HELP! My glasses are fogging up when I wear a mask

In light of everything that is happening globally right now, many people are choosing to wear a face covering of some kind.   While this is a great option to help keep us safe, the biggest problem that comes with a mask is having to deal with glasses that fog up while wearing the mask.

Why do they fog up?

This is a simple answer.  We are full of hot air!  OK, seriously though, it’s simple physics, your warm breath is escaping through the top of the mask, going up into your lenses, which are room temperature (cooler than your breath) and turns the water vapor into water molecules.  These water molecules form on the lenses and causes the cloudiness; or fogging up.

I want to break down a few things for you regarding this as well as share some tips and tricks to try to minimize this problem WITHOUT ruining your lenses.

Is your mask fitting properly?

The first thing we want to look at is how is your mask fitting you?  If the mask is fitting you properly, you should not have lenses fog up because very little air is going to be up and out of the top of the mask hitting your lenses.  Surgical (n95) masks have a piece built into them to help form them along the nose and the cheeks.  It is important to start with the nose, and then flatten along the face so it is smooth on your cheeks.  Remember, if the air is escaping through the top and fogging up your glasses, it is easier for air particles to get down through the top and into your respiratory system!

If you are wearing a homemade (sewn) mask, make sure it is one that has a pipe cleaner or some other forming agent to allow you to tighten it against your nose and face.  Always wash your hands before putting your mask on.  Place it on using the straps, then form it along the nose and upper cheek area.  Once you have done that, do not touch your mask again!  This is very important, not for the fogging lenses, but for your safety.

If you have a sewn mask and it does not have something built into it to form to your nose, you can also apply some surgical tape to the top of it.  This will keep your mask tight against your nose and cheeks and minimize the amount of air escaping up through the top of the mask.

Another thing to check is the elastic or ties you are using to keep it on.  Some go over your ears, some around the back of your head.  Either way your mask is held on, it has to be tight enough to keep your mask snug against your face.  The mask shouldn’t hurt, but yes, it probably will be a little uncomfortable until you get used to it.  It will most likely  leave a slight line along the top of your cheeks and nose….as long as it’s not digging into your skin, the faint line is to be expected.

What else can I do?

OK, so your mask is fitting properly but you’re still getting a little big of fogging up.  It’s better, but still bothersome.  There are a few other things you can do.

Fogged up frame without nosepads
The top mask is sitting lower, causing the lenses to fog up. The bottom mask is placed higher on the bridge with the frame over top of the mask

Wear your mask higher up on your nose and place your glasses OVER the mask, resulting it them sticking out a little more, allowing more air to circulate around them. This is, in my opinion, the BEST option AFTER making sure the mask is fitting properly. Be careful with this option and how far you lift them out if you have a higher prescription as it may alter your prescription / vision slightly.  As you can see from the pictures, it works with frames with nose-pads and those frames without.

Frame with nose pads fogged up
Here is a frame with nose pads.  The top mask is placed lower and the lenses are fogging up, the bottom picture shows the mask higher on the bridge with the nose pads placed on the mask.

Another option is to fold a tissue and place it under your mask along the nose.  Remember to wash your hands before folding the tissue or when getting ready to remove it.  The tissue helps fill in any gaps.  Make sure it is folded over quite a few times though to give yourself extra protection and throw away often to prevent it from collecting any germs.  Close your eyes and pull up and away keeping the shape in tact and dispose of immediately.

Mask with tissue folded and along nose
Mask with folded tissue along nose

Can I buy anything to help? 

You can purchase some anti fog cleaner / wipes.  Now there are a lot of options out there so you must make sure you are only buying a product that is safe for ALL LENS TYPES.  Some of the anti fog products available are not designed for lenses with special types of coatings.  It may strip your scratch resistant coatings and / or anti reflective coatings resulting in permanently damaged lenses.  You think your glasses appear “foggy” with a mask, try having them feel like that the whole time you’re wearing them.  It might happen if you use a product not designed for your lenses.  Some of the disadvantages of an anti-fog cleaner is a lot of them have a slight smell.  If you are sensitive to smells, it could bother you.  They don’t work that well and you may have to apply often.  This can get a little annoying.

The other thing to remember is any product you are putting on your lenses results in some type of chemical being close to your eye, which can cause some discomfort or irritation to the eyes.

Long term solution is there are coatings you can order for your lenses which come with special cleaning cloths and reduce fogging.   This option is especially good for those who work in an industry where their lenses fog up a lot.  For example, someone who cooks in a kitchen or someone who goes in and out of a freezer a lot.  It is a little more expensive and you have to use the cleaning supplies provided to you for them, but it is great for those who truly need that feature.  The one I usually recommend to my patients if they have a need for this is the Crizal OptiFog Anti Reflective coating.

Are there any home remedies or products I already have at home to help?

There is one option which I personally don’t think works very well, but some people swear by it so I will include it……because there is a right way and a wrong way to do it.  Apply a fine barrier of bar soap.  Make sure to not use any soap with anti-bacterial properties; it may damage some of your coatings.  Use a mild soap, like Ivory.  Let the soap dry slightly on the lenses and then gently wipe the excess soap away.  I feel like it still fogs up slightly and again, I’m a scent person.  I can smell the soap when I put them back on and I don’t want to smell the soap.

