How to communicate to customer - "They Must Adjust to their new glasses"

[Judy Parker]

Would you all give me your input on how you go about communicating to your customer at the dispensing table the need to wear the glasses. The adjustment period to get use to the new Rx or new type of lenses. Could someone reference as to why it seems when customers first put on the glasses, they don't see quite as well, but given some time in wearing the new RX or different style lens, they adapt, while others do not.

For example- progressive lens , I have heard said, must be worn without taking on and off, for at least a couple of weeks.

I am not totally convinced!

I would like to give the customer more than, it will take you a couple of hours to start noticing clearer vision. Again, not convinced!

J Parker

[John R]

How about dont wear them for now wait till you get up in the morning and then put them on. As their eyes will be fresh and not adjusted to their old specs. I bet they will see great then.
They are like anything new, takes a bit of getting used too after using an older version, but start afreash and things are ok.

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Every day a grind
Every week a bind
www.iooi.co.uk

[Pete Hanlin]

I've always thought the importance of "trying" glasses for a while was largely psychological, not physiological. After all, there's nothing about the design of the lens that is going to change over time- and I don't believe the physical structure of the eye is going to change either.

Perception, however, does change. The brain will perceive based on what it expects to see. If the brain is used to perceiving images that have been distorted in a particular manner, it will percieve images viewed normally (or in any other dissimilarly distorted manner) to be "distorted." The fact is, we don't really "see" a very clear image with our eyes regardless of what type of correction we have. After all, the real image presented to the brain is inverted and fragmented. The brain "fills in" the rest.

Additionally, when we first try on new glasses (or new shoes, or new anything), we are consciously "looking" (pun intended) for any inconsistancy. I usually explain to my patients that using a new pair of glasses is like driving a new car. The brakes may seem "touchy" or the steering "stiff." Its not necessarily that the car is faulty (though it may, upon inspection, prove to be)- just that it has different characteristics. Through use, we tend to begin to ignore- or get used to- the new characteristics and redefine them as "normal."

Also important, however, is recognizing instances where the patient is not going to "get used" to the new glasses. For instance, vertical imbalance is not likely to resolve itself. In some cases, different image sizes may also prove prohibitive. Also, sometimes people "get used" to something they really shouldn't get used to... like when lenses are switched and the patient "gets used to" the prism.

Come to think of it, you're right... it is a pretty hard pill to swallow! I always think of printing a t-shirt that shows an escalator descending into hell. At the bottom is an optician at his desk saying to the grief stricken new arrivals, "Don't worry, you'll get used to it."

Pete



[This message has been edited by Pete Hanlin (edited 12-05-2000).]

[lguess]

I think Pete hit the nail right on the head. Some time spent explaining to the customer what changes they can expect will be time well spent (object may look a little larger, or smaller, or picket fences will quit looking like they're "running", etc.). This is, of course, assuming that the refractionist did the job right and that the eyeglasses or cl's are made'fit correctly.

[eyedude]

I would recommend you use the phrase "you have to LEARN how to use your new progressive lens". It sounds more professional than saying you have to get use to them. Learning how to use them makes the patient realize it takes a little time.
Dispense with confidence. Guarantee the product. Take the time and illustrate how this new product works. I've found I have very little "non-adapts" using some of these suggestions.

[Blake]

Although PAL's have been around for many years, the technology is constantly changing, and consumers are for the most part willing to "learn" to use new technology when the benefits are made known to them.
"Getting used to" something implies that there is indeed something wrong with it, but they are stuck with it anyhow.
Since we offer one hour service, we often dispense to patients who are still dilated, so it's important to let them know that their vision won't be at its best right then.

Blake

[karen]

Pete, as usual, hit it right on. When I dispensed I would explain to them that the information they were getting was different because the new corrective lens was sending different info to their brain and while things certainly might look different they were not necessarily wrong. I found that if I challenged the patient by saying "this lens works differently than what you are used to but I find that very intelligent people have no problem adjusting to it" they tended to take that as a personal challenge to not have any problems.

[Darris Chambless]

Hello all,

You've all got it wrong. You should hand them the glasses and if they experience a problem or have any questions tell them to shut the hell up and call you in a couple of weeks when your ready to listen to their incessant whining. You have to be firm sometimes :-)

Actually what we do is to explain the whole process before the glasses are even made. During the selection process we talk to the patient about different lenses and what they will experience with each one. Then we will explain why the vision will be a little different for a short period of time. When we dispense the glasses we go over it once again before we hand them the glasses. We do this mainly to get some acknowledgement from them then we can proceed and have no problems.

If that doesn't work a 44 magnum pressed firmly against the temple usually gets them to understand you much better :-)

Darris "CLICK! How do you like them now Mrs. Jones? :-)" Chambless

[Judy Parker]

Darris,

From your reply, I think what I am looking for is just those very details, you suggested in your reply. What is the differentials? A little dispensing review!

