How To Troubleshoot Vision Problems With Prescription Eyeglasses

by admin on 20/10/2011

When a patient or customer returns not satisfied with eyeglasses, complaining of vision problems during wear, the first thing any Optician must do is listen well in order to learn how to troubleshoot the patient’s vision problems swiftly and accurately by a list of quality standards checks.


  • Review the eyeglasses prescription to be certain the eyeglasses prescription is identical to the prescribing doctor’s Rx, taking notice that if the eyeglasses prescription is in the high plus or minus that there can’t be too much variation at all in the prescription as this could alter a patient’s vision.
  • Check the patient’s pupillary distance, or PD, with what is marked on the eyewear.  If they are at different locations, this could cause a “pulling”  or “strain” effect on the person’s eyes.  The inset/outset of the lenses in the frame should match with the person’s pupil.
  • Check pupil height, being certain that it isn’t too high or low.
  • Check for prism and waves.
  • Check bifocal heights, making certain the bifocal isn’t too high or low.
  • Check for scratches or swirl marks interfering with vision.
  • Check vertex distance and ask the patient at what location is the vision better, closer of further away from the face.  Sometimes this can be fixed with a simple adjustment, but other times, the patient needs a change in prescription.
  • Check for proper pantoscopic tilt which could move the pupil height dramatically.

Lastly, if needed, check with the prescribing physician to find out what the person’s best refracted vision is with correction.  Also find out if there are any ocular conditions such as cataracts or recent cataracts removal, macular degeneration or more than could create possible vision difficulties for the patient.  If so, simply send the patient back to speak with their Ophthalmologist or Optometrist for further information or a prescription recheck.  Do not take on the doctor’s assignment and begin to explain a patient’s diagnosis.  Allow that person to visit their doctor.  Use the information obtained for future reference and issues that may arise in the future.

If you are an Optician working side by side with a doctor, this type situation is made much easier as the doctor is there in a snap and has possibly already given certain permissions to his staff.

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