New eyeglasses help - Act 2
August 29, 2014 3:07 PM   Subscribe

This is a follow-up to a question I asked two weeks ago. There's still no resolution - replacement eyeglasses are just as bad.

So, I asked a question two weeks ago pertaining to new eyeglasses, and got some very helpful answers. To summarize for those of you in a hurry, I got a new RX and eyeglasses (lenses+frames), but the eyesight was way too slant-ey and had a serious fishbowl effect. I tried wearing the eyeglasses for several days, but just couldn't bear it, especially when walking and when I was using my computer.

So, I've gone back to the store, explained the situation, and was given a retest. It was determined that the new lenses were given too strong a RX, so the optometrist said it would be best to reduce the strength for both eyes about halfway between the old and new RX, so there would be less of a fishbowl effect. Okay, no problem. That was done, and two days ago, I went in to pick my new glasses up.

Unfortunately, they're still not working. To give you a bit of background of my eyes - the left eye has always been a bit weaker than the right eye. The right len was pretty much just right, but the left len felt very off - it was even more blurry than the current eyeglasses I have now, in the left eye, and caused a serious fishbowl effect. If I closed my left eye and just used the right eye, everything seemed almost normal, with enhanced vision.

I explained this to the manager on duty (who I've been working with since the beginning), and she suggested I try it and let her know on Monday. I've been trying them, and no go. This is beyond frustrating. I also asked if the reason behind the distorted vision was because the new frames were smaller than the old one, and was told it was possible, but that they weren't sure. So, here's two pictures - one of my current eyeglasses frame, and one of my new, smaller eyeglasses frame. Please tell me, based on your experience, if that would be what makes a difference.

Picture 1 - old/current eyeglasses frame
Picture 2 - new eyeglasses frame

You can see that the old/current frame is wider and more rectangle-shaped, while the newer frame is more circular and not as wide. Would that make a difference in vision, or is it purely stylish differences??

I talked to the original (different) eye provider who gave me the RX and frames/lens for my current eyeglasses (not the new ones), explained the situation, to see what my financial options would be. I explained my current frames are falling apart/has a screw missing, etc. So, right now, my options here are:

a) Get a full refund from the new provider, cancel the whole thing altogether, keep my current frame - get a free replacement of the frame from the previous provider (they offered), then simply re-test and get new lens with the old provider.

b) Stay with the new provider, see if they accept empty frames, get new lenses only for the frame.

b) Stay with the new provider, try and get the left lens replaced.

I'm not sure about (b) and (c) because it's already been two times - and I'm not completely sure the second re-test was completely understood by the doctor testing me. Being Deaf does allow for a communication gap. There felt to be kind of a small communication gap between me and the second doctor/retest, but at the end, I was confident it was fully understood. However, I feel very guilty for putting them through all this, and being a pain in the ass, probably. Just getting a full refund would make them lose out on the money, but at the same time, I feel like I've kept trying, and I'm still not completely sure they understand the issue I'm having. They're a small boutique - here's their Yelp. The previous provider was MyEyeDr, and the first test in 2012 was perfect with perfect results, and it just felt more smoother overall. This has been so frustrating. I know this isn't the normal adjusting process, because I've NEVER had this problem in the 15+ years I've had working with various optometrists.

I could tell that the manager was a bit frustrated, too - whether or not it was with me or with the whole process in general, I couldn't tell. I've been very polite throughout, apologetic for their time being consumed, etc, but there's only so much I can do. I'm not saying my eyesight is any more important than yours, but being Deaf does deprive me of one vital sense (hearing) so I depend on my visual senses all the time, so this is really important to me.

I have no idea what to do next. Seriously, I'm at a standstill here.

Bonus info/question:
-The current eyeglasses I have now (the old ones) use poly. The new ones use hi-index, if that makes a difference.
-When they clean my glasses, at any eyeglasses store (any chain/business), they simply use a dry cleaning cloth to clean the glasses, no spray. Wouldn't this leave scratches where dirt were?

OD - sphere, -6.00; cylinder, -0.75; axis, 096; dist PD, 35.5; near PD, 0
OS - sphere, -7.75; cylinder, -0.75; axis 065; dist PD, 32; near PD, 0

The above RX was for the original new eyeglasses RX, but they said they reduced it by 0.25 or 0.50 (not sure). I don't have all the information, sorry.