Judy

[Judy Parker]

Iguess,

Would you give me the specifics on your reply!

Here is your quote: "(object may look a little larger, or smaller, or picket fences will quit looking like they're "running", etc.)"

Explain those aspects would ya?

[Judy Parker]

Hey All,

Also thanks for your input in the replys, five years at home, I am a little rusty, and have forgotten so much, and have much to learn even yet.

Judy Parker

[Joann Raytar]

I agree with Darris and Iguess. I explain right up front that things will appear a little strange at first. With progressives I let them know that they will have to point their nose at what they want to look at to get the best vision. I also let them know what they are getting out of the lens they choose. A PAL with a smaller drop to the add will have more of a reduced periphery but not as much lifting of the chin to read. A lens with less distortion in the periphery will require more head movement to read. Increased adds mean a Px doesn't have to hold reading material as far out as they have gotten used to; their desk tops will no longer be in focus through an increased FT add. An introduction of cylinder may make things look a little slanted at first. First time minus Rx eyeglass wearers will see things clearer but may feel like they are in a fishbowl until they adjust to the glasses. Etc, etc.

Hope this helps.

[Dave Nelson]

An ounce of prevention is really important. simply checking the old rx against the new one and FOREWARNING patients to expect adaptation difficulties has saved the day for me countless times. Changes in cylinder axiis, increases in add powers, ect can be difficult to adapt to, (as Jo just pointed out). so a little forewarning saves the "surprise" and patients will readily "try them for a few days" without putting up a fuss.

[lguess]

Judy,

I sent you an e-mail with one of my usual long-winded explanations, but it basically mirrors the two posts prior to this one. As I said in that e-mail, I no longer dispense; but there were many times when the concept of the .44 Mag would have been wonderful!

L "as in Larry, not I as in Iris" Guess

[Darris Chambless]

Hello Judy,

Here comes the long winded part :-)

We explain to the patients that there are certain things they will have to expect when they get their new glasses. First we inform them that a different prescription will warrant different curvatures of the lenses therefore redirecting light in a different manner than they are use to. We let them know that they may experience a slight magnification/minification (depending on the power change) of objects.

We then explain to the patient that their eyes are use to relaxing or accommodating for the current script. Since the muscles that control this process are involuntary you can't make them stop accommodating by telling them to do so. The muscles must "learn" what they need to do just like they have with the current script. BUT since the change in the current script has been made gradually they may not have noticed it.

When we are fitting Progressives we inform the patient up front that they probably won't like us much for the first two weeks. We assure them that what they will experience is perfectly normal and that every new wearer experiences the same thing. I even go so far as to tell them, if they have had anyone say that when they got their first pair they just put them on and did fine, that they're lying to them ;-)

We explain the differences in the manufacturing process of the front surface of the lens and simplify the term aspheric vs. spherical. We may even physically draw them a picture of what will happen (we have simple little sheets that we print out to demonstrate this) We show them how the curves affect the way light travels through the lens as well as showing them where the channels are in the lenses.

We explain the aberrations in the periphery of the lens by using "the sand" theory. If you're not familiar with it let me know and I will explain it but it is a good educational tool. I will assume you are familiar with it though to conserve space on this post.

We show the patient in advance about head positioning and the different ranges of focus they will have with a Progressive. We also give them a pamphlet to take with them to read at their leisure.

The important thing is that you do all this before they ever get the glasses. Once this is done the patient will feel confident in your abilities and even more so when they get the glasses. Why? Because you already answered all of their questions about the lenses even before they have any and they will know in advance what to expect. Once they put the glasses on nothing will be out of the ordinary to them. Most of the time the patients tell us that they aren't anywhere near as bad as they expected and thought we actually made them up to be worse than they really are.

At this point you should know what the feed back on lenses are from your patients on different designs, so use that experience as your tool to put the patient at ease beforehand. Explain to a CR-39 wearer that by going into a Poly lens that it will be thinner and lighter weight, but that they will have to adapt into a flatter base curve and a different medium through which light passes. Tell them they may experience a little distortion for a couple of days but that it will pass "as it does with all first time wearers."

If you say all of this beforehand then you never look like you're trying to cover anything up. After the fact is too late and you will be perceived as incompetent if something looks or feels funny to the patient.

If there are any specifics you would like to address let me know and I will do what I can. I hope I touched on enough to start with.

Darris C.

[Texas Ranger]

Wow, you guys are really sharp today! I'm truly impressed, and Darris is right, when to solve "adaptation" problems is at the dispensing table in what we call pre-styling, i.e. discussing their new prescription, the changes from their current ones, alternatives, materials, costs,sunglass needs, etc., BEFORE we do any frame styling. Then during frame styling we can give some pointers about why some styles might be better or worse, relative to the lens designs we just discussed. they then know exactly what to expect, and very seldom do they have any problems, unless there is a prescription problem. Al.