There is some communication saying to use shaving cream to eliminate fogging, PLEASE DO NOT do this.  It is not safe for most lenses and can result in damaging your lenses.

Overall, the best solution is a proper fitting and properly adjusted mask, regardless of the style.  Wearing it high on your bridge and putting your glasses on over the mask will work the best.

Have a great day everyone and see the world as clearly as you can! 🤓

If you liked this article and want to read more, please follow me on Facebook @PaulaTheOptician or subscribe to this blog.  You can find my other writing, not related to eye care and optical on my site:  HaliPawz  Where I enjoy writing reviews, ADA adventures with my mom, as well as just some humorous things that happen to me.

 

Bella the Mastiff wearing her K9 Closet Optical Collar
Bella the Mastiff wearing her K9 Closet Optical Collar

 

I want to give special recognition to K9 Closet in Kansas City.  They made my optical themed face mask and I love it!  They normally do dog collars and my Neapolitan Mastiff, Bella, has the same fabric in her collar!

 

 

 

Product Update:  For those of you who  remember the green frames I’m wearing from my blog about purchasing eye-wear online, I used them for some of the testing I did so I wouldn’t ruin the lenses in my quality eye-wear.  I hardly ever wear them for the reasons I indicated in the blog.  They are kept in a case when I am not wearing them and they still have a lot of tiny scratches on them.

 

 

An article about expensive glasses; truths and myths

I recently read an article about why glasses are so expensive.   While I do agree, at times, glasses can be expensive.  There is a lot more that goes into it and I wanted to clear up some truths vs myths in the article.

Let’s look at the first section I read.

Why are these things so damn expensive?The answer: Because no one is doing anything to prevent a near-monopolistic, $100-billion industry from shamelessly abusing its market power.

As you read further, you will learn the author is referring to Luxottica, or as some know now as EssilorLuxottica.  While EssilorLuxottica is a large player in the optical industry, they do not monopolize the industry.  In addition, Essilor works very hard to keep up with the needs of our eyes, which are changing every day as technology changes.  I’ll talk a little more about that later in the blog.

The true cost of a pair of acetate frames — three pieces of plastic and some bits of metal — is as low as $10, according to some estimates. Check out the prices of Chinese designer knockoffs available online.

Here is another myth.  While there are some frames that may only cost $10 to make, not all plastic or acetate frames fall in the same category.  There is a difference of exactly HOW they are made.  Are they hand-made, where the colors are fused together to give them a unique, quality look?  Did the designer have to design 20 different versions before they found the design that did the proper balance of beauty over optical quality.  Not everyone can design a frame to hold as many different variables of lenses as we ask it to.  It takes design, work, and rework.  Do you pay more for a known celebrity’s name to be on it?  Sometimes yes.  Sometimes no.  Does a brand name up the price?  Again, the answer is no.  Take Ray-Ban frames.  This is a brand known all over the world.  I have had patients come in and say, “Oh, those are Ray-Bans, we can’t afford those” Well Ray-Ban, like so many other brands, have multi level styles of frames.  We have some retailing at $150 and we have some retailing for over $300.  They are all Ray-Bans so why the price difference?  Quality of materials, intricacies of the designs; from the type of hinge to hold everything together to the decals used.  Everything on the frame, even the trim work, the Ray-Ban logo, can affect what price category a particular frame is in.

Lenses require precision work, but they are almost entirely made of plastic and almost all production is automated.

This could be said about almost everything we purchase.  A car is made mostly out of metal and plastic and is automated, why are they expensive?  It amazes me how someone can take something they know NOTHING about and put thoughts like this together to come up with this reasoning.  It doesn’t make sense.

The bottom line: You’re paying a markup on glasses that would make a luxury car dealer blush, with retail costs from start to finish bearing no relation to reality.

This is ABSOLUTELY untrue.  Many optical places put in fair mark ups for products.  While, like every company, you have some who go extravagant and try to make as much money as possible on every little sale there are also those companies who make a fair margin of profit.  Everyone has to make a profit of some kind or they won’t stay in business.  The lights have to stay on.  The 1000 frames you enjoy choosing from in the display all have to be paid for with the hope someone will buy them.  If the buyer makes some bad decisions then the product may be sitting there for a while or might have to be marked down, minimizing the amount of profit the company is making on that frame.  As a consumer, you have every right to go to more than one location to get price quotes, just remember to make sure you are having them price exactly what it is you are getting and you are comparing apples to apples.  For example, I recently quoted a patient a price for Varilux X lenses with Crizal Sapphire 360.  The patient went to a retail establishment and was told their “top of the line” lenses were just as good as the Varilux X.  Their “top of the line” lenses came out for sale back in 2007.  Varilux X lenses came out in 2017.  Tell me how they could POSSIBLY be just as good?  Would you want to go from your brand new, HD television back to watching a television that came out for sale in 2007?  The image will be different.  It comes down to what type of quality you want.

She said soaring eyeglass costs should be a part of the country’s overall healthcare debate in light of the fact that many people simply couldn’t function without corrective lenses.

