Free
Training Course
For Dispensing Opticians
Sponsored by OpticiansForChange.com
Introduction
"It
is how well the eyewear makes contact with the Patient that
ultimately
defines Ophthalmic Dispensing, whether it be spectacles
or contact lenses."
This
Frame Fitting Course will cover the basic parts of the ophthalmic
frame and summarize its various measurement criteria, as well
as both horizontal and vertical lens decentration, the theoretical
and actual minimum lens blank size based on pupillary distance
and frame measurements along with required procedures for making
hands-on, in place,
on-the-face assessment
and the all-important final-fitting
frame adjustments. See course outline here.
Some
of the most common, and some of the more exotic frame materials
will be covered in addition, with a brief mention of the general
characteristics of each.
Next,
an outline of the various frame styles, and bridge and temple
designs currently available with an emphasis on the importance
of proper bridge and temple selection, using the shape of the
face and head, placement of eyes and ears, and most importantly,
the nature of the prescription as criteria.
The
last and most important item in this work, Final
Fitting, will then be addressed with special emphasis on
the necessity for the qualitative dispensing of prescription
eyewear using direct, tactile, hands-on, in-place, on-the-face
assessment and subsequent frame fitting techniques. See Custom
Frame Fitting, Up Close
and Personal.
As
indicated elsewhere, the Hands-on-the-Patient tactile
assessment is one of the most important, yet least implemented
aspects of today's Ophthalmic Dispensing. Although frame adjustment,
especially the more subtle aspects, is an artful skill which
must be acquired through practice and experience, this course
presents some basic guidelines, which may be applied immediately.
These will be covered only briefly along with a mention of the
fitting triangle, the various frame tilts and face forms along
with the reasons for applying them. A quick summary of the various
types of frame fitting issues and their solutions is presented
later.
To
those accustomed to working with ophthalmic terms, some of the
points about to be covered may be familiar. This work, therefore,
can be used as a simple review to ensure a better understanding
of the subject.
Abbreviations,
Definitions, and Terms
"A"
is the Horizontal measurement of a box enclosing the lens area.
ASTIGMATISM
is a blurred vision condition produced by a football-shaped
cornea, which is too steep in one meridian and too flat in another.
An astigmatic cornea (see
example here) focuses light in two different places in the
eye, adversely affecting both near and distance vision. Also
see "CYL" below.
AXIS corresponds
to the orientation of the cylinder power in terms of degrees
from 0 to180.
"B"
is the Vertical measurement of a box enclosing the lens area.
BRIDGE
is that part of the frame front that connects the eyewires and
holds the frame in place at the nose.
BRIDGE
TYPES: KEYHOLE BRIDGE is a type of bridge that fits only on
the sides, and does not touch the top. Resembles a keyhole.
SADDLE BRIDGE is a type of bridge that sits uniformly over the
nasal crest.
"C"
is the Width of the lens along the central datum line.
CATARACT
is a clouding of the lens of the eye. Click
here for more.
"CYL"
is the abbreviation for CYLINDER and corresponds to numbers
indicating the amount of astigmatism correction. See ASTIGMATISM
above.

