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Ophthalmic Frames: Final Fitting

by Brianna Cuenca on October 25, 2024

Final Fitting for Ophthalmic Frames: Checklist & Guide

A proper frame adjustment is one of the most important aspects of optical dispensing. A poorly fit frame will result in an unhappy patient. Not only is it likely to cause discomfort, but in cases of stronger powers or high astigmatic corrections, it may even alter the prescription. Although frame adjusting is a skill which needs to be acquired through experience, there are certain basic principles which can be learned and applied almost immediately and we will cover those here.

In this article, we delve into the essential aspects of final fitting for ophthalmic frames, providing insights into techniques, measurements, and best practices that ensure optimal comfort and performance. We have also added key takeaways to consider for ABO/NCLE exams.

 

Opthalmic Frames

The Impact of Eyeglass Fitting on Patient Satisfaction

A frame that does not sit correctly can cause headaches, blurred vision, and frustration.

  • Comfort: A well-fitted frame should feel secure without being tight. It should not exert undue pressure on any part of the head or face.
  • Visual Clarity: Proper alignment of the lenses with the eyes ensures that the wearer sees through the optimal part of the lens, maximizing visual acuity.
  • Aesthetic Appeal: The right fit enhances the overall appearance, making the glasses an accessory that complements the individual’s style.

The Role of the Optician

Opticians play a crucial role in ensuring that the frames fit correctly. Their expertise in frame adjustment is essential for achieving a perfect fit. An optician must not only understand the technical aspects of fitting but also be able to communicate effectively with patients about their needs and preferences.

  • Personalized Service: Each patient’s face shape and size are unique. A skilled optician can tailor the fitting process to individual requirements.
  • Attention to Detail: The final fitting process involves meticulous attention to various measurements and adjustments, ensuring that every aspect of the frame is optimized for the wearer.

Key Measurements for Frame Fitting

The Fitting Triangle

Understanding the fitting triangle is fundamental to achieving a proper fit. This concept involves three primary contact points: the bridge of the nose and the areas behind each ear. These points form a triangle that supports the weight of the glasses, distributing it evenly.

  • Bridge of the Nose: The frame should rest comfortably on the nose without slipping or pinching.
  • Behind the Ears: The temples should not touch the head before reaching the ears, as this can cause the frame to slide forward.

The fitting triangle

The temples should never touch the patient on the side of the head before reaching the ears. Should this occur, it creates a constant tendency for the frame to slip forward resulting in additional pressure on the nose and behind the ears often causing soreness. Also, great care should be taken to ensure the temple tips do not touch the sensitive cartilage behind the ear. The frame is held on as the result of friction on the side of the head behind the ears due to a slight pressure.

Essential Measurements

To ensure that frames fit correctly, several key measurements should be taken:

Measurement          Description
Eye Size          The width of the lens, typically measured in millimeters
Bridge Size          The shortest distance between the lenses
Temple Length         The length of the arm from the front of the frame to the ear
Head Width          The distance across the head at the ear point

 

These measurements are critical in determining the appropriate frame size and style for each patient.

The Methodology of Adjustment: “HELP” Model

Step-by-Step Adjustment Process

Adjusting frames is not merely about bending them into shape; it requires a systematic approach. The following mnemonic, “HELP,” can guide opticians through the adjustment process.

H is for Head Width

The first step is to ensure that the frame’s head width corresponds to the patient’s head size. A frame that is too narrow can cause discomfort and misalignment.

  • Measurement: The distance between the fully opened temples at the bends should match the patient’s head width.
  • Adjustment: If the frame is too narrow, it may need to be widened slightly to avoid excessive pressure.

E is for Ears

Next, the length to bend of the temples must be adjusted. This is crucial for ensuring that the frame sits properly behind the ears.

  • Visual Check: Each side should rest snugly on the top of the ear without causing pressure.
  • Adjustment Techniques: Depending on the frame material, adjustments can be made by heating or bending the temples.

L is for Angle

The angle of the temples, known as the pantoscopic tilt, should be adjusted to ensure the frame sits squarely on the face.

  • Assessment: Many individuals have asymmetrical ears, so the angle on one side may need to be steeper.
  • Final Positioning: The front of the frame should remain parallel to the plane of the face.

P is for Pads

For frames equipped with nose pads, proper adjustment is essential for comfort.

  • Alignment: The pads should be positioned to ensure the frame sits at the correct height and does not dig into the skin.
  • Material Consideration: Depending on the patient’s comfort, different types of nose pads may be recommended.

Verification and Pre-Delivery Inspection

Ensuring Quality Before Delivery

Before handing over the completed spectacles, a thorough inspection is necessary. This process ensures that the lenses conform to the prescribed specifications and that the frames are free from defects.

