By David Lineaweaver, ABOC
Ask, “What are you having trouble reading and at what distance?”
The answers to this question will give clues to what the true complaint is. Difficulty reading road signs or seeing print on TV is a classic indication of a distance vision complaint. Difficulty viewing a computer screen or seeing gauges on a dashboard indicate that the complaint is intermediate vision. Difficulty reading print on a medicine bottle is a “small print” complaint, which is outside the range of “book reading” complaints.
Here’s a list of other useful questions that help get to a solution:
In what environment or situation are you viewing?
(Well-lighted indoors setting, bright outdoor sunlight, dim room?)
Carefully listen to this description. For example, you may recommend specific lighting and avoiding the glare of outdoor light coming in through the window.
How often does this occur?
An answer of “all the time” likely indicates that the problem is something beyond frame adjustment. This may be a problem of incorrect Rx, dry eyes or a follow-up with the examining optometrist or ophthalmologist.
How long do you read before you have trouble reading?
If the response is a reading duration of more than 15 minutes, the near correction is most likely correct. The issue is probably changes in viewing distance due to fatigue, dry eyes or a combination of these two issues.
Are you wearing single vision reading glasses or multifocals when reading?
This may seem obvious, but many people voice reading complaints that would be resolved if they simply wore their reading or multi-focal glasses. If the customer is wearing a multifocal, ask, “What part of the lens are you looking through?” Often, the answer requires separate single-vision distance and single-vision near glasses, so the patient doesn’t have to walk the “seg height tightrope.”
Do you ever feel that your upper lids ever “dim” or cut off some of your upper vision when reading?
Upper lids move in a downward direction (down gaze) in the typical reading posture. This sometimes results in the upper lids covering a portion of the pupils, reducing the “window” of vision and causing images to be dimmer. Give the customer a reading card while wearing near correction and have him read through it. Note where the customer holds the card and also if upper lids droop over the pupils. If drooping upper lids are “shadowing” or “dimming” near vision, ask the customer to exert extra effort to raise their brows and open their eyes wider or alter their posture. The doctor may discuss upper lid surgery.
Determine environmental and ergonomic factors that affect reading.
Maintaining proper viewing distance (focal length) is of the utmost importance for reading. To determine the optimum viewing distance, have the patient find the sharpest viewing distance and take note of it. This should also be physically comfortable. If not, the workstation (desk height, chair height, and height and arm supports) should be altered ergonomically to be more comfortable. If the sharpest image cannot be maintained in a physically comfortable manner, the customer should be referred back to their doctor to discuss an add power that will provide the sharpest near acuity, at the posture that is physically comfortable to the patient. Book holders are a great hands-free aid to maintain proper viewing distance without movement.
It’s all about lighting.
Lighting is also critical to effective reading. Download a copy of The Principles of Task Light from Luxo Corporation.
March 2017
Eyes/Optics