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Thread: Lab Delays due to Prism

  1. #1
    OptiBoard Professional KrystleClear's Avatar
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    Confused Lab Delays due to Prism

    I wanted to see what your opinions are on this. I really appreciate your knowledge and wealth of experience!

    We have a patient who has been prescribed a total of 20 diopters of prism secondary to an injury (10 base out each eye). He is a forklift driver and has been out of work due to this, and needs the glasses to get back to work, as he cannot safely drive the forklift with double vision.

    We ordered his glasses 5/18/2021. The patient is a big and tall guy and thus had to go for a larger frame. Ten days after ordering, the lab calls and says they want to change the material. I say fine, we'll eat the cost. I get another call back saying, no, they don't want to change the material (I guess we heard them wrong or some miscommunication), but rather they are demanding he restyle to a smaller size. I mean, I understand why, but he is a larger man and it has already been 10 days (5/28/2021) and now we will be starting from square one. He also lives a distance away and has to have a driver bring him. So he comes back in same day, picks out smaller ones - the fit isn't ideal but this is a small as we can really go. I wish we could go with a smaller frame, but it just isn't feasible for his size.

    We hear nothing until 6/10 and they say there is lens spoilage and are restarting. It has been in the prism block phase for several days if not a week, and no end in sight. Patient is getting upset and now his employer is too, as they don't want to keep paying out medical leave. We use an outside lab. They are going to still have to mail them to use when done via UPS.

    I am at the point where if/when they come in, and the patient accepts them, I feel that I should refund him. He has been out of work for 5 weeks because there was a week or two before the doctor prescribed prism after the injury. I am just waiting for him to call or show up and yell at me. :( Does that seem reasonable? His glasses are not going to be cheap for him and I hate to collect that money knowing we have put him and his employer out like this.

    Thanks!
    Krystle

  2. #2
    OptiBoard Professional OptiBoard Silver Supporter Optical Roy's Avatar
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    It's not your fault for the delay, or injury. It really doesn't matter if his company is tired of paying medical leave, they should also pay the expense for the glasses as I am assuming that his injury happened while working. Here in Texas, workman's comp pays everything. We have 1 individual that has received workman's comp glasses for the last 7 years due to injury on the job. I would advise him to look into this.
    Roy W. Jackson, Sr. ABOC

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    You have my permission to steal this apology:

    "I'm going to ask that you call on your better angels to forgive me. I am so sorry that we are experiencing this delay for your complicated custom designed glasses and am doing everything I can to get them from the lab- but this is a prescription that often needs multiple attempts to get the finished lens accurate and mounted in the frame. Meanwhile- I can get a pair of Fresnel press on prisms that should work until the order comes in at no charge to you (explain a Fresnel yadah yadah)"

    Don't do them no charge. If you must- offer a future credit/discount toward another pair.

    Also- any future job like this would do well if you call the lab and ask them beforehand if the order is doable in the frame he chooses and how long will it take.

    Hopefully he will be ok with this.

    fwiw-We've all been there with jobs that if it can go wrong it does.

    Like this one last week-

    Had a chem clip job where the lens magnet fell out. Sent it back to the lab (poly- didn't want to risk crazy gluing myself) and said it should take a couple of days. I call 5 days later and get told it will go out "today" Next day comes no job. Assured today for sure! Next day job comes in. THE MAGNET WAS REVERSED!!! Now we need a new rx lens ordered on a rush- A Week later the lab calls saying they have the blank but need the frame. "WHAT! YOU HAVE THE FRAME AND CLIP!! I start hyperventilating until a half hour later- Oopps sorry we found it. We'll get it going rush rush.

    Bottom line a 3 day turn around turned into a 3 week fiasco. Thank goodness she was nice about it and came away realizing the importance of an updated, functioning spare pair of glasses.
    Last edited by Uncle Fester; 06-17-2021 at 12:54 PM.

  4. #4
    Ghost in the OptiMachine Quince's Avatar
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    Out of your control. When the problem is due to a difficult Rx, I do try and set expectations for a longer time frame but other than that, if you've done your best to communicate with the patient and be sympathetic, there isn't much more you can do. Most people are very understanding of this, so don't beat yourself up!