“At the very least,” Balber said, “there needs to be some transparency about how much things really cost.”

The question I have to this quote is WHY?  Why does there have to be transparency?  Some of the responsibility is on the patient to also educate themselves on what it is they want or need.  I have said all along more money needs to go into the quality of the lenses, not the frame, but so many patients spend more time and money on the frame.  I often ask my patients, what is more important, the pills or the pill bottle?  I do agree  overall healthcare costs are crazy.  When a hospital can bill a patient $6 for a regular bandage with a cost to the hospital of $.10 there is a problem.  In most cases, the optical industry does not have crazy mark-ups like that.   Again, you will find some offices that do.  For example, I worked in a private office that marked frames up 3+ times the cost to them to purchase it.  Did I think it was high?  Yes!  Did I try to discount the frame for the patient?  Yes, I did.  Did I get yelled at for it?  Yes, I did.  How did I get around this problem?  I listened to the owner yell at me, smiled, nodded, and looked for another job.

And because it represents so many different manufacturers and brands, she said, it’s difficult for the association “to make any comments on pricing.”

Of course it is!  Every office has the right to charge what they want.  If you want a small, private office to be in your neighborhood and your average rent for a business space is 10 times greater than going 5 miles in another direction, the cost of the rent has to be paid for somewhere.  Since there is hardly any money made for the optometrists because of how little insurances reimburse them for a comprehensive healthy eye exam, then a lot of private offices have to rely on the profit made with the frames and lenses.  Can a big box retailer sell a single vision pair of glasses cheaper?  Yes, they can because they are buying 1000 sets of lenses a month vs only 100 sets a month or in some cases, 10 sets a month.  Online locations can sell even cheaper yet because they don’t have to pay for an optician, rent, lights, but they also can get away with not worrying about quality because people just assume they may or may not be correct because they were cheap.  I wrote a blog about my experience with an online purchase.

“We often see low-ball retailers promise price savings but fail to deliver the quality patients expect in terms of fit, comfort, durability and, of critical importance, precision in vision, over one or two years of daily wear,” he said.

This is a very good point.  The expectation from patients is to have an amazing pair of glasses at the best price possible.  Sometimes the expectation doesn’t match reality.  I’ve had patients come in expecting to pay $200 for top of the line quality.  Again, not to continue to focus on electronics, but when the phone they are carrying costs $1100 and they only expect to use it 1-3 years, why is there an expectation of GREAT VISION costing only $200.

“Today’s glasses aren’t the glasses of 20 years ago, and the price can reflect these technological advances.”

Fair enough. But with about 126 million American adults wearing prescription glasses, and many replacing those glasses every few years, you have to assume it doesn’t take long for frame and lens makers to recover any R&D costs.

Again, there is some truth to this but just like everything, some of the money you are paying for an item is helping the manufacturers to make an even better product.  When I first started as an optician, the progressive lenses (no line multifocal) were HORRIBLE.  They were a hard design meaning the minute you moved one way or another outside of the correction, you wouldn’t be able to see anything.  The amount of intermediate vision was very minimal.  As computers and tablets became an everyday thing, the demand for more digital friendly lenses increased.  Even with some of the best we have now, patients still want something better.  The something better is coming from the design and testing being done all over the world in order to make an even better progressive lens.  Every time a quality progressive lens is purchased, I can guarantee a fraction of the cost for the optical location to purchase those lenses is going towards the men and women working behind the scenes to make them even better than what we already have.

It won’t. And the more than 1,000% markup for most vision products proves that.

If there is a 1000% mark-up, I can guarantee is isn’t at most of the optical places you are visiting.  I don’t think it is right to throw a number out like it is a fact when there are no basis of truth to it.  Where did the author get that number?  I prefer to deal with facts and this author does not have his facts straight.

Why do glasses cost so damn much?

Because this industry has been getting away with fleecing people for decades.

Again, an opinion of one person with no merit to base it on.

Now, I want to share some true, behind the scenes scenarios we face each and every day in this industry.

Patient A comes in for an eye exam.  Feels it isn’t necessary to fill out all of the medical questions on the form because it’s “just an eye exam”.  The optometrist does a thorough eye exam, writes the prescription.  The patient takes it to a quality optician who fills it correctly.  Patient picks up the glasses and a week or so later, comes back and says, “I can’t see out of these”  The optician double checks to make sure he or she didn’t make a mistake.  Does some other checks and everything is coming out exactly as it should.  They schedule an appointment with the optometrist and learns the patient is on a new medication known to affect vision.  They had only been on it for a week when they came in for the eye exam but now, a month later, has an entirely new prescription.  The patient expects the optical office to remake them at no charge since it’s a new prescription.  The optical shop re-orders the lenses.  The lab makes the new lenses at no charge.  Who should really have to pay for those lenses?  The patient because he or she couldn’t be bothered to indicate all of the medication they are taking?  No, the lab has to eat the cost of those lenses even though they did nothing wrong.  I know you want to say, well that doesn’t happen very often, but it does.  It happens more than you think it would.  So now, not only does the lab have to have enough of a markup to absorb their cost of doing business but also those occasions where they will have to remake lenses at no charge for the office.