YANMD. Any questions you've got, please feel free to ask.
posted by dubious_dude to Health & Fitness (17 answers total) 1 user marked this as a favorite
The stronger the prescription, the more the size of the lens makes a difference. That may well be part of the problem.
posted by prefpara at 4:13 PM on August 29, 2014

Two things I know are:
- High index lenses have the worst optics of any lens options. Polycarbonate isn't much better, but it is better. Regular plastic is best of all. Your provider should have told you that.
- Smaller frames make a big difference, especially with strong prescriptions like yours.

I would definitely suggest going with your option A. I had a terrible time when I first got progressive lenses; went through several opticians over a few years, and learned a lot. Two of the things I learned are:
- There are a lot of people dispensing glasses and lenses who don't know as much as they should. A good optician, who knows what they're doing and who listens to you, is worth finding, no matter how much time it takes. A good optometrist too.
- Some of the reason glasses and lenses are so expensive is that the cost of a lot of remakes is built in. Do not feel bad about how much money your current provider is out - it's very little. And you need and deserve good lenses. This isn't something you should compromise on.

Good luck. I've been there and it's horrible. Find a knowledgeable optometrist and optician who are willing to take the time to work with you to get the lenses you need.
posted by still_wears_a_hat at 4:43 PM on August 29, 2014 [1 favorite]

Response by poster: Thanks for the helpful answers so far!

So, part of the problem is that I'm on a budget, I'm on MedicAid (which most optical places do not accept in the DC area, for whether reason), and I'm trying to save money.

As I've had a good experience in 2012 with MyEyeDr, it's likely I'll go back with them. How should I go about getting a refund? Issue- I paid hard cash upfront.

With the LivingSocial voucher, there was a $225 credit towards the exam, frame, and lens. If I get what I paid out of pocket ($270) back and keep my frame, the exam and lens at MyEyrDr should cost about that. Why would poly be less better than plastic? I've have had poly for as long as I can remember.

Also, wow. I now look back on it, and I think I was given an upsell. Either that, or the manager really was convinced it was better. Why does hi-index have the worst optics?

Sorry if there's so many questions!
posted by dubious_dude at 4:59 PM on August 29, 2014

> That PD is a huge flag.. Especially for how wide it is on the right eye where you are experiencing the fishbowl effect. It could very well be inducing prism, especially with such a high rx.  The high index material  is a flatter lens and probably better than the wider framed polycarbonate as far as optics go. More lens = more room for distortion.   (Plastic would be bulky, and if you haven't had issue with poly in the past it is most likely not material. Poly is safer/shatterproof. Glass is clearest optically , but it is extremely difficult to find for safety reasons and would of course be even heavier ).  Without seeing them on your  face it is harder to tell (if the frame was too wrapped or otherwise warped that can cause screwy optics as well)   but what you are describing sounds like unintentional prism (bending of light /fishbowl). It is very possible to get untrained storefront opticians that have no understanding of optics, that is so true.   If the glasses are verified to that rx/pd, this could be why they act frustrated..I agree with requesting someone else immediately who listens and processes. Instead they should be double checking all measurements ON the patient (including remeasuring PD as well as OC height) and not fudging on ANSI standards (not allowing the rx to be a quarter or a tenth of a diopter off etc. With your high rx there is less wiggle room). They can dot the lenses, recheck fit, and verify for prism. PD should be individually measured at the time of purchase, especially if you haven't been there before, so if they didn't do that in store or again before remaking them, they should do it now to reverify. Entirely up to you if you want a refund, most places have their own refund/remake policy so ask them. Should be safe to assume the remake costs are built in at least for a certain period of time, and if they were careless with measurements making and remaking them, then the remake is again on them. It might help to call the previous place for unofficial pd's since you had success there and it's a valid starting point.
Compromised vision is very frustrating /unsettling and affects quality of life. You are not wrong to be insistent. Good luck! (PD= pupil distance OC= optical center hth)
posted by lawliet at 6:46 PM on August 29, 2014 [2 favorites]

Response by poster: What exactly is a PD?

