Now let’s review the proper way to adjust a pair of glasses on our patients face. It’s important to note that prior to taking any measurements, whether it be PD or OC or seg-height also including vertex, pantoscopic tilt or wrap, that you perform any and all frame adjustments possible to get the frame sitting exactly how you want it prior to taking any of these measurements.
Now let’s get started. The first thing that you want to make sure is that your patients’ eyes are sitting level in the frame. Once it looks level to you, you can either use a digital measuring device or take your PD ruler and measure from the bottom of the lens to the center of the pupil on each eye. This will verify that the glasses are sitting straight. If they are not sitting straight what we have to do is take the glasses off of our patients face and adjust accordingly. If we have a lens that is sitting too high like this or too low, we have to adjust accordingly on those temples.
So, when our glasses are on our patients face, we must first determine is this side too high or is this side too low? This is technically chosen specifically by how it looks aesthetically on your patients’ face. The eyes should always be at geometric center on the lens or higher. But the frame itself should never cover up someone’s eyebrows. Unless they choose an oversized frame intentionally, because of the design that they want. So, in this case I feel that this side of the patient’s frame is slightly higher and I like the way that this side looks. So, I need to make this side drop down. In order to make this side of the frame drop down. I need the temple to go up in the back, that’s how we drop a lens down. If I wanted to raise it up, I would do the exact opposite by making the temple go down. But we need to adjust it with the proper tools. So, I want you to take you wide angle jaw pliers, placing them correctly on the hinge itself and now since we need the lens to drop down, I want you to take and bend the temple up to give it the slight curve we need. Then we place it back on our patients face. And we notice that we’ve bent too much.
Now if we look here, we can see that this side looks too high or that side looks too low. So, let’s even that back out. Again, we grab the correct pliers, rather than using our hands. If you don’t use your pliers, all of the bending that you will do, will actually be on the hinge itself which can ruin the integrity of the frame. So, once we grab it with our pliers, we can get our proper adjustment by bending the temple back down slightly and then try it again on our patients face.
Once we are happy with the adjustment, for straightness here, we then want to move to how the nose pads look. Now here if we look in, we can see that the nose pads are sitting fairly even. But you always want your nose pads to match the curvature on your patients nose. So, as we put it on, we do what I call a bounce test. Where I simply lift the glasses up and let them fall. To see if the nose pads appear to be contacting the nose at the same time. If they are not impacting the nose at the same time when they drop on the patients face, you can create some undo pressure, creating a red mark on one side of the nose and not the other. It’s also important to note, that nose pads should not be what hold the glasses up on the patient’s face, that’s the job of the temples. And that is what we are going to adjust next.