Optician’s Guide

Optician’s Guide
(A Manual for Opticians)

Ajay Kumar Bhootra

DOS, FAO, FOAI, FCLI (Aligarh)
ICLEP (Hyderabad)
Optometrist and Ocularist

JAYPEE BROTHERS
MEDICAL PUBLISHERS (P) LTD
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Optician’s Guide
© 2006, Ajay Kumar Bhootra
All rights reserved. No part of this publication should be reproduced, stored in a
retrieval system, or transmitted in any form or by any means: electronic, mechanical,
photocopying, recording, or otherwise, without the prior written permission of the
author and the publisher.

This book has been published in good faith that the material provided by contribu-
tors is original. Every effort is made to ensure accuracy of material, but the
publisher, printer, author will not be held responsible for any inadvertent error(s).
In case of any dispute, all legal matters are to be settled under Delhi jurisdiction
only.

First Edition : 2006

ISBN 81-8061-610-X
Typeset at JPBMP typesetting unit
Printed at Replika Press Pvt. Ltd., Plot No. 310, EPIP, Kundli, Sonepat, Haryana,
India
 Respectfully dedicated to
my uncle

(Late) Sri Krishna Kumar Binani

 Preface

This book is a basic reference book for all the Dispensing

Opticians. This has been designed and developed in such a
manner so as to give very basic and minimum required
technical information about optics and dispensing of spectacles
in a very simple language. Practical requirements of the subject
have been given primary importance. I feel all the personnels
from counter salesman, store incharge and works people to
the top level segments must have a copy of this book with
them to know the basics of the subject.
I shall be failing in my duty if I do not acknowledge the
support which I got from the following personalities for
providing me immediate informations as and when I required:
Mr Prasanta Gupta From Essilor SRF Optics Ltd.
Ms Padmaja P Pathan From Essilor SRF Optics Ltd.
Mr Sujay Debnath From Bausch & Lomb India Pvt. Ltd.
Dr S Mehmood Chief Editor “The Optometry India”
(Published By : Optometric Associa-
tion of India, Kolkata)
My heartiest thanks to them.
I do not claim that this is a complete textbook, rather it
contains almost all the aspects of dispensing spectacles which
we come across during our daily routine work in an optical
store. I shall be highly satisfied if this book serves the purpose
of those for whom this has been written.

Ajay Kumar Bhootra

 Acknowledgement

It gives me immense pleasure and I am proud to say that I

could think of writing this book only on the belief that my
uncle Sri Krishna Kumar Binani who is an eminent personality
in the field of Optical Industry in India is always with me to
extend any kind of help if I get stuck anywhere in between. It
is because of his suggestions and inspirations I selected
optometry as my postgraduate subject. Today whatever I have
achieved in my life, it is all because of his constant support
and guidance. I extend my sincere and humble salutation to
him before the commencement of this book.
 Contents

1. Light ....................................................................................... 1
2. Lenses ..................................................................................... 6
3. Prism ..................................................................................... 15
4. Transposition ..................................................................... 19
5. The Prescription ................................................................. 27
6. Selection of Lenses............................................................ 29
7. Frames and Measurements............................................... 41
8. Lens Grinding .................................................................... 51
9. Verification of Spectacles ................................................ 60
10. Dispensing Spectacles to Children ............................... 64
11. Contact Lenses ................................................................... 69
12. Eyes ....................................................................................... 74
13. Troubleshooting: A Fast Reference Guide .................. 80
14. Some Useful Terms............................................................ 89
Appendix ................................................................................ 95
References ............................................................................... 97
Index ...................................................................................... 99
 Chapter 1

Light

Light is a form of radiant energy, arising out of a source and

always travels in a straight line. A straight line represents the
path of a ray of light. A few such rays taken together is called
the beam of light. It is not possible to produce a single ray of
light. However the small source may be, it always produces a
beam of light, consisting of several rays.

Fig. 1.1: Parallel rays

A beam of light may be of three different types (Figs 1.1 to

1.3):
1. Parallel.
2. Divergent, and
3. Convergent.

Fig. 1.2: Covergent rays Fig. 1.3: Divergent rays

2 Optician’s Guide

In a parallel beam of light the rays are parallel to one

another (Fig. 1.1). Rays of light coming from a very distant
source, are regarded as Parallel. When the rays of light are
produced from a point and are spread out is called the
Divergent rays (Fig. 1.3) and when it travels towards a point
is called Convergent rays (Fig. 1.2).
When the light falls upon the retina, it stimulates certain
highly specialised cells, which produces nerve impulses. These
produce perception of light, colour, form, size and motion. It
has been found that light travels 1,86,000 miles per second in
the air and takes about 8.3 minutes to reach the earth from the
sun.

OPTICAL MEDIUM
A substance or any portion of space through which light can
pass is called Optical Medium. All the objects or substances
around us are either self-luminous or non-luminous. A body
is called self-luminous when it emits light by itself. It may be
used as a source of light, such as sun, burning candles, etc.
Bodies which are not self-luminous are not visible unless light
falls upon them and is scattered in all directions. Each point
then behaves like a luminous source. Most of the objects around
us are non-luminous, such as table, chair, etc.
Non-luminous bodies may be transparent, translucent and
opaque. A transparent body is one which transmits the light
according to the straight line law whereas a body is opaque
when it does not transmit the light at all. There are substances
which transmit the light but not in straight line. They are called
translucent bodies. Light in passing through them is scattered:
Translucent bodies may be used as screen on which optical
images are projected.

REFLECTION OF LIGHT
When the rays of light passes from one medium to another,
some of the light is reflected or bent back to the original
medium. The phenomenon is known as reflection of light.
 Light 3

If the ray of light falls on a very smooth and polished

surface, all the reflected rays will travel in a definite direction,
keeping a relation with the incident rays like in the Figure 1.4.
The reflection occurs in accordance with the following two
laws:
1. The incident ray, the reflected ray and the normal ray or
the ray perpendicular to the reflecting surface – all lie in
the one plane.
2. The angle of incidence is equal to the angle of reflection.

Fig. 1.4: Reflection of light

The Figure 1.5 shows the reflection of a single ray of light.

Here AO is the incident ray which is reflected along OB by a
plane mirror MN. The ray AO is the direction in which the light
falls on the surface. O is the point of incidence and OB is the
reflected ray. PO is the normal ray which is perpendicular to
the surface MN at the point of incidence. The angle made by
the incident ray with the normal ∠AOP is called the angle of
incidence which is equal to the ∠BOP which is the angle of
reflection.

Fig. 1.5: Laws of reflection

4 Optician’s Guide

If the surface is not plane, the reflected rays will have

various directions and the light will be scattered. But at each
point the law of reflection is obeyed. When the surface is rough
or matt, the reflected light is scattered or diffused.

REFRACTION OF LIGHT
When a ray of light travels from one medium to another, it
changes its path. The change in direction of light is known as
refraction.
Suppose a ray of light traveling along AB in the air falls
obliquely on the block of glass. The ray will now enter into the
glass block. But the direction of the AB now takes the path
BC (Fig. 1.6).

Fig. 1.6: Refraction of light

When a ray of light passes from rare medium (i.e. air) to a

dense medium (i.e. glass) it bends towards the normal and
when it passes from a dense medium to rare medium, it bends
away from the normal. But when a ray of light from one
medium falls normally on another, it passes straight into the
second medium without any change of its direction.

VELOCITY OF LIGHT
The velocity of light is different in different media. It is greater
in optically rare medium and less in optically dense medium.
So when a light passes from a rare medium to a dense medium
its velocity reduces and vice versa. For this reason the ratio of
velocity of light in air to that in a given medium is taken as
the refractive index {(µ) pronounced as mew} of the medium
(air being taken as standard).
 Light 5

Therefore:
Velocity of light in the air
μ of a medium =
Velocity of light in the medium

Example 1: To find the refractive index of crown glass, (if the

velocity of light through it is 1,22,000 miles per second):

μ=

μ = 1.52
Refractive index of crown glass = 1.52.

Example 2: To find the refractive index of flint glass (if the

velocity of light through it is 1,13,000 miles per second):

μ=

μ = 1.65
Refractive index of flint glass is 1.65.

X
 Chapter 2

Lenses
Lenses are the bodies made of transparent materials and bound
by the two spherical surfaces. Although there are several
varieties of forms in lenses they may be divided into two
classes according to their behaviour towards a parallel beam
of light—convex and concave. Both convex and concave may
be of the following types (Fig. 2.1):

Fig. 2.1: Classification of lenses

A – Bi-convex lens (Bi – Cx)
B – Plano-convex lens (Pl – Cx)
C – Convex meniscus lens (Cx – o – CC)
D – Bi-concave lens (Bi – CC)
E – Plano-concave lens (Pl – CC)
F – Concave meniscus lens (CC – O – Cx)

CONVEX AND CONCAVE LENS

When the lens is thicker at its centre than its edges, it is called
a Convex lens or Converging lens. It is considered as the
collection of prisms placed base to base. The line passing
through this junction is called the Principal Axis. When a ray
of light passes through a convex lens, they converge to a point
on the principal axis. In Figure 2.2, the rays A, B and C strike
the convex lens at D, E and F respectively. The middle ray B
is perpendicular to its surface and passes through the centre
 Lenses 7

of the lens in a straight

line and is the principal
axis. The other ray A
which is parallel to the
principal axis meets the
lens at D, and it gets
deflected towards the
base of the prism and
meets the other surface
at G. From here it is Fig. 2.2: Convex lens
further deflected
towards the principal axis and meets at point P. So is this case
with the ray C. These two rays meet at the point P on the
principal axis. Therefore, parallel rays passing through a convex
lens are brought to a focus at certain fixed point in front of
the lens which is known as principal focus and the distance
between this focus point P to the optical centre of the lens is
the focal length of the lens.

Fig. 2.3: Concave lens

Concave lenses are thicker at its edge than its centre. It is

considered as the collection of prisms placed apex to apex.
When the rays of light pass through the concave lens, they
appear to diverge from the principal axis. In the Figure 2.3,
the ray A which is parallel to the principal axis, meets the
surface of the concave lens at D and is bent towards the base
and meets the other surface at F. From this point it further
deviates from the principal axis. Similar is the case with ray
C. Thus the rays after passing through the concave lens diverge
8 Optician’s Guide

and are appearing to come from point P, which is principal

focus which in fact is virtual.

DIOPTRE
The dioptre is the unit of measurement of the power of the
lens. The power of a lens is the measurement of the degree of
convergence in case of convex lens or degree of divergence in
case of concave lens. It is the strength of the lens and is
denoted by the abbreviation D. One dioptre corresponds to a
lens of the focal length of 1 metre. The dioptric value of the
lens is inversely proportion to the focal length of the lens in
metres. Thus

Power = D

Or, = D

Example: To find the dioptric value of the lens if it has a focal

length of 50 cm

P= D

P = 2.00 D

OPTICAL CENTRE
The optical centre of a lens is defined as a point within the
lens and lying on its principal axis such that all the rays passing
through it emerge undeviated. The point ‘O’ indicated in the
Figure 2.4 is the optical centre of the lens. All the ophthalmic
lenses are having many meridians. But there are two principal
meridians which are at right angles. The point at which they
cross each other is the optical centre of the lens. The rays of
light passing through this point goes without any deviation.
 Lenses 9

Fig. 2.4: Optical centres of the lenses

SPHERICAL LENSES
A spherical lens is one in which each surface forms the part of
surface of a sphere. There are two principal meridians of a
lens which are at right angles. For example if one meridian is
at 90°, other will be at 180°, or if one meridian is at 30° other
will be at 120°. In case of spherical lens both the principal
meridians will have the same power.

Fig. 2.5: Principal meridians have same power

CYLINDRICAL LENSES
If a small slab is cut out from a roller shaped glass and from
the centre of this slab if we cut a round shaped glass, this will
have two different curvature on its surface. These are
cylindrical lenses. The cylindrical lens does not have same
curvature in all meridians. In case of simple cylindrical lens
one meridian is plane and other will have some curvature.
The plane meridian will be the axis of the cylindrical lens.
10 Optician’s Guide

In Figure 2.6A 180° meridian is plane and 90° meridian is

+2.00D. So the resultant power is +2.00 Dcyl × 180°. Similarly
in Figure 2.6B lower value meridian will be taken as spherical
and difference of power between two meridians will be
cylinder and the lower value meridian will be the axis. The
resultant power in this case will be +1.00 Dsph. –c + 1.00 Dcyl
× 180°.

A B
Figs 2.6A and B: Power of a cylindrical lens

Parallel rays passing through a cylindrical lens will be

refracted in such a way so as that the lens will form a focal line
instead of a focal point.

Fig. 2.7: Refraction through a convex cylinder

Figure 2.7 shows the course of action of a plano cylinder

convex lens. AB is the axis of the cylindrical lens. The ray of
light passing through AB goes undeviated whereas rays from
O and P which are parallel to the principal axis XY are
converged to a points M and N. Thus focus instead of being a
point is a focal line MN.
 Lenses 11

METHODS TO FIND OUT CONVEX AND

CONCAVE LENS
A convex lens is denoted by the plus sign ‘+’ and a concave
lens is denoted by minus sign ‘–’. There are three ways by
which we check whether a lens is plus or a minus:
1. If the edges of the lens are thinner than its centre, it is plus
lens and if the edges are thicker than its centre it is a minus
lens as shown in earlier figures.
2. If the focal point of a lens is in front of the lens, it is a plus
or convex lens and if the focal point of a lens is behind the
lens, it is a minus or concave lens as shown in Figures 2.2
and 2.3.
3. The above two methods are very difficult to apply if the
dioptrical value of a lens is low. So we apply the movement
test which is most widely in practice. To do this we hold the
lens in front of our eye and observe the object through the
lens. Now move the lens up and down or right and left and
watch the movement of the object. If the object appears to
move with the lens, it is a minus or concave lens and if the
object appears to move against the lens it a convex or plus
lens. It follows therefore:
• With movement—Minus lens
• Against movement—Plus lens.
Note: If the power is low hold the lens far from eyes and if
the power is high hold the lens close to the eyes.