    I absolutely would communicate with your lab rep that the situation could have been handled better on their end.

    As for cost- I wouldn't be inclined to not charge them, but instead you could offer an extremely reasonable 2nd pair (especially if your lab offers multipair pricing) or maybe some retail items- free lens cleaner/ extra cloths and whatnot. I wouldn't rush to take the blame because he most likely would have run into similar problems elsewhere.
    Have I told you today how much I hate poly?

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    Master OptiBoarder optical24/7's Avatar
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    Order a 20D Fresnel and put it on a pair Of his old glasses until the new order comes in. You can order them direct from the maker.

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    Quote Originally Posted by optical24/7 View Post
    Order a 20D Fresnel and put it on a pair Of his old glasses until the new order comes in. You can order them direct from the maker.
    Of course the simplest answer is usually the right answer. Also one would have guess the Dr would have asked for a Fresnel prism before ordering 20D prescribed prism and crossing their fingers...

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    Master OptiBoarder AngeHamm's Avatar
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    Quote Originally Posted by Kwill212 View Post
    Of course the simplest answer is usually the right answer. Also one would have guess the Dr would have asked for a Fresnel prism before ordering 20D prescribed prism and crossing their fingers...
    This. That's a hell of a Hail Mary RX.
    I'm Andrew Hamm and I approve this message.

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    OptiBoard Professional KrystleClear's Avatar
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    Quote Originally Posted by Kwill212 View Post
    Also one would have guess the Dr would have asked for a Fresnel prism before ordering 20D prescribed prism and crossing their fingers...
    Yes! Funny thing is this whole started out with ordering a 20 diopter Fresnel. It came and just as I was about to call and let him know it came and he could come in at his convenience for me to fit it to his lens, the doctor said "nevermind," and to order ground in lenses. My coworker sent it back for credit, per the doctor's instructions, and I wish I could time travel and make sure we held on to it. Lesson learned! I should have just re-ordered it from the first sign of trouble. Normally our lab does tell us if a script is doable in a particular frame but there was a transcribing error on the lab's part when taking the order. I just placed an ASAP order for either a 20PD Fresnel, or two 10PD Fresnel stickers, whichever they can get to us sooner.

    Lab said this afternoon that the current ETA for the lenses is Monday if everything goes perfectly, which it may not, so either way we will have something to give him.

    It apparently was not work related, so he is on his own for the glasses. I am going to comp the fresnel(s) for him. It's the least I can do.


    I started at a chain optical that just threw us to the wolves with no formal training, left there, came back to the eye biz but as a receptionist for an ophthalmology practice for several years. I left there in October for a completely different field and they ended up offering me a significant raise to come back as their optician. That was January and since then I have been studying as my coworker is not really formally trained well enough to teach me anything I didn't already know. (No offense to her- she's great.) Thank you all for your kind answers! I really appreciate it!
    Krystle

  9. #9
    OptiBoard Professional OptiBoard Silver Supporter Optical Roy's Avatar
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    Quote Originally Posted by KrystleClear View Post

    It apparently was not work related, so he is on his own for the glasses. I am going to comp the fresnel(s) for him. It's the least I can do.
    Get with your lab rep and see if they will comp a set of lens due to the delay, or credit that lens order if you want to give him a better credit. I usually go the 2nd set, they use a extra frame they have, or purchase a frame, so they have a backup, which I would say he does need a backup. The worse they can do is say no.
    Roy W. Jackson, Sr. ABOC

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    OptiBoard Professional KrystleClear's Avatar
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    Quote Originally Posted by Optical Roy View Post
    Get with your lab rep and see if they will comp a set of lens due to the delay, or credit that lens order if you want to give him a better credit. I usually go the 2nd set, they use a extra frame they have, or purchase a frame, so they have a backup, which I would say he does need a backup. The worse they can do is say no.
    I actually did try that - explained the situation and that the patient has been greatly inconvenienced due to being unable to perform his job functions, but no dice. They just gave me the complex RX speech. I have no inner "Karen," but it would be handy right about now! I'll give it another go if it is still not finished next week. I understand it's difficult for them, though.
    Krystle

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    OptiBoard Professional OptiBoard Silver Supporter Optical Roy's Avatar
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    I wouldn't just call the lab, call the rep, they have more pull. We all understand the complex RX speech, but the upfront honesty goes further than this restart, that restart, blah blah blah.
    Roy W. Jackson, Sr. ABOC

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    Don't give them to him, don't discount them to him. Take this opportunity to educate your patient, that this will be the norm with a difficult prescription like his. Sell him a second pair so he won't have to miss weeks of work when he loses or breaks this very special pair of glasses, that have taken so long to get. Perhaps you can give him a break on the second pair.