Left
image, spherical lens with no cylinder.
Vertical and horizontal meridians are equal.
Right, lens with cylinder to correct astigmatism.
Vertical and horizontal meridians are unequal.
DBL
is the Distance Between Lenses, the least distance between the
two lenses, the bridge size.
DIOPTER
is a measurement of lens refractive power equal to the reciprocal
of the focal length of a lens in terms of meters, e.g., a 2.00
Diopter lens will bring parallel rays of light to a focus at
a half meter, i.e., .50 meters. Also, the measurement of the
degree to which light converges (a plus Diopter, +2.00D, lens
will correct farsighted vision), or the degree to which light
diverges (a minus Diopter, -2.00D, lens will correct nearsighted
vision).
DISPENSING
OPTICIAN, LICENSED DISPENSING OPTICIAN, LDO, and OPTICIAN, are
herein defined as Board Certified and-or State Licensed healthcare
providers who specialize
in the design of prescription
eyewear, i.e., lenses, frames and contact lenses, which includes
the duplicating, measuring, inspecting, and verifying of prescription
lenses, and any subsequent frame Alignment
or other Adjustments,
including the Final
Fitting,
whereby the Patient's visual comfort, and the long-term comfort
and wear-ability of their eyewear is the primary objective.
An
expanded definition as defined by the U.S. Dept. of Labor, Bureau
of Labor Statistics: "Designs, measures, fits, and adapts
lenses and frames according to written optical prescription
or specifications; assists with selecting frames; measures for
size of eyeglasses and coordinates frames with facial and eye
measurements and optical prescriptions; prepares work order
for optical laboratory containing instructions for grinding
and mounting lenses in frames; verifies exactness of finished
lens spectacles; adjusts frame and lens position to fit; shapes
or reshapes frames. Includes contact lens Opticians."
Note:
"Of
the over 67,000 Opticians designing, manufacturing and dispensing
eyewear - less than half have any formal certification or licensure."
U.S. Dept. of Labor
See
also Ophthalmic Dispensing,
the Final Fitting,
and our Consumer-Industry advisory at www.OpticianryReview.com.
DS is an
abbreviation for "Distance Sphere."
DV is an
abbreviation for "Distance Vision."
ED
is the Effective Diameter, twice the distance from the geometrical
center of the lens to the bevel farthest away from it.
EYEWEAR,
as defined within the Ophthalmic
Industry,
is inclusive of spectacles and contact lenses. But for the purposes
of this Course, EYEWEAR refers to any sunwear, streetwear, safety,
athletic, or other occupational or avocational, corrective or
plano lenses, worn in combination with an ophthalmic frame.
EYEWIRE is
that portion of the frame front into which the lenses are inserted
or mounted and which is connected to its opposite by the bridge.
FRAME
is that portion of a pair of spectacles that is designed to
hold the lenses in the proper position before the eyes.
FRAME
DIFFERENCE is the difference between the horizontal and vertical
measurements of the eyewire.
FTB, or Front To Bend, is the distance between the plane of
the frame front and the bend
of the temple. Applies to frames where the endpieces wrap around
and there is some distance between
the frame front and the beginning of the temple.
HANDS-ON-THE-PATIENT
DISPENSING
AND DELIVERY
is herein
defined as
those procedures,
which involve eyewear adjustments performed by a skilled Dispensing
Optician, which
specifically include,
a) the
visual and 'touch and feel,' hands-on-the-Patient, tactile assessment
of the frame, while it is in-place, on-the-face of the Patient,
in order to determine any misalignment, and b) any subsequent
multi-dimensional hands-on-the-Patient, tactile, 'touch and
feel' handcrafting that is required to refit, align, adjust,
reshape, bend, stretch, twist and sculpt the components of the
frame in order to personalize the eyewear for maximum visual
comfort and wear-ability. See
example.
Special
Note: This level of craftsmanship can be accomplished only after
a visual as well as a tactile, i.e., touch and feel, assessment
of the frame, in-place, on the Patient, and requires the removal
and re-placement of the eyewear directly on the Patient, BY
THE OPTICIAN, as many times as necessary to complete the procedure.
Unfortunately, many of today's Dispensers make no contact with
either the Patient or their eyewear while in place, on-the-face,
whereby it is impossible to make a significant assessment or
subsequent multi-dimensional adjustments to the frame. This
practice is akin to a Dentist making no direct contact with
a Patient while attempting to fit dentures. Sadly, latter generation
Dispensers give little or no attention to fitting a new frame
after it arrives from the lab, presumably four-point inspected
on a flat surface by the lab technicians. Just as in the case
of fitting a set of dentures, a frame must ultimately be custom
fitted to the variable dimensions of the Patient, not the one-dimensional
surface of a flat table. The lab only zeroes-out any frame misalignment
in lieu of anticipated adjustments by the Optician.
Furthermore, a properly executed hands-on, in-place, on-the-face
assessment, and frame fitting procedure requires not only appropriate
communications between the Dispenser and the Patient, but some
direct physical contact must occur as well. Again, a hands-on
fitting involves the repeated removal and re-placement of the
frame on and off the Patient by the Dispenser until such time
as the fitting is completed, which depends of course on the
experience of the Dispenser, any asymmetric features of the
Patient, and the type and design of the eyewear. See
example. The Dispenser cannot rush the procedure. Much time
is actually saved in the long run when the fitting is done with
sensitivity and patience whereby Patient return visits are minimized.
HEALING
ARTS are those skillful healthcare practices, which contribute
to the health and wellness of those to whom they are applied.
See Ophthalmic Health
and Wellness.
HEALTHCARE PROVIDER
is herein defined as one who contributes to making a person
whole, a HEALER.
GCD,
or Geometric Center Distance, also known as the DBC, Distance
Between Centers, and sometimes referred to as the FPD or Frame
Pupillary Distance, is the distance from the geometric center
of one eyewire to the geometric center of the other.
Note:
Theoretically, the GCD may be calculated by adding the "A"
measurement to the DBL. In practice, however, there are often
differences in the actual measurements and those marked on the
frame. An experienced Optician is capable of taking accurate
measurements, and this skill plays an especially important roll
as it relates to frame dimensions.
LTB,
or Length To Bend, is the distance from the center of the temple
screw barrel to the middle of the temple bend.
NV is an
abbreviation for "Near Vision."
OC is an
abbreviation for "Optical Center."
OD stands
for Oculus Dexter, which is Latin for "right eye."
OPHTHALMIC
means anything that pertains to the eye or is situated near
the eye.
OPHTHALMIC
DISPENSER
is any healthcare provider who specializes
in the design of prescription
eyewear, i.e., lenses, frames and contact lenses, which includes
the duplicating, measuring, inspecting, and verifying of lenses,
and any subsequent Alignment
and other Adjustments,
including the Final
Fitting
of the eyewear. See DISPENSING
OPTICIAN, LDO.
OPHTHALMIC
DISPENSING is herein defined as those
frame adjustments performed by a qualified Dispensing Optician,
which include, a) the fullest discovery and maximum consideration
of the Patient's visual needs, b) the assistance and advice
to the Patient regarding the appropriate choice of lens design
and frame selection, c) the duplicating, measuring, inspecting,
and verifying of lenses, and d) any subsequent Gross
FrameAlignment
and Subtle Frame
Adjustments, including the Final
Fitting.
OPHTHALMIC
HEALTH AND WELLNESS is herein defined as that state of well-being
wherein a Patient's visual health and comfort is supported,
and the long-term wear-ability of their eyewear is provided
and maintained.
OPHTHALMIC
PATIENT is herein defined as one who needs or receives health
related services having to do with their vision
and-or eyewear.
OPTHALMOLOGIST,
MD or DO, is a State Licensed-Board Certified healthcare provider
who specializes
in the diagnostic, surgical, and other medical treatments as
well as the refraction of the eye in
order to determine any refractive visual error and the means
by which the error can be corrected.
OPTICIAN,
see DISPENSING OPTICIAN,
LDO.
OPTOMETRIST,
OD, is a State Licensed-Board Certified healthcare provider
who specializes in the refraction of the eye in order to determine
any refractive visual error and the means by which the error
can be corrected.
OS stands
for Oculus Sinister, which is Latin for "left eye."
OU stands
for Oculus Uterque, which is Latin for "both eyes."
OVERALL
TEMPLE LENGTH is the distance from the center of the temple
screw barrel to the end of the temple tip.
PD is the
abbreviation for Pupillary Distance, the distance between the
Patient's pupils in terms of millimeters (mm). This measurement
helps ensure that the OC is properly centered in the frame relative
to the pupil.
PLANO is
a term used to describe a lens with no corrective power.
PRISM is
an element added to the prescription if the Patient's eyes need
help working more effectively together, and-or to remain in
proper alignment.
RX is an
abbreviation of the word, Prescription, and refers to the document,
which expresses the lens powers and other pertinent details,
and is signed by the attending Refractionist, i.e., Optometrist,
OD, or Ophthalmologist, MD.
SEG HEIGHT
is an abbreviation for Segment Height, the vertical placement
of the Reading Segment in terms of millimeters, sometimes called
the Add, the Addition, or the Reading Addition.
SPH
is the abbreviation for "Sphere" and corresponds to
numbers that indicate the degree to which the Patient is near-sighted
or far-sighted.
SPRING
HINGE is a type of hinge on eyeglass frames that flexes, making
the frames more durable. Spring hinges also help keep the eyewear
in proper alignment and help reduce the need for some adjustments.
TEMPLES can
be generally defined as the
hinged extensions on each side of the frame front, which when
the frame is worn, extend along each side of the head, and in
most styles, bend down behind the ears. Temples are made to
be reshaped to follow the contours of the skull (see
example) and avoid direct contact with ears, while resting
evenly against the skull with minimum pressure, whereby they
act to hold the eyewear comfortably in place. See variations
on styles of temples below.
TEMPLE-END
is that part of the temple that extends down behind the ear
and makes direct contact with the mastoid portion of the skull.
The temple-end is designed to be reshaped to follow the contours
of the skull whereby it acts to stabilize and hold the eyewear
in place for long-term comfort and wear-ability. The temple-ends,
with all gaps and space removed, and making full contact with
the skull, NOT THE EARS, are the primary means of holding the
eyewear in place.
See
Consumer Guide to optical
terms.
Equipment
And Tools As Required By The
Florida State Board For The Practice of Opticianry
The
following 10 items of equipment must be maintained in each office
in which an Optician practices Opticianry:
Pupillary
gauge
Thickness
gauge
One
set of hand tools necessary for the fitting of eyeglasses
One
lensometer or vertometer or similar instrument
One
colmascope or similar instrument, when manufacturing glass lenses
on premises
One
frame heater
One
lens measure
Set
of sample frames and mountings
Keratometer
or similar instrument and slit lamp or similar instrument if
fitting and adapting contact lenses pursuant to subsection 64B12-10.009(2),
F.A.C.
Set
of trial soft contact lenses, if fitting and adapting contact
lenses pursuant to subsection 64B12-10.009(2), F.A.C.
64B12-10.007 Minimum Equipment Requirements.
Specific
Authority 484.005(2) FS. Law Implemented 484.002(3), 484.005(2)
FS.
History
-- New 12-6-79, Formerly 21P-10.07. Amended 5-31-87.
Formerly
21P-10.007, 61G13-10.007, 59U-10.007. Amended 8-16-04. Click
here for reference.
Florida
State Board of Opticianry
Continuing Education Requirements:
20 Hours Total Per Biennium For License Renewal

