IT IS A GREAT FIT

Tami Hagemeyer, A.B.O.C.

TLHConsulting, LLC

Eyewear styling is not an exact science, and definitely not for wimps!

Our responsibility is offering a quality ophthalmic frame that will provide comfort and functionality. A patient’s preferred style is always a consideration, but never the only thought. If our patients’ view a unique frame style seen thru social media, on a friend or celebrity, doesn’t necessarily mean that frame will be conducive to a comfortable frame, or the best choice for out patient. There are many factors that will dictate the ophthalmic frames we choose. Every patient has a unique facial structure. Each patient deserves the best comfort and wear ability we are capable of providing them. That is when we become challenged. Some frames must be physically altered to provide a great fit. Our creativity and sometimes our imagination are heightened, and we may be required to make very unique changes to the frame. It is possible to customize almost any ophthalmic frame. We have anexceptional opportunity that while we enhance our patient’s physical appearance, we will also improve their vision.

Fitting pediatric patients has it’s challenges. Infants and children have extremely flat nose/bridge structures. Many frame companies have responded to the need for frames that are designed for pediatric noses, but many are not. When a metal frame is chosen for a young patient, it is imperative that silicone nosepads are used and they are moved in to place to avoid frame movement, and slipping down our patient’s nose. Some manufacturers of children’s frames have responded with flexible straps that can be or are attached to the frames. When straps are available or added it provides the parents the confidence the child will not remove his/her glasses. It is important to advise that the straps are adjustable, to accommodate the child’s growth. Cable temples are a helpful feature on pediatric frames. But if they are not available a temple conversion is an easy fix.

To add cable temples to a metal frame, first have the patient put on the frame, next using the cable adapter, line the adapter in the proper placement that will be worn as, mark the end of the adapter. The mark will be used as a reference point, not the place to cut the temple. Remove temple tips, and measure approximately 6mm longer than the mark, then cut the temple. The temple is now ready for the cable adapter. Using an adhesive attach the cable temple and apply heat for approximately 10 seconds.

Plastic frame temple conversion is a little more challenging. The initial measurement is the same. When cutting the plastic temple, cut aproxometly20 mm, use caution cutting the plastic around the metal inside the temple. The metal is what the adapter will be attached to. If the metal is too large, a dremel drill, with a file attachment works great for filing the metal down to the correct size (this takes some practice). The procedure is identical to metal frame temple conversion at thispoint.

The recommendation for infants and children is polycarbonate or Trivex. Both lenses are impact resistant, and have an ultra violet filter. Hi Index lenses may be beneficial if the young patient has a prescription + or – 6.00.

Advocating an anti-reflective lens will encourage the child’sbest vision available. Most parents are not aware that the anti glare lens will also decrease scratching.

It is estimated that 40 – 90% of individuals diagnosed with Downs Syndrome have some refractive errors that are significant enough to require corrective lenses. Individuals with Downs Syndrome present a distinct fitting challenge, as they typically have a flattened bridge (70%), and their heads are narrower, and usually have a shorter distance the temple and nose. Temple lengths are predictably long and difficult to fit. There are frame manufacturers that cater to the unique facial structures, and work well. Using average frames with some modifications will help when individuals prefer a more “normal look.” A modification offered is to convert a temple in to a cable temple.

When dispensing for the more unique facial abnormalities can also be a challenge. Missing extremities, like ears or a nose will require some likely modifications to ophthalmic frames. A recent patient of mine has a missing left ear. His right ear is perfect. We have found that plastic frames are his personal choice, as they feel more comfortable. When I dispense his glasses, I form the right side normally which can make the frame less symmetrical, and pull slightly to the right. To avoid the frame pulling slightly to the right, I bow both temples, putting the fitting point slightly above the right ear and roughly on the same spot on the left side. The frame then sits very comfortably on my patients’ face.

The “perfect face” does not exist. Patients have multi dimensional faces, which as opticians have to utilize craftsmanship, and skill to manipulate most frames to provide comfort and wear ability.

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