Patient B comes in for a pair of eyeglasses with a prescription over 6 months old.  The prescription was written by an outside doctor.  The optician recommends a new eye exam but since it is still technically not expired, they fill it documenting they had recommended a new eye exam since it had been more than 6 months.  (Yes, your eyes can change in 6 months, while rare, it can happen)  The patient picks up the glasses and then three months later they go in for their annual comprehensive eye examination.  The prescription is slightly different because it had been over a year.  They bring the new prescription back to the optical office they purchased from and demand they remake the lenses because “they made them wrong” when, in fact, they did not make them wrong.  The patient’s eye changed.  So the optical department has two choices.  Make a patient mad and refuse to remake them (which they would have the right to do) or remake them for the patient at no charge to keep the patient happy.  Some offices may opt to remake them.  Now, just because they aren’t charging the patient doesn’t mean they aren’t being charged for the lenses from the lab.  They still have to pay the lab for the new lenses.  Again, you would think these are rare incidences, but they are not.  Everyday optical locations have to make a decision between trying to keep a patient happy vs not losing money on a remake.

This is why some locations have such strict remake, refund policies.  Eyeglasses are custom-made to the individual as well as to the frame selected.  Every change done, every prescription change, every measurement change often results in a cost to someone other than the patient.

Insurances do not help the fact.  Here is another example.  Patient has VSP.  They purchase a frame covered in full by their insurance and purchase just the basic lens covered by their insurance.  They have a co-pay of $25.  In reality, even though the frame allowance on VSP is $150, the location may not even make enough to pay for the cost of the frame plus shipping….or make JUST that amount.  VSP isn’t paying the location $150.  They are paying a very small portion of that.  Now, the lenses…….since they are covered in full by the insurance, you would assume the location was receiving the amount the optical location charged for the lenses, right?  WRONG.  They are receiving exactly $25.  VSP will pay the lab for the lenses.  So the office made maybe $35 if they made a $10 profit on the frame, and that is very unlikely.  So $35 for the optician to take the time to help them select a frame, within a certain price range, and do all of the measurements necessary as well as go over any options the patient should consider to help them see better. A good optician won’t compromise quality of care just because the office isn’t making as much money on the sale.  All of this can take up to 30 – 45 minutes depending on the patient.  If every patient was like this, how could an office afford to stay in business.  I’m not picking on VSP, I just want to break down some real truths behind it.  I actually like VSP insurance.  It helps our patients afford the items they want and need to have the best optics available.  I just want everyone to understand your insurance may not pay for everything you need for the best visual outcome.  Sometimes you still have to pay some additional money for a great pair of eyeglasses.

All of this affects the markup of lenses and frames at both the optical shop level as well as the lab level.

Another truth, I work at a location where we don’t focus on heavy markups.  We like to try to keep the products our patients need at an affordable price.  With that being said, there are some product where, if you were to go to locations around us and price out the exact same items, you would find we were cheaper, but we still have patients asking us for a discount.  Our society has become so ingrained in getting discounts where, even when the discounted amount is more than it would cost from some place else, we can’t see the value.

So, David Lazarus….the next time you want to bash an industry without trying to get your facts straight, please leave optical alone.

If you would like to read the original article written in the LA Times by David Lazarus, please click the link below

https://www.latimes.com/business/lazarus/la-fi-lazarus-why-are-eyeglasses-so-expensive-20190122-story.html?fbclid=IwAR0qUKKQJ6r_ACp7Cj4nMo7cHKxZvdCcIB22dXDsPzLbSjlneL4rdSAmgJk

If you liked this article and want to read more, please follow me on Facebook @PaulaTheOptician or subscribe to this blog.  You can find my other writing, not related to eye care and optical on my site:  HaliPawz  Where I enjoy writing reviews, ADA adventures with my mom, as well as just some humorous things that happen to me.

 

 

Ultimate Lens Package Promotion Ending January 31, 2019

I try to be brand neutral for the most part on my site.  I may tell you what brands I like and why, but I also respect there are a lot of different options and what is good for one optician or patient may not be as good for another patient.  I started to share this information just on my Facebook page but decided to put something on here as well.

If you are needing new glasses and can get to a location over the next week to take advantage of this, I highly recommend you do.

The Ultimate Lens Package promotion is ending January 31st. This promotion has been really good for us in the sense that it has helped a lot of our patients be able to purchase two pairs of glasses for an affordable price. It hasn’t been great from a business perspective, which may be why some locations didn’t really like it. It created more work for the opticians, as well as more time spent with the patient without a real fiscal gain. I loved it though because it truly benefited the patient.
 
Here’s how it worked……if you bought the qualifying items in your first set of glasses, you would get the second set of lenses completely free, you just had to pay for the frame. To help our patients out, we would still give them the second pair discount and give them 20% off their frame. 
 
There is a single vision option; Eyezen as well as a progressive (no line multifocal) option; Varilux X. It can be combined with insurance. Our VSP patients often took advantage of the promotion.
 