Also, I'm a bit confused - one poster said hi-index has the worst optics, while another said the hi-index material is better. Can you clarify what you meant, lawliet?
posted by dubious_dude at 7:22 PM on August 29, 2014

I think PD is pupillary distance, no?
posted by limeonaire at 7:43 PM on August 29, 2014

Response by poster: Sorry, I overlooked that part. There's a lot to take in, so I'm trying to process it all.

How can I tell an optician/optometrist is good or not?
posted by dubious_dude at 8:28 PM on August 29, 2014

If you look at yourself straight in the mirror, is the part of your nose where your glasses sits centered between your pupils? Take a ruler and actually measure this. As lawliet says, the PD numbers on your prescription say that they measured your nose as being off center, toward your left pupil, by quite a bit. If it looks centered between your pupils, I'd be very suspicious that the PD measurement is the problem.

If you can't see, keep going back. It sounds like you've paid them $495? You should get glasses you can see through for that price, for pete's sake.
posted by fritley at 10:09 PM on August 29, 2014

I've seen cases like yours bewilder licensed opticians with 15 years experience, there are a lot of factors involved and sometimes someone is an outlier. These are my thoughts on your situation (I only had 2 years experience myself)

1. The times I've seen a prescription changed by one full diopter the patient has never been able to handle it. It seems this must be done in steps. (We always wished the one doctor who did that would remember, as this doctor always got these patients coming back and we always had to remake the lenses. This doctor did explain to us that the person tested again at the big diopter change but since he/she could not adjust to the first pair the doctor weakened the new prescription--we didn't just assume this was the case)

2. They should look at how you wear the old glasses, if the lenses are sitting typically or not. Bent frame or nosepads adjusted strangely on old glasses are two things that could affect how the lens sits. Fresh new glasses will sit differently. If the glasses were broken and you wore them crookedly for some time this will affect how you react to new glasses.

3. What is the PD on your old glasses? The store may have measured your PD accurately but if it's different than what you're used to, the lenses will feel weird. As the optician I would call the old optical place for PD/get PD off old glasses and ask for any notes they may have kept when you got those glasses. I'd also want to know all your old prescriptions from them or anywhere else, how you reacted to prescription changes (if there are any notes or retests) and what lens materials you have worn in the past if any of that info could be tracked down. Also, adding an astigmatism correction (or possibly just a change) can cause a fishbowl feeling. (I got the fishbowl feeling when 0.25 of astigmatism correction was added to one eye that hadn't had it before.)

4. Looking at the glasses photos you posted, the nosepads appear much farther apart on the new pair so they may be sitting oddly in comparison to your old glasses. I wish I knew the measurements of the two pairs, but it looks like the lenses of the new glasses are larger or at least deeper, and get much thicker on the bottom edges. Since they actually went with a thinner lens material on those this tells me they allowed you (or even guided you) to pick a frame that didn't suit your prescription very well.

5. There was one man whose lenses we remade several times and they just weren't right for him, until we went back to the lens material of his old pair, poly, and then his eyes were happy. I know he went home with those various new lenses and then came back (I do not know how long he wore those lenses to try to get used to them so it's possible he could have eventually become used to it). He was the only person my 15-year-experienced coworker had ever heard of with this situation (of only being able to deal with one lens material). It's possible you may be another such person, although the other things I brought up should be addressed.

High-index lens material is not optically best--it does not have the best refractive index--which standard plastic or poly lenses do, and that's the way those two are better. However for high prescriptions like yours, with aspheric high-index plastic the lens stays flatter and can be quite a bit thinner than it otherwise would be. It's a tradeoff that's usually worth it and most people have no perception of the difference. While being a somewhat poorer lens material means there can be distortion or abberation, the curvature caused by using standard plastic or poly for a prescription like yours may create distortion of its own. It's possible you're used to that exact distortion and now when faced with less distortion (or just different) due to a different lens material you're not doing well.

High-index is not a safety lens, poly and trivex/duralite are. However I faintly recall that a nominal thickness makes any lens into a safety lens, so your lens may indeed be thick enough to be shatterproof and thus protect your eyes. (I know this came up with a child with a very high prescription suitable to high-index, but normally we put children into a safety lens since they're so active. I don't recall the outcome for sure) The optician should be able to address whether this is the case with your current lens material. The safety lens issue is one that as an optician I would have considered important, wanting to protect your sight ability as much as possible.