METHODS TO FIND OUT SPHERICAL,

CYLINDRICAL AND SPHEROCYLINDRICAL LENSES
We can find out whether a lens is a spherical or cylindrical or
spherocylinder with the help of rotation test. To do this hold
the lens in front of our eye and observe the object through it by
closing one eye. Now rotate the lens in any direction. If the
shape of the object does not appear to change while rotation, it
is a spherical lens and if the shape appears to change or we
find a scissor like movement while rotation, it is either
cylindrical lens or spherocylindrical lens. Now apply the
movement test to confirm whether it is a planocylinder or
spherocylinder. Move the lens in different meridians and
12 Optician’s Guide

observe the movement through it. If we find that there is no

movement at any meridian, the lens is a planocylinder and if
we find movement at every meridian but more at one meridian
and less at other, it is a spherocylindrical lens. The zero
movement meridian or lower movement meridian will be the
axis of the lens.

MERIDIANS
An ophthalmic lens has various meridians. But there are two
principal meridians which are at right angles. For example if
one meridian is at 90°, other will be at 180° or if one meridian
is at 20°, other will be at 110° and so on. To find the principal
meridians of a lens, we require a cross chart.

Fig. 2.8: Determining meridians with the use of cross chart

Hold the lens parallel to the chart and view through the
observer side of the lens. Close one eye and try to bring the
lens in such a position from where we can see that the lines of
the chart through the lens and outside the lens are in one line,
as shown in the Figure 2.8B. Put four dots coinciding with the
lines of the chart. Now join these dots from top to bottom and
right to left. The crossing point is the optical centre. If the lens
is spherical keep the centre and rub out the lines. But if the lens
is either cylindrical or spherocylindrical, keep the centre and
nil or lower movement meridian which is the axis meridian.
Note: Lensometer can also be used to find out the two
meridians.

OPHTHALMIC LENS MATERIALS

The following materials are normally used as ophthalmic lenses:
i. Crown glass.
 Lenses 13

ii. Flint glass.

iii. Hi-index glass.
iv. Plastic.
v. Polycarbonate.

Crown Glass
This is most widely used in ophthalmic industry. This glass
contains silica, calcium oxide, sodium oxide and also in smaller
percentage potassium borax, arsenic, etc. These glasses have
a refractive index of 1.523.

Flint Glass
It contains mainly lead oxide, silica, soda potash, etc. The effect
of lead oxide is to increase the refractive index. The refractive
index is 1.65. These are mainly used to fuse the segments of
the fused bifocal lenses.

Hi-index Glass
High-index is an advanced lens material that has made it
possible to obtain finer and thinner glasses than traditional
1.523 index crown glass with the same power. The term “Hi-
index” refers to the lens material’s index of refraction or degree
to which it refracts light. Because of higher index of refraction,
the lens bends the light to a greater degree and less curvature
is needed to make a specific power. There are hi-index lens of
different grades, such as, 1.7, 1.8 and 1.9 are available. The
features of Hi-index lenses are:
a. Power rings round the edges of the lens is reduced.
b. They reduce the centre thickness in a convex and edge
thickness in a concave lens.
c. They look flatter so as to ensure less, bulging of lens from
the frame.
d. The high index lens reduces the light transmissibility.
High index glasses are nowadays made of lanthanum or
titanium rather than barium as it gives similar optical properties
and also weighs less.
14 Optician’s Guide

Plastic Lens
Plastics are organic materials which are usually manufactured
from chemicals found in crude oil, coal or vegetable oils. There
are many types of clear plastics available. Initially the
ophthalmic plastic lenses were made of polymethylmetha-
crylate, but later on CR39 was developed which may easily be
ground to get desired power. The refractive index of these lenses
are 1.498. Nowadays high index plastic lenses have also been
developed having the refractive index of 1.6, 1.67 and so on.

Polycarbonate
Polycarbonate, a recent development in the lens materials, is
10 times more impact resistant than other plastics and is
extremely thin and light weight. The index of refraction of these
lenses is 1.586 which is higher than that of CR39 lenses.

X
 Chapter 3

Prism
The prism may be defined as two plane optical surfaces which
are not parallel to each other but are inclined at a definite angle
and enclose a medium with uniform refractive index different
from that of the medium outside. The point at which these two
surfaces meet is called apex or apical angle and the surface
opposite to apex is termed as the base of the prism. Since the
ray of light is bent towards the perpendicular as entering dense
medium (glass) from a rare medium (air), it will bend as it enters
the prism and when it goes out from the prism into the air, it
will be refracted away from the perpendicular towards the base.
This may be shown with the help of the Figure 3.1.

Fig. 3.1: Deviation produced by prism

ABC represents the prism and DE is the incident ray meeting
the surface AB at E. The ray of light is passing from air to glass.
DE is therefore, refracted along EF, i.e. the ray is bending
towards the normal. The refracted ray EF meets the surface AC
at F. EF acts as an incident ray for the surface AC and is
travelling from glass to air. The ray emerges as GF is bending
away from the normal and bends towards the base. The path
of the ray is observed as DEFG. It is evident that the entire
bend is towards the base and the total deviation of the incident
16 Optician’s Guide

ray up to the emergent ray is called the angle of deviation

and is represented by ∠K. If an observer is at point G and
luminous body is at D, the image will be projected at H. Thus
when the ray of light is deviated towards the base the image
is displaced towards the apex of the prism.

APPLICATION OF PRISM
IN OPTICS
In optics prism glass is used
to produce the deviation of
rays of light at a given dis–
tance. A ray of light striking
the front surface of the prism
is deflected towards the base
of the prism and image
seems to be deflected to–
Fig. 3.2: Application of prism
wards the apex of the prism.
The amount of deflection is
called the prism power and is expressed in prism dioptre
denoted by D. A prism having the power of 1D deflects a beam
of parallel light by 1 cm at a distance of 1 metre, 2D produces a
displacement of 2 cm at a distance of 1 metre and 5D produces
a displacement of 5 cms at the same distance. The concept of
prismatic power of the lens is based on the ability of the lens to
refract light. A ray of light striking the margin of the convex
lens will refract more than a ray of light striking the lens closer
to its optical centre. In fact, rays passing through the optical
centre is not refracted at all.

PRISM AND LENS DECENTRATION

A lens is a combination of prisms which meet at the optical
centre so that the rays of light passing through it go undeviated.
If the rays meet the lens at a point other than optical centre,
they act as prism. It is essential that the optical centre of the
lens coincides with the IPD of the patient, otherwise prismatic
effects may give rise to eye strain. The non-coincidence of the
 Prism 17

optical centre with IPD results in decentration of the lens, giving

prismatic effect. General theory is that if the lens power is 1.00D
and we decentre the lens by 10 mm, it produces 1D prism. Or if
the lens power is 10.00D and we decentre 1 mm, it also produces
1D prism. This is a constant. The equation is:

1. d=

2. P=

where, d = decentration in mm
D = dioptre or lens power
P = prism degree
The prism degree can be found out with the help of above
equation. At the time of grinding prisms can be produced by
keeping the edge difference for which the equation is:
Prism × size of lens × 0.019 = Edge difference.

DETECTION OF PRISM IN AN OPTICAL LENS

Hold the glass up between the eye and an object which forms
a straight line. If the continuity of the line is broken as seen in
the Figure 3.3, it implies that the prism is present and since
the line appears to be deviated towards the apex, we know
the direction of apex of the prism. The amount of displacement
produced is the strength of the prism and can be measured by
neutralising. To do so put the prism lens of known strength in
contact with the lens under checking with its apex in opposite
direction. The prism lens with which the continuity of the line
is again established, we know the strength of the prism.

Fig. 3.3: Detection of prism in a lens

18 Optician’s Guide

Fig. 3.4: Detection of prism in a lens using lensometer

Lensometer can also be used to detect the prism dioptre.

To check this get the best focus point of the target images and
read the prismatic power. In most of the lensometer each circle
of the scale indicate one prism dioptre. But for higher dioptre
of prism an additional accessory called prism compensator is
to be attached to the lensometer. Figure 3.4 shows 2.5 prism
dioptre towards 90 degrees in PENTAX OLH-1 lensometer.

X
 Chapter 4

Transposition
Transposition of lenses is to rewrite the expressions of its
power without actually changing them. It implies transfer of
lens power from one form to another so as to their meridian
values remain the same in both the forms. Before we
understand the transposition rules we need to understand
the following two cases:
1. How to draw meridian values from a given lens power?
2. How to transfer a meridian values to a lens power?

LENS POWER TO MERIDIAN VALUES

When we get a lens power first we draw the two principal
meridians according to the direction of axis. Now put the
spherical power on the axis meridian and the sum of spherical
and cylindrical power on the opposite meridian.
Examples:
Lens power Meridian values

1. + 1.00 Dsph.

2. + 1.00 Dsph. c– + 0.50 Dcyl × 90°

20 Optician’s Guide

3. – 2.00 Dsph c– – 1.00 Dcyl × 20°

4. + 1.00 Dsph c– – 1.00 Dcyl × 90°

5. + 1.00 Dcyl × 60°

6. + 1.75 Dsph c– – 0.75 Dcyl × 160°

7. – 2.00 Dsph c– + 0.50 Dcyl × 90°

 Transposition 21

8. + 0.75 Dsph c– – 1.75 Dcyl × 90°

The example 8 shows the cross compound lens power

because cylindrical power is more than spherical power with
opposite sign. Even if we draw their meridian values, they
are represented with opposite signs in the meridians.

MERIDIAN VALUES TO LENS POWER

To transfer the meridian values to lens power, we take lower
meridian value as spherical and the difference of the two
meridian values as cylindrical. Lower value meridian is taken
as axis. If both meridians have the same sign, i.e. either plus
or minus, we get the difference by subtraction. But if it is the
case of cross compound, i.e. one meridian is having plus sign
and other is having minus, by adding both we get the
difference.
Examples:
Meridian values Lens power

1. + 1.00 Dsph

2. – 0.50 Dsph c– – 0.75 Dcyl × 30°

22 Optician’s Guide

3. + 0.75 Dcyl × 100°

4. + 1.00 Dsph c– – 2.00 Dcyl × 180°

or, – 1.00 Dsph c– + 2.00 Dcyl × 90°

TRANSPOSITION RULES
There are three ways in which a lens power may be written.
For example:
Lens power = + 1.50 Dsph c– + 0.50 Dcyl × 180°
or, + 2.00 Dsph c– – 0.50 Dcyl × 90°
or, + 1.50 Dcyl × 90° c– + 2.00 Dcyl × 180°
The first two forms are spherocylinder forms and the third
is double cylinder form. To transpose one spherocylinder form
to another add the spherical and cylinder together algebraically
to get the spherical power. Retain the same power of cylinder
with opposite sign. Change the axis by 90°.
Examples:
1. + 1.50 Dsph c– + 0.50 Dcyl × 10°
+ 2.00 Dsph c– – 0.50 Dcyl × 100°
2. + 1.25 Dcyl × 180°
+ 1.25 Dsph –c – 1.25 Dcyl × 90°
3. + 1.00 Dsph c– – 2.00 Dcyl × 75°
– 1.00 Dsph c– + 2.00 Dcyl × 165°.

To Transpose a Spherocylindrical
Form into a Double Cylindrical Form
First Method
Draw the meridians in the direction of axis given in the sphero-
cylindrical form. Now write any one meridian power as
 Transposition 23

cylindrical with the axis of opposite meridian and also other

meridian power as second cylinder with the axis opposite to
that meridian.
Examples:

1. + 1.00 Dsph c– + 0.75 Dcyl × 90°

+ 1.00 Dcyl × 180° –c + 1.75 Dcyl × 90°

2. + 0.50 Dsph c– – 1.25 Dcyl × 90°

+ 0.50 Dcyl × 180° c– – 0.75 Dcyl × 90°

3. + 1.00 Dsph
In case of spherical power, draw the meridians of your
choice with the difference of 90° axis. Suppose if one meridian
is taken as 30°, other will be taken as 120°, or if one meridian
is taken as 90°, other will be taken as 180°. So the meridian
values are:
24 Optician’s Guide

+ 1.00 Dcyl × 90° –c + 1.00 Dcyl × 180°

Second Method
Transpose the given spherocylinder lens power into the second
spherocylindrical form. Now we have two sphericals in two
forms and two axis of two forms are the two meridians. Take
spherical power of first form as cylinder with the axis of the
second form as its axis and spherical power of second form as
the cylinder with the axis of the first form as its axis.
Examples:
+ 0.50 Dsph c– + 1.00 Dcyl × 75°
⇒ + 1.50 Dsph –c – 1.00 Dcyl × 165°
⇒ + 0.50 Dcyl × 165° –c + 1.50 Dcyl × 75°

Third Method
Take the spherical power of the given spherocylindrical form
as cylinder with the axis opposite to the given axis. The second
cylinder will be algebraic sum of the spherical and cylinder
given and its axis will be same as given.
Examples:
1. + 1.25 Dsph c– – 0.25 Dcyl × 25°
⇒ + 1.25 Dcyl × 115° –c + 1.00 Dcyl × 25°
2. – 1.50 Dsph c– – 0.75 Dcyl × 90°
⇒ – 1.50 Dcyl × 180° c– – 2.25 Dcyl × 90°
3. + 0.25 Dsph c– – 0.50 Dcyl × 75°
⇒ + 0.25 Dcyl × 165° – 0.25 Dcyl × 75°
 Transposition 25

To Transpose a Double Cylinder Lens

Power to a Spherocylinder Form
First Method
To transfer a double cylindrical lens power into a sphero-
cylinder form, draw the meridians according to the directions
of axis. Put the value of first cylinder on the axis of second
cylinder and second cylinder on the axis of the first cylinder.
From this meridian values, we may find out the lens power in
the spherocylinder form.
Examples:
1. + 0.50 Dcyl × 10° c– + 1.50 Dcyl × 100°

⇒ + 0.50 Dsph c– + 1.00 Dcyl × 100°

2. – 2.25 Dcyl × 15° –c – 3.50 Dcyl × 105°

⇒ – 2.25 Dsph c– – 1.25 Dcyl × 105°

3. + 0.25 Dcyl × 60° –c – 0.50 Dcyl × 150°

⇒ + 0.25 Dsph c– – 0.75 Dcyl × 150°

26 Optician’s Guide

Second Method
Take the smallest cylinder power as spherical and axis will be
opposite of that cylinder power. The difference of the two
cylinder value will be the cylinder.
Examples:
1. + 1.75 Dcyl × 30° c– + 0.75 Dcyl × 120°
⇒ + 0.75 Dsph c– + 1.00 Dcyl × 30°
2. + 1.50 Dcyl × 45° –c – 0.50 Dcyl × 135°
⇒ – 0.50 Dsph c– + 2.00 Dcyl × 45°