  13. #13
    Master OptiBoarder OptiBoard Silver Supporter lensmanmd's Avatar
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    We are going through something similar, except it's 11^ BO OU. This is outside of our bread and butter, so we outsourced them. We got rid of our toric surfacing line, and are now a STP/FF platfrom.
    Lab calls and says that they cannot get a thick enough blank for 11^OU, but can do 10^ OU. But, the lab did not take 3+ weeks to communicate with us.
    I call the clinic and gave them the FRP or 10^ option. They called the PT, trialed the PT and the OD agreed on the 10^.
    Moral here, communicate with the lab, clinic, PT and the OD/MD. Give them options. Give the PT a realistic timeframe.

    10^ OU is not overly difficult to grind on a manual platform, but most pucks are not thick enough. Then there is the edging. Most edgers do not have wide enough wheels to handle the added 4-5mm thickness that this amount of prism adds to the edge.
    I bend light. That is what I do.

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    Master OptiBoarder optical24/7's Avatar
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    Note to Fresnel users; Do Not use 2 Fresnel’s! You will reduce vision on BOTH eyes if you put one on both lenses, due to VCA’s that prisms induce, especially hi prism amounts. The proper way to utilize these is to put the full amount of prescribed prism on their non-dominant/least acuity eye. If it’s compound prism ( horizontal and vertical) you still only put it on one lens by mathematically finding the axis to put the base to induce both.

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by optical24/7 View Post
    Note to Fresnel users; Do Not use 2 Fresnel’s! You will reduce vision on BOTH eyes if you put one on both lenses, due to VCA’s that prisms induce, especially hi prism amounts. The proper way to utilize these is to put the full amount of prescribed prism on their non-dominant/least acuity eye. If it’s compound prism ( horizontal and vertical) you still only put it on one lens by mathematically finding the axis to put the base to induce both.
    So I know we need to adjust the PD 1mm for each 3^ of prism in a progressive but what is the effect of 20^ on an existing lens?

  16. #16
    Master OptiBoarder optical24/7's Avatar
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    Quote Originally Posted by Uncle Fester View Post
    So I know we need to adjust the PD 1mm for each 3^ of prism in a progressive but what is the effect of 20^ on an existing lens?
    Yep, adjust the Decentration for prescribed lenses (particularly PAL’s), but a Fresnel is usually used for trial/temporary/diagnostic reasons. Another reason to use only one Fresnel when you’re utilizing them.

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    Master OptiBoarder OptiBoard Silver Supporter
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    Quote Originally Posted by Uncle Fester View Post
    You have my permission to steal this apology:

    "I'm going to ask that you call on your better angels to forgive me. I am so sorry that we are experiencing this delay for your complicated custom designed glasses and am doing everything I can to get them from the lab- but this is a prescription that often needs multiple attempts to get the finished lens accurate and mounted in the frame. Meanwhile- I can get a pair of Fresnel press on prisms that should work until the order comes in at no charge to you (explain a Fresnel yadah yadah)"

    Don't do them no charge. If you must- offer a future credit/discount toward another pair.

    Also- any future job like this would do well if you call the lab and ask them beforehand if the order is doable in the frame he chooses and how long will it take.

    Hopefully he will be ok with this.

    fwiw-We've all been there with jobs that if it can go wrong it does.

    Like this one last week-

    Had a chem clip job where the lens magnet fell out. Sent it back to the lab (poly- didn't want to risk crazy gluing myself) and said it should take a couple of days. I call 5 days later and get told it will go out "today" Next day comes no job. Assured today for sure! Next day job comes in. THE MAGNET WAS REVERSED!!!
    Why didn't you just pop out the magnet in the clip and reverse it?