11
hrs. Technical (To include 4 Contact Lens hours if Florida Board
Certified only)
2
hrs. Law
2
hrs. Prevention of Medical Errors
5
hrs. Elective (To include 1 HIV-AIDS hour upon first-time license
renewal only)
The
Ophthalmic Frame


A
FRAME is that portion of a pair of spectacles designed to hold
the lenses in the proper position before the eyes. Although
ophthalmic frames come in a variety of styles, sizes,*
shapes, and colors, they usually have basic parts in common.
As illustrated above, the principal parts of a frame include
the front and the temples.
THE FRONT consists of two eyewires which surround and hold the
lenses in place, a bridge which connects the two eyewires, and
a pair of endpieces to which the temples, i.e., earpieces, are
connected.

TEMPLES can be divided into five basic categories:
Skull Temples, which are the most commonly used on prescription
spectacles,
bend down behind the ears and follow the contour of the skull,
resting evenly against it;
Library Temples, which are generally straight and do not bend
down behind the ears, hold the spectacles
on the Patient, primarily by light pressure against the side
of the head;
Convertible Temples, which can be used either as library or
skull temples depending on the manner in which they are bent;
Riding Bow Temples, which curve around the ear and extend to
the level of the ear lobe. They are often used mostly on children’s,
athletic, and industrial safety frames;
Comfort Cable Temples, which are similar to the riding bow but
are constructed from a coiled, metal, flexible cable.
*Special
Note: Some of these styles may not be readily available due
to the demise of multiple front, bridge, and temple sizes, which
provided the Patient with made-to-fit options. See Part I, the
previously mentioned, "Some
Contributing Factors." It is especially appropriate
to stress here that the Dispenser must fully disclose any adverse
or ill-fitting qualities of any frame selected by the Patient,
e.g., eyesize too narrow, temples too short or too long, bridge
too narrow or too wide, etc. Full disclosure during the frame
selection process can work to minimize or even prevent the possibility
of an unhappy Patient and the loss of the Patient's good will
and future referrals, or even a remake, or worse, a refund.
Unfortunately,
there are lots of people who are wearing ill-fitting, uncomplimentary
and uncomfortable frames with either too long or too short temples,
poorly fitting bridges, or too large or too small eye sizes.
It is incumbent on the Dispenser to guide the Patient throughout
the entire lens and frame selection process and to give expert
counsel when appropriate.
Sometimes
a plastic bridge, for instance, can be heated and manipulated,
or the temples can be lengthened by slightly extending the temple
cover to get more length. Or they can be shortened by removing
the temple cover, cutting off the appropriate excess, and replacing
the temple cover. These make-do efforts can mostly be avoided
however, if the Dispenser anticipates the potential for any
frame fitting deficiencies, and at least recommends more appropriate
alternatives for the Patient to consider at the time of their
frame selection.
Frame
Measurements
Frames may be measured using the Datum System,
or the Box system.


Box System Of Measurement
When measuring an eye size using the datum system, an imaginary
line is drawn through the middle of the eyewear both in the
horizontal and vertical planes. The length of the lines correspond
to the horizontal and vertical measurements of the eyewire.
Given a shape such as illustrated above, it is easy to see how
inconsistencies in measurement can result using this system.
The box system is more accurate and more widely used in the
optical industry. In this system an imaginary box is drawn around
the area to be measured. The distance between opposite, parallel
sides of the box determine the length of the distance being
measured. This system yields more accurate measurements even
with unusual shapes.
Horizontal
Lens Decentration
Example
A

In
the first example the OC, Optical Center, of the lens is in
the same position as the geometric center of each eyewire. No
decentration is necessary.
Example
B

In
this case the GCD is 4 mm wider than the PD, the lenses must
be decentered 2 mm in on each eye. This will position the MRP's
to properly correspond with the PD, Pupillary Distance.
The amount of decentration required in each eye is equal to
the GCD - PD or 2 mm in.
In most cases the Pupillary Distance of the Patient will be
narrower than the distance between the geometric centers of
the selected frame. Less commonly, the PD will be equal to the
frame’s geometric centers, and in rare cases the width
of the PD will be greater than the GCD. In any case, to avoid
unwanted prism, it is essential that the major reference points
(MRP's) of the lens correspond to the Pupillary Distance. In
the first example above, the PD and GCD are equal to 64 mm and
therefore no decentration is necessary. In the second example,
the GCD is 4 mm wider than the PD. By applying the formula above,
it can be seen that the amount of decentration required in each
lens is 2 mm.
Minimum
Blank Size and Vertical Decentration
The formula for determining the smallest possible lens blank,
which will work for any given frame and PD combination, is as
follows:
Minimum Blank Size (MBS) = (GCD - PD) + ED
In the examples below the ED is the same as the "A"
measurement since the frame illustrated is round. Therefore,
the theoretically smallest lens size that can be used in Example
1 is 44 mm. The theoretically smallest lens, which can be used
in Example 2, is equal to 48 mm.
Example 1:
MBS = (64 - 64) + 44 = 44
Example
1

