A Post-It note leads me on a quest to make it right for the patient
After three glorious vacation days, days I spent catching up with my family and getting some much-needed sleep, I returned to my office. I appreciate time off as much as anyone, but after a few days I feel ready to return to my office with its cheerful photos and framed motivational messages designed to keep me in my imagined happy place. It is almost always a pleasure to return to my little “home-away-from-home.”
This return would have been perfect if it weren’t for the dreaded Post-It notes! These Post-It notes are becoming the bane of my professional existence and wreaking havoc in my quaint little office space.
They are found stuck everywhere-on my computer screen, on my keyboard, and this week a Post-It had been placed on one of my beloved motivational message frames.
After a few deep breaths, I began perusing through the seven or eight Post-Its when one note caught my attention. It was from the optometrist, and said: “Mr. Smith stopped in today and is noticing blurred vision with his new sunglasses. I re-checked his refraction, and the problem does not seem to be with his new prescription. I did, however, notice his sun frame has quite a curve on it, would you please check the base curve?”
He went on to explain the lensometer verified the prescription and the pupillary distance. He wrote, “I told him you would call him today to fix the problem.” Signed, The Prescribing Doctor.
When I receive multiple Post-It notes, I know they usually require prompt attention. This note from the prescribing doctor meant two things to me.
The first is the confidence shown by the doctor in my ability as an optician to troubleshoot and find the answer for the patient, and the second is I had some serious detective work to do.
I began by reviewing the patient’s file. I looked at the prior prescription, comparing it with any changes made by the doctor. The changes were minimal, although one significant change was an addition of prism in each eye. I also noted a chief complaint during his most recent comprehensive eye examination of his distance vision seeming slightly weaker than during his previous examinations.
It was interesting that my patient had also purchased dress glasses dispensed without any complication, which was an indication to me that the new prescription was, as the doctor thought, probably not the cause.
The plot thickened as I realized the patient had purchased the exact frame with the exact style, material, and tinted lenses the year before, so he clearly had been comfortable with the base curve of the sunglass frame and lenses.
I continued by checking the pupillary distance, which had not changed from the previous year. Every measurement taken seemed fine. The culprit could possibly be the position of the frame on his face together with the new prisms; the placement of the lenses may hold the answer to our optical dilemma.
I admit I had thoughts of returning his new sunglasses to our lab for a lens evaluation when our patient dropped in. It seems he was curious about the situation and wondered if I had any new thoughts. I spoke with complete candor when I told him that I as currently working on a solution but hadn’t found one yet.
I asked him to put on the new sunglasses and describe exactly what he was experiencing. He said his vision seemed blurred, and it was impossible for him to read the documents on our wall approximately 15 feet away. He then put on the new dress glasses and read the documents with complete clarity. I asked to see his previous/original sunglasses.
When he retrieved them from his car, to my surprise the lenses had the same base curve as his dress glasses, which was approximately 6.25 BC OU. That seemed a little strange because the frame appeared to have a significant wrap.
When looking directly at my patient, I realized the frame had a natural wrap from the bridge. The new lenses, however, had a base curve of 8.75 and a more conventional wrap style. It was becoming clear to me what the possible problem might be.
I removed both lenses from the new sunglass frame and let them “rest” for about 10 minutes. Then, using my lens clock, I checked the base curve again.
After rest, the lenses were both at approximately 7.50 BC. I have a small hand edger in my office I use for occasional lens size corrections. I began by re-edging the lenses-minimal edging was necessary because I didn’t want the lenses too small for the frames. I re-mounted them in the frame.
Much to my relief, the lenses seemed better to my patient. His visual acuity was improved, and he was able to read some of the wall documents. Following adjustments to the wrap of the frame, our patient began to feel more comfortable with his new sunglasses.
However, in the end I had to return the sunglasses to my lab because the lenses did not maintain their base curve, which did not optimize my patient’s new prescription.
When his sunglasses arrived following their re-make, I allowed extra time during dispensing to talk with my patient.
We discussed the events that had transpired and the many steps we had gone through to ensure he received the finest eyewear, and I made certain he understood that his visual comfort was our top priority. After careful alignment, his visual acuity seemed perfect.
He was beyond satisfied. He felt that although he had to make several trips to our office, it was worth every second, and the extra attention assured him that he is a valued patient.
Although my patient had to wait an additional three days to receive his new sunglasses, I had been able to restore his confidence in our practice, making a return visit for his eyewear probable.
I don’t actually think of myself as a super optician, but I find that I am super at finding answers to dispensing dilemmas. I also take great pleasure in developing an understanding of trust with the doctor-together we recognize each individual patient and his importance to our practice’s continued growth.