Third Method
Transpose any one of the planocylinder form into sphero-
cylinder form. Now we will have the axis of remaining plano-
cylinder form and the axis of spherocylinder form as same
and there is one spherical and two cylinder. Keep the spherical
alone and add the two cylinder of same axis, we get the sphero-
cylinder form.
Examples:
1. + 1.50 Dcyl × 30° c– + 3.00 Dcyl × 120°
⇒ + 1.50 Dsph c– – 1.50 Dcyl × 120° / + 3.00 Dcyl × 120°
⇒ + 1.50 Dsph c– + 1.50 Dcyl × 120°
2. + 0.75 Dcyl × 45° –c – 0.50 Dcyl × 135°
⇒ + 0.75 Dsph c– – 0.75 Dcyl × 135° / – 0.50 Dcyl × 135°
⇒ + 0.75 Dsph c– – 1.25 Dcyl × 135°

X
 Chapter 5

The Prescription

In a prescription the lens power is written at the step of 0.25D

and the axis of cylinder at the interval of 5° ranging from 0°
to 180°. Some of the specimen of writing prescription are as
under:
1. RE — – 2.00 Dsph –c – 1.00 Dcyl × 180° 6/6
LE — – 0.50 Dsph –c – 0.50 Dcyl × 180° 6/6P
2. OD — + 2.00 Dsph 6/6
OS — + 1.50 Dsph 6/6
3. BE — – 1.00 Dcyl × 180° 6/6
4. OU — + 1.00 Dsph 6/6
5. BE — + 0.50 Dsph 6/6
BE add + 1.00 Dsph N6.
There are some terms and abbreviations which are used
while writing a prescription. And in case the prescription is
written by an ophthalmologist, some complicated abbreviation
may be seen. The idea behind this chapter is to understand
these terms:
RE ⇒ Right eye
LE ⇒ Left eye
BE ⇒ Both eyes
OD ⇒ Oculus dexter (Latin) stands for RE
OS ⇒ Oculus sinister (Latin) stands for LE
OU ⇒ Oculi uterque (Latin) stands for both eyes
VR ⇒ Visus remotum, stands for distance vision
VP ⇒ Visus proximum, stands for near vision
Add ⇒ Near addition power
–c ⇒ Combined with
28 Optician’s Guide

() ⇒ Combined with
X ⇒ Axis
BU ⇒ Base up prism
BD ⇒ Base down prism
BI ⇒ Base in prism
BO ⇒ Base out prism
OE ⇒ On examination
NAD ⇒ No abnormality detected
FOH ⇒ Fundus oculi healthy
IOP ⇒ Intraocular pressure
PMT ⇒ Postmydriatic test
ESO ⇒ Esophoria
ET ⇒ Esotropia
EXO ⇒ Exophoria
XT ⇒ Exotropia
ET ⇒ Esotropia for near
EX ⇒ Exotropia for near
RH ⇒ Right hyperphoria
LH ⇒ Left hyperphoria
RHT ⇒ Right hyper-tropia
LHT ⇒ Left hyper-tropia

X
 Chapter 6

Selection of Lenses
Different types of ophthalmic lenses are available to serve the
different purposes. For example, a hypermetropic patient is
benefitted more by the lens design while a myope is benefitted
more by the index of the lens. A presbyope has all together a
separate list of lenses for them.
Let us discuss some of the special types of lenses available
in today’s optical industry.

PHOTOCHROMATIC LENSES
Photochromatic lenses are ones that visibly darken and fade
indefinitely under bright and dull light respectively. They were
developed by Corning in 1964 and are made of optical materials
containing microscopic crystals of Silver Halide. When exposed
to UV light or visible light from sunlight, these crystals absorb
energy and causes the formation of metallic silver deposit on
silver halide crystals. It is this metallic silver that absorbs the
light. This reduces the amount of light passing through the lens
and the lens turns darker. With the disappearance of UV rays,
or sunlight, the lens returns to its faded state by the reconversion
of deposited metallic silver into silver halide. Since these crystals
are within the lens material, the process of darkening and fading
can be repeated. It is important to note that the darkening and
fading performance of photochromatic lenses depends on
intensity of the UV light, on the thickness of the glass and on
temperature. At low temperature the lens darkens more
quickly and intensely but fades very slowly. Also as thickness
increases, the transmission of light decreases. Photochromic
properties of the lens may be permanently affected by the
very high temperature. So fused bifocals in photochromic
materials are not very successful.
30 Optician’s Guide

Features
1. It darkens to a comfortable sunglass in the bright sunlight
in less than one minute.
2. Fades back to virtually clear tint.
3. Light transmittance is automatically adjusted to brightness
of sunlight.
4. It is a good UV absorber in the darkened state.
5. Photochromic lenses must be darkened and faded through
many cycles to achieve maximum performance.

ASPHERIC LENSES
The literal meaning of the term ‘asphere’ is ‘non-spherical’.
Unlike conventional lenses the front surface of the aspheric
lens design is not spherical. If a lens measure is placed on the
front surface of the conventional lens, the reading will be
constant regardless of where the lens measure is placed. This
is because the surface is spherical. But if the same process is
repeated on the front surface of the aspheric design lens,
changing curvature across the surface can be noticed. The
aspheric lenses are spherical at the centre but aspherical as we
go away from the central optical axis. The plus aspheric lens
flattens as they approach the edges of the lenses and the
curvature of minus lens steepens near the edge. This creates a
flatter, thinner and lighter lens, making them cosmetically more
appealing (Fig. 6.1).

Fig. 6.1: Aspheric lenses

 Selection of Lenses 31

To satisfy the growing requirements of thinner and flatter

ophthalmic lenses for cosmetic reasons, the lens manufacturers
sometimes produce lenses with base curves that are generally
flatter than the best form curves that would provide the best
optics. This may be accomplished to a certain extent with the
spherical lens without damaging their off-axis performance. But
if a significant change of lens curvature is required, flatter curves
can no longer be employed as they would cause off-axis blurred
vision for the wearer due to marginal astigmatism and power
error in the lens periphery. These anomalies are compensated
by introducing asphericity or variation of spherical curves in
the lens peripheral surface. Thus introducing asphericity into
the lens surface is the technique to maintain good peripheral
optics while improving the cosmetic look of the lens.
Not all aspheric lenses have the same amount of asphericity.
Some lenses change a very minimal amount in curvature. This
does not make much of a difference in flatness and peripheral
vision. The more the front curve changes, the more advanced
the aspheric design will be.

Features
1. Minimises distortions at the edge of the lens.
2. They produce less magnification for plus lens and less
minification for strong minus lens. So more natural look is
ensured.
3. Flatter lens looks more attractive in frames because there is
less lens material sticking out either in the front of or behind
the frame which allows patients a greater variety of frame
options.
4. Beneficial for high refractive error specially plus powers.

POLAROID LENSES
Light is a wave motion. It travels in waves oscillating in all
directions horizontally, vertically and also everywhere in-
between. When sunlight or artificial light hit a smooth surface
at a given angle, it undergoes a process as it reflects off the
surface. This is called polarization. More precisely when the
32 Optician’s Guide

light waves reflect off the smooth surface, they all travel in the
same direction, intensifying their effect on the eyes. This
phenomenon produces disturbing optical noise or glare. The
effects of such glare includes loss of clear vision, colour
distortion, loss of depth perception, resulting in discomfort.
Polaroid lens eliminates or reduces the effects of such glare
significantly. They are made of special film sandwiched in the
lens to cut out the effect of glare and reflection. The back
surface of the lens is cast first and the precurved polaroid film
is placed on the cast part and then liquid material is injected
over to indicate the polarising axis. Thus polarising lens is the
way of imposing order on the light that reaches the eyes. Using
polarising lenses, the wearer can look through water, the glare
of a patch of snow, beyond the reflections of wet road and so
on.

Features
1. Reduces reflective glare at the horizontal meridian.
2. It can be used for driving comfortably.
3. It is good lens for recreational sunglass.
4. It enhances the depth and colour perception.

LENTICULAR LENSES
The central portion of the lenticular lenses is designed to the
given prescription and is called the aperture of the lens and the
peripheral portion is known as carrier. These lenses are good
for either high hypermetropic or high myopic patients. They
are made either by grinding process or by cementing or by
fusing, etc. Lenticular lenses are of two types—convex for
hypermetropic and concave for myopic cases. Concave
lenticular lenses are also known as myoplate lenses.

Features
1. Good for high power lens.
2. Reduces the weight of the lens.
3. Thin edges ensure better fitting of lens into the frame.
4. Peripheral aberrations are minimised.
 Selection of Lenses 33

ANTI-REFLECTION COATED LENSES

As light strikes an optical system, it is either transmitted or
reflected. Some percentage of reflected light does not reach the
eyes, reducing the visual acuity and some percentage of the
reflected light enters the pupil of the eye along the same path
as the light used in seeing an object, causing visual disturbances.
Light can be reflected off the front surface of the lens, back
surface of a lens and also within the lens creating a ghost image
that may annoy the wearer. Anti-reflection coating is applied
to both the front and back surfaces of a lens to allow more light
to travel through the lens without interruption and thus
enhances the vision clarity.
Anti-reflection coating is a super thin optical coating of
several layers of transparent materials, which are evaporated
by a very high energy evaporator. The process cannot be done
under the atmospheric pressure. High vaccum chambers are
necessary for such process. The last layer is the hydrophobic
layer evaporated on top of an anti-reflection stack. It is a dirt
and water repellant layer. It makes the lens surface easy to clean.
Almost all types of ophthalmic lenses can be AR coated.

Features
1. It improves the optical performance of the lens. To put it
simply, the wearer sees better, look better with anti-reflection
coated lenses.
2. It enhances the cosmetic look of the lens. Patient’s eyes are
seen and not their lenses only. It virtually makes the lens
invisible.
3. AR coated lens also reduces the myopic concentric rings in
case of high myopic lens.
4. AR coated lenses allow maximum transmission of visible
light to pass through the lens and reach the eyes. This
improves the contrast, so the objects are seen clearly.
5. It eliminates reflections, direct glare and ghost images
specially during night driving and thus reduces the eye
fatigue.
6. Useful for people who work on computers for long hours.
34 Optician’s Guide

FUSED BIFOCAL LENSES

Basically there are two types of fused bifocal lenses available
nowadays for presbyopic patients – KRYPTOK and UNIVIS
‘D’ type. The round moon shaped bifocal is known as kryptok
bifocal (Fig. 6.2). A countersink curve is made onto the front
surface of the crown lens and a flint is prepared with the same
curvature and the two are fused together in a furnace at a
temperature of above 650°C. Since the index of the flint is
higher than that of the crown glass, a round shaped segment
appears on the front surface. Mostly kryptok bifocals usually
have 22 mm to 26 mm round segment.
The first flat top fused bifocal was the UNIVIS ‘D’ bifocal
developed by Universal Optical Co. of Canada. This lens uses
a button made of two pieces of glasses, the lower part being
flint and the upper part being crown. The round button is then
fused onto the front surface of the crown lens. The upper part
of the button disappears during the fusing process, resulting
in ‘D’ shaped segment. UNIVIS ‘D’ bifocal lenses are usually
available in segment width of 25 mm, 28 mm and 35 mm.
The segment is on the front surface of the fused bifocal lens,
if any cylinder power is required, it must be ground in the back
surface. Every fused bifocal have a note on the blank which
has to be followed at the time of grinding. For example if the
note is 6.125, it implies that the front surface of the blank has to
be ground on +6.00 base to get a near addition of +1.25 D.

Kryptok bifocal Univis ‘D’ bifocal

Fig. 6.2: Fused bifocal lenses

BLENDED INVISIBLE BIFOCAL LENSES

Blended invisible bifocal lenses are one piece bifocal lens
having round segment in which the line of demarcation
between the distance portion and the bifocal segment has been
 Selection of Lenses 35

obliterated. This results in an invisible bifocal segment. There

is a blurred area surrounding the segment through which
neither the distance nor the near vision is clear. This type of
lens is designed to make the bifocal segment invisible and
they cater strictly to the wearer’s vanity. It should be fitted
atleast 1 mm upper than the normal kryptok bifocal height.
For example, if we fit the kryptok bifocal to the top of lower
lid, blended invisible bifocal will have to be fitted a little upper
than the lower lid height.

SPECIAL TYPE LENS

Access, developed by Sola, is a good alternative to near vision
lens because it provides wide, clear and continuous vision
from close-up to intermediate, it has been manufactured in
conventional Hard Resin material having a refractive index of
1.499. It uses the modern aspheric technology and has a full
near prescription in the lower portion of the lens and the upper
portion is used for viewing at the intermediate area. It should
be fitted 3 to 5 mm below the pupil centre (Fig. 6.3).

Fig. 6.3: Access lens

Features
1. It is a superior alternative to near vision lenses because it
provides clear vision from close-up to intermediate.
2. Good for all presbyopes who normally prefer single vision
reading lens only.
3. At times it is good for specific visual performance like office
use, etc.
36 Optician’s Guide

PROGRESSIVE ADDITION LENS

Progressive addition lens offers a continuous gradual change
in prescription strength as our line of vision sweep downward.
More precisely as we go down from distance viewing zone to
near viewing zone in case of PAL, near addition power increases
gradually providing us an additional intermediate distance
viewing zone. This has been made possible by using the modern
aspheric design on the front surface of the lens at the expense
of blurred vision on either side due to the presence of unwanted
astigmatism. All the PAL contains certain important markings,
which are used to identify the lens and to assist in their fitting
and verification. Let us see the main markings (Fig. 6.4).

Fig. 6.4: Left eye PAL

A & A1 : They are two hidden circles which are per-

manently etched on the lens at 34 mm apart. When
the ink marking is removed, they are made visible
by fogging.
B : This point is the Distance Optical Centre (DOC)
of the lens and is also known as Prism Reference
Point.
C : Hidden addition power situated at the temporal
side and is made visible by fogging.
D : 0-180° axis line passing through the DOC.
E : Fitting cross lies above the DOC.
 Selection of Lenses 37

F : This is the Distance Power (DP) circle to check

the exact distance power with the help of
lensometer.
G : Hidden logo situated nasally and is made visible
by fogging when the ink marking is removed.
H : 7 to 9 mm circle is the centre of the near vision
area and is inset by 2.5 mm.

PAL Designs
Basically we can categorise the PAL designs into three groups:
1. Mono-Design and Multi-Design.
2. Asymmetry and Symmetry Design.
3. Hard and Soft Design.

