There are many tricky challenges when crafting, dispensing and repairing glasses. All these can be avoided by one simple method: Never provide any. But heres the thing: I do. Do you?

Prescribing
The baby boomers are here, my friends, and their arms are now too short. I spend half my day examining people who have always had perfect eyesight and now they cant tell the shampoo from the conditioner. My advice? Explain all their options, then run. They are gonna hate you.

On the other hand, consider this: Their first eye doctor after the onset of presbyopia is the idiot. If you are the next eye doctor, you will seem a genius by comparison. My late senior partner and mentor, Dr. Bodie, gave me a great piece of advice for these folks: Dont put a bifocal on these patients until they beg you for one. Sooner or later, they will.

What about the guy who tells you that he has perfect eyesight, but the wife made him come in? Then you find out hes 20/50 and +150-175 x 90 in the perfect left eye. What to do? Patch the good right eye and leave him in the exam room with a magazine and a wall chart for a few minutes. When you come back, ask him my favorite question, Can you see? Listen to the answer. If it aint broke, dont fix it. Reschedule it.

And consider the LASIK patient who is a little blurry when driving at night. Yes, a little blurry in the same way that Michael Jackson had a little work done on his nose. Try 20/60 O.S. Try the Can you see? approach, then tell him why he will be sooooo happy hes a -1.75D myope when he turns 50, 25 years from now. Or he could have an enhancement and then hate his eyes when hes 50, 25 years from now.

Dispensing and Repairs
How about when you bring the glasses out and the patient asks that age-old question, Are those the right glasses?

What do you say? Maybe, Ill check. Maybe, Ask Renee and have a nice day. Maybe just a simple, Yep. Maybe even a simpler, AAAARRRRRGGGGHHHH!!! The point is this: Think like a Boy Scout. Be prepared. Be prepared to avoid homicide. You do not look good in orange prison overalls, although I doubt a jury of your peers would convict you.

How about those glasses that the lens fell out of 90 times? I have noticed that this never happens when the patient is on the sidewalk in front of your office. She is always on a cruise or in a wedding. The old joke I always knew you had a screw loose will only work about 83 times. After that, nothings funny. My advice? Either fix the damn thing or fake a stroke, now!

Ever hear this? Can you remove these scratches? I always clean them right, and theyre only 12 years old. What do you say? The fact that you are a rodeo clown has nothing at all to do with the scratches on your glasses. They should hold up to the occasional goring.

How do we live with the fact that all frames seem to have 150mm temple lengths now? Even the good stuff has very standard and looooooonnnggg temple lengths because designers in the Far East just know we Westerners have huge noggins. So, we stick the frame on the patient and the temple covers can touch behind their head. It seems that working on a computer makes your ears migrate toward your nose. Within the next 10 years, I fully expect to see patients whose ears are actually attached to their nose.

Frame designers, please take note: We do not have huge noggins. Its our other ends that are growing. Make bigger pants! 




Vol. No: 141:03Issue: 3/15/04