Example
2:
MBS = (64 - 60) + 44 = 48
Example
2

These Minimum Blank Sizes are considered to be theoretical for
two reasons:
Two
to three millimeters should always be added to the MBS to allow
for imperfections such as chips or bubbles, which may exist
along the periphery of an uncut lens.
Lens
sizes are available from the manufacturers only in certain predetermined
sizes, the diameters of which usually range from 60 mm to 80
mm, in 5 to 6 mm increments.
It is necessary to calculate vertical decentration when determining
where the line of a bifocal segment is positioned relative to
the datum line of the frame. This may be expressed in the following
formula.
Vertical Decentration = Segment Height (1/2 "B" measurement
minus desired vertical segment position in mm's)

In
this example, since the "B" measurement = 50 mm the
datum line is 25 mm from the bottom most portion of the lens.
The desired vertical seg position is 22 mm. Subtracting the
desired seg height from half the "B" measurement results
in : 25 - 22 = 3. Therefore the segment line is decentered 3
mm below the datum line. This would be commonly referred to
as seg = “3 below.” If the desired seg height were
at 28 mm, the result will be + 3 mm,
positioning the seg line 3 mm above the datum line, or “3
above.”
Frame
Selection
"When
presented with a prescription of higher powers, the
Optician must draw upon many of his-her skills to achieve a
satisfactory fit and a satisfied Patient. Proper frame selection
is
of utmost importance. The frame size must be kept to a minimum,
and the fit and style of the bridge takes on added importance
due to
additional lens weight-thickness. The eyes should be well centered
in order to minimize decentration. If the lens power exceeds
±7.00
diopters, vertex distance
must be considered as an important factor."
Frame
Materials Guide
PLASTIC
Cellulose Acetate - Zyl
The most popular material for plastic frames. Nonflammable,
durable, color fast, and available in large quantities. For
the colors of the rainbow, zyl (Zylonite, or Cellulose Acetate)
is the material. Zyl is a very cost-effective and creative option
for eyewear and is extremely lightweight. Particularly popular
in some areas are laminated zyl frames that have layered colors.
Multi-Colored
Zyl Frame

Plastic frames do have some drawbacks. They are easier to break
than metal frames, they will burn, but are not easily ignited,
and aging and exposure to sunlight slightly decrease their strength
but do not affect color.
Plastic
Zyl Frame

Optyl
Relatively new epoxy material. Light in weight, cannot be overheated
or burned, will not shrink. Optyl's “memory” will
cause it to revert to original shape when heated.
Cellulose Propionate
Durable material. Molded rather than cut from a flat sheet like
acetate.
Metal
Gold
Made of gold in combination with other materials such as nickel,
copper, beryllium, and chrome. Frames may be gold filled, or
gold plated. Some solid gold frames are available, but aside
from the high cost, the softness of the material makes them
difficult to work with and keep in adjustment.
Some
companies make gold eyewear, typically gold plating rather than
solid gold. Like silver, gold can also be used for accenting
plastic or metal frames.
Metal
Frame

Silver
Silver itself is not used in the manufacturing of frames due
to its softness. Instead, white gold is used.
Solid
silver or sterling silver is not commonly used as the primary
frame material because it doesn't make very wearable or comfortable
frames. Silver is sometimes used as a trace element in metal
alloy frames, and is often used as a jewelry-like accent on
plastic frames.
Stainless Steel
Non-corrosive, strong, and light weight. Qualities of stainless
steel frames include light weight, low toxicity and strength;
many stainless steel frames are also nickel-free and thus hypoallergenic.
Stainless steel is readily available and reasonably priced.
It's an alloy of steel and chromium; it may also contain another
element. Most stainless steels contain anywhere from 10 to 30
% chromium, which imparts an excellent resistance to corrosion,
abrasion and heat.
Aluminum
Light in weight, long lasting, may be anodized allowing for
many variations in color. Frames made from aluminum are highly
corrosion-resistant. Aluminum is used primarily by high-end
eyewear designers, because of the unique look it creates. Aluminum
is not only the world's most abundant, but also the most widely
used, nonferrous material. Pure aluminum is actually soft and
weak, but commercial aluminum with small amounts of silicon
and iron is hard and strong.
Beryllium
A steel-gray metal, is experiencing increased popularity as
a lower-cost alternative to titanium eyewear. It resists corrosion
and tarnish, making it an excellent choice for wearers who have
high skin acidity or spend a good amount of time in or around
salt water. It's also lightweight, very strong, very flexible
(making it easy for an optician to adjust the spectacles)
and available in a wide range of colors.
Titanium
Relatively new material. Light weight, durable, and available
in a variety of colors and styles. Frame manufacturers are coming
out with more and more titanium styles these days; titanium
is a silver-gray metal that's lightweight, durable, strong and
corrosion-resistant. It has been used for everything from the
Gemini and Apollo space capsules to medical implants such as
heart valves. Titanium eyewear can be produced in a variety
of colors for a clean, modern look with a hint of color.
Titanium
Frame

Not
all titanium frames are 100 % titanium. Some are made from an
alloy that is a combination of titanium and other metals, such
as nickel or copper. In general, titanium alloy frames cost
less than 100 % titanium frames.
Relatively
new to the eyewear market, Ticral is an alloy of titanium, copper
and chrome. It is nickel-free and thus hypoallergenic. It's
also extremely lightweight and offers many of the features of
titanium without the high cost. It can be cut a bit thicker
than titanium, which enables it to have the popular look of
a thin plastic frame while still offering light weight. The
material is also strong, durable and available in a variety
of colors.
Flexon
A titanium-based alloy. This unique and popular material, which
is proprietary to the eyewear manufacturer Marchon, is called
a "memory metal" because it can go back to its original
shape if damaged. Frames made of Flexon come back into shape
even after twisting, bending and crushing. Flexon frames are
lightweight, hypoallergenic and corrosion-resistant.
NYLON
Synthetic material made from coal, water, and air. Light weight
and very strong. Often used in children's frames and industrial
safety eyewear. Requires a good deal of heat for lens insertion
and adjustments.
Eyewear made of nylon was first introduced in the late 1940s.
Because of brittleness and other problems, frame manufacturers
switched to blended nylon (polyamides, co-polyamides and gliamides).
Today's blended nylon frames are both strong and lightweight.
Nylon is also a premier material for sports and performance
frames - typically made of gliamides, which are very resistant
to hot and cold and are more flexible, yet also stiff. Nylon
is also easily molded into today's popular wraparound styles,
as well as other shapes that are difficult to produce.
WOOD
AND BONE
These frames are usually handmade, one-of-a-kind pieces that
satisfy a specialty niche. Although stiffer and less adjustable
than other frame materials, and much more expensive, wood and
bone redeem themselves as frame materials because of their unique
look and beauty.
Bamboo
Wood Frame

LEATHER
Often used on temples or even across frame fronts, leather is
not as durable or practical as other materials used for accenting,
but it provides an interesting and fashionable look.
SEMI-PRECIOUS
OR PRECIOUS STONES
These are sometimes used as accents in frames, especially in
the temples. Popular choices are onyx and turquoise, but even
diamonds can be used, for a luxurious touch. Such designs are
usually worn in a formal office or on dressy occasions. Rhinestones
are a less expensive alternative and are often used to create
a flashy or retro look, especially in upturned cateye frames.