You do have to get Transitions lenses in the first pair. If you haven’t been a fan of transitions in the past, I would highly recommend the Graphite Green color.  Another option for single vision lens wearer is to go with a fun new color like Sapphire, just pick one that matches your frame colors. If you give the transitions a whirl for 30 days and determine you just don’t like them, because the promotion is sponsored by Essilor, you can have them remade in a clear pair as long as you let the office know in a reasonable amount of time. We generally said between 30-60 days to let us know.
The second pair can be another regular everyday pair with or without transitions, it can be an occupational pair, or a great sunglass complete with polarized lenses, including fun colors like Xperio UV lenses.  Occupational lenses, for those who don’t know, are designed for someone who spends a lot of time focused on the intermediate portion such as reading music or sitting at a desktop computer for long periods of time.  If you are doing that, make sure your optician does a modified version of the Varilux x for your occupational lens, not just do a single vision or even the Essilor computer.  We have the modified Varilux X is more comfortable, especially for those patients who sit and use multiple monitors at work.
 
It is ending soon so if you’re in the Kansas City Area you can come see me.  You’re also welcome to go see any essilor provider.  To locate an office near you, feel free to use the location finder to find a location this next week to help you. https://www.essilorusa.com/get-lenses/where-to-buy#/
Please note, while this may seem like an Essilor advertisement, it is not.  I am not getting any compensation for posting this post.  I’m doing it because I feel like it was a great promotion and it’s ending in a week so I wanted to make sure it was known it was ending.   If you are reading this AFTER the promotion ended, I know they have another promotion starting February 1st but it isn’t as great of a deal for the patient.  Always remember to ask your optician if there are any promotions you can take advantage of, especially if you are purchasing multiple pairs.
If you want to stay up on different optical solutions for the consumer / patient, follow me here or like my Facebook page:  @PaulaTheOptician

 

Purchasing glasses online, missing a key ingredient

I am a bargain shopper. I appreciate a great deal just like any other person. I understand wanting to get the best price for anything. The problem is, sometimes a great deal isn’t what you think it is. Buying glasses online is like baking a chocolate cake without any chocolate. You’re missing a key ingredient; the optician!

Just yesterday I had a patient tell me he never understood how important the optician was in his seeing clearly. He came in to see me about a month ago because he could never see as sharp as he would like to. The optometrist did a complete comprehensive exam, corrected his vision to 20/20 with a new prescription, and referred him to me specifically. He told the patient to tell me what was going on. After talking to the patient for about 10 minutes, we came up with a plan for him. It would ultimately be 3 – 4 pairs of glasses (same amount as he currently had) but he wanted to start with one pair to see if he noticed a difference. When we talked yesterday, he openly said ” I know it’s a different prescription and that helps, but whatever you did….that’s the remarkable difference. I had no clue it was that important to see the right person for my glasses”

Of course I was appreciative of his words. I’m always happy when I can help someone see the best they can. I would like to believe every optician has the same goal.

Back to purchasing online, the optician is taken out of the equation. Let’s first talk about single vision lenses. I decided to purchase a pair of glasses on-line. I really wanted a pair of lime green frames big enough to fit my head. Not an easy task. I had been looking at the lines we carried but none of them had exactly what I was looking for. I finally found a pair and looked to see where I could get them. I saw they could be purchased online from Daniel Waters Eyewear. I won’t include a link because I don’t recommend purchasing glasses online. Now, if you want to take a chance and purchase a frame online because it is the frame you want, and take it to an optician for lenses, I have no issue with it. You are never guaranteed a good fit though so you may end up wasting your money. I know enough about frame sizing and shapes to know this frame was going to fit me.

The frame I chose was by Geek Eyewear

Geek Rad 09 Lime Green
Geek Rad 09 Lime Green Photo courtesy of Geek Rad Eyewear

 

Now, I ordered my lenses with a simple +.75 in both lenses. I knew I wasn’t going to be using the lenses, I had other plans for these beauties, but I wanted to see just how accurate everything was, so I treated it as if I was going to be wearing them.

The first question asked is for a PD (pupil distance) This measurement is the distance from one pupil to the other pupil. Now, a good optician will always measure this in relation to the center of your bridge because the distance from your bridge to your right pupil and from your bridge to your left pupil may be slightly different. Most of us are not perfectly symmetrical. In my case, I am more than a mm different.

When I put in my PD, I put in 62 which is my PD from pupil to pupil, but remember, I am not symmetrical so my PD for each eye is not 31. I selected single vision distance and regular plastic lenses. All of their lenses come with AR (Anti Reflective) coating. We will talk more about coatings at a different time. As an optician, I would normally take another measurement, an optical center measurement, for a single vision distance order, but it is not possible to do with online orders because you have to be wearing the frame in order to take it.  In theory, when a pair of glasses are complete, the optical center of the eyeglass lens should be directly over your pupil, especially in a single vision, distance only lens.

I placed my order. I received an email asking me which color I wanted. I found that a little odd since I had clicked on the lime green frame when I selected it. I did not see the email right away so it was a day or two more before I responded.

The glasses shipped out the day after I responded. When they arrived, I will admit the presentation was nice. They arrived in a case, a bottle of cleaner, and a lens cleaning cloth. The AR coating was visibly on the lenses.