If there is a difference between old and new in some of the the things brought up like PD and how the lenses sit I would pursue having the current place remaking the lenses, but also addressing the thickness issues at the edges of the lens. They should be able to find several frames of similar design and SIZE to your current pair to ensure you're not getting lenses with more thickness on the edges--no matter what lens material.

Previewing I see PD was brought up in a way I forgot to address. The different numbers for your right side and left side distances aren't outside of normal range, but some optical places just use the total measurement, they would just give your PD as 67.5 and each lens would be ground to a PD of 33.75. The way the new place measured is more correct for where your eyes really are on your face (if they measured correctly) but your older glasses may have been made the other way and that makes the old pD vs the new PD become a factor more easily.
posted by Anwan at 10:31 PM on August 29, 2014 [3 favorites]

It looks like most of your questions have gotten answered, and by people with more knowledge than me. One other thing I'd suggest is always paying for glasses with a credit card rather than cash - you can take up problems with your credit card company if the optician isn't willing to help you. In your case, it looks like the provider at least cares about their reviews, so maybe that will be useful.

In my experience, good opticians are not in chains or franchises (like Lenscrafters); they tend to be small, with the same opticians there whenever you go. They don't usually have optometrists on their staff, though I probably wouldn't rule one out based on that. But what I ended up doing was going to every local optician and just talking to them about the problems I'd run into with my progressives. The good ones were willing to talk to me at length, had good suggestions, and told me things I hadn't known before (like about lens materials, lens brands, pupil distance, prisms, etc.). I found my optometrist, who is great, by asking the best optician for a recommendation. That's clearly going to be harder for you to do, but maybe there's someone you could bring that could have the actual conversations. I was looking for knowledge, and willingness to share it. But there was a lot of trial and error before I figured it all out.

You can save some money on glasses by buying frames online or on eBay; just get similar sizes (lens height, width, and distance from each other) to your old ones. Any good optician will put lenses in any frames you bring in (I'd stay far away from any who won't). There's some amount of size information on the frames themselves; here's a chart and some explanation. If you get frames with a very similar size and shape to your old ones, that will help narrow down what's bothering you about the lenses.
posted by still_wears_a_hat at 6:32 AM on August 30, 2014 [1 favorite]

Just to clarify: I am not suggesting you buy your glasses online. Just the frames. People like us need the fitting, adjustments and advice you can't get online.
posted by still_wears_a_hat at 6:47 AM on August 30, 2014

If your new glasses aren't right, keep going back until they fix the problem. It's amazing how common it is for optical stores to make errors.

I stepped on my glasses and destroyed them when camping in the Colorado high country years ago. I went into town and had an eye exam and ordered new glasses. When I picked them up and put them on oooh I did not feel right at all. I complained and they told me that it had to do with moving from a narrower, smaller lens to a wider, larger lens and that my eyes would take a few days to adjust to the new center of each lens. Or something like that. I drove around the block and had to pull over and vomit because I got so sick so fast with the new lenses. I went back and they took the glasses back and told me the optician would look at them and see if there was anything wrong when he came in the next day.

Back to the mountains with one lens taped into my old taped up frame -

Back to the store. Turned out the lenses had been ground backwards/upside down - what it amounted to was that the left lens was upside down and had been ground "backwards". That time the new lenses worked just fine - no problems with my eyes adjustiing to center or any such nonsense - I've been wearing glasses since I was 12 and I've had every size and shape imaginable - even "cat-eyes" - and never had any problem adjusting to center.

Just keep going back - Medicaid or no. And if you feel queasy, take off your glasses pronto!
posted by aryma at 11:08 PM on August 30, 2014

Optician here.

Some people above are confused. Polycarbonate has the worst optics out there, but 1.74 and 1.67 high index are not much better. They do have DIFFERENT optics from one another, though, so let's start with my first recommendation: go back to your original material. In a high Rx consistency tends to be the key. If you are feeling adventurous, maybe try a material called Trivex -- very lightweight, a bit thicker than poly, but the best optics you can get outside of regular plastic and crown glass. It's all I wear.

