When I’m investigating whether a patient needs an increase in the strength of their reading/close work lenses I frequently struggle to decide if stronger lenses will help them see better. I want to let the patient know if they will get a visual benefit from new stronger lenses. Do you have any suggestions?

It can be difficult to determine if new lenses will provide a patient with a visual benefit whether in the form of a near vision, bifocal or progressive addition lens, it is important to document some aspect of improvement.

I also struggle with this. It would be great if when I put the stronger lenses in the trial frame and the patient could now read print they can’t read with their current glasses. This sometimes does happen but often the improvement can be subtle.

I use a near chart on which the smallest print is N5. Some patients who complain of reading problems at home and/or work can sometimes read N5 with their current glasses. So, I have to look for other methods of detecting an improvement with stronger lenses.

Sometimes patients say ‘the print got larger, ‘my eyes feel less strained’, ‘my eyes feel more relaxed’ or ‘my eyes are working easier’. These are positive changes.

Let the patient use their words, and don’t lead them with our own words to describe an improvement. Don’t lead the patient to say what you want them to say.

Also, watch out for the patient moving the print to a more natural/comfortable working distance with the stronger lenses.

Some patients, especially younger ones, do not know how to describe the change that has taken place. When probing, steer clear of only asking questions that yield positive answers; present both sides equally and perhaps even concentrate on the middle of the spectrum of possibilities.

While much of an eye examination is based on science, some of it requires the touch of an artist.