14 Rx Check

What follows is an approach for Rx checks.  It is by no means complete, and is intended only to provide a framework which you can alter to suit the particular task at hand.

1. History, history, history!
   • For each pair of glasses (I’ve had patients bring bags filled with 7 pair of glasses before), gather a history.  Is vision good in the distance?  Up close?
   • How much time have they spent wearing new glasses; i.e., have they adapted?
2. Verify all glasses they bring and record distance and near acuities for each pair of glasses, measuring base curves when necessary.  Changes in base curve can result in adaptation problems for the patient, even when the prescription is accurate (i.e., exactly as written) and acuities are good.
3. Perform refraction and record your results with distance and near acuities.
4. Verify that the glasses fit as they should.  Do eyeglass PDs align with the patient’s PDs?  Are PALs appropriately centered?  Are bifocals of appropriate height?
5. Perform trial frame as appropriate.  Remember, trial frame is not a refraction.  You should have refractive choices nailed down to 2-3; present each to the patient to see which they prefer and record the results.

The table below encapsulates the ideas above, and provides a a solid framework that allows you to solve the patient’s refractive issue.  With this data in hand, you can more easily rectify the patient’s issue(s).