[Judy Parker]

To all of you,

Thanks for the wonderful input. A lot of the information I use on a daily basis, some of it is new to me, and the explanations different, and simplified somewhat. I have learned some areas I certainly need to improve in, some areas I haven't attempted at all, and some long forgotten information.

Darris_ "Do explain the sand theory!"

I am not certain if I understand it called something different, or if I am unaware of it at all.

You all are excellent!

Judy Parker

[Joann Raytar]

Terminology

I just realized in my post I used the word "strange" and in the post following it Darris used the word "different." As eyedude and Blake have mentioned, how you say things is important; it can change the customers perception of their eyewear. If you imply something will be difficult or weird the Px will expect that or try to find that. Just like thickness issues. If someone comes in wearing high minus PSR and your fitting revolves around solving thickness issues and you seem to promise the Px the world you had better make good on your promises. When the Px picks up their glasses the first thing they are going to look at is the edge. In this case thinner than what your wearing is totally different from the thinnest lens. At fitting you are setting that persons excectations. It is OK if you do better than they expect. It is tough to explain that their glasses are the best they are going to get with the lens frame combination they chose if the glasses don't live up to what they thought they were going to get.

Many of us now use learn instead of adjust to or get used to. I sometimes use "fine tune" and "re-align" to describe adjusting eyewear. What other user friendly terminology is out there that you guys use?

[Darris Chambless]

Howdy Judy,

The "sand" theory is what we use to make aberration easier to understand for the patient since we know in advance that marginal astigmatism will exist in the lenses somewhere.

The "sand" theory.

As it was explained to me went like this: Marginal astigmatism, aberrations or distortions we will refer to as "sand." Since no matter what one does to the lens there will always be some "sand" in the lens it is the labs as well as the dispensers objective to eliminate as much of the "sand" as we can via OC placement as well as lens material, bifocal style and frame selection.

In order to do this the labs ask for a "B" and an "ED" measurement so that they can place the sand outside of these parameters. By doing this most of the "sand" is cut off during the edging process which in turn makes the vision through the lens much better with less peripheral distortion. Since there will always be "sand" in the lenses you might as well put it where it will be out of the way or gone altogether.

This is merely a tool that makes it easier to explain the aberrations to the patient that he or she may experience in their new lenses. The patients are more apt to understand what they are seeing if they first understand "why" they are seeing it. It makes life simpler for us here at "The Sight Center, home of quality eyewear and the two best damn looking opticians in the world." :-) (Just a little plug there)

Take care and I'll talk to you later.

Darris "Master of The Keep" Chambless

[Alan W]

Judy
You are asking an age old question. My response is that not enough opticians realize that putting glasses on adults and putting glasses on kids are two different experiences. Opticians, from my experience over the last 35 years, tend not to be as interactive at the fitting table as needed. It tends to be a lecturing situation. For adults, the adult learning process calls for demonstration (explanation of what is to be expected, stimulus), a command to repeat back (response) what has been explained, and an acknowledgement (relevant and appropriate feedback from you). In the younger age group (and, possibly even geriatric) asking the patient what he experiences and responding with confirming feedback and suggestions for adjustment,shortens the adaptation cycle.
I stopped using the term "You need to get used to it." or similar ones years ago and spend my time getting into the Stimulus/Response/Feedback cycle. That way you and your patient both train, diagnose, and solve problems during the same session. You also reinforce the patients trust in you. This, to me, is the stuff that separates professional from "shlock." I wrote a thesis several years ago on interactive fitting techniques for progressive lenses using a tangential field plotting technique I learned in Europe. I'd be happy to share it with you if you give me your e-mail address. It is a hefty text cause it has quite a lot of graphics, so expect a long upload. I'd be happy to post it on the Optiboard, but it's long. It's my Masters paper.

[Steve Machol]

Alan,

I'd be happy to add your thesis to OptiBoard's download section if you'd like.

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OptiBoard Administrator

[Judy Parker]

Alan,

I would love to have a copy of your Master Thesis.


Thank you in advance,

Judy Parker
parkerr@ccdi.net

[chip anderson]

You have to remember that to many of people,
"You have to wear them means:
1) I put them own at night after I take my contacts off.
2) I keep them on top of my head until I need to see/read something.

Such people will not change an will never adapt.

Most others will make friends with thier new glasses/Rx (unless something is wrong with same) in 5 days, so tell them to leave them on their face for 2 weeks and you will have no problems that are not "genuine" problems with either the Rx or your mechanics on the job. Not that you or the doctor ever make a mistake that is. Of course if the patient sees several lines worse at near or far than they did with their old Rx, there is no point waiting, check your work, check the doctors origional Rx against what you wrote down. If all your measurements are O.K. the lenses check out, send them back to the doctor. Most labs will help if the "clinical error" is fresh. What I hate is those patient's who come back months later and say: "I never have been able to see out of these glasses!"

Chip "getting too old and tired to put up with as much as I used to" Anderson