  18. #18
    OptiBoard Professional KrystleClear's Avatar
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    Quote Originally Posted by optical24/7 View Post
    Note to Fresnel users; Do Not use 2 Fresnel’s! You will reduce vision on BOTH eyes if you put one on both lenses, due to VCA’s that prisms induce, especially hi prism amounts. The proper way to utilize these is to put the full amount of prescribed prism on their non-dominant/least acuity eye. If it’s compound prism ( horizontal and vertical) you still only put it on one lens by mathematically finding the axis to put the base to induce both.
    I did not know that! I was going off of our optom's recommendation to do 2 separate Fresnels if we could not get a 20PD. Good to know, thank you.
    Krystle

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    OptiBoard Professional KrystleClear's Avatar
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    Quote Originally Posted by lensmanmd View Post
    We are going through something similar, except it's 11^ BO OU. This is outside of our bread and butter, so we outsourced them. We got rid of our toric surfacing line, and are now a STP/FF platfrom.
    Lab calls and says that they cannot get a thick enough blank for 11^OU, but can do 10^ OU. But, the lab did not take 3+ weeks to communicate with us.
    I call the clinic and gave them the FRP or 10^ option. They called the PT, trialed the PT and the OD agreed on the 10^.
    Moral here, communicate with the lab, clinic, PT and the OD/MD. Give them options. Give the PT a realistic timeframe.

    10^ OU is not overly difficult to grind on a manual platform, but most pucks are not thick enough. Then there is the edging. Most edgers do not have wide enough wheels to handle the added 4-5mm thickness that this amount of prism adds to the edge.
    I am chalking this all up as a valuable learning experience. I have only been back in optical for about 4 ish months and some things I am learning the hard way. We only work one optician at a time (we split the week) and my coworker is not that much more experienced.

    I am not trying to put down our lab either - this was a mess from the get go, but I would just like better communication all around. I was never told he was out of work because of this until last week! Good grief.
    Krystle

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    May I ask, are these lenses ordered with anti reflective coating as well?

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    OptiBoard Professional KrystleClear's Avatar
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    Quote Originally Posted by Plausible View Post
    May I ask, are these lenses ordered with anti reflective coating as well?
    Yes to the AR.

    As of today, my coworker was told that they should ship Wednesday or Thursday. The fresnel came in in one 20D sticker, but the doctor is telling us NOT to call him to tell him it is in and to just wait until the glasses come, since it won't be much longer. (I get not that wanting to cut and place and fresnel for just a few days of wear but I'm willing to do it.) I am so stressed about it at this point that I dread the phone ringing, because I know he isn't happy. Waiting for the other shoe to drop drives me nuts!
    Krystle

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    Master OptiBoarder OptiBoard Silver Supporter
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    Quote Originally Posted by KrystleClear View Post
    Yes to the AR.

    As of today, my coworker was told that they should ship Wednesday or Thursday. The fresnel came in in one 20D sticker, but the doctor is telling us NOT to call him to tell him it is in and to just wait until the glasses come, since it won't be much longer. (I get not that wanting to cut and place and fresnel for just a few days of wear but I'm willing to do it.) I am so stressed about it at this point that I dread the phone ringing, because I know he isn't happy. Waiting for the other shoe to drop drives me nuts!
    If you're getting the lenses as uncuts, be very careful to avoid slippage during edging due to the wedge shape. The lenses will have a tendency to slip outwards when there's that much base out prism. The AR will increase that tendency.

  23. #23
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by jefe View Post
    If you're getting the lenses as uncuts, be very careful to avoid slippage during edging due to the wedge shape. The lenses will have a tendency to slip outwards when there's that much base out prism. The AR will increase that tendency.
    even if I could you guys that edge this in house are way braver than me!!!

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    Quote Originally Posted by jefe View Post
    If you're getting the lenses as uncuts, be very careful to avoid slippage during edging due to the wedge shape. The lenses will have a tendency to slip outwards when there's that much base out prism. The AR will increase that tendency.
    Would you put non slip film on front and back?

  25. #25
    OptiBoard Professional OptiBoard Silver Supporter Optical Roy's Avatar
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    Quote Originally Posted by NAICITPO View Post
    Would you put non slip film on front and back?
    Yes
    Roy W. Jackson, Sr. ABOC

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