In community practice, some of my new patients tell me that they are disappointed with the thickness and/or weight of their new lenses. Sometimes they show me their previous lenses and I can see that they are thinner and lighter than the ones I have prescribed. How can I avoid having disappointed patients?

 I sometimes miss the fact that a new patient has thinner and lighter lenses and I prescribe them standard index lenses usually resulting in a complaint about the increase in thickness and weight.

 For a new patient once I have measured the lens power I take a look at the thickness of the lenses and see if they are thinner than the power would suggest. I also ask the patient if they had thinner and lighter lenses last time. As they are more expensive and usually involve a discussion between the patient and the previous optician many new patients know if they have thinner and lighter lenses in their current glasses.

Once I have examined a new patient and determined their current refractive error ask myself if they would benefit from thinner and lighter lenses even if they didn’t have them in their previous glasses. For a prescription that is greater than ±2.00 DS but less than ± 4.00 DS I will advise lenses with a refractive index of 1.59. For a prescription that is greater than ±4.00 DS but less than ± 6.00 DS I will advise lenses with a refractive index of 1.67. For a prescription that is greater than ±6.00 DS I will advise lenses with a refractive index of 1.74.

Yes, these lenses are more expensive than those with a standard index but I think it’s important for patients to know about how thinner and lighter lenses can help them. Let the patient decide if they want to invest in lenses that look better and feel lighter.