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Troubleshooting: Fixing Problems with a Methodical and Professional Attitude

Learn how to troubleshoot and fix problems effectively with the right attitude. Discover tips for addressing personalty types, handling emotional issues, checking for errors, and managing changes in prescription, lens design, frame, and physical health.

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Troubleshooting: Fixing Problems with a Methodical and Professional Attitude

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  1. Troubleshooting - you’ve got a problem… Fix it Once and Fix it Right

  2. Attitude • Your attitude • Confident • Scared • Defensive • Rushed

  3. First Step • Take a deep breath • Calm attitude • Speed is not the issue be methodical • Act like a professional - listen

  4. PERSONALITY TYPE • Competitor – Fight with the patient • Fun Lover – Play with the patient • Respectful – Analyze with the patient • Peacekeeper – Please the patient

  5. Emotional issues • Did you properly prepare the patient for the differences from previous pair ? • Is the product right for the patient? • Does the patient understand adaption? • Policies • 60 day • Desert island

  6. Check for your errors • Was it ordered correctly? • Check the doctors notes on the chart. • Was it received correctly?

  7. Check the history • Previous prescription versus new prescription • Is there a change? • Where? • How much? • Determine total power change? • Previous: OD -2.00 -1.00 x 050 • New: OD -2.50 -1.25 x 055 New RX • Change in progression of power? • Previous: OD +0.75 -2.00 x 135 ADD +1.50 • New: OD +1.25 -2.25 x 136 ADD +2.00 • How much is too much?

  8. Measurement differences Pupillary Distance (PD) Seg height Optical Center (OC) Trifocal Bifocal Changes in history PD Progressive OR Optical Center

  9. Changes in history • Base curve • Pantoscopic distance - Vertex distance

  10. CR-39 Poly 1.66 1.70 13.8 mm 11.6 mm 10.3 mm 9.8 mm Check the history • Lens material • Poly to High index • High index to Poly • Patient might experience • Images appearing different in size • Reflections • Decrease in sharpness of acuity

  11. Change in history • Lens design • Single vision to progressive • Patient might experience • Peripheral blur • Frustration with need to move head • Difficulty walking, reading in bed

  12. Change in history • Progressive design change • How long was the patient wearing the previous design? • What are the design changes? • How long to adapt?

  13. FRAME • Fit • Adjustment • Differences in • Fit • Pantoscopic angle • Vertex distance • Too far away? What happens? Plus lens? Minus lens?

  14. PHYSICAL HEALTH • Discuss medications • Ocular side effects • Heart medication: blurred vision, color distortion • Tetracycline & steroids: swelling of the optic nerve • Involve your doctor

  15. PHSYICAL HEALTH • Systemic changes • Hypertension • Diabetes • Hemorrhages • Involve your doctor

  16. PHSYICAL HEALTH • Ocular changes • Halos – acute glaucoma • Cloudy veil – retinal issues • Sudden lose of vision or double vision • Involve the doctor

  17. Troubleshooting Checklist • Double check all parameters are as ordered • Sphere, cylinder power in each lens • Axis • Base curve • Distance and near PD’s • Optical centers • Prism as ordered – Is it unwanted prism • Multifocal segment – style, size, height, differences • Segment alignment – even or crooked • Add power

  18. Troubleshooting Checklist • Lens materials • Lens coatings or tints • Lens thickness • Lens surfaces – scratches, imperfections • Lens mounting

  19. Troubleshooting Checklist • Frame received as ordered? • Differences from previous pair • Frame style, size, metal, plastic • Frame condition – torn pads, loose hinges • Frame alignment

  20. Closing • Stay calm • Work through problem solving step by step • Discuss patients options • Inform patient of practice policies

  21. QUESTIONS

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