Frame
Style Guide
See
video here.





Ophthalmic
frames may be divided into two broad categories of materials,
plastic and metal. As indicated in the diagram above the basic
frame styles used today include the full frame, combination
frame, half eye, rimless, and semi-rimless.
Rimless

Semi-Rimless

The
styles we commonly called rimless are actually semi-rimless
designs since there is a bar connecting the endpieces to the
bridge. The lenses of a semi-rimless frame may be mounted in
several different ways. These include the screw mounting, where
a screw is placed through a drilled hole in the lens then attached
to the frame. One type of screw-mounted design is called a Numont
mounting where each lens is held in place by only one screw.
Some
lenses are tension mounted where clips attached to the eyewire
fit into notches in the lens and are held it in place with tension.
Tension mountings are sometimes referred to as Balgrip mountings.

Rimless
Sunwear
Nylon
mounted frames are the most popular semi-rimless design currently
used. In this design, a nylon cord attached to the eyewire fits
into a groove located around the periphery of the lens. A nylon
mounted semi-rimless design is safe, durable, relatively easy
to work with and fashionable.
Note:
It is a common habit for Patients to remove their eyewear with
one hand only. Patients should be advised to remove their eyewear
with two hands in order to avoid undo pressure on the lenses,
endpieces and temples. This is especially true with rimless
and semi-rimless mountings.
Frame
Selection By Face
Oval Oblong
Round

Square Triangular Diamond
While
most faces are a combination of shapes and angles, there are
seven basic face shapes: Oval, Oblong, Round, Square, Triangular
base-down, Triangular base-up, and Diamond. Here is a further
description of these face shapes and which types of frames work
for each. By considering these three main aspects and the seven
face shapes that follow, the Dispenser can give Patients valuable
guidance in the selection of their new eyewear.
The
frame shape should contrast with the face shape. Rounder faces
look best in frames with some angles. Angular faces look best
in frames with some curves.
The
frame size should be in scale with the face size. Frames should
be selected in proportion to the face size, e.g., a petite woman
with delicate features will want a smaller, lighter weight frame.
Eyewear
should repeat the Patient's best features, e.g., a blue frame
to match blue eyes.
Oval-Normal
Face - Most shapes will be suitable. The oval face is considered
to be the ideal shape because of its balanced proportions. To
keep the oval's natural balance, look for ophthalmic frames
that are as wide as (or wider than) the broadest part of the
face, or walnut-shaped frames that are not too deep or too narrow.
Oblong-Long
Face - Deep frame preferably with low temple attachment. Frames
with a lot of depth, such as aviator frames, suit oblong faces.
A low nose bridge will shorten the nose, too. The oblong face
is longer than it is wide and has a long straight cheek line,
and sometimes a longish nose. To make the face appear shorter
and more balanced, try frames that have a top-to-bottom depth,
decorative or contrasting temples that add width to the face
or a low bridge to shorten the nose.
Round-Wide
Face - Relatively narrow frame preferably with a high temple
attachment. Round faces look good with angular narrow frames
that lengthen the face. A round face has curvilinear lines with
the width and length in the same proportions and no angles.
To make the face appear thinner and longer, try angular narrow
frames to lengthen the face, a clear bridge that widens the
eyes and frames that are wider than they are deep, such as a
rectangular shape.
Square-Wide
Face - Same criteria as round face. Needs frame that softens
the face angles, such as narrow ovals. A square face has a strong
jaw line and a broad forehead, plus the width and length are
in the same proportions. To make the square face look longer
and soften the angles, try narrow frame styles, frames that
have more width than depth, and narrow ovals.
Triangular-Inverted
Base-Up (Heart) Face - Lighter looking frame is recommended
such as metal or rimless or lighter colors in zyl. Faces in
the shape of a base-up triangle need frames that are wider at
the bottom, with very light colors. Rimless frames and semi-rimless
frames are also good choices. This face has a very wide top
third and small bottom third. To minimize the width of the top
of the face, try frames that are wider at the bottom, very light
colors and materials, and rimless frame styles, which have a
light, airy effect since the lenses are simply held in place
at the temples with screws.
Triangular-Erect
Base-Down Face - Width of frame should approximately equal lower
widest part of facial area. Darker colors work well. Faces in
the shape of a base down triangle look great with eyeglasses,
which have color accents, details on the top half of the frame,
or cat eye shapes. The triangular base-down face has a narrow
forehead that widens at the cheek and chin areas. To add width
and emphasize the narrow upper third of the face, try frames
that are heavily accented with color and detailing on the top
half or cat-eye shapes.
Diamond
Shaped Face - Looks well with frames that have detailing or
distinctive brow lines. Diamond-shaped faces are narrow at the
eye line and jaw line, and cheekbones are often high and dramatic.
This is the rarest face shape. To highlight the eyes and bring
out the cheekbones, try frames that have detailing or distinctive
brow lines, or try rimless frames, or oval and cat-eye shapes.
Frame
Color Guide

