ask the labs

by Karlen McLean, ABOC, NCLC

Special Cases

FACE FORM
Q: Due to severe facial injuries, one of our patients currently has no nose or ears. The patient is not a contact lens candidate. Can you suggest a vision correction solution?
A: The easiest solution would be to mount lenses in a sport frame chassis designed to be secured using only a headband. The design does not require support from the nose or ears.
Another option is to mount standard lenses in a head-worn magnifier, similar to what surgeons use in an operating room. This would allow the lab to put proper lenses in front of the patient’s eyes, but not come into direct contact with any facial features.
A third option would be to mount corrective lenses into a swim goggle secured by headband strap only.
There are also several safety eyewear applications, including mounting lenses on the inside of a full-face shield or within a carrier, that are designed to fit onto a number of different apparatuses, such as headgear, hat visor, or respirator attachment. None would require direct contact with the face.
— Jeff Szymanski, vice president, Toledo Optical Laboratory, Inc., Toledo, Ohio

WIG OUT
Q: I have a patient who wears a wig that makes her frame temples fit too tightly. Do you have any recommendations for a temple type and adjustment?
A: Many new metal frames are available with flexible temples that bow out around the side of the face and come in behind the ears at the tips. With a plastic frame, we could file the temples slightly at the hinge, which would cause them to fit in a more open, wider manner. Then we could bring the temple tips in for fit.
Many labs can send a representative to your practice to help consult with patient troubleshooting challenges like this.
— Susan Armel, branch manager, Rooney Optical of Pennsylvania, Latrobe, Pa.

TINY eyes
Q: Can you recommend a few of the best ways to adjust an infant’s eyewear?
A: Frames must have comfort cable temples to wrap around the ear for security. The cable should be long enough to encircle the earlobe. If the temple is too short, the glasses may press into the face causing red marks or pressure at the bridge or ears.
Since the bridge of an infant’s nose is not fully developed, the bestfitting frame in most cases is a plastic frame with a flat saddle bridge. When adjusting, make sure the cable temples aren’t too tight. When the glasses are opened, the temples should be even. When held to the side, the temples should also be evenly angled. If a temple is angled too low, the glasses will sit too high on that side. The temples should be adjusted to fit the individual with pantoscopic or retroscopic tilt.
— Sam Odom, director of education and marketing & Mark Schanbaum, national sales director, Legends 4.0, Optical Laboratory, Lewisville, Texas

If you have a question you’d like to have answered in Ask the Labs, send it to Karlen McLean. E-mail: mcleank@lwwvisioncare.com. Fax: 215-643- 1705. An archive of past Ask the Labs columns can be found on the Eyecare Business Website at www.eyecarebusiness.com.