  • Lens Quality: Check for scratches, blemishes, and proper optical centers.
  • Frame Integrity: Ensure all screws are tightened, and the frame is clean before delivery.
  • Standard Bench Alignment: Pre-adjust the eyeglasses before delivery to ensure standard bench alignment.

Final Adjustments

After the inspection, any last-minute adjustments should be made to guarantee that the glasses fit perfectly.

  • Fine-Tuning: Small adjustments can make a significant difference in comfort and fit.
  • Patient Feedback: Engaging with the patient during this stage allows for immediate feedback and further adjustments if necessary.

The Importance of Comfort in Eyewear

Understanding Patient Needs

Comfort is paramount when it comes to eyewear. Frames that fit well should feel as if they are not even there, allowing the wearer to focus on their activities without distraction.

  • Common Issues: Poor-fitting glasses can lead to headaches, fatigue, and blurred vision.
  • Adjustments for Comfort: Regular adjustments may be necessary as the wearer adapts to their new frames.

Tailoring to Individual Preferences

Each patient has unique preferences regarding how their glasses feel and look. Open communication can help opticians make the necessary adjustments.

  • Feedback Loop: Encouraging patients to share their experiences with the fit will help in making precise adjustments.
  • Personalization: Different styles and materials can be explored to find the best match for comfort.

The Role of Frame Materials

Material Types and Their Impact on Fit

The choice of material used in eyeglass frames can significantly affect the fitting process. Different materials behave differently during adjustments.

  • Plastic Frames: Generally easier to adjust, but care must be taken to avoid overheating.
  • Metal Frames: Often more durable, but adjustments can be more challenging due to their rigidity.

Material Considerations for Comfort

Choosing the right material can enhance comfort. Lightweight materials can reduce pressure on the nose and ears.

  • Flexibility: Some materials offer more flexibility, which can be beneficial for active individuals.
  • Hypoallergenic Options: For patients with sensitive skin, hypoallergenic materials should be considered.

The Aesthetic Aspect of Frame Fitting

Style and Fit

The visual appeal of eyeglasses is an important consideration for many patients. The frames should not only fit well but also align with the wearer’s personal style.

  • Frame Shape: Different face shapes can influence the choice of frame style.
  • Color and Design: Patients often seek frames that complement their skin tone, wardrobe, and personality.

Balancing Aesthetics and Functionality

While aesthetics are important, the primary focus should always be on functionality and fit. A beautiful frame that does not fit well will ultimately lead to dissatisfaction.

  • Educating Patients: Helping patients understand the importance of fit over fashion can lead to better choices.
  • Trial and Error: Encouraging patients to try on various styles can help them find the perfect balance.

The Final Hand-Off

Ensuring a Positive Experience

The moment of handing over the completed spectacles is crucial. It is essential to ensure that the patient feels confident and satisfied with their new eyewear.

  • Demonstration: Show the patient how to wear and care for their glasses properly.
  • Encouragement: Encourage them to wear the glasses for a few hours to ensure comfort.

Follow-Up

A follow-up appointment can be beneficial to address any concerns that may arise after the initial fitting.

  • Adjustment Opportunities: Patients should feel comfortable returning for any necessary adjustments.
  • Long-Term Satisfaction: Regular check-ins can help maintain patient satisfaction over time.

Key Take Away Points for ABO & NCLE Exams Around Frame Fitting

Master the Fitting Triangle

  • Understand the three points that make up the fitting triangle: nose bridge and both ears.

Accurate Measurements are Critical

  • Eye size, bridge size, temple length, and head width are essential for selecting the correct frame size and ensuring a proper fit.

Adjustments for Function and Comfort

  • Obtain practical knowledge of pantoscopic tilt, temple adjustments, and nose pad alignment in order to achieve optimal comfort and functionality when fitting. 

Frame Materials Impact Fit and Comfort

  • Know how different frame materials behave during adjustments. Plastic frames offer more flexibility but risk damage when overheated, while metal frames are durable but hard to adjust. Understand material properties such as lightweight, flexibility, or hypoallergenic materials to enhance patient comfort and fulfill specific needs.

Patient Feedback and Final Inspection

  • Be sure to fully engage with the patient during and after the fitting. Encourage feedback to make final adjustments. Before delivery, inspect for lens quality, frame integrity, and standard bench alignment.

Fitting ophthalmic frames is a meticulous process that requires a blend of technical skill, attention to detail, and an understanding of patient needs. One needs to focus on proper measurements, thorough adjustments, and ensuring comfort, opticians can provide a service that not only meets but exceeds patient expectations.