Knowledge Is The Key (Forty-Eight Years Old, Black, Optician, Indianapolis, Indiana Native) 2014

“Well I can’t see what I used to out of these new glasses!  Why is that?”  She stated and then asked.

“Let’s check out what’s going on.  Shall we?”  I stated and then asked.

“Please.  Because I feel like that I have wasted my money with these things,” she said.

“I understand.  But I guarantee you that we are not in the business of making an individual visually challenged.  That wouldn’t be good for business at all,” I said.  And thankfully she laughed.

“No.  I guess that wouldn’t be good at all,” she said.

“You know?”  I said.  And thankfully again, she laughed.

We sat down at the dispensing table.  I pulled out a standard optical reading card that had different font sizes, handed the card to her, so she could read utilizing her new lenses/glasses, to see what was happening with these DPALs (Digital Progressive Addition Lenses) the patient had purchased and I had chosen for her when I entered the order via the internet in VSP’s (Vision Service Plan's) website LOS (Lab Order Screen).

“Okay read the ten point line,” I said.

“I can see it.  But it’s kind of blurry and my other glasses weren’t like this.  My other glasses are clearer than this looking at this line.  I brought them with me if you would like for me to bring them out and show you,” she said.

“Please,” I said.

She pulled her old glasses out with the old prescription, took her new glasses off and put the old glasses on.  

“You see?  It’s not blurry.  I can read this line now,” she said with vehemence.

“And I understand.  Makes sense to me.  But based on my experience and what I am witnessing, can you do something for me?”  I stated and asked.

“Sure,” she said.

“Normal reading distance is bent arms length, twelve to sixteen inches from your eyes.  Tilt your head up while keep looking at the same ten point line and tell me what you see?”  I stated and asked.  She did as I requested.

“It’s looking like the new glasses.  It’s not quite clear.  That’s not making any sense to me,” she said.

“Okay.  Now put on your new glasses if you would please?”  I asked.  She did again as I requested.

“Now look at the ten point line,” I said.

“It’s still not quite clear,” she said scoffingly.

“I understand.  But indulge me for a sec.  Look at that same ten point line.  Based on what I informed you before of, normal reading distance is bent arms length, twelve to sixteen inches from your eyes” I said.

“It’s still looking the same,” she said, patience and indulgence gone at this point.

“I understand. Believe me.  Now indulge me just a little bit longer.  And tilt your head up a little bit more while keeping your eyes on the same ten point font sentence, looking out of the very bottom of your lenses,” I said.  She started tilting her head up.

“Oh,” she said.

I smiled inside, not letting her understand that I knew what the problem was even before we had sat down.

“I’m just telling you this but I’m sure you know already.  The eyes, over time, as we get more mature are not able to accommodate like they used to.  The muscles in our eyes over that same time weaken and going from our distance to our near vision is compromised because of that weakening of said muscles.  That being said, your eyes have accommodated, adjusted to your old prescription by using the intermediate zone for reading and the reading zone has not been utilized because of that.  You have three fields of vision in Progressive Addition Lenses, or what the industry calls, PALs:  distance, intermediate and reading.  Your eyes have told your brain with the old prescription, “Don’t go any further on these lenses because that reading zone is not needed, just put whatever you are reading further from us.”  And it has worked.  But the technology of the PALs now have been compromised unbeknownst to you because of the brain and eyes interaction with one another because the eyes have successfully did what they needed to do to see whatever you have put in front of them given the medium, in this case, the old prescription,” I said.

“You know, the way you explained it to me I really understand that.  I have been to other offices and they would always tell me, “Give it more time. You’ll get used to it.”  And I never did.  I thought you were going to give me the same old trite response to me not being satisfied with my vision.  But you explained it to me the way I can understand it.  And I totally appreciate that,”  she said as she tilted her head down and up slowly.  “Why couldn’t they just explain it to me like you just did?”  She asked.

“Well, you know now.  And really, that’s all that matters,” I said.

“I like you. I really do. Thank you,” she said while looking at me deeply.

“You’re welcome.  Anytime,” I said.