There
are three key elements in the choice of frame colors.
Everyone
has either a cool (blue-base) coloring, or a warm (yellow-base)
coloring.
Everyone
looks best in his or her personal color base.
Eyewear
color should complement personal coloring.
The
best frame color depends on the look the Patient is interested
in creating:
The "Look, ma! No glasses!" look -- try rimless or
semi-rimless mountings in colors to blend with the skin tone,
light frames for fair skin, darker frames for darker tones.
The "Please notice my eyes" look -- try rimless, semi-rimless
or full front (fully rimmed) mountings-frames, and match the
frame color fairly closely to the skin tone.
The "Hey, I'm wearing GLASSES!" look -- for this bold
look, go for contrast, with dark frames for fair skin and bright
or light frames for darker tones.
Try several colors in the shade range to find the best one.
For example, if considering dark frames, try the same frame
in dark blue, dark green, dark purple and black, or any other
available dark color, to see if one of those is better than
the others for their skin tone.
The main factors to determine the best color palette are the
colors of the skin, eyes, and hair.
SKIN
Skin tone is the prime element in determining coloring. All
complexions fall into one of two color bases - blue (cool),
or yellow (warm).
A
cool complexion has blue or pink undertones, and a warm complexion
has a "peaches and cream" or yellow cast. Olive skin
is considered cool because it is a mixture of blue and yellow.
In the United States, cool, blue-based, complexions are more
common than the yellow-based, warm, complexions. About 60 %
of the population, are "cools."
EYES
Eye colors are usually a secondary element in determining coloring
because of the wide range of eye colors.
Examples:
Blue eyes can range from a cool, almost-violet, to a pale blue-gray,
which is warm.
Brown
eyes can vary from a light cider shade, warm, through a medium-brown
to a cool, almost-black.
HAIR
Hair colors are also considered warm or cool.
Strawberry
blond, platinum, blue-black, white, salt-and-pepper, and "dishwater"
brown are cool.
Warm
hair colors include golden blond, flat black, brown-gold, "carrot"
and "dirty" gray.
Frame
Colors
Once
it has been determined the Patient has "warm" or "cool"
coloring, find the frame colors that will suit them best.
Some
examples of frame colors best for warm coloring are: camel,
khaki, gold, copper, peach, orange, coral, off-white, fire-engine
red, warm blue and blond tortoise.
For
cool coloring, the best frame hues are black, rose-brown, blue-gray,
plum, magenta, pink, jade, blue and demi-amber (darker tortoise).
Bridge
Selection Guide
Selecting the proper bridge size and shape for any given Patient
is a crucial part of frame selection both from a cosmetic, and
purely practical perspective.
Since
a “high” bridge such as a keyhole style, tends to
accentuate nose length, it should be avoided with longer noses,
and recommended with shorter, stubbier noses. The opposite holds
true with “lower” bridge designs, such as a saddle
bridge.

Patients
with especially narrow bridges are generally successful with
adjustable nose pads. Very often adjustable pads can be added
to a zyl frame, which may increase the selection of wearable
frames for the narrow-bridged Patient.
Saddle
bridges and “comfort” bridges for metal frames are
difficult to adjust, therefore care must be taken to insure
the fit is suitable, right from the beginning, during the initial
frame selection.
Note:
Full disclosure is important. During the frame selection process,
the Patient should always be advised, by the Dispenser, of any
critical fitting issues, i.e., too short or too long temples,
too narrow bridge, too shallow eye size, if they should select
a frame with these adverse fitting qualities. The Patient can
then make a more informed selection. Full disclosure can help
to avoid recurrent complaints and-or refunds.
Frame
Selection and Prescription Considerations
High
Minus Lenses
Smaller
Eye Size
Heavier
Frame Material
Rounder
Shapes
Lightweight
Lenses
Higher
Index Lens Material
Antireflection
Coating Lightweight Lenses
Edge
Coating
High Plus Lenses
Smaller
Eye Size
Sturdy
Frame Construction
Rounder
Shapes
Small
Frame Difference
Adjustable
Nose Pads
Lightweight
Lenses
Higher
Index Lens Material
When presented with a prescription of higher powers, the Optician
must draw upon many of his-her skills to achieve a satisfactory
fit and a satisfied Patient. Proper frame selection is of utmost
importance. The frame size must be kept to a minimum, and the
fit and style of the bridge takes on added importance due to
additional lens weight-thickness. The eyes should be well centered
in order to minimize decentration. Usually, when the lens power
exceeds ±6.00 or ±7.00 diopters, depending on
the Patient, vertex
distance must be considered as an important factor.
Other
considerations include higher index lens materials and special
lens designs such as lenticular and myodisc which are designed
to minimize thickness. The various lens coatings should be considered
in an effort to enhance the functional as well as cosmetic value
of the eyewear.
The
Final Fitting
The Conscious Delivery of Eyewear
"You
are fitting a Patient for comfort,
not a table for square or for pretty."
Although
the Full Discovery and Disclosure Lifestyle Interview and Frame
Fitting Techniques are not the only aspects of what we call
Ophthalmic Dispensing,
today they are much underrated, even subordinated skills. Frame
fitting skills can be acquired only through direct, practical
experience and must include a) Visual as well as Tactile Hands-on
Assessment, b) Gross
Frame Alignment, i.e., correcting the most obvious frame and
lens misalignments, and c) Subtle
Frame-Temple Adjustments, i.e., hand crafted multi-dimensional
adjustments that include 'touch and feel' procedures such as
reshaping the temple ends to make direct but light contact with
the skull and mastoid behind the ears, while simultaneously
avoiding any direct contact of the frame components with the
pressure-sensitive ears, is one of the single most important
considerations for the Patient's long-term comfort and wear-ability.
Full but light contact with the skull, NOT THE EARS, along with
the bridge of the nose, are the primary means of alignment and
support for the frame. See
example.
"The
most perfect prescription can be compromised if the eyewear
does not provide the Patient with comfortable, long-term wear-ability."
Not
only is a poorly fitted frame likely to cause discomfort, and
inconvenience to the Patient, but in cases of higher lens powers
and high astigmatic corrections it can even adversely impact
the effectiveness of the prescription, thus creating additional
visual problems. And a poorly fit frame will most often result
in the Patient broadcasting an undesirable image of Ophthalmic
Dispensing, as well. Get the rap on wrap-arounds here.
See advisory on frame selection here.
"It
is how well the eyewear makes contact with the
Patient that ultimately defines Ophthalmic Dispensing."
The Fitting Triangle