Daniel Walters Online Purchase
Everything I received with my Daniel Walters order

So the optician in me immediately got to work checking the quality of the glasses.  To make sure the technical aspects are easy to understand, I will give you a little information.  A “B” measurement is the number of millimeters from the top of the lens to the bottom of the lens.  An OC (Optical Center) height should be specified when ordering distance glasses.  When it is not specified, the lab should cut the lenses with the pupil distance horizontally and to the middle of the frame vertically.  The vertical heights should be the same on both sides unless different heights are requested by the optician (again, it can not be done with an online order).   In looking at the picture below, you will see a couple of things.  First, you will see one set of three dots on the right lens (left side of the picture) and two sets of three dots on the left lens (right side of the picture).  As you can clearly see, the dots are not centered vertically in the frame.  They are extremely low.  I will explain how this could affect the wearer a little bit later in this post.  On the left lens, I first marked them up evenly with the right and then I moved the lens to mark it up to where the true actual optical center is.

Daniel Walters Eyewear marked up with optical centers located
Daniel Walters Eyewear marked up with optical centers located

As you can see from the next picture, there is a 4mm difference.  I would actually be ok with the difference (in theory) if it was centered vertically in the frame because then I would just assume they made the right lens wrong, but it isn’t so clearly they just have no care as to where they put the optical center.  Now, to be fair, the distance between one optical center to the other is 63 mm.  Yes, I ordered 62 mm, but the lab is allowed a 1mm variance, so it would be considered good.

 

Glasses not cut evenly
Optical centers not evenly placed on both lenses – Daniel Walters Online Orders

Next I put the frame on.  As you can see, my actual pupil is above the center of the frame.  This is the case with most frames today because it allows a better fit for progressive (no line bifocal) wearers, which a majority of eyeglass wearers are.  What my pupil is not, is it is not anywhere near the optical center!  If I chose to wear them, I could be causing some issues with my eye called induced prism.

Center of my pupil in comparison to optical centers Online purchase
Center of my pupil in comparison to optical centers – Daniel Walters Eyewear online purchase

Induced prism is complicated.  I don’t want to get too technical on this post because I want everyone to be able to understand it.  Prism bends the light.  Sometimes patients have a need for prism such as a lazy eye or double vision.  Prism moves the optical center of the lens in a way that it forces those muscles to work more so the patient sees evenly (no double vision).  Induced prism occurs when eyeglasses are measured or made wrong, resulting in prism being in the lenses when it wasn’t wanted.  If you are a technical person and want to know more, click here for an interesting article on induced prism.  The amount of prism induced can be calculated by a formula called Prentice Rule.

Center of my pupil in comparison to actual optical center marked up
Center of my pupil in comparison to actual optical center marked up

Prentice’s Rule is something all licensed, certified, or good opticians know and understand.  Prentice’s rule was named after an optician; Charles Prentice.  It is a formula to determine the amount of induced prism in an optical lens.  The formula is simple.  P(prism) = cf/ 100  c is decentration (the distance between the pupil center and the lens’s optical center, in millimetres  f is the lens power.  So taking all of this into account.   P = 5 x .75/100  P = .0375  So, in this pair, it is not even quite half a diopter of prism (prism is discussed in diopters)  That isn’t a lot but imagine if my prescription was a -3.00 instead.  The amount of prism would be quite a bit more.

bad online eyeglass purchase with mark ups
Noticable difference between eyeglass lenses cut and center of pupil – online eyeglass purchase

So, how does all of this affect you?  Prism affects the muscles in your eyes.  First, you have to understand, you may pick up a pair of glasses and have induced prism and you wouldn’t even realize it.  Now some patients can tell right away, they may have a slight double image, they may feel a little dizzy, but depending on the amount of induced prism, you may not even know it’s there.  If you don’t know it’s there, then it’s not a problem, right?  WRONG!!!  The best way I can explain it is, imagine you go to the gym and you’re working out your triceps.  You start out lifting 10 pounds with your left arm only.  You don’t do anything with your right arm.  Then you eventually add 10 pounds to your right arm but whatever you lift with your right, you add 10 more pounds to your left.  You get to 80 pounds with your right so you’re lifting 90 pounds with your left.  Now, you go to lift a 100 pound object and you start out doing great, but your right arm isn’t quite as strong as your left so you feel it inching lower and lower until you are forced to put it down.  The left muscle just got worked differently than your right for too long.

Now, imagine you go to the optometrist for a comprehensive eye exam.  You walk away with a prescription and you take it to an optician who fits you with a great pair of SV distance only lenses, digital, with a smart blue filter because you spend a lot of time on your cell phone and tablet.  They are measured perfectly, you come in to pick them up and you can’t see clearly.  You’re seeing a slight double image.  The optician tries to figure out what’s going on, recheck their measurements, everything is correct.  You make an appointment for a recheck and the double vision isn’t making sense.  Then they have to begin a series of tests to rule out any medical issues because double vision when you don’t have a history or double vision can be caused for a medical alarm.  Your old glasses are rechecked a little more in-depth and it is discovered you’ve been wearing a pair of glasses which have caused induced prism for the last year  / year and a half.  You then have two choices, work with the doctor and the optician to begin the slow process of reversing it, which could end up costing you a little more because you may have to buy a couple sets of lenses over the course of 12 – 18 months OR you have the doctor now prescribe some prism in your new glasses and you will have to always make sure your glasses have prism in them going forward, which means you will have to always go to an optician who is skilled at fitting prism.  All of this time and energy could have been avoided if you would have just had your glasses done by a skilled, professional optician in the first place and not taken the “cheap” route.

