactly what it was, "Anti-reflective coating". Now people think they are getting "Scratch-proof, No-Glare, magic lenses". rant over.
The most recent instance: pt's old glasses were poly with Avance. He picks up his new glasses, which are same material and AR, minimal change in rx, minimal change in frame size/shape, and after wearing them for about a week he says he sees way more glare with the new pair vs the old. We've matched all the adjustments to his old pair, yet he still has a glare issue. Do we automatically switch gears to material change? Could someone become unable to wear poly? It sounds dumb after writing it...
You will not be able to fix his problem. It is between his ears, not on the lenses.
Schmoozing is the only solution.
I relate to patients like this a true story of a patient who just wanted new polarized lenses to replace their scratched ones. Nothing was different but they came back complaining of a reflection on the lower backside of the right lens. Asked if it was noticeable in the old pair she emphatically said no. I asked to see the old lenses (which I always return with an admonition to keep for a few days) and surreptitiously put the old lenses back.
Low and behold the reflection was "definitely" there.
When told of my ruse she chuckled and admitted maybe she was being overly sensitive.
You can't do this to everyone but I do sympathize with this dilemma which we all eventually face.
There is no easy answer how to correct it short of powerful medications (for both the patient and you!).
Hang in there 5 o'clock coming!!!
edit- Give Tallboy's suggestion a shot but I got a cyber sawbuck at 3-1 odds it'll still be there.
99.99% of the time, the problem is retail in nature. The patient was oversold/"built up" around the phrase "no-glare," which is a ridiculous expectation. The only solution here is prevention and clearly measured product education that favors the patient's accurate expectations and not the sales people's interests.
If it's actually a performance issue (the patient has had AR in the past & feels his current lenses are underperforming,) that's potentially a very complicated ball of wax if you're not seeing any coating defects.
Edit: Kwill beat me to a good rant.
I removes reflections on the lens itself. That is all. Only polarized lenses reduce environmental glare, and that is relative to the amount of tint (lighter tints = less polarization efficiency). The main benefit of AR lenses for me is increased light transmittance and brighter seeming colors.
Apologize this wasn't explained to them when they got them and offer to remake them and return the money. They won't do it if you explain this well. Tell them it is the difference between looking through a clean window and an open window.
I loathe Crizal commercials because of this, and make sure people understand this when getting them.
There are times with AR (it happens with crizal to me) that there is a problem with part of the AR stack. It allows certain wavelengths to be reflected. Usually you will see an extra reflection apart from the normal Greenish hue. Compare his lenses to another Avance lens. Have it remade if this is the problem, it is a known issue that can occur and your lab will fix it.
I've become good at spotting it after dealing with it a few times, it actually looks kind of pretty but is not good for vision. It is possible if it is poly that they were edged too large and the lens has stress on it causing distortion for the wearer that they are interpreting as "glare". People often don't know how to explain what they feel/see. Good Luck
Yes, usually a pale blue or purplish. I wish I had one around to take a picture of. The green reflex is there and then right next to it is a reflex that is ice/pale blue or purplish. I don't mean the color variation that can occur where the green reflex is yellowish or reddish - that is something different usually newton index rings or a dirty AR chamber - in these instances there are still only the normal reflex on the lens (just a different color).
In the problem ones I was talking about its like an extra reflection on the lens. Also it is totally unnoticeable until the purple protective coating is taken off - so labs can't catch it in uncuts. If you hold a good Crizal lens next to them its very very noticeable what the difference is. Its probably happened 4 times to me in about 5 years or so. 2 of those times were on ST28 poly, once on trivex and once on a poly PAL. All 4 times was Crizal Avance
I'd +1 you, Tallboy, but the webware says I like you too much already.
Great post--if you happened to be able to rustle up some comparative photographs, I'd love to see them.
I use Sapphire almost exclusively. For the modest price difference, you're getting twice as much AR performance as Alize & Avance. Plus I know in a heartbeat if the lab accidentally switcheroo'd me with a different product.
Uncle Fester mentions a great tact--side by side demos are the best way to get a patient's brain out of the way of their eyes. (I can't count the number of times I've had to do that to show patients who say "My transitions don't get dark!" Waltz 'em outside with their specs and mine and they point at mine saying 'see, yours are turning dark!' Then we both take them off and hold them side-by-side. Be sure to be facing the same direction outside ...)
When it comes to AR, I'm ready to do that side-by-side test of AR lenses before the sale. Where patient perception is more subjective, it sure beats having to do it after...
As others have said, anti-glare is a misnomer. When someone mentions "anti glare" to me, I let patients know the primary purpose of anti reflective is helping prevent an issue caused by the presence of the lens itself (reflections), not preventing or correcting an environmental issue a la polarization.
When I have complaints of reflections, I look for changes from the old pair such as frame type/bevel change, edge polish, and base curvature.
Here is a picture of a lens with AR on the front and no AR on the back, a different type of "defect". You see the greenish reflex and next to it the clear white reflection? Imagine that clear white one is pale blue but on the other side of the green reflection. Usually on correct Avance there are two reflex visible, one from the rear and one from the front. On the problem I'm describing there are actually 3, two green and one blue, or 4 - two green and two blue/purple.
Am I the only one who has to deal with this? Its happened from my favorite wholesale lab as well as a Crizal coating center where a job was outsourced for coating. The wearer's experience was exactly as you describe, they come back and say they see reflections more in this pair.
Not saying that is the case here though, Uncle Fester's point is well taken. In that case ascribe an appropriate PITA fee and do what you have to do.
That's crazy, I've never seen that before! Thanks for sharing! I did not see anything like that on our problem pt's lenses, just the green reflection. Turns out he had a new refraction done by the doc today, so we have to remake the lenses anyway.
Another common error made by many opticians and promoted by ar marketer's is "AR will reduce reflections/glare coming from the computer".
When the correct phrasing should be "will not enhance" it.
https://www.ncbi.nlm.nih.gov/pubmed/10457687
https://www.ncbi.nlm.nih.gov/pubmed/9190135
There are five ghost images that can be minimized (see image below):
- Light entering the lens from the front that reflects off the back surface, and then off the front and enters the eye.
- Light from the front that reflects off the cornea, and then off the back surface and enters the eye.
- Light from the front that reflects off the cornea, and then off the front surface enters the eye.
- Light from the back that reflects off the back surface and enters the eye.
- Light from the back that reflects off the front surface and enters the eye.
Increased light transmission from eight to fifteen percent depending on the lens material.
Hope this helps,
Robert Martellaro
Science is a way of trying not to fool yourself. - Richard P. Feynman
Experience is the hardest teacher. She gives the test before the lesson.
Step one: immediately stop using the word "glare" to describe reflections on lens surfaces. People expect AR coatings to leap off of their lenses and clean their car windshields, clear the rain out of the air at night, dry the road, etc.
We need to spend more time managing our patients' expectations through education.
I'm Andrew Hamm and I approve this message.
http://www.optiboard.com/forums/show...ll=1#post93023How do specular reflections and ghost images reduce visual performance? These ghost images can serve as sources of glare within the visual field. Moreover, when the reflected glare source is large or defocused, it can produce a veiling glare over a large portion of the visual field. Since this reflected glare is added to the brightness of both the object of interest and its background, the difference in brightness between them remains constant. However, since the background brightness, which is the denominator of the contrast expression above, still increases, the contrast of the retinal image decreases.
Science is a way of trying not to fool yourself. - Richard P. Feynman
Experience is the hardest teacher. She gives the test before the lesson.
Back to TB's picture. Easiest to determine which surface is at fault - steeper curves will show smaller reflections.
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