THE DYNAMIC DUO
Hands-on, In-Place, On-The-Face Assessment
Along With Handcrafted 'Touch and Feel' Adjustments
A
well-fit frame will come into physical contact with the wearer
at only three points, namely the bridge of the nose, and on
each side of the head including behind each ear. These three
points form a triangle known as the fitting triangle, as illustrated
above. The temples should not touch the side of the head before
reaching the ears. Should this occur, it creates a constant
tendency for the eyewear to slip forward and down resulting
in an unacceptable displacement of the lenses, and unwanted
pressure on the Patient's nose and behind the ears, often causing
soreness.
Also,
great care must be taken to ensure the temple ends-tips do not
touch the sensitive cartilage behind the ear. The frame is held
steadfastly as the result of slight and caressing pressure on
the side of the head behind each ear. The temple ends should
be crafted to follow the contours of the mastoid complex. See
example. When executed properly, this procedure creates
a multi-dimensional and pleasant pressure balance both at a
right angle to the skull and at right angles to the ears, resulting
in a skull conforming and very comfortable, 'like-a-glove' fit
that completely matches the uneven surface of just about everybody's
skull. To the inexperienced Dispenser the results can look severe
(see example) but
it all blends in, unseen and unnoticed, when worn by the Patient.
This is perhaps the least understood and least applied of any
of the Subtle Frame
Adjustments, which 'Mature Generation' Opticians are accustomed
to providing.
Note:
When completed, the temple ends may even look crooked, bent
and misshapen. But
how do the temples fit the Patient? Dispensers
are hereby cautioned against making subjective judgments as
to frame appearance, especially the temples, following the application
of any Subtle Frame Adjustments since the objective is to make
the Patient comfortable while wearing the eyewear long term,
and not just to satisfy the Dispenser's personal aesthetic sense
of the frame, especially for the temples to look straight, squared,
and 'pretty' while 'four pointed' on a flat, 'one-dimensional'
surface. A PATIENT IS NOT A FLAT SURFACE. Given the numerous
anomalies of human facial and skull structure, a 'frame-squared'
fitting can be, and in most cases is, the antithesis of Patient
comfort. "You are fitting a Patient for comfort, not a
flat surface for square or for pretty."
An
experienced Dispenser is able to 'take charge' of the dispensing
process and anticipate adverse visual and fitting issues before
the Patient has to endure them, thereby avoiding the necessity
and inconvenience of return visits and-or a possible remake(s),
or worse, a refund.
Touching
and Feeling
Hands-on The Patient Is Essential

"The Optician must touch and feel
the eyewear
in-place, on-the-face in order for chronic discomfort
issues to be eliminated or at least minimized."
After
placing the frame on the Patient and making a hands-on assessment
in-place, the careful adjustment of the nose piece along with
hand crafted sculpting of the temples at all points of contact
is extremely important so that any frame contact is made caressingly,
i.e., there's no pressure, pinching, rubbing or grabbing. One
principle to remember in three-point fitting is, "No
touch, no hold", i.e., at any point of the fitting
triangle where the bridge and temple ends do not touch the nose
and head, there is a reduced ability for the face-head to support
the eyewear and thus hold it comfortably in place.
Gaps
and spaces are obvious when observing poorly fit frames, especially
while touching and feeling the frame while it is in-place on
the Patient. The idea is to remove ANY gaps or spaces between
the Patient's skull and respective points of frame contact.
Again, if there's no touch, there's no hold. And the displacement
can be so subtle that if there is no direct touching-feeling
by the Dispenser while the frame is in-place, on-the-face of
the Patient, there's no way to really assess the most subtle
points of no-contact.
Custom
Frame Fitting
A Three Tiered Procedure
The
complete frame fitting procedure, when it is fully applied,
involves three distinct steps, 1) Simultaneous Visual and Tactile
Assessment of the frame's contact with the Patient, 2) Gross
Frame Alignment, and 3) Subtle
Frame Adjustment.
Gaps
between the frame temples and the skull can be easily felt behind
the Patient's ears using the Sense
of Touch. When the temple ends are hand crafted and contoured
to fit the mastoid complex, they may resemble something akin
to a segment of a pretzel, as in the case of a 'wavy' mastoid
bone. But when the treated temple-ends are placed on the Patient,
even the most radical reshaping becomes invisible to an observer
and the resultant fit is extremely comfortable.
See photo below.
Example
of Old Fashioned
Hands-on Craftsmanship
"The
temple-ends cannot hold an eyeglass frame
in-place comfortably if they do not touch the skull."
Every Patient deserves a sufficiently handcrafted,
multi-dimensional, personalized frame fitting, e.g.,
gaps and spaces are removed from between the frame's
temples and the skull behind the ears, in order to enhance
comfort, stability, and long-term wear-ability. Full contact,
with
a light touch of the skull, NOT THE EARS, is the primary means
by which the frame should be held in place for long-term comfort.

'Before' temple-end is in out-of-the-box condition.
As such, it makes little contact with this Patient's skull,
whereas the 'After' temple-end has been customized.
It now fits the mastoid bone like a glove since it has been
shaped to make full, direct contact with this Patient's skull.
The customized temple-ends become invisible when worn
by the Patient and the resultant fit is extremely comfortable.
But
when worn by the Patient, as shown in the photo above, the temple
ends look, feel, and fit like a glove, no space or gaps. This
kind of custom fitting utilizes the contact surfaces to their
maximum. The removal of the space and gaps however, requires
Subtle Frame Adjustments,
reshaping, even 'sculpting' of the temples with a bit of artistic
skill. The eyewear will now fit only that person for whom it
was intended, and provides a truly customized, balanced and
comfortable fit.
Custom
Frame Fitting
Up Close and Personal
The
highest level of customized frame fitting, aligning, and sculpting,
is achieved mostly with handcrafting skill and the trained eye,
along with the aid of hand tools. A successful multi-dimensional
frame alignment and fitting can be achieved only when the Optician
1) visually assesses the eyewear in-place, on the face of the
Patient, and 2) uses the sense of touch simultaneously to determine
any anomalies between the frame's temples and the Patient's
skull. In most cases, the Dispenser cannot remain seated.
That
is to say, the Optician must get up, and get close to the face
of the Patient, otherwise neither a proper evaluation or fitting
can occur. In other words, the Optician must stand and lean
over the seated Patient in order to make the required observations
at different angles to the front and rear of the Patient's head.
The fitting-adjustment procedure itself also requires the removal
and re-placement of the eyewear directly on the Patient as many
times as necessary to complete, and the entire evaluation and
fitting process requires sufficient time to execute properly,
i.e., it should not be rushed. See more Hands-on Fitting details
here.
Gross
Frame Alignment