Mono Design and Multi Design

In case of mono-design PAL, a single design is used for all
addition powers, i.e. the position for the near vision does not
change with the change in near addition power causing
difficulties while viewing near objects as the wearer holds
reading material closer to him with the increase in his near
addition power. Hence it can never offer optimum comfort to
both emerging presbyopes and mature presbyopes as their
needs are different.
In multi-design the position for near vision changes with
the addition power change, i.e. the near area goes up with the
increase in the addition. All the twelve additions from 0.75 D
to 3.50 D have been studied separately to define the ideal design
for each stage of presbyopes.

Asymmetry and Symmetry Design

In case of Symmetric PAL design the right and left lenses are
identical. Nasal decentration of the near zones is achieved by
the lens rotation of equal and opposite amount in the two
lenses, i.e. 10° anti-clockwise in the right lens and 10° clock
wise in the left lens. This results in uneven peripheral optical
features in the two lenses and difficult wearer adaptation.
38 Optician’s Guide

Asymmetric PAL design incorporates a nasal offset of the

near zone and have separate design for right and left lens. So
there is no need of lens rotation in this case. This results in same
peripheral optical characteristics and better adaptation,
improved visual comfort, better binocular vision and
convergence.

Hard and Soft Design

The features of Hard Design PAL are:
a. Power changes very quickly from distance to near.
b. Shorter and narrower intermediate zones.
c. Wider distance and near zones.
d. Unwanted cylinder power is pushed towards the centre of
the lens. Therefore the intermediate and peripheral vision
are both restricted.
e. When seen through the sides of the lens, the peripheral
distortions create a swimming effects.
f. Difficult to adapt.
The features of Soft Design PAL are as under:
a. Power changes very gradually from distance to near.
b. Relatively smaller distance and near zones.
c. Unwanted cylinder power is pushed towards the periphery.
Therefore intermediate zone is wider and larger.
d. Lower add power position, especially with higher
additions.
The current technology has further modified the concept of
soft design to include a few changes like:
a. Larger effective distance and near zones.
b. Peripheral aberrations are very well controlled to enable
the wearer to adapt easily.
c. Combination of hard and soft design.

Features of PAL
1. PALs are suitable for almost all presbyopes.
2. It provides an additional intermediate viewing area apart
from distance and reading areas.
 Selection of Lenses 39

3. Good for people working on computers.

4. Cosmetically good looking as there is no visible line between
zones.
5. No jump in vision from distance to near. More comfortable
in negotiating stairs, etc.

TINTED LENSES
Tinted lenses are used to protect the eyes from glare and
harmful radiations. Spectacle lenses can be tinted in three ways:
1. Solid glass tint: They are available in ophthalmic glass lenses.
In such cases the material of the glass itself is being tinted
by adding various metallic oxides to the raw materials of
the lenses. The following tinted glass lenses are available:
A1 — Light Blue
A2 — Deep Blue
B1 — Light Grey
B2 — Deep Grey
SP2 — Light Pink
SP4 — Deep Pink
SP9 — Light Brown
SP10 — Deep Brown
2. Surface coated: Various tints may be produced by applying
surface coating process designed to intensify the reflection.
Mirror coating and gradient coating on the mineral glass
are the examples.
3. Dyed tints: Plastic lenses can be effectively tinted by
immersing them in a special dye. Almost all tints are
possible.

Features
Different tints have different applications, for example:
Pink
1. Commonly used for reduction of visible light transmittance.
2. Colour is considered cosmetically pleasing because it blends
well with the skin tones.
40 Optician’s Guide

Green
1. Popular sunglass colour in tropical climate.
2. Good absorption in both ultraviolet and infrared areas.
Grey
1. Most commonly used sunglass fixed tint, having the least
colour distortion.
2. Generally considered to be a cool sunglass colour.
Brown
1. Considered to be a pleasing warm cosmetic colour.
2. Considered to be a good comfortable colour in the lighter
shade.
Yellow
1. Often used for skiing to enhance terrain definition.
2. Often used for hunting or shooting to enhance target
definition.
3. Enhances contrast during cloudy and foggy weather.
Blue
1. Basically a cosmetic colour.

X
 Chapter 7

Frames and
Measurements
Frames are used to hold the lenses and to put them in front of
the eyes so that one can see through them. Broadly speaking
they are made of two kinds of materials—Plastics and Metals.
The most commonly used materials for plastic frames are
cellulose acetate, cellulose propionate, polycarbonate, nylon,
etc. They may be made either by injection moulding process or
by cutting sheets. Rolled gold, stainless steel, nickel silver,
monel, bronze, titanium, niculan, etc. are used to make metal
frames. For visual and technical reasons they are coated by
means of galvanising.
All the spectacle frames have two parts—Front and Sides

Front (Fig 7.1, Plate 1)

Sides

Fig. 7.2: Side or temple of a frame

A—Joints, A–B—Thicker portion of sides and are called butt, C—Side bend
portion, A–D—Side length, A–C—Side bend

SPECTACLE FRAME FITTINGS (Fig 7.3, Plate 1)

The selection and fitting of the frames are highly skilled
process. It requires strong observation power and skilled
hands. Various types of devices are available to measure as
regard to the size and shape of the bridge of the nose, the
temple width, distance from the spectacle plane to the top of
the ears, front angle and apical curves, etc. But practically
42 Optician’s Guide

observation, judgement and skilled hands help more than

anything else while fitting a frame. Sometimes while fitting a
spectacle frame we may find a significant degree of facial
asymmetry, one eye may be higher than other, the bridge of
the nose may be irregular or the ears may not have a
symmetrical relationship to their respective eyes. A skilful
optician will make sure to disguise such abnormalities by a
suitable design and ideal fitting of the frame. Let us discuss
some of the fitting procedures:

Base of the Bridge

There are varieties of bases of bridge available in different sizes
of the frames. We can select the base of bridge by placing the
frame on the wearer’s face. This may be measured by the
optician’s ruler. A few nose crest of different sizes are on one
side of the ruler. To measure ask the wearer to close the eyes
and then check the size of nose crest which is fitting the wearer.
But the best way is the observation method. Put the frame on
the wearer’s face and see that the bridge of the frame is gently
wraping around the nose crest in case of plastic frames. If there
is a gap between the bridge of the frame and wearer’s nose
crest, this implies that the bridge is broader than required
(Fig: 7.4, Plate 1). Either make the bridge narrow before fitting
the lenses into the frame or select a small bridge frame.
Contrarily, if the base of the bridge is too tight on the nose
crest or if the frame is too high on the face, it implies that the
bridge is smaller than required (Fig. 7.5, Plate 1). Either select
a broad bridge frame or make the bridge broad before fitting
the lenses. In any case a uniform grip of bridge has to be
made through out the nose crest to ensure equal weight
distribution of the spectacle frame (Fig. 7.6, Plate 1). The thin
nose requires a ‘V’ shaped bridge or ‘keyhole’ type bridge
whereas a thick nose may require a ‘U’ shaped bridge and in
case of snub nose ‘C’ type bridge is ideal. In case of metal
frame, the bridge adjustment is little simpler as they rest with
the help of two nose pads on the nose crest of the wearer. If
the spectacle frame is too high, splay the nose pads and if it is
too low, bring in the nose pads. Some times in rare cases we
 Frames and Measurements 43

may need to make the bridge of the metal frame a little broader
by its rim. This is essential in case where even by splaying the
pads, the frame is high on the face. This must be done before
fitting the lenses into the frame (Figs 7.7 and 7.8, Plate 1).

Length of the sides

While fitting hockey end sides three things are to be measured:

Fig. 7.9: a—Length of the bend, b—Length of the drop, c—Angle of the drop

The length of the bend is the distance between the spectacle

plane to the point from where the sides of the frame are bent
to give them a hockey end shape. In case of straight sides, the
length of the side is measured from the spectacle plane to the
point behind the level of ear where the bone of the skull start
to turn inward and in case of curl sides it is measured from
the spectacle plane to a point at the bottom of the ear just
short of the junction of the lobe of the ear. The length of the
bend may be measured with the help of optician’s ruler.
There are certain principles which should be followed while
making the side bend. The bend should be given in such a
way that the length of the drop should not go below the lower
part of the lobe of the ear. Otherwise it does not look good
and it also poses problem while wearing and removing the
spectacle. If possible like in case of metal side frames where
the end plastic tips can be removed, the sides should be cut
and should be jacketed again by the tips in case of larger drop.
Contrarily if the length of the sides is smaller than required,
it should be adjusted as we adjust the straight sides. The angle
of the drop of the bend is also very important. Ideally the
bend should be made at an angle of 45° so that wearing and
removing of the spectacle is uninterrupted and easy (Figs 7.10
to 7.13, Plate 2)
44 Optician’s Guide

Front Fitting
While doing the front fitting, attention has to be given to three
important things.
a. Front Inclination
b. Front Alignment
c. Apical Curve
Front inclination is the angle between the spectacle front
and their temples. It refers to the pantoscopic tilt given to the
spectacle from its joint area. Applying the observation method,
make sure that the top rim of the front of the spectacle is slightly
leaned forward and the bottom rim is approaching the cheek
avoiding a contact with it.
Apical curve refers to the facial wrap shape given to the
entire front of the spectacle frame, i.e. the spectacle front follows
the line of face but not excessively. It may be provided from
two places of the front—the bridge of the frame and from the
rim of the front.
Both right and left fronts must be aligned in such a manner
so as to ensure similar gap between the cheek and rims. It may
be adjusted either from the bridge or from the joint area. (Figs
7.14 to 7.17, Plate 2 and 7.18, Plate 3)

Temple Width
Temple width or the facial width is the distance between the
two temporal bones of the face at a level approximately 25 to
30 mm behind the spectacle plane. When we talk about the
temple width of the spectacle frame, it is the distance between
the inner portion of one side to the inner portion of the other
side. An ideal temple width fitting must fulfil the following
criterias:
a. There should be a little gap between the temporal face and
the temples of the spectacle.
b. The area around the bending point of the sides should
have a little curve following the facial line behind the ears.
(Figs 7.19 to 7.21, Plate 3).

OTHER MEASUREMENTS
The following other measurements are also required:
 Frames and Measurements 45

1. Pupillary Distance (PD)

2. Curvature of lenses (Base)
3. Height of the segment in case of bifocals
4. Segment inset in case of bifocals

PD Measurements
We require two kinds of PD measurements—Distance PD for
constant use glasses and for distance vision lenses and near PD
for near vision lenses. But in case of bifocal lenses, we need to
have both. To measure this the patient’s head and the
observeror’s head must be in same line. Place the optician’s
ruler on the nose crest of the patient. Ask him to look at your
left eye, bisect the right eye pupil with the inner side of the
projected portion of the ruler. Keep the ruler there and do not
move your hand. Now ask the patient to look at your right eye
and observe the point on the lower reading of the scale where
his left eye pupil is been bisected. This is the PD for the distance
vision or divergent PD.
To measure the PD for near or convergent PD again place
the scale on the nose crest of the patient and ask the patient to
look at your forehead. Bisect the right eye pupil with the inner
side of the projected portion of the scale and observe the point
on the lower reading of the scale where his left eye pupil is
been bisected. This is the PD for near vision. Usually there is a
difference of 4 mm between the distance and near PD.
If there is any abnormality in the eyes, for example, one eye
is closer to the nose than the other. In such cases PD should be
taken separately for each eye. Place the scale on the nose crest
of patient. Keeping the zero at the centre of the nose, ask the
patient to look at your left eye and observe the point on the
lower reading of the scale where his right eye pupil is been
bisected. Now ask the patient to look at your right eye and
observe left eye pupil bisecting point. The distance between
zero to the left eye pupil bisecting point is the left eye distance
PD.
In case of alternate squint we apply the same method but
while measuring the right eye PD, we close the left eye of the
patient with our palm and while measuring the left eye PD,
we close the right eye of the patient with our palm.
46 Optician’s Guide

In case of small children or permanent squint, we take PD

as the distance between inner end of one eye to the outer end
of the other eye.

Fig. 7.22: Showing PD measurement

Curvature of Lenses
We must check the front surface curvature in case of high
minus lens and back surface curvature in case of high plus
lenticular lens to ensure the uniformity of curvature, if an
existing user of high power lens is ordering a new pair. Lens
measure watch is used to ascertain it. We must also check the
cylinder side with the help of this watch specially in case of
high spherocylinder power.

Height of the Bifocal Segment

While dispensing bifocal lenses, the height of the bifocal
segment is a very important measurement. Different frames
occupy different position on the face and therefore the segment
height also varies in different frames for the same patient. The
optimum height of the bifocal segment may vary with the
different conditions, like:
1. The type of the bifocal and the shape of the segment.
2. The purpose for which the bifocal is to be used.
3. The habitual posture of an individual.
4. The patient’s past wearing habit.
 Frames and Measurements 47

To ascertain the segment height, put the selected frame on

the patient’s face and ask the patient to look straight ahead at
the fitter’s eyes. Now measure the distance from the top of the
patient’s lower lid to the lower rim of the frame where the bevel
of the lens will fit into the groove. If the patient has an unusually
low eyelid, with sclera showing underneath the limbus, the
measurement should be from the lower limbus rather than from
the top of the lower lid.
The following criteria may be taken into consideration
before deciding the segment height of a bifocal lens:
1. A person who habitually holds his head high may need a
lower segment height than a person who slouches a bit and
habitually keeps the head down.
2. An individual who works more at the desk will prefer an
unusually high segment and will learn to keep head down
for certain distance work.
3. A tall person may need to wear segment a little up, whereas
a short man may prefer a little lower segment.
4. If a patient is used to wearing higher segment, he may again
prefer to have a higher segment than required.
If a patient needs an intermediate lens together with the
near vision lens, he needs on top of the bifocal segment rather
than in place of it. So do not make mistake of fitting near
segment of the bifocal a little lower than required in case of
trifocal fitting. The 7 mm intermediate segment will split the
patient’s pupil but he will soon learn to tilt his head down
slightly when distance vision required.
Progressive addition lenses have no visible segments like
other bifocal lenses. The technique to fit PAL is altogether a
different which we will discuss separately.

Segment Inset
Segment inset is specified as the difference between the
patient’s distance and near PD. In the normal range of PD, the
near PD for a reading distance of 40 cm is approximately 4
mm less than the distance PD. Segment inset, therefore, is
usually specified as 2 mm for each eye atleast. Basically there
are two reasons for segment insetting:
48 Optician’s Guide

1. To ensure that the patient’s line of sight goes through the

segment at its centre.
2. To ensure that the reading field for the two segments will
coincide with each other.
In case of Univis D bifocal, the segment is been fused by
decentering the near PD but in case of Kryptok bifocal segment
inset is provided during grinding only. No such segment inset
is required in case of executive bifocal as it encompasses the
full width of the lens.