In addition, a lot of offices are starting to charge patients a discovery / troubleshooting fee when you purchase your glasses online and you can not see out of them.  Most optometrists will do a prescription recheck on a patient who purchases glasses from another optical location if they did the original exam but some optometrists are saying no, they won’t do it for free if you purchased online because it is resulting in too many patients coming back in and they are finding it isn’t the prescription that is the problem, but it is the way the glasses were made.

This next picture shows an actual pair of glasses purchased by one of my patients (before he was my patient).  He came in because he was struggling to see out of his new glasses.  I marked them up to double-check all measurements and as you can see from the picture, where the center of his pupil sits is not where the center of the lens is and his prescription is a lot higher than +0.75 so he was noticing the difference.

Bad online glasses
Patient’s online purchase indicating his pupil and optical center of lens.

As I said at the beginning, I understand wanting to save a few dollars here and there, but when it comes to your eyes, sometimes it’s a little better to spend a little more on the front side so you’re not dealing with issues later.  Don’t leave the chocolate out of the chocolate cake.  Find a great optician who understand his or her profession really well and trust them to take care of you and your eyes.  As I often say, a prescription is only half the solution, your optician is the other half!  When you purchase online, you take away that key ingredient, the optician!

Have a great day everyone and see the world as clearly as you can! 🤓

If you liked this article and want to read more, please follow me on Facebook @PaulaTheOptician or subscribe to this blog.  You can find my other writing, not related to eye care and optical on my site:  HaliPawz  Where I enjoy writing reviews, ADA adventures with my mom, as well as just some humorous things that happen to me.

 

Picking up your eye wear; what you should expect – PaulaTheOptician

As an optician, I know there is some excitement over picking up your new eye wear and wanting to wear them.  Perhaps it is because your old ones are not working anymore or you’re just ready for a new look, for whatever reason for the excitement, it is there and I understand it. I’m always excited to get my new ones as well.

What I want to share with you today is what YOU, as the patient, should expect when you are picking up your eye wear and some expectations you should, or should not, have.

First, and foremost, whenever possible, YOU should always be the one picking up your new eye wear.  I understand sometimes our busy schedules get in the way and we want a family member to grab them for us, but logically, it doesn’t make sense.  It’s like going to be measured for a bridal gown and then not showing up for the fitting before you wear it to the wedding.  When you work with a good optician, they take the critical measurements to help you see the best you can possibly see, but you have to have the final fitting for them to be perfect.

If your prescription has changed, please understand you may not see perfectly out of the glasses instantly, especially if it is later in the day.  Our eyes are already tired and aren’t ready to work to look through something different.  We are creatures of habit and even our brain / eyes want our comfort zone, even if the new prescription is better.

cat no needz glasses

Another thing to note is your prescription MAY have changed slightly even if the doctor tells you there isn’t a change, especially if you are a new patient seeing the doctor for the first time and you didn’t bring your current prescription with you.  See my blog, Preparing for your optical visit to understand what you should bring with you to an optical appointment.  Even if it is the exact same prescription on paper, there may be slight changes to the lenses based on measurement and frames so your eyes may see slightly different in the new pair.  I used to have two pairs of glasses, the frames were the exact same frame, just different colors.  The lenses were the exact same, made by me, with the exact same measurements.  With everything being the same, I could still tell which pair I had on when I put them on.  It doesn’t mean I saw worse in one over the other, there was just a slight variation.  Some people are a little more sensitive to those variations than others.  The variations don’t mean they were made wrong,  understand making a lens is not an exact science, especially in today’s digital world.  There is a standard chart letting us know how much of a variation is allowed in your lens based on your prescription.  Good lab technicians and opticians will reject a pair of glasses if, after manufacturing, it is determined the prescription is slightly PAST the variation allowance.  Unfortunately, not every optician will reject a pair , or, worse yet, they don’t even bother inspecting the glasses when they arrive from the lab, they just assume the lenses are correct.  Mistakes do happen.  Variations come out a little more than we anticipated.  As an optician, I hate having to tell a patient their eye wear didn’t pass inspection and a lens has to be restarted but I feel it is better than allowing the patient to pick up their new eye wear, excited to wear them, only to discover they just can not see out of them and something has to be re-ordered.

