Presentation on theme: "Trouble shooting in problematic spectacles"— Presentation transcript:
1Trouble shooting in problematic spectacles FacultyAravind School of Optometry
2Key to Problem solving is to: Listening the patient’s complaint carefully first to understand the genuine cause of complaint.Identify the problem.Start a systematic approach & do the appropriate correction depends on the symptoms /sign.Assure the patient of our best efforts.
3Approaches in Problem solving The more traditional, rational approach is typically used and involves,clarifying description of the problem,analyzing causes,identifying alternatives,assessing each alternative,choosing one,implementing it, andevaluating whether the problem was solved or not.
4Problems…. Patient may feel discomfort due to…., Clinical Errors, Technical Errors,Non-technical ErrorsAlways refer the patient’s medical record first.
5Clinical errors Inaccurate refraction. Wrong prescription. Poor communicationLess priority to the patient’s main complaint.Inadequate information about recommended lens/frame.Not so impressed approach.No differentiation the new prescription and using spectacle.
6If suspect any Clinical problem, Check the PG power as in the prescription.Check the Rx is written correctly as in the case sheet.Check the given prescription to correct patient.Check the vision with present glass.Repeat the refraction if need,Confirm the astigmatic axis as in the prescription.
11If suspect any technical problem, Check the lens quality.Verify the centring.Check the surfacing defects (thickness, unwanted prism etc.,)Ensure that any other materials defect occurred.Reassure the frame alignments.
12How to identify the problem? Use only open –ended questions.Ask the patient to specify the problem.Do keen observation of use.Understand the possible cause of the problem.
13First approach…Refer the patient’s medical records to confirm the prescription details.Ask a patient to wear the spec’s and Observe.Misaligned frames and improper frames size can cause the following problems:Vertex distance discrepancy which can affect the effective power of the spectaclesMisaligned frames may be positioned awkwardlyIncorrect size frames /temples cause discomfort to the wearer.
14Patient complaints - Possible causes Symptoms (complaints) Possible causes Distance vision is blurred Incorrect prescription Incorrect axis Segment height is too highNear vision is blurred Incorrect prescription Segment height is too lowLarge vertex distance Incorrect PD Insufficient pantoscopic tilt Insufficient facial wrapWaves seen in distance vision zone Incorrect prescription Incorrect axis
15Patient complaints - Possible causes Symptoms (complaints) Possible causes Difficulty in reading (excessive lateral head movements when reading) Over correction in near vision zone Incorrect PD Segment height too low Large vertex distance Insufficient facial wrap Insufficient pantoscopic tilt Insufficient segment area; frame is too small Distance vision is clear only when head is tilted back In correct Prescription Head has to be tilted back for reading In correct Prescription Fitting height too low Head tilt Forward at distance Fitting Height too Low Head tilt Forward at near & Intermediate Incorrect Prescription
16Always keep it in mind…If there is no technical problem found, gentle counseling can help to understand the real cause of the dissatisfaction.Other reasonsCost factorPoor counselingBehaviorMiscommunication by staffcan also make the patient unhappy.
17Key points to remember… Everyone may do mistakes but don’t deny.Final verification before delivery is always better.Ensure the patient’s satisfaction by doingon-eye verificationNecessary frame alignmentsVision check for both distance and near.Overall comfortness check.Patient’s relationship is highly important.