The frame is likely not causing any issues. Strong Rxs can have trouble with swim, peripheral blur, and fishbowl effect going from smaller to larger, but not vice versa.

Forget about trying to measure your own PD in a mirror. The fixation gets off and you won't get any kind of accurate answer. That said, that PD is more than likely off, and even if it's not, it's possible that your old glasses were made using a binocular PD instead of a monocular one, which means they divide the full distance between your eyes exactly in half, instead of measuring from the center of your nose to each side and coming up with different distances. This is not the best way to do it, and if it happened with this kind of prescription it means you would have kind of been screwed by the old office since you get used to looking out the induced prism that an incorrect PD causes, but if you're used to it, well, you're used to it and it's too late now. The best option would to ask your old eye doctor for the PD in your current glasses and to match that. If they won't give it to you (I'm sure they will if you explain the situation) then have the new office measure what it is in the old glasses. In sum, my second recommendation -- go back to the old PD.

Third recommendation: Have them match the base curve of the lenses in your old pair. There is nothing wrong with changing the base curve to the one that presents the best fit with the frame and Rx, but sometimes people are sensitive to any change and it needs to be consistent. It doesn't need to be exactly the same, but within -/+0.50 either way is best for optimum consistency.

Fourth recommendation: Have them measure and manufacture an optical center in the new lenses. PD is the side-to-side measurement of the location of your eye in the glasses, but that's only half the equation! You also need the up-and-down measurement, which is the OC. Many places are too lazy to do this on a regular basis and it's an awful shame. It's imperative with an Rx of this caliber.

Fifth recommendation: When they are adjusting the glasses, ask them to put a bit of face form (curvature) on the front of the frame. This helps with peripheral vision issues.

So now after all this: if they balk at any of the above suggestions or claim they can't do them, you are dealing with incompetence and you need to demand a refund and go elsewhere. Hopefully they can fix the issues and this sorts out the problem.
posted by silveridol at 1:00 PM on August 31, 2014 [3 favorites]

Oh, and also? If they do the above things and they don't work? The Rx is probably screwed and I'd get a refund and go back to the old place.
posted by silveridol at 1:04 PM on August 31, 2014

I explained this to the manager on duty (who I've been working with since the beginning), and she suggested I try it and let her know on Monday.

It does not sound like she is effectively relaying your concerns to either the optometrist, optician or lab that makes the glasses.

As someone with a -5.75 Rx and high astigmatism, I would be beyond frustrated. Insist that they get it right, and absolutely do not feel an ounce of guilt for making them do what you have already offered them two tries to accomplish.

Remind them that their website advertises "100% satisfaction" and hold them accountable to it.
posted by invisible ink at 3:19 PM on August 31, 2014

Response by poster: Worst case scenario: if I ask for a refund, and am refused, what recourse do I have? As I mentioned in my original posting, I paid with hard cash, so having the credit card company intervene is not a possibility.
posted by dubious_dude at 9:36 PM on August 31, 2014

They are actually a small chain so they should have some sort of small corporate office. I didn't find a direct way to contact that though. If the store goes through the steps outlined above and it doesn't work, and you want to take your money to the previous place, and they won't refund you, say "If you cannot refund me, I would like a contact number for your chain's main office before I go on Yelp and Google and let people know you can't handle high Rxes and won't refund my money. I want your company to have every chance to handle this correctly before I tell anyone that you did not treat me right. I will also contact the Better Business Bureau and if I have to, I will file in Small Claims Court."

The store's manager will probably refund you at that point. If not, and if the manager actually does not give you a contact number (possibly they are so small they actually don't have a main office?), I would then try calling a different store and pleasantly asking for the main office's contact info. If/when they ask why, say something like the above statement. If they still will not give you contact info/issue a refund, then go on those sites and make a factual report of what they did and didn't do. I would do it for all 4 store locations, specifying that it happened at the one particular store but that buyers should beware their ineptness and no-refund policy. Definitely contact the Better Business Bureau.

I think you should be willing to let them try a few things to make your glasses work, but I am not right there with you hearing what the manager is saying/seeing what they are doing so I can't really make the call if bailing now is reasonable or unreasonable. But you have a script now.
posted by Anwan at 10:07 PM on September 2, 2014

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