What to expect if you are single vision:  Single vision lenses are usually the easiest for us to dispense.  They are the lenses designed for one specific vision.  Usually, if you are younger than 38, they may be for every day, all day wear.  Sometimes they are for reading only or for a more detailed vision need, such as piano playing or computer use.  There are two measurements I always take for single vision lenses UNLESS they are for reading only.  Then I can skip one of them because of how a patient holds their head to read.  If your optician ordered a newer, digital lens, such as the Eyezen lens, then there may be some fitting dots or even some fitting clings on your lenses.  If you pick up your eye wear and you’ve worn them for a few days and you’re not seeing as clear as you feel you should be, then talk to your optician.  Ask him or her if they took a specific optical center height on them.  If they did ask them if they verified it when the eye wear came in from their lab.  If they did not take an optical center height or they did not double-check it, take them back in to the office and ask them to dot the center of the prescription.  It is easy to do and it is an easy way for you to visually see a potential problem with your vision.  The dot (once they mark it) should be directly over your pupil when you are looking straight ahead.  All too often I have had to show a patient who purchased the eye wear somewhere else how off-center from their actual pupil the lenses were made.  This can create strain on a patient’s eyes or even a pulling feeling.  Sadly, too many opticians skip this step or do not feel it is important.  In all my years, I have found it to make a difference in a patient’s sight so any optician I hire or train is trained to always take it.  The only exception, as I stated, is for reading / computer only lenses.

What to expect if you are picking up a progressive lens (often referred to as a no line bifocal):  This lens is a lot trickier for some opticians.  All too often I have patients who saw one of our doctors for their examination but chose to purchase their eye wear somewhere else come in to see us and tell us they are having a problem with their glasses.  We instantly “mark them up” before we read the prescription or check the fit.

Progressive lens with a Varilux Lens cling
Example of a progressive lens “marked up” with a Varilux lens cling

This can be done with a lens cling or a lens marker.  Opticians use the marking to determine what adjustments, if any, need to be made.  We also use the marking to read the actual prescription in the lens to determine if the lenses match the prescription written for them.  I’ll ask the patient who is having the trouble if they remember seeing any markings on their lenses when they picked up their glasses and, sadly, I am often told no, they don’t remember seeing anything on the lenses.  I have talked to other opticians (who don’t mark progressive lenses up to dispense) and they say they don’t do it because they feel it makes the lenses appear ugly and the patient doesn’t like it.  I just do not understand this thought process!!!  What is more important, correct placement for quality vision or the aesthetics of the lenses immediately at dispense?  We tell the patients as we hand the lenses to them….”Don’t try to look through the lenses, I’m going to double-check the fit and then we’ll check the vision”   I have never had a patient get upset with me because I’m trying to help them see as best as I can.

All progressive lenses have hidden water / laser marks on them to also tell us what brand of progressive lenses they are as well as what material and what add (bifocal) power is built into the lens.  We use those markings to determine the placement of everything.  Sometimes those laser marks may be visible if you catch the light just right and you’re looking off to the side of your glasses.  They do not interfere with your vision and they are perfectly normal.  They are supposed to be there.

Please understand there are different types of progressive lenses and the older the technology, the more difficult it may be for you to see out of them.  I’m going to be breaking progressive lenses down for you in another blog, so keep your eyes open for it.

If you are picking up a lined bi-focal or lined tri-focal: Every measurement surrounding a lined bifocal or lined trifocals varies depending on the patient’s needs as well as their preferences.  At the time of ordering, the optician should have asked you clear questions about what your expectations were of the lenses, how you were going to use them (if a specialty pair) and then verify those expectations are being met when you pick them up.

There are times however, your expectations just can not be made a reality and your optician should take the time to discuss with you when you are ordering them WHY it might not be a reality and give you an alternative solution.

If you pick up your glasses and you feel you can’t see as well as you should be able to, don’t panic!  As great as your optometrist or ophthalmologist is, sometimes the prescription does get written wrong.  The best way I can explain it is…..when in the room during the examination and you’re asked “Which is better, A or B” and you say A, but B is better in your real world.  Another thing is, sometime the prescription just gets transferred from the phoropter (the thing you look into during your examination) to the computer or Rx pad incorrectly.   You always need to allow for a little human error.  I can assure you, errors are never done intentionally so don’t be upset with your optician if they suggest you try them for three or four days before troubleshooting and getting you back in with your prescribing doctor.  Talk to your optician as ask them what the time line is for correction.  For example, if we determine a prescription is close to the previous prescription but the vision seems to be slightly off, we will ask the patient to try them for three or four days.  If they continue to have problems, we will have them come back in to see us so we can go through our troubleshooting page to determine if the problem is occurring due to a prescription error or a manufacturing error.  As you can see from my example, there are a lot of things we troubleshoot BEFORE recommending you go back in to see your prescribing doctor.

Recheck List Sample
Sample of document used to do a recheck when eye wear seems to not be clear

 

We may not always be able to determine what the problem is, but it’s a good start.

All in all, communication with your optician is very important.  If you purchase your glasses from a different location than where you had your eye exam, be sure to ask them what their policy is on remakes and ask if they are willing to troubleshoot any concerns before you make your appointment with your doctor for a recheck.  A lot of places will JUST check the prescription and nothing else. While you never want anything to be wrong with your glasses, asking the correct questions ahead of time will have you prepared in case there is something wrong.

It is always OK to ask questions.  Eye wear is an important part of your eye health and having the wrong prescription or the wrong measurements can affect you negatively down the road.

I hope this information helps you be more prepared when picking up your new eye wear.  If you want to stay up to date with the new information I’ll be providing, be sure to subscribe to this blog or like me on Facebook as PaulaTheOptician 

Have a great day everyone! 🤓