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PRESCRIPTION PERPLEXITIES

HOW TO HANDLE PATIENT DENIAL AND DEFIANCE

ALAN GLAZIER, O.D., F.A.A.O.

AS AN optometrist, you’re are also an “opticalogist,” or one well versed in the study of the behavior and mental processes associated with eyewear.

The following are two statements we “opticalogists” hear often, along with suggestions from “ODs on Facebook” colleagues regarding how to effectively deal with them.

“I READ BETTER WITHOUT MY GLASSES”

Denial: It’s not just a river in Egypt. In this case, it was a -2.00D to -4.00D progressive wearer. Explaining to these patients why they still need a reading element in their lenses can be frustrating.

Here are the replies that received the most “likes”:

• “I’d say, ‘you’re right; but do you want to always have to take off your glasses every time you need to casually see something up close?’” 31 likes

• “You don’t [explain it.] Just let [these patients] take their glasses off.” 13 likes

• “I tell [these patients] being nearsighted is like having a built-in bifocal. You are actually using your nearsightedness to your advantage, so progressives are lenses of convenience, not of necessity, for you.” 11 likes

• “A progressive in their case is for convenience. I discuss the options with the patient: advantages and disadvantages. I let them make the decision. Your patients will be much happier. . . Telling patients they need a progressive will only lead to an unsuccessful progressive wearer.” 11 likes

• “I tell them (and myself) that ‘yes, nothing can beat wearing nothing, as that is your natural set point; however, progressives are great so that you are not taking your specs on and off constantly. By all means, [for] extended reading, feel free to take them off!’” 10 likes

“MY GLASSES MAKE ME FEEL SICK”

A member of “ODs on Facebook” recently posted that a woman who had gotten her glasses elsewhere presented to his office with this complaint. Specifically, her new prescription was -0.50 sphere. The doctor informed her that she is too sensitive to withstand any prescription change and would do best with her previous prescription, which was -0.25 sphere. The patient replied she couldn’t see “clearly” in her former prescription. This post received 165 likes.

The replies that received the most “likes”:

• “If you get -0.25 as a prescription, she’s probably really a +0.50. What’s her incorrect uncorrected VA? I’d check it wet.” 12 likes

• “If we had made [the glasses], I’d give them the ‘shelf’ redo. Tell her that you’re going to fix them, stick them on the shelf for a week and then dispense them. It works like magic.” 7 likes

• “With the perception that -0.50 is wayyyyy too strong, your only option is to bite the bullet and remake them to -0.37 O.U. This is most likely a psychological issue, and this step ‘should’ appease her by giving her half way between the old and new. . . If the ANSI tolerances err low, do the shelf trick as described above. Good luck!!” 4 likes. OM

DR. GLAZIER is founder of Shady Grove Eye and Vision Care, a five-doctor medical-model practice in the Rockville, Md. suburbs of Washington DC. He is an author, inventor, industry consultant and frequent lecturer on ocular disease and Internet marketing. He can be reached at aglazier@youreyesite.com. Be sure to follow him on Twitter @EyeInfo or PM him on Facebook.