PROGRESSIVE ADDITION LENS FITTING

The fitting procedure of PAL requires an extra-attention
regarding the selection and adjustment of the spectacle frame.
Before taking any measurements adjust the selected frame
completely on the wearer’s face. Then we need to have two
specific measurements:
1. Monocular PD and
2. Height of the fitting cross.

Monocular PD Measurement
The monocular PD is the distance from the centre of the nose
bridge to the centre of the pupil. There are three ways to measure
monocular PD (Fig. 7.23, Plate 3).

Pupillometer
This is a battery operated device to measure the monocular PD
and is very simple and fast. We just need to put the meter on
the patient’s nose crest and bisect the pupil vertically. The
reading will digitally appear on the meter automatically.

PD Ruler
A modified ruler with a nose bridge cut out can be used in the
following manner:
1. Sit directly opposite the wearer at the same height and at
arms length.
 Frames and Measurements 49

2. Place the ruler on the bridge of the nose.

3. Hold the pen torch just below your left eye directed at the
wearer’s right eye.
4. Ask the wearer to look at your left eye.
5. Close your right eye to avoid parallax error.
6. With your left eye, observe the corneal reflection in the
wearer’s right pupil.
7. Read the measurement from the PD ruler.
8. Repeat the same procedure for the other eye.
9. Repeat the measurements once again for both eyes to
confirm.

Marking on the Demonstration Lens

If demonstration lens is fitted in the frame we can mark the
lens directly in the following manner:
1. Using the similar procedure as above, mark the position of
the corneal reflection of the pen torch light on the
demonstration lens using a marking pen.
2. Now place the frame on the layout card.
3. Line up the lower edge of the frame with one of the
horizontal lines.
4. Ensure the frame bridge is placed symmetrically over the
lateral guide.
5. Read the PD off the central horizontal scale.

Height of the fitting cross

The fitting cross on PAL must coincide with the pupil centre
of the wearer in their natural posture. The position of the
pupil centre relative to the correctly adjusted frame is the fitting
height, and is specified as the distance above the deepest point
of the inner frame rim. The following procedure is used to
measure fitting height:
• Position and posture of the wearer and observer remaining
the same, place the frame with the vertical PD line marked
on its lens on the wearer’s face
• Observe the position of torch line reflection in the right
eye relative to the vertical PD line
50 Optician’s Guide

• Place a small horizontal marks on the PD line corresponding

to the pupil centre
• Repeat the same process for the other eye
• Move the frame up and down slightly and verify the
marking (Fig. 7.24, Plate 3).

X
 Chapter 8

Lens Grinding

Procedure applied to convert a slab of glass or plastic or more

precisely a blank into a spectacle lens is known as grinding or
surfacing of lenses, i.e. we grind specific curvatures and the
difference of curvature between the front surface and back
surface gives us the required dioptrical value. The required
curvature is attained by a series of grinding operations and
the blank is held against a tool of opposite curvature. A wide
range of tools, calibrated for a specific power of the lens and
are made of cast iron are used in the process. The front surface
known as ‘+’ side of the lens is surfaced on the concave tools
to make required curvature and the back surface is surfaced
on the convex tools. These cast iron tools must be checked
frequently by means of a brass template or gauge of opposite
curvature and if required the tools may be trued by means of
tool truing device to rectify the curvature.

Fig. 8.1: Various tools to check curvature of the glass

The various surfacing processes in the manufacturing of

an ophthalmic lens are as under:
• Blocking,
• Roughing,
• Smoothening
52 Optician’s Guide

• Polishing, and
• Deblocking.

Step-1
The blank is attached to a cast iron or metal block with the
help of pitch or lac or soft metal alloy. The metal block provides
a support for holding blank through out the grinding
operation.

Step-2
Now, it is put to the roughing process. Roughing means
generating the desired curvature. The surface of the blank is
brought to its approximate curvature by rotating the blank
against the tool of desired curvature. During this process a
course abrasive powder is used. Carborundum/sand is the
commonly used abrasive powder. We obtain rough surface of
the lens.

Step-3
After the roughing is completed the blank is now ground on
the proper tool as required by the specific power with the
help of finer grain abrasive like aluminous oxide. Two grades
of abrasive are used which are commonly expressed as 302
and 303. The surface of the blank is trued with the help of
grade 302 and then it is finished by smoothing with the grade
303. The correct surface curvature is now obtained and the
lens is ready for the final polish.

Step-4
Now the lens is ready by polishing. A soft pad either felt
cloth or wool cloth or specially designed polishing pads are
attached to the tool and rouge (iron oxide) commonly known
as 309 or cerium oxide is applied to polish the lens. The rouge
is mixed with the water and is applied to the attached pad to
polish the lens surface.
 Lens Grinding 53

Step-5
The polished lens surface is to be inspected by putting it under
an incandescent bulb and if found satisfactory, the lens is
deblocked from the metal block. The lens and the block is
immersed in the cold water and the block is tapped by a wooden
mallet. Ice cubes may also be used to facilitate the deblocking
process. The thermal change causes the lens to come out from
the block and also from pitch. If any particles of the pitch is
still found on the surface, it is being cleaned by using thinner.
This is how the surfacing process of one side of the lens is
completed. The same process is again applied for the other
surface of the lens. The final thickness of the lens is controlled
during the other side surfacing. It is essential that every trace
of the abrasive used at each step must be washed out from the
lens and the block before going on to the next step of the
grinding.
Recently the roughing process where the lens surface is
brought to approximately correct curvature is being replaced
by the faster method of surface generating. In this process the
required curvature of the lens is formed simply by tilting the
specially designed tools on the blanks at a predetermined angle.

SPHERICAL GRINDING
In case of spherical power grinding we need to make the same
curvature on both meridians of lens. The tool rotates in a circular
movement cutting the surface of the blank uniformly in its both
meridians. When we get a required power to grind, we need to
select two things-thickness of the blank and the required tool.
The approximate thickness of the blank must be 1 mm per
dioptre in case of smaller diameter. If the diameter is bigger
we must select a little thicker blank than so calculated. The
thickness of the blank selection is very important because
during the grinding process the diameter of the lens may reduce
in case of convex lens. But in case of concave lens diameter
remains the same, the lens becomes thinner from its centre.
Selection of the tool depends upon the curvature which we need
to make on the front surface of the lens. Usually high minus
54 Optician’s Guide

lenses are made with lower front curvature and high plus
lenses are made with higher front curvature.

Examples:
1. Prescription requires +4.00 Dsph.
Ans. We will grind this with +6.00 curvature on the front
surface. Tool require for front surface grinding is 6 base
CC tool. Tool required for back surface grinding is 2 base
Cx tool.
The result will be +6.00 curvature on the front surface and
–2.00 curvature on the back surface. The lens power will be
algebraic summation of the two curvatures, i.e. +4.00 Dsph.
2. To grind +8.00 Dsph in bi-convex form.
Ans. Tool required for front surface grinding is 4.00 base
CC tool. Tool required for the back surface grinding is
4.00 base CC tool.
Both the surface will have +4.00 curvature. The lens power
will be the algebraic summation of the two, i.e. +8.00 Dsph.
3. To grind –7.00 Dsph.
Ans. We will grind this with +2.00 curvature on the front
surface. Tool required for front surface grinding is 2 base
CC tool. Tool required for back surface grinding is 9 base
Cx tool.
The result will be +2.00 curvature on the front surface and
–9.00 curvature on the back surface. The lens power will be
the algebraic summation of the two, i.e. –7.00 Dsph.
4. To grind +7.00 Dsph.
Ans. We will grind this with +9.00 front surface curvature.
Tool required for front surface is 9.00 base CC tool. Tool
required for back surface is 2.00 base Cx tool.
The result will be +7.00 Dsph.

CYLINDRICAL GRINDING
In case of cylindrical prescription, we require two different
values of power in two different meridians. So the movement
 Lens Grinding 55

of the lens is restricted to the two principal meridians only,

i.e. vertical and horizontal. The lens moves in two directions
instead of circularly and the tools are stationary. Naturally
the two meridians are cut at the same time with the different
curvatures. Tools also have two different curvatures in two
meridians. Nowadays usually cylinder power is made on the
back surface of the lens. To select the tool required for the
cylinder lens, we need to draw the meridian values of the
lens. Then we decide the curvature for the front surface and
then calculate the tools required for back surface.
Examples:
1. To grind +3.00 Dsph c– + 1.00 Dcyl

Meridian values

Selecting curvature
for front surface + 6.00

Cyl tool required for back

surface

Cx cyl. tool required is 2.00 base 1.00 cyl.

2. To grind –7.00 Dsph c –1.50 Dcyl

Meridian values
56 Optician’s Guide

Selecting curvature for

the front surface + 2.00

Cyl tool required for

back surface

Cx Cyl tool required is 9.00 base 1.50 cyl

3. To grind +1.25 Dcyl

Meridian values

Selecting curvature
for front surface + 6.00

Cyl tool required

for back surface

Cx cyl tool required is 4.75 base 1.25 cyl.

 Lens Grinding 57

BIFOCAL GRINDING
The grinding process of bifocal lens is same as that of any
other lens, but the difference arises only when bifocal lens
has to be made either with cylinder power or spherocylinder
power. In that case we need to mark the required axis on the
blank with the help of axis chart and then paste the blank on
the cylinder block or button keeping the marked axis coinciding
with the extended rod of the block. For bifocal lenses, we
always grind the cylinder power on the concave or back surface
of the lens. If the cylinder power is given in plus, transpose it
into the minus cylinder form and then mark the axis which is
derived after transposition. But if the cylinder power is given
in minus, no need of transposition. We can straight away mark
the given axis and paste the blank on the block, for examples:
1. To grind +2.00 Dsph c– + 1.00 Dcyl × 45° Add +2.00 Dsph
After transposition we get:
+3.00 Dsph c– – 1.00 Dcyl × 135° Add + 2.00 Dsph
In this case we will mark the axis at 135° and then paste the
blank coinciding the axis with the extended rod.
2. To grind –0.50 Dsph c– – 0.50 Dcyl × 90° Add + 1.50 Dsph
In this case we will mark the axis at 90°
In case of kryptok bifocal grinding, we need to make
provision for the segment inset while grinding only. If the
spherocylinder power is given, we do not grind the given
axis but we grind the adjusted axis calculating the inset
requirement but we cut the lens at the given axis. For every 5°
adjusted axis, the segment is moved in by 1 mm approx. So in
case of right eye, we subtract from the given axis and in case
of left eye we add to the given axis and then grind.
For example to grind:
RE + 2.00 Dsph c– + 1.00 Dcyl × 90°
LE + 2.00 Dsph c– + 0.50 Dcyl × 80°
BE Add + 2.00 Dsph.
Segment inset required is say 15° IN
We will grind RE + 2.00 Dsph c– + 1.00 Dcyl × 75°
LE + 2.00 Dsph c– + 0.50 Dcyl × 95°
BE add + 2.00 Dsph.
58 Optician’s Guide

Now we will transpose into minus cylinder form and paste

the blank.
Important: All the bifocal blank has a notation of base and
addition on it. For example suppose a fused bifocal has a
notation of 6.150. It implies that if we grind the front surface of
the same blank at + 6.00 base, we will get the near addition of +
1.50 D. But if we grind the same at + 5.00 base, the resultant
addition will reduce nearer to + 1.25 D or vice versa. For every
change of 1.00 D in base curvature, there is a change of resultant
addition by 0.25 D approx.
Note: If we need to grind the front surface of the bifocal lens,
care has to be taken to ensure the similarity in the right and left
lens segment size.

NEW SYSTEM OF LENS GRINDING

Normally we grind the lens twice to get the required power.
But to grind a new system or lenticular type lens, we need to
grind it thrice. The first operation is on the front surface to grind
either plano or any cylinder power and the second operation is
on the back surface to grind the required minus power with a
Cx tool at the centre of the lens as required by the segment size.
Last operation is to reduce the thickness of the edges of the
back surface. High curvature CC tool (curvature must be more
than that of the Cx tool used) is used to grind the edges of the
back surface without disturbing the power at the centre.

CUTTING OF LENSES
1. The first step is to find out two principal meridians and
the optical centre of the lens.
2. Keep the axis meridian and the centre and rub out the other
meridian.
3. Put the lens on the axis chart assuming the axis chart as an
eye and coincide the centre of the lens with the centre of the
chart.
4. Without disturbing the centre, bring the axis meridian on
to the desired axis and put the dots on the zero or 180°
 Lens Grinding 59

line of the axis chart. Now join these two dots. Make it
prominent because this is our datum line now.
5. Mark the lens with RE or LE as the case may be.
6. Take the size glass and put a dot mark at the required PD.
Now put the size glass on the lens as if the size glass is an
eye. Coincide the centre with the dot on the size glass and
datum line of the lens with that of the size glass.
7. Now mark the shape and size on the lens and start cutting.

X
 Chapter 9

Verification of
Spectacles
When the spectacles are received from the prescription
laboratory, it is very much essential to verify it in two
respects—the lens verification and fitting of frame on the
wearer’s face.

LENS VERIFICATION
The lens should be checked for colour uniformity, bubbles,
dazzling, polish and accuracy of power, axis, centration and
thickness. There are three ways to check the accuracy of lens
power.

Geneva Lens Measure

Geneva lens measure is a very simple instrument to determine
the dioptric power of the lens. It has been designed in watch
form with two fixed legs on the either side and a movable one
is placed at the centre. The central moving leg is spring loaded
so that the three point contact can be maintained even on the
steepest concave surface. When this watch is placed on a lens,
the movable leg is deflected by an amount depending upon
the curvature of the surface and the amount of deflection can
be measured on the dial of the instrument. The curvature of
the both surface is measured separately. The dial of the watch
shows a few numbers with convex and concave signs. To check
the lens power with this instrument, place it on the front surface
of the lens and if the needle moves towards the convex side,
it implies that the front surface has a plus curvature. Now
place the watch on the back surface of the lens and if the needle
is deflected towards the concave side, it implies that the surface
 Verification of Spectacles 61

has a minus curvature. An algebraic summation of the two

readings gives the dioptric strength of the lens. On both the
surface the watch must be put at the two principle axis. If at
both the axis the reading is same, it is a case of spherical power.
But if there is a different in dioptric power between the two
axis on any surface, it indicates the presence of cylinder. The
cylinder is the difference between the readings of the two
axis. The axis of the cylinder is the axis of the lower dioptric
value.
Geneva lens measure is graduated for the glass of a refractive
index of 1.523. If any other glass is employed a correcting factor
must be applied. Its accuracy should be checked periodically
by putting it on a plane surface and adjusting it to the zero of
the scale by screwing middle leg.