"Most people have at least a few
subtle
facial-cranial anomalies to be reckoned with.
The Dispenser must get up, look and feel
behind
the ears, then look down over the top of the Patient's
head in order to acquire the above view of the fitting triangle.
Use of the hands to manipulate the head, the frame, and to
feel the temple ends relative to the mastoid complex is a
must-do for any comprehensive frame fitting assessment."
Example
A: Incorrect fit.
The temples touch the side of the head before reaching the ears.
This is a common fitting error and can be very uncomfortable
for the Patient. It creates a constant tendency for the frame
to slip forward resulting in additional pressure on the nose
and behind the ears as well.
Do
this: Bring the temples out at the end piece and bend the temples
in toward the skull and behind the ear line if necessary.
Example
B: Incorrect fit.
There is excessive bowing of the temples causing extra pressure
behind the ears. In this case the eyewear frame should have
been adjusted from the end- pieces first to allow for a straighter
temple alignment.
Do
this: Bring the temples in at the end piece and remove the bowing
if necessary.
Example
C: Correct fit.
Note how the temples go straight back toward the ears and come
in contact with the Patient only at the three points of the
fitting triangle. Also note that the equal and parallel distance
of planes of the lenses to the plane of the face can only be
observed from above the Patient. The Dispenser cannot accomplish
this while seated.
Again, the Dispenser is greatly handicapped in the fitting process:
a) by merely looking frontally into the Patient's face from
across the dispensing table, b) by not visually assessing the
lay of the frame from multiple angles, even from above the Patient,
and c) by not touching and feeling the eyewear, in-place, on-the-face,
which includes the frame temples as they make contact with the
head, especially the mastoid complex behind the ears.
The
Gross Frame Alignment, being the most obvious, begins even before
placement of the frame on the Patient with the squaring of the
'x' frame axis or plane, as illustrated here, followed by the
Hands-on Assessment, on the patient, of the nosepiece-bridge,
then continues on to the squaring of the 'y' and 'z' planes,
and ends with the reshaping of the temples.
Conventional
coordinates for optical system analysis:
X-axis the horizontal, the Y-axis the vertical
and the Z-axis the optical axis of the system.

Frame
Tilt


In
most cases frames are fit so that the pupil is positioned several
millimeters above the optical center of the lens. When this
occurs some Pantoscopic tilt is desirable as shown in figure
A, above.
Less
commonly, when the pupil is positioned directly behind the optical
center, an Orthoscopic frame tilt is recommended. In the very
unusual situation where the pupil is positioned below the optical
center of the lens, a Retroscopic angle is called for as in
figure C.
For
every millimeter the pupil is positioned above the optical center
of the lens about two degrees of pantoscopic angle should be
applied to the front.
Ideally,
for good cosmetics, there should be approximately 8 - 10 degrees
of pantoscopic angle for most frames. With some unusual shapes,
it may be even be necessary to specify the vertical decentration
of the distance optical center.
Positive
face form should be used when the Patient's PD is narrower than
the GCD of the frame. Since this is usually the case, most frames
will have some positive face form.
In
instances where the GCD and the PD are the same, no face form
is best.
In
the very unusual instance where the Patient's PD is actually
wider than the frame PD, negative face form should be employed.
However, the need to apply negative face form can usually be
avoided with a more appropriate frame selection.
The
Patient should always be advised of any critical fitting issues,
e.g., too short or too long temples, too narrow bridge, too
shallow eyesize, should they select a frame with poor fitting
qualities, which does not accommodate their features, there
being no alternate sizes available. The Patient can then make
a more informed selection. Get the rap on wrap-arounds here.
See advisory on frame selection here.
As mentioned earlier, care should be taken during frame selection
to insure a good fit for the bridge. When using non-adjustable
bridges, little can be done to alter the fit at the time of
delivery. When fitting frames with adjustable nose pads, the
main issue is to be sure the entire area of the pad is resting
on the nose. If the pad is angled in such a way that only a
portion of it is resting on the nose, there's a tendency for
it to “dig in” and cause soreness.
Commonly
Required Gross Frame Alignment
Left
lens is higher - Bend left temple up, or right temple
down.
Right
lens is higher - Bend right temple
up, or left temp down.
Left
lens is lower - Bend left temple down, or right temple
up.
Right
lens is lower - Bend right temple down, or left temple
up.
Left
lens is farther in - Bend left endpiece in.
Left
lens is farther out - Bend left endpiece out.
Right
lens is farther in - Bend right endpiece in.
Right
lens is farther out - Bend right endpiece out.
Increase
pantoscopic angle - Bend both temples, or endpiece
down.
Decrease
pantoscopic angle - Bend both temples, or endpieces
up.
The
list above may be partially summarized by the following: “in
with in; out with out; up with up; down with down.” Which
means if a lens too far in, bend the temple or endpiece in to
bring it farther out; if one lens is too far up, bend the temple
or endpiece up to lower that side, and so on. Manipulating the
frame tilt has the effect of bringing the frame either farther
away or closer to the cheeks and eyebrows. Manipulating the
face form will also effect the distance the frame lies from
the cheeks. The entire frame front may be lowered or raised
by widening or narrowing the bridge, and as previously mentioned,
this is most easily accomplished with adjustable nose pads.
See Common Complaints
and Causes.
Subtle
Frame Adjustment
The
Subtle Frame Adjustment, (see
example) is considered to be a more advanced and sophisticated
aspect of dispensing procedure, i.e., it is multi-dimensional,
with most attention given to hand-crafting detail, along with
sufficient time and patience to accomplish. It can be demonstrated
only by hands-on-direct instruction, and it can be successfully
applied only by direct experience. Therefore, this subject cannot
be fully addressed within the confines of this Course. A workshop
setting, whereby the proper tools and materials are available
to the participants, is the most practical venue for the best
results.
For
instance, Subtle Frame Adjustment involves the conscious, and
somewhat artistic hand crafting or contouring-sculpting of the
temples to the Patients skull whereby any space or gaps between
the skull and temples are removed. (See
photo.) This is the most sophisticated aspect of hands-on
frame fitting and requires some level of artistic skill. It
is the least known and thereby the least practiced, even by
many senior generation Opticians. The resultant effects are
the least visible but most comfortable while being worn in-place
by the Patient, yet it is given the least attention by today's
Dispensers due to the subtleties involved. It is of great importance,
however, in spite of its subtlety, for the Patient's maximum
long-term comfort. --

Quick
Quiz Questions
Determine
the amount of horizontal decentration for the following:
1. "A" measurement = 54 DBL = 16 PD
= 62
2. "A" measurement = 42 DBL = 14 PD
= 50
3. "A" measurement = 50 DBL = 16 PD
= 66
4. "A" measurement = 58 DBL = 22 PD
= 64
Determine
the "theoretical" minimum blank size for each of the
following:
5. "A" measurement = 58 DBL = 18 PD
= 68 ED = 60
6. "A" measurement = 52 DBL = 20 PD
= 60 ED = 54
7. "A" measurement = 56 DBL = 16 PD
= 64 ED = 59
8. "A" measurement = 48 DBL = 14 PD
= 50 ED = 50
Calculate
vertical decentration of the bifocal segment for the following:
9. "B" Measurement = 52 Seg height = 23
10. "B" Measurement = 48 Seg height =
24
11. "B" Measurement = 50 Seg height =
28
12. "B" Measurement = 46 Seg height =
19
Get
the Quick Quiz Answers here.

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