What would you do?

[Robert_S]

What would you do in this situation?

Px wearing progressive glasses +4.75/0.00 with 1.75 ADD Right and Left for more than 6 years. Had a few eye tests since then, all suggesting he needs more plus. However, on each occasion he doesn't tolerate the RX change and gets a refund (one time coming to us and the others with different stores).

So this time we go with his old Rx, match everything from the design to the material to the base curve. Basically copying his old lenses identically, because his old lenses are significantly scratched and he needs something that works. Px collects and agrees they are more or less the same and seems happy (although I know his acuity isn't what it could be).

6 months later I get an email from him saying he isn't happy with his new glasses as they aren't as clear at distance or near as his previous pair.

[optical24/7]

“ Kind Sir, we are going to decline the opportunity to disappoint you again.”

[AngeHamm]

“ Kind Sir, we are going to decline the opportunity to disappoint you again.”

+1. History aside, six months later is a no.

[mervinek]

agreed. I always tell my patients not to let anything go more than a week or two. Even if it's a simple adjustment they shouldn't wait that long to get it taken care of. 6 months later? nope.

[jc17777]

Sounds like a case of buyers remorse to me.

[uncut]

What would you do in this situation?

Px wearing progressive glasses +4.75/0.00 with 1.75 ADD Right and Left for more than 6 years. Had a few eye tests since then, all suggesting he needs more plus. However, on each occasion he doesn't tolerate the RX change and gets a refund (one time coming to us and the others with different stores).

So this time we go with his old Rx, match everything from the design to the material to the base curve. Basically copying his old lenses identically, because his old lenses are significantly scratched and he needs something that works. Px collects and agrees they are more or less the same and seems happy (although I know his acuity isn't what it could be).

6 months later I get an email from him saying he isn't happy with his new glasses as they aren't as clear at distance or near as his previous pair.

I would suggest, in a email reply, that:
since they were virtually reproduced that he must have gotten the new pair horribly out of alignment, and that he should have them adjusted.

[drk]

What would you do in this situation?

Px wearing progressive glasses +4.75/0.00 with 1.75 ADD Right and Left for more than 6 years. Had a few eye tests since then, all suggesting he needs more plus. However, on each occasion he doesn't tolerate the RX change and gets a refund (one time coming to us and the others with different stores).

So this time we go with his old Rx, match everything from the design to the material to the base curve. Basically copying his old lenses identically, because his old lenses are significantly scratched and he needs something that works. Px collects and agrees they are more or less the same and seems happy (although I know his acuity isn't what it could be).

6 months later I get an email from him saying he isn't happy with his new glasses as they aren't as clear at distance or near as his previous pair.

See, why oh why would you take on prescribing for this chappy? Because that's essentially what you did...you "prescribed" his "old prescription" and he doesn't like the visual outcome.

How about, next time, you simply limit yourself to filling Rxs? One year old or less. Then, if junior doesn't like the plus power, it's the doc's burden. You can just say "well, we allow one remake, so go back to ol' doc and see what he says". Maybe call ol' doc yourself, afterwards and kibbutz to help this pain-in-the-butt.

Now you have to decide why his vision isn't good. Is he growing a subretinal neovascular membrane in his dominant eye? Cataracts? What? Because now you are dealing with a medical complaint, technically.

Filter that crap through a medical doctor, not some "I keep remaking his old glasses as closely as possible". That's crap care. Don't do it.

Tell the guy "At this point, you should see your eye doctor, and we'll go from there."

[Don Gilman]

See, why oh why would you take on prescribing for this chappy? Because that's essentially what you did...you "prescribed" his "old prescription" and he doesn't like the visual outcome.

How about, next time, you simply limit yourself to filling Rxs? One year old or less. Then, if junior doesn't like the plus power, it's the doc's burden. You can just say "well, we allow one remake, so go back to ol' doc and see what he says". Maybe call ol' doc yourself, afterwards and kibbutz to help this pain-in-the-butt.

Now you have to decide why his vision isn't good. Is he growing a subretinal neovascular membrane in his dominant eye? Cataracts? What? Because now you are dealing with a medical complaint, technically.

Filter that crap through a medical doctor, not some "I keep remaking his old glasses as closely as possible". That's crap care. Don't do it.

Tell the guy "At this point, you should see your eye doctor, and we'll go from there."

Would seem prudent.

[Robert_S]

See, why oh why would you take on prescribing for this chappy? Because that's essentially what you did...you "prescribed" his "old prescription" and he doesn't like the visual outcome.

How about, next time, you simply limit yourself to filling Rxs? One year old or less. Then, if junior doesn't like the plus power, it's the doc's burden. You can just say "well, we allow one remake, so go back to ol' doc and see what he says". Maybe call ol' doc yourself, afterwards and kibbutz to help this pain-in-the-butt.

Now you have to decide why his vision isn't good. Is he growing a subretinal neovascular membrane in his dominant eye? Cataracts? What? Because now you are dealing with a medical complaint, technically.

Filter that crap through a medical doctor, not some "I keep remaking his old glasses as closely as possible". That's crap care. Don't do it.

Tell the guy "At this point, you should see your eye doctor, and we'll go from there."

Because in the UK if you make glasses for someone, you are liable for any changes and the Px clearly has a psychological problem with changing his glasses. You cannot send them back to wherever they had their eye test. You have to resolve the problem yourself or refund.

You're telling me you've never come across a patient like this where no matter what you do they don't accept an Rx change??

I really respect you Drk, one of the best posters on here so I take it seriously that you criticised my approach. I was trying to find a solution for the patient that worked for him.

[uncut]

Failing to find a responsible adult in the household that can communicate to and with this individual, a refund might be the solution.

[Robert_S]

6 months down the line?

[drk]

Because in the UK if you make glasses for someone, you are liable for any changes and the Px clearly has a psychological problem with changing his glasses. You cannot send them back to wherever they had their eye test. You have to resolve the problem yourself or refund.

You're telling me you've never come across a patient like this where no matter what you do they don't accept an Rx change??

I really respect you Drk, one of the best posters on here so I take it seriously that you criticised my approach. I was trying to find a solution for the patient that worked for him.

You are so very kind, please don't take offense. I don't mean anything personally.

If there is a difference in our mother country, I apologize.

I think in terms of what's over here.

[drk]

If this guy were in my chair, I'd browbeat him a little, then I'd give him 1/2D more plus. And tell him he's going to get a change per year until I think he's done.

I'd couch it in some nice talk about how he's not personally responsible, his eyes and visual system are this or that, yada yada.

He's a tip from an old guy: On old folks, especially plus:
1. 1/4 diopter in glasses isn't significant.
2. 1/2 diopter in glasses is quite significant.
3. 3/4 diopter in glasses is radioactive.

So, if you really don't want to do anything, 1/4D.
If you want to make the minimal (and probably maximal) impact, go with 1/2D.
If you're feeling dangerous, come to your senses...and don't add 3/4D!

[drk]

The point being:

The "JND" (just noticeable difference) in an oldster (lens opacifications, small pupils) is 1/2D.

The "max tolerable change" (prismatic increase, change in orthoscopy, etc.) in an oldster is..........

.......1/2D.

Some things are just perfect together!

Like Depends and Ensure.