Lensometer
Lensometer also known as Focimeter is an electronic instrument
to measure the lens power, check the optical centre and locate
the cylindrical axis. The general principle is that the image of a
target, commonly a ring of illuminated dots, is seen through a
telescope and is focused by a standard lens. The spectacle
lens is then inserted into the system and its power is measured
by the change in the position of the target required to bring it
again into focus. If the lens is spherical, the circle dots are
refocussed. But cylinder lens splays out each dot into a linear
form and these lines are being brought to focus as sharply as
possible in two main meridians. The first point of clearest
focus is taken as the spherical (if started from zero) and the
second clearest focussed image is taken as the combination of
spherical and cylinder. The axis is seen when the focus is clear
for the second time. It is read where the central most line of
the image points on the axis chart inside the focimeter coincides.
(Fig. 9.1, Plate 4)

Neutralisation
It is the most practical method to check the nearest lens power.
A distant object is viewed through a lens and the lens is moved
from side to side or up and down. If the image of the object
62 Optician’s Guide

moves in the opposite direction, the lens is a convex and if the

image moves in the same direction the lens is a concave lens.
if the lens is rotated and there is a scissor like movement, it
has cylinder.
Now the lens from the trial set of opposite signs are held
up in combination with the lens under examination in such a
way that their centre coincides. Trial lenses are changed till
there is no movement of the image of the distant object. This
gives us the spherical value of the lens. Now the combination
of the lens and trial lens is moved in direction at right angle
to the original axis, and if there is no movement, the lens is
spherical, the dioptrical value of which is already determined.
But if the image moves, this is again been neutralised likewise.
The dioptrical value of the additional lens put to neutralise
gives the cylinder values. The axis of the lens is the axis at
which it was first neutralised.

FINAL FITTING OF SPECTACLE

No matter how well the fitting and measurements are carried
out, there is one essential fact to the successful dispensing of
spectacle, i.e. the final fitting and adjustments. No patient
should be allowed to take away the finished spectacle until
they have been fitted and adjusted on their face. This final
touch may make all the difference between spectacles that are
uncomfortable, painful and ill fitted and the spectacles that
are delight to wear. A correct fitting may need a few frequent
modifications when the spectacle is put on the face.
It is often seen that even a good fitting measurements and
careful refraction have been deprived of the chance of
providing the wearer with complete comfort for lack of
comparatively small amount of care and time spent in the final
adjustments of the spectacles. Badly adjusted sides may cause
intense pain behind the ear or on the bridge of the nose, or
can cause the frame to slip down to look most unattractive.
Many bifocal prescription have proved futile on account of
nothing more serious than the bad positioning of segment
and angle of the frame.
 Verification of Spectacles 63

In checking, therefore, it should be borne in mind that even

if the measurements stipulated may have to be varied to small
extent, the spectacles are to be adjusted on the face of the
wearer. So before delivery we must ensure to check the
following things:
1. Temple width.
2. Side bend.
3. Nose pads.
4. Segment position.
5. Bowing or apical curve.
6. Alignment and balancing.

VERIFICATION OF PROGRESSIVE LENS

PAL contains a number of small permanent micro-engravings
on the front surface which are not visible. To verify a PAL, these
markings are to be relocated which can be done by going
through the following process:
1. The two hidden circles which are 34 mm apart on the 0-180°
axis line or 17 mm to either side of the prism reference point
can be detected by reflecting light from overhead lights off
the lens surface against a dark background.
2. It can also be detected by fogging the lens surface by
breathing heavily warm moist air on to the lens surface and
by positioning a light source behind the lens.
3. Once these two circles are relocated, the other markings like
distance power circle and near vision circle can be relocated
by placing the lens on the PAL layout card.
4. Now check the distance power at the Distance Power Circle
with the help of lensometer as shown in Fig. 9.2, Plate 4.

X
 Chapter 10

Dispensing Spectacles
to Children
Children up to 10 years of age are among the most difficult
age groups to fit comfortably with eyeglasses. This is because
their nose and ears characteristics are soft and rapidly changing
and also because youngsters are typically careless in the way
they handle their spectacles. Thus dispensing glasses to kids
is an art involving mechanical, physiological and management
skills.
While dispensing glasses to children, the special attention must
be given to following factors:
1. Proper frame selection.
2. Taking accurate pupillary distance.
3. Common problems associated with dispensing glasses to
kids.
4. Solving common problems encountered while fitting
eyewear to children.
5. Assuring compliance with wearing and caring instructions.

Proper Frame Selection

When selecting proper frames for children, the dispenser needs
to satisfy two persons—the child and the parents. For the
children who have never worn glasses before:
1. The first thing to do is to assure the parents that there is no
stigma to young persons wearing glasses since modern style
has made spectacles an “in” thing.
2. Allow the new wearer to handle several frames to get the
“feel” of them and also to get them out of the fear about
having to wear them.
 Dispensing Spectacles to Children 65

3. Ask the child about his or her favourite colour and try to
select a suitable eyewear suiting the kid’s eye colour,
complexion and hair colouring.
4. Of course, parents would like to get into the act here, but
try to convince them that kids enjoy their glasses much
more when they have a hand in the decision. Also stress
the fact that you will be guiding their kids so that they do
not choose a frame that is unbecoming or ill-fitting.
5. Avoid extra large sizes. There is no rationale for making
glasses too large, since they lead to excessive and
unnecessary weight only. Also do not stress upon the very
small size, as they will not fit properly and will tend to
slide forward.
6. Avoid extra narrow shape for the kids.
7. A good check for determining proper bridge is very
essential. Keyhole bridge is a better choice in almost any
case except the infants whose frames come in sizes 34 to 40
mm as their nasal bridge are flat and almost non-existent.
These young children should be filted with thick plastic
saddle bridge or metal frames with adjustable strap bridge,
to keep the frame off the cheeks.

Accurate Pupillary Distance Measurement

Unless you use a sophisticated equipments like pupillometer,
taking pupillary distance manually on children can be very
frustrating because kid’s eyes wander all over the place. To
maintain proper fixation while taking manual PD on these
patients, several interesting devices that delight the kids can
be used. Moreover, after the PD is measured, you can give
that interesting device to the child.

Problems Associated with Dispensing Glasses to Kids

A basic concept for fitting and adjusting eyewear, is to
distribute the frame’s weight over the greatest bearing surface,
thus keeping pressure points to a minimum. Essentially the
bridge of the nose has to carry the frame’s weight while the
temples must stabilize the frame and prevent it from sliding
forward.
66 Optician’s Guide

Studies have shown that as the child grows older, there

are major changes that take place in relation to nasal
topography. A poorly fitted and adjusted frame could impede
nasal growth and eventually lead to permanent nasal
disfigurement. The underlying tissues of the nasal skin may
become irritated and possibly infected when the frame’s bridge
continually irritates or abrades the patient’s nose. Besides a
continuous sliding down spectacle leads to poor visual
performance due to change in vertex and introduction of
unwanted prism. Moreover poorly fitted glasses defeat the
patching therapy for amblyopic and strabismus patients. Atlast
a poorly fitted spectacle will take away the motivation from
the child to continue to wear them.

Solving Problems while Fitting Eyewear to Children

Locate the points of excessive contact. It is relatively simple
to locate the points of excessive contact after the patients has
worn the spectacle for a while, but not so easy to pinpoint
these areas during frame selection and frame measurement
procedure. For this reason, no matter how well you think the
selected bridge fits or how well you believe the temples
conform to face-and-ear topography, you should not stop at
this point. Rather, in order to circumvent future problems that
probably will occur because of young people’s skin, you should
continue the frame fitting session by modifying the frame so
as to fit the same wearer’s face comfortably. This can be done
by a trial and error method as follows:
1. Apply a moderate amount of hand pressure for a few
moments to the bridge of the frame against the bridge of
the nose.
2. Remove the frame from the patient’s face and examine the
patients skin of the nose and behind the ears.
3. Irritated areas now clearly reveal themselves by the telltale
signs they leave; specially indentation and/or red marks.
If such signs are found, modification must be made in the
areas that need change.
Every effort should be made to correct irritated areas
behind the ears also. The side bend should gently wrap behind
the ears. If plastic temples are too long and it is not possible
to cut the same, try non-slipping silicon temple tips. Spring
 Dispensing Spectacles to Children 67

hinged temple may also be tried. Spring hinged temple causes

the frame to hug the head, thus adding gentle pressure that
helps prevent spectacles from sliding down the nose. Curl
tips may also be used to solve the dilemma of sliding down.

LENS TIPS FOR CHILDREN

The following lens should be recommended to parents in order
to provide utmost conformance with accepted safety standard
for kid’s eyewear:
1. Ultraviolet protection—It has been established that over
exposure of children to ultraviolet rays leads to formation
of cataract later in their lives. Proper use of UV protective
sunglasses will help prevent development of cataract.
2. CR 39—The shatter proof and light weight properties of
CR 39 lenses make them suitable for kid’s eye wear. If
dispensing with anti-scratch coating, CR 39 lenses can be
safely used till the tenure of a prescription.
3. High index lens—Always recommend high index lenses
for strong minus power. The edge of concave lens gets
thinner in case of high index lenses as compare to crown
lenses. They are available in several glasses as well as in
CR 39 material.
4. Aspheric lens—In case of high plus prescription aspheric
lens can be a good choice since they make the lens look
flatter. When prescribed in conjunction with high–index
material, aspherics are able to reduce the lens thickness by
40%, thereby reducing the weight of the lens substantially.
5. Polycarbonate Lenses—Polycarbonate lenses are virtually
unbreakable and also lighter in weight than either CR–39
or glasses. Prescription can be ground much thinner with
poly lenses. In build UV protection is the added benefit,
thereby eliminating the need to purchase additional UV
protection. However they are more expensive and they are
more prone to scratches as the material is soft. This may be
a factor for cost-conscious parents.
68 Optician’s Guide

CARE INSTRUCTIONS
Compliance is an important part for successful dispensing
glasses to the children. If the kids and the parents fail to carry
out instructions for proper wearing and caring of the glasses,
the prescription will not be as beneficial as it might be. In
addition to being uncomfortable or unsightly, the eyewear
may even have undesirable optical effect. Accordingly dispenser
should take the time to teach parents and kids how to wear
and care for their eye glasses. Instructions should stress the
following points:
1. Teach children to clean their lenses at least once a day by
first blowing to remove dust or grit. Then wash them with
soapy water and dry with a soft clean cloth. Never attempt
to clean glasses without first wetting them.
2. If chemically treated papers are used to clean the lenses,
follow the instructions on the label; not all papers are safe
for cleaning plastic lenses.
3. While keeping glasses on a hard surface, be sure they are
placed face up in order to prevent scratches. Better keep
the spectacle in spectacle case when not in use.
4. The temple from its joints should be able to swing freely. If
they tend to bind, they can be made to swing easily with a
drop of thin lubricant put directly on hinges. Lubricating
hinges is especially important if the spectacle have been
exposed to salt air or excessive perspiration as the salt
crystals that form after evaporation restricts their movement.
5. If the spectacle has plastic movable pads, the pads should
be wiped with soap using an old toothbrush.
6. When putting on or taking off eye glasses, the youngster
should be taught to use both hands so that the frame’s
alignment is not disturbed.

X
 Chapter 11

Contact Lenses
Contact lenses are a tiny disc of plastic designed to rest on the
cornea and are used to correct the refractive errors of the
eyes like spectacles. The idea of contact lenses was first
conceived by Leonarda Da Vinci in the year 1508. But the first
successful plastic contact lens was introduced as late as in 1947
by Kelvin Tuohy. Till then only haptic lenses were available
which were rather more expensive and at the same time they
required the patient to spend weeks at the clinic in several
sittings, before they could actually get the final lens. Added
to this were the disadvantages of restricted tolerance. Thus
the introduction of corneal lens has ushered a new era in this
intriguing field of optics. Within a few years the contact lenses
captured the imagination of the people and the practitioners
also. Today millions of people around the world enjoy the
perfect vision through contact lenses. Several varieties of
contact lenses have been introduced which include a few like
Hard, Gas Permeable, Soft and different modules of
Disposable Soft Contact Lenses. Cosmetic lenses have also
been developed to mask the corneal opacities and also to
change the eye colour. The most wonderful creation in the
contact lenses is the development of Extended Wear Soft
Lenses which are put on the eyes and once inserted can be
used for a month at a stretch without removing it. Soft Toric
has also come for high astigmatic cases (Fig. 11.1, Plate 4).

ADVANTAGES OF CONTACT LENSES

Contact lenses have a number of advantages over spectacles.
1. Wider filed of view.
2. No peripheral aberrations.
70 Optician’s Guide

3. No diplopia in uniocular aphakia.

4. Good for sports.
5. Rain and fog do not condense upon the contact lenses as
they do on spectacle.
6. Improved vision for keratoconus cases which is not possible
with spectacle.
7. Decreases the amplitude of nystagmus, (Oscillation of eye).
8. It can be used as a low visual aid.

A FEW CONTACT LENS TERMINOLOGY

Water Content
Water content of a contact lens is the total amount of bond
and free water present in the contact lens which is material
specific. Contact lenses have pores which are formed by cross
linking of monomers. These pores absorb water forming the
water content of the lens. An increase in water content
increases the oxygen transmissibility, and also mechanical
strength of the contact lenses.

Oxygen Permeability
Oxygen permeability refers to the diffusion of oxygen from
the atmosphere through the lens and into the cornea. This is
expressed by the term DK, where
D = Diffusion co-efficient
K = Solubility co-efficient.
Diffusion co-efficient refers to the speed with which the
gas travels or diffuses through a material and the amount of
gas that is dissolved in a unit volume of the material at a
specific pressure is called the solubility co-efficient. But for a
practitioner the actual oxygen transmissibility is more
important which is denoted by DK/L, where L = Thickness of
the lens. The thickness may be central thickness or an average
thickness of the lens. If the thickness of the lens increases, the
amount of oxygen transmission from it reduces.
 Contact Lenses 71

Sagittal Depth
Perpendicular distance from the central posterior portion of
the contact lens to the chord diameter of the lens.

Fig. 11.2: Chord diameter and sagittal depth of the lens

If the base curve of a lens is constant, increase in the
diameter of the lens increases the sagittal depth and thereby
making it a steeper fit. And if the diameter is constant, increase
in the base curve decreases the sagittal depth and thereby
making it a flat fit (Fig. 11.2).

Thickness
It is the distance between the anterior and the posterior surface
measured at the geometric centre of the lens. It is measured
in mm by using a thickness gauge and determines the optical
power and fit of the lens on the cornea.

CONTACT LENS MATERIALS

The following polymers are used to manufacture the different
types of contact lenses.

Hard Lens
Polymethylmethacrylate (PMMA) is most commonly used to
manufacture rigid or hard contact lenses. It has an excellent
machining and moulding qualities but is practically imper-
meable to oxygen. That is why lenses can be used for limited
period only. The refractive index of this material is 1.49.

Gas Permeable Lens

Cellulose acetate butyrate (CAB), siloxane, etc. are used to
manufacture the RGP varieties. Recently a new group of gas
72 Optician’s Guide

permeable materials containing fluorocarbon has been

introduced.

Soft Lens Materials

The most commonly used material for soft lens is Hydroxy-
ethylmethacrylate (HEMA).

PATIENT SELECTION FOR CONTACT LENSES

A careful patient selection benefits both the patient and the
practitioner by avoiding complications with lens wear and
increasing the patient comfort and their survival in lenses.
The following factor, may influence the selection of ideal
candidate for contact lenses:
1. In inflammatory conditions the patient cannot tolerate the
lens.
2. Uncontrolled diabetes patients are prone to bacterial and
fungal infection of the eye which is difficult to control.
3. Non motivated patients are also not the right candidates.
4. Skin disease, allergies, pregnancy, etc. also may influence
the lens wear in an adverse manner.
5. Patient’s general hygiene level also plays a part in patient
selection.

CONTACT LENS MANUFACTURING TECHNIQUES

Spin Cast
The polymer in its liquid state is dropped on to a rotating
mould. The surface in contact with the mould forms the front
surface of the lens and the back surface is determined by the
speed at which the mould is rotated and the amount of polymer
used.

Lathe Cut
The polymer in its solid state is cut using the precision lathe
machines. The curvature of the front and back surface of the
lens is determined by the curvature of the lathe.
 Contact Lenses 73

Cast Moulding
The polymer in its liquid form is placed between two moulds
which determine the front and back surface of the contact
lens. The mould is then casted to obtain the contact lens which
is then polished and hydrated, if necessary.

INSTRUMENTS REQUIRED FOR

CONTACT LENS VERIFICATION
Verification is the process by which parameters of the contact
lens received from the laboratory are checked and compared
with the parameters ordered by the practitioners. The following
instruments are required for the purpose:
1. V. channel gauge: To check over all diameter of the lens.
2. Measuring magnifier: To check the over all diameter and
also optic zone diameter of the contact lens.
3. Focimeter: To check the power of the lens.
4. Radiuscope: To check the base curve of the lenses.
5. Slit lamp biomicroscope: To check the surface quality of the
lens under higher magnification.

X
 Chapter 12

Eyes

Eye is the organ of vision which contains two types of visual

receptors, the rod cells and cone cells. The two eyes are located
in the deep cavities of the skull called orbits which are situated
on the frontal side of the cranium. Two eyeballs rest on the
pad of fat.

STRUCTURE OF THE EYEBALL

Each eyeball is nearly spherical, fluid filled ball and is
approximately 2.5 cm in diameter. It consists of the coats of
the eyeball and the refractory media of the eyeball.

Fig. 12.1: Structure of human eye

Coats of the Eyeball

The eyeball is covered by outer, middle and inner coats.

Outer Coat
The outer most tough fibrous layer of the eyeball is called the
fibrous coat. It has two parts:
 Eyes 75

1 Cornea and
2. Sclera.
Cornea: The anterior one-sixth of the eyeball is the cornea of
the eye. It forms the transparent bulging part of the eyeball.
The dioptrical value of the cornea is appr. + 42.00 D and the
refractive index is 1.337. It has many layers. It allows the light
to enter the interior of the eyeball. That is why it is some
times termed as “Window of the eye.”
Sclera: The posterior five-sixth opaque white part is known as
sclera. It gives shape to the eye and prevents light rays to pass
through it.

Middle Coat
This is the vascular coat of the eyes and has two parts:
1. Choroid and
2. Ciliary body.
Choroid: The vascular layer which forms the inner lining of the
opaque portion of the sclera is called choroid. It is heavily
charged with the black pigments called pigmentum nigrum.
Hence this layer looks black. This is also a protective covering
of the eyeball and does not allow any external reflection.
Ciliary body: At the anterior end of the choroid there is a circular
zone which is known as ciliary body. It holds the crystalline
lens with the help of suspensory ligaments. There is a coloured
disc situated in between the cornea and the lens which is called
the iris. At the periphery it is continuous with the ciliary body
and at the centre there is a circular aperture called the pupil.
The ciliary body muscles contract and relax and thereby altering
the lens thickness.

Inner Nervous Coat

Retina is the innermost light sensitive nervous layer and is
present at the posterior side of the eyeball between the choroid
76 Optician’s Guide

and vitreous humor. This layer contains many neurons and

light sensitive cells called photo-receptors. According to the
shapes, the photoreceptors are called rod cells and cone cells.
Rod cells are cylindrical and are mostly found on periphery
part of the retina. The cone cells are pyramidal in shape and
are found at the central portion of the retina, opposite to the
pupil and the lens. At about the centre of the retina, there is a
round depressed portion, yellow in color which is extremely
sensitive to the light and is called the Yellow Spot or Macula
Lutea. This area contains highly developed cone cells only.
Just below the yellow spot a disc like area is located which
does not contain any rods and cones. This is known as optic
disc or blind spot. This is the place at which optic nerves leave
the eyeball and blood vessels enter into the eyes.
Rods and cones contain photosensitive pigments called
rhodopsin and iodopsin respectively. When the light falls on
retina, these pigments are bleached and the light energy is
converted into visual impulse. Rod cells are responsible for dim
light vision and cones for bright light vision, colour vision and
for detail perception.

Refractive Media of the Eyeball

There are four refractive media of the eye, which help to
converge the light rays and focus them on the retina—cornea,
aqueous humor, lens and vitreous humor.

Aqueous Humor
It is a watery fluid that fills up the chambers in front of the lens
and supplies nutrition to lens and cornea. The refractive index
of this is 1.337.

Lens
The eye is provided with transparent, elastic circular lens,
enclosed in a capsule and suspended through the suspensory
 Eyes 77

ligaments and is located approximately 2 mm behind the

cornea. It is biconvex but its rear surface is more convex than
the front. The refractive index of the lens is 1.42 and is
approximately + 18.00 D of power.

Vitreous Humor
It is a protein matrix that forms a gelatinous but clear fluid
and is present in the compartment behind the lens. It maintains
the eyeball pressure.

MECHANISM OF VISION
The working of the eye can be compared to that of a camera.
Light is essential to see an object as for taking a photograph
by a camera. Light rays reflected from an object enters the
eye through cornea, pupil, aqueous humor, lens, vitreous
humor and finally falls on retina.
The size of the pupil is regulated by the contraction of
muscles present in the iris. This contraction of muscles takes
place reflexly. Size of pupil regulates the intensity of light that
enters the eye. The light rays refracted by different refractory
media like cornea, lens, aqueous humor and vitreous humor
is finally converged on the retina. It forms an inverted and
reduced size image. The muscles of the ciliary body adjust the
curvature of the lens, thus light rays are clearly focussed on
the retina. The rods and cones exposed to the light in the
region of the image are stimulated by photochemical reactions.
They convert these stimulation into visual impulse. It is
conducted through the optic nerve into the visual centre of
the cerebrum. The result is vision.
Passage of light through eye:
Light rays from an object
⇓
Cornea
⇓
Aqueous Humor
⇓
Pupil
Contd...
78 Optician’s Guide

Contd...
⇓
Lens
⇓
Vitreous Humor
⇓
Retina
⇓
Optic Nerve
⇓
Brain

SOME DEFECTS OF VISION

A healthy eye focusses the parallel light rays exactly on the
retina. This is called emmetropia. However some common
abnormalities may occur due to which the light rays are not
focussed exactly on retina. This situation is known as
ammetropia.

Myopia
In this case the person cannot see the distant object in any
case but some how manage to see the near object at a certain
distance. So they are called short-sighted. The light rays are
focussed in front of the retina. The defect can be corrected by
using a concave lens.

Hypermetropia
In this case the person can manage to see the distant object by
applying accommodation but he fails to see the near object at
all. So they are called long-sighted. The parallel rays coming
from infinity comes to a focus behind the retina when
accommodation is at rest. The defect can be corrected by using
a convex lens.
Astigmatism
It is a common structural defect in the cornea or the lens. There
may be a difference in the curvature of the two principal
meridians of the cornea or the lens. The result being that the
rays refracting by these surfaces do not focus at one point.
 Eyes 79

For this reason the vision is not sharp. The defect can be
corrected by using cylindrical lenses.

Presbyopia
Presbyopia is an age related visual defect. Usually above the
age of 40 years the person can see the distant object but he can
not see the near objects. This is due to loss of elasticity of the
lens and weakness of the ciliary muscles to accommodate. The
defect can be corrected either by using near power spectacle or
by bifocal lenses.

Cataract
It is a condition in which the crystalline lens inside the eye
turn opaque and the vision is cut down to even total blindness.
It can be corrected by surgically removing the lens and by
using a very high power convex lens compensating for the
removed lens. In new technique, a small artificial lens made
of plastics (IOL) is implanted behind the iris.

ACCOMMODATION
A normal eye can see an object at infinity without giving any
strain to the eyes. This implies that a normal eye can focus the
object of infinity on the retina in a state of relaxation. But when
the object is brought nearer to the eyes, it is found that the image
has a tendency to focus behind the retina. But the ciliary body
muscles automatically get contracted and pulls the choroid coat
in front. Thus the ligaments which are connected to the ciliary
body become loose and the surfaces, specially the anterior
surface become more curve and the effective focal length is thus
reduced so that the images is now focussed on the retina.
This process of the eye is known as accommodation of the
eyes. In precise words the process of focusing the objects at
different distances is called the accommodation. It is a reflex
process and is mainly done by changing the curvature of the
elastic lens. The amplitude of accommodation is very strong
in case of children but reduces with the increase in age.

X
 Chapter 13

Troubleshooting: A Fast
Reference Guide
A bird in hand is worth two in the bush.
As someone wisely put it, service is to sales as ink is to pen—
even the best pen is useless if the ink leaks. So don’t make the
mistake of thinking that because you are not hearing complaints
you don’t have to worry about “service.” The fact is that more
than 50 percent of your dissatisfied customers do not
complain—they just pick up and go to your competitor because
they do not believe that you are competent enough to satisfy
them.
So when a wearer comes with a complain, you must attend
them immediately so that he gets the feeling that he is still
welcome. Always put yourself in customer’s place and think
out the solution. Listen to his problem very carefully without
interrupting. It may be sometimes difficult, but always
rewarding.
In a study conducted on complaints about the lenses as well
as the adjustment of the spectacles, it has been shown that
majority of patient’s complaints are related to the physical fit
of the frame—the direct result of the frame selection and
spectacle adjustment. Many wearers seem more likely to
tolerate spectacles in which the prescriptions are slightly awry
if the frame fits comfortably. A wearer is not as likely to
tolerate spectacles even if the prescription is correct, if the
frame fits poorly. The comfort and suitability of the fitting
seems to be the most significant criteria for satisfaction. So when
a wearer comes with complain, a systematic approach to
identifying the cause of the problem is required from the wearer,
for example:
 Troubleshooting: A Fast Reference Guide 81

• How are you going with the spectacles?

• If the wearer reports a problem, encourage them to be
specific by saying: “Please describe your problem in details”
• It is helpful to have a good wearer history and the following
informations should be sought to assist while identifying
the cause of the problem:
1. Is the spectacle for the first time?
2. When were they made?
3. Was the prescription updated at that time?
4. What was the previous correction?
5. What was the lens type before, if known?
6. Did this happen with the previous spectacles?
7. Was the onset of the problem gradual or sudden?
Let us discuss some of the possible cases of problem with
which a wearer can come:

1. Frame is loose and has the tendency to slip down.

Probable Cause and Suggested Solution

a. Side bend may be inadequate.
b. Temple width may be too spread out or too close.
c. Angle of the side bend may not be correct.
d. Pads spread too far or bridge size too large. Narrow the
same.
e. No natural stop point on nose. Adjust pads so that the
surface is on nose. Distribute weight over larger area by
using larger pads.
f. Frame too heavy, replace it.
2. Frame sits too high.

Probable Cause and Suggested Solution

a. Stretch the bridge or increase the distance between nose
pads.
b. Side bend may be more than required. Correct.
c. Temple width may be too narrow. Check.
3. Frame sits too low
82 Optician’s Guide

Probable Cause and Suggested Solution

a. Narrow the bridge (plastic)
b. Decrease the distance between pads (metal)
c. Bend the guard arm (nob) down and re-angle the pads
4. Lenses unequal distance from eyes or lashes of one eye
touch the lens

Probable Cause and Suggested Solution

a. Temple width uneven. One temple is outer than other.
b. One temple is bowed.
c. Side bend unequally placed.
d. One side of wearer’s head is wider than other.
I. Decrease temple spread on side closest to face. Or
II. Increase temple spread on side farthest from face.

5. Lenses too far away from face.

Probable Cause and Suggested Solution

a. Pads too close together or distance between bridge too
narrow.
b. Guard arm (nobs) too straight or too long, curl nobs.
6. One lens higher than other.

Probable Cause and Suggested Solution

a. Improper side bend.
b. Pantoscopic angle incorrect on one side:
I. Increase pantoscopic angle on lower side. Or
II. Decrease pantoscopic angle on higher side.
c. Bridge shows skewing.
d. Temple spread unequal.
e. One lens is rotated, giving the appearance of one lens being
higher.

7. Frame touches the eyebrows.

 Troubleshooting: A Fast Reference Guide 83

Probable Cause and Suggested Solution

a. Frontal angle is too retroscopic.
b. Increase the pantoscopic angle.
c. Frame is too near the face.
8. Eye lashes touch both lenses.

Probable Cause and Suggested Solution

a. Pads may be too wide apart, narrow pads or bridge or put
rocking pads on plastic frames.
b. Guard arms (nobs) may be too short or curled. Lengthen
them.
c. Frontal bow may be more. Reduce.
d. Base curve of the lens fitted may be too flat from inside.
There is a 0.6 mm vertex distance change in base curve for
every 1.00 D surface change.
e. Temple pull behind ear may be too great.
9. Eye rim touches cheek.

Probable Cause and Suggested Solution

a. Too much pantoscopic angle.
b. Pads too far apart.
c. Pads rest too low on nose.
d. The frame is too large vertically.
e. Guard arm (nob) too short.
10. One nose pad hurts or cuts the nose.

Probable Cause and Suggested Solution

a. The pad angle is incorrect.
b. If the pad angle is correct then the temple spread is not
even.
11. Both pads press nose or indent too much.

Probable Cause and Suggested Solution

a. Pads are too small for frame weight, replace with larger
pads.
84 Optician’s Guide

b. Pads are too close together.

c. Side bend is too much.
d. If none of the above appear to be a problem, then:
I. Use a soft pad for a frame with adjustable nose pads. Or
II. Use a stick on cushion pad for plastic frames.
12. Frame hurts behind the ears.
Probable Cause and Suggested Solution
a. Side bend too short, change the bend position.
b. Temple width behind the ears may be too narrow, causing
more temple pressure.
c. Temple rides too high on ear, increase side bend.
d. Angle of side bend may not be proper.
13. Patients complaining poor quality of vision with new
spectacles.
Probable Cause and Suggested Solution
a. Check the power of the lenses and compare with old power.
Notice the change in refraction.
b. Check the vertex distance of spectacle.
c. Compare the frontal bow and frontal angle with that of
old spectacle.
d. Check the index of lens material:
• If vision quality improves, ask to wear the spectacle for
some days. Otherwise advise the patient for re-
refraction.
14. Patient complaining of double vision with the new
spectacle.

Probable Cause and Suggested Solution

a. Check the pupillary distance of the spectacles dispensed
and compare it with that of old spectacle.
b. Check the height of the pupillary distance.
c. Check the frontal bow of the spectacle.
d. Advise anti-reflection coated lens.
15. Patient complaining of skewed vision with the new
spectacle.
 Troubleshooting: A Fast Reference Guide 85

Probable Cause and Suggested Solution

a. Check the spectacle power and compare it with that of old
spectacle, with special emphasis on cylindrical element and
axis.
b. Check the frontal angle and front bow of the spectacle and
compare it with the old spectacle.
c. If not yet corrected, advise the patient to go for re-
refraction.
16. Headache with new glasses.
Probable Cause and Suggested Solution
a. Check glass power and compare it with that of old
spectacle.
b. Check for any tint if he is used to wearing.
c. Look for excessive tight fitting of spectacle.
d. Try and see if any improvement can be done by altering
frontal angle or frontal bow.
e. Advise for re-refraction.
17. Bifocal lens user complaining of shading effect over line
while reading.

Probable Cause and Suggested Solution

a. This kind of problem is usually seen with fused bifocal
specially with kryptok bifocal.
b. Try to increase the height of the segment by altering bridge
or narrowing pads position.
c. Try to re-polish both the surface of lens, if it is glass lens.
d. Otherwise change the glass or type of bifocal.
18. Bifocal segment height seems to be low.

Probable Cause and Suggested Solution

a. Narrow bridge or bring the pads closer together.
b. Bend guard arms down.
c. Decrease pantoscopic tilt.
d. Re-measure.

19. Bifocal segment height seems to be high.

86 Optician’s Guide

Probable Cause and Suggested Solution

a. Widen pads or stretch bridge.
b. Bend guard arms up.
c. Increase pantoscopic tilt.
d. Re-measure.

20. Both eye bifocal segments are not equally high.

Probable Cause and Suggested Solution

a. Adjust the pantoscopic angle on one side.
b. Raise one lens at bridge by purposely skewing the bridge.
c. Re-measure.

21. Bifocal user complaining poor field of vision while reading.

Probable Cause and Suggested Solution

a. Check the segment inset.
b. Check the segment size.
c. Re-measure pupillary distance specially for near vision.

22. Bifocal user complaining of closer reading distance.

Probable Cause and Suggested Solution

a. Near addition prescribed may be more than required.
b. Advise re-refraction.

23. Progressive Lens wearer complaining of distance blurring

vision.

Probable Cause and Suggested Solution

a. Restore the progressive marking.
b. Fitting height may be too high.
c. Possibility of incorrect prescription–
• Overplus or underminus.

24. Progressive lens wearer complaining of near blur.

 Troubleshooting: A Fast Reference Guide 87

Probable Cause and Suggested Solution

a. Restore the progressive marking.
b. Fitting height may be too low.
c. Larger vertex distance.
d. Incorrect prescription—near add or distance refraction.
e. Pupillary distance may be incorrect.
f. Insufficient pantoscopic tilt.
g. Check lens base curves.

25. Progressive lens wearer complaining for waviness or swim

effect at distance vision.

Probable Cause and Suggested Solution

a. Restore the progressive marking.
b. Possibility of larger vertex distance.
c. Facial wrap or frontal bow insufficient.
d. Insufficient pantoscopic tilt.
e. Incorrect pupillary distance.

26. Progressive lens wearer complaining of reading area smaller

or excessive lateral head movement when reading.

Probable Cause and Suggested Solution

a. Restore the progressive marking.
b. Over plus at near.
c. Incorrect pupillary distance.
d. Fitting height too low.
e. Large vertex distance.
f. Insufficient facial wrap.
g. Insufficient pantoscopic tilt.
h. Check lens base curve.

27. Progressive lens wearer complaining of head tilt back at

distance.

Probable Cause and Suggested Solution

a. Restore the progressive marking.
88 Optician’s Guide

b. Prescription may be incorrect.

• Overminus or underplus–
c. Check the vertex distance.

28. Progressive lens wearer complaining of head tilt back at

near/intermediate.

Probable Cause and Suggested Solution

a. Restore the progressive marking.
b. Prescription may be incorrect–
• Underplus.
c. Fitting height too low, make the bridge or nose pads closer.

29. Progressive lens wearer complaining of head tilt forward

at distance.

Probable Cause and Suggested Solution

a. Restore the progressive marking.
b. Fitting height is too high, widen the bridge or nose pads.

30. Progressive lens wearer complaining of excessive head tilt

forward at near/intermediate.

Probable Cause and Suggested Solution

a. Restore the progressive marking.
b. Incorrect prescription–
Overplus.

X
 Chapter 14

Some Useful Terms

Amblyopia
It is a condition of diminished visual acuity which is not a
result of any clinically identifiable organic lesion of the visual
pathway and is not relieved by any optical device. It is
commonly known as lazy eyes. It is usually caused by the
inadequate stimulation of the visual system during the critical
period of visual development in early childhood. This may be
uniocular or binocular.

Aberration
It is a defect in the optical system which prevents a point object
being imaged as a point.

Adaptation
The ability of our body or any organ of our body to adjust to its
environment either externally or internally. The eyes can adapt
to all kinds of light intensities whether medium, high or low.

Atrophy
Wasting of body tissues.

Aphakia
Aphakia means the absence of lens from the eye. In most cases
it is due to removal of the lens by surgery.
90 Optician’s Guide

Anisometropia
It is a condition when there is a marked difference, usually
difference of 2.00 D or more between the refraction of two eyes.
If the refraction in two eye is equal, it is termed as isometropia.

Aniseikonia
It is condition when there is a considerable difference in size or
shape between the retinal images of two eyes.

Antimetropia
A type of anisometropia in which one eye is myopic and other
is hyperopic.

Blink
A temporary closer of both eyes, involving movement of both
upper and lower lids. Blink rate is usually more in case of a
male than a female.

Bubble
It is an air or gas pocket in the glass.

Canada Balsam
A resinous substance used for cementing optical elements such
as cementing bifocals, lenticular lens, etc.

Cycloplegia
Paralysis of the ciliary muscles resulting in accommodation
control.

Datum Line
The horizontal reference line passing through the geometric
centre of a lens shape.

Caliper
An instrument used to measure thickness.
 Some Useful Terms 91

Decentration
The distance between the optical centre of a lens and its
geometric centre.

Diplopia
Seeing an object as two. Diplopia may be monocular or
binocular.

Distortion
The defect in a lens which causes a straight line to appear
curved.

Dominant Eye
The eye that leads the other in fixation.

Dry Eyes
A dry eye is a condition in which the precorneal tear film is
deficient and cannot fulfill its normal function of lubricating
the anterior surface of the cornea.

Dispersion
The separation of light into its component colours when it
passes through a prism is called dispersion. When the light
passes through a prism, it splits up into seven colours. The
sequence of colours can be remembered by the word VIBGYOR
which is formed by taking the initial letter of each colour.

Floaters
Opacities in the vitreous humor.

Haloes
The perception of light ring in circular form seen specially
around the light source.
92 Optician’s Guide

UV Rays
Ultraviolet light is the electromagnetic radiation in the part of
the spectrum between X-rays and visible lights. Its wave
lengths are too short to be seen by the human eyes. The chief
natural source of UV rays is the sun. Artificial sources include
incandescent light, gas discharge, low pressure mercury, xenon
lamps, etc.

Night Blindness
This is the condition of the eyes in which vision under low
illumination is significantly poor. It is usually due to
malfunctioning of rods in retina.

Lap
A tool which has been cut to prescribed surface curvature and
is used for grinding and polishing lens.

Scotoma
An area of lost or depressed vision within the visual field
surrounded by an area of less depressed or normal vision.

Proptosis
It is a forward protrusion of one or both eyeball.

Ptosis
Drooping of the upper eyelid due to faulty development of the
levator muscle. It may be congenital or acquired and may affect
either or both eyes.

Parallax
The apparent displacement of an object due to a change in the
position of the observer’s eye.
 Some Useful Terms 93

Visual Acuity
Visual acuity is the power to distinguish an object from the
other and to appreciate the details of the visible object.
Snellen’s chart is used to measure the visual acuity for
distance vision. Normal vision on this chart is taken as 6/6.
The numerator in this fraction is the distance in metres at which
the patient is from the types and denominator is the distance
in metres at which a person with normal vision ought to be
able to read the line which he succeeds in reading. The chart
measures the visual acuity as under:
6/60, 6/36, 6/24, 6/18, 6/12, 6/9, 6/6
If the patient cannot see the largest letter, i.e. 6/60 type,
he is asked to move slowly towards the types and the farthest
point at which he can see the top letter is determined. If this is
3 m, the vision is recorded as 3/60. If he is unable to see the
top letter even at close, he is asked to count the extend fingers
of the practitioner’s hand held at about 1 m. against a dark
background and this is recorded as “V = fingers at 1 m.” If he
cannot count the fingers, the practitioner’s hand is moved in
front of the eye and if he can distinguish the movement, the
vision is recorded as “V = hand movement”. If he is unable to
see the movement, a light is concentrated on his eye in the
darkroom and he is asked to say when the light is on the eye
and when it is off. If he succeeds in this, vision is recorded as
“V = P.1” (Perception of light) and if he fails to see the light,
the vision is recorded as “V = no. P.1”.

Colour Blindness
The defect occurs when the cones present in retina are totally
or partially absent or inactive. A colour blind person’s eyes
cannot interpret the various shades of colour.

Binocular Single Vision (BSV)

The BSV is ability to use both eyes simultaneously so that
each eye contributes to common single perception.

X
 Appendix
VISUAL ACUITY SCALES FOR DISTANCE VISION

Keeler Distant Vision Notations

“A” % Snellen Fractions
Series English American
A1 100 6/6 20/20
A2 80
A3 64 6/9 20/30
A4 51 6/12 20/40
A5 41
A6 33 6/18 20/60
A7 26 6/24 20/80
A8 21
A9 17 6/36 20/120
A10 13
A11 11 6/60 20/200
A12 8.6
A13 6.9
A14 5.5 3/60 20/400
A15 4.4
A16 3.5
A17 2.8
A18 2.3
A19 1.8 1/60 3/200 (Appr.)
A20 1.4

NEAR VISION NOTATION

JAEGER
J1, J2, J3, J4, J5, J6, J7, J8, J9, J10, J12, J14
Times New Roman
N5, N6, N8, N10, N12, N14, N18, N24, N36
96 Optician’s Guide

VERTEX DISTANCE CALCULATION

CHART FOR CONTACT LENS FITTING
(AVERAGE BVD OF 12 MM)
For minus read For plus read
left-right right-left
– + – +
5.00 4.75 10.25 9.12
5.12 4.87 10.50 9.25
5.37 5.00 10.75 9.37
5.50 5.12 11.00 9.62
5.62 5.25 11.25 9.75
5.75 5.37 11.50 10.00
5.87 5.50 11.75 10.25
6.00 5.62 12.00 10.37
6.12 5.75 12.50 10.75
6.37 5.87 12.75 11.00
6.50 6.00 13.00 11.25
6.62 6.12 13.50 11.50
6.75 6.25 13.75 11.75
6.87 6.37 14.00 12.00
7.00 6.50 14.25 12.25
7.12 6.62 14.75 12.50
7.37 6.75 15.00 12.75
7.50 6.87 15.50 13.00
7.62 7.00 15.75 13.25
7.75 7.12 16.25 13.50
7.87 7.25 16.75 13.75
8.00 7.37 17.00 14.00
8.12 7.50 17.25 14.25
8.25 7.62 17.62 14.37
8.50 7.75 18.00 14.50
8.75 8.00 18.12 14.75
9.00 8.25 18.50 15.00
9.25 8.37 18.75 15.25
9.50 8.62 19.00 15.50
9.75 8.75 19.50 15.75
10.00 9.00 20.00 16.00
 References

1. Physical Optics by A. Verstrae Ten.

2. A Text-Book of Physics by J. Duncan and SG Starling.
3. Primary Care Optometry by Theodore P. Grosvenor.
4. Duke-Elder’s Practice of Refraction revised by David Abrams.
5. Lyle and Jackson’s Practical Orthoptics in the Treatment of
Squint.
6. Principles of Optics and Refraction by Prof. (Dr.) Lalit P Agarwal.
7. “Practitioner Program Handbook” Developed for the prac–
titioners participating in Presbyopia Education program in
Asia, conducted by International Center for Eyecare Education
and sponsored by Essilor.
8. A Short cut to Optometry by SM Bose.
9. Contact Lenses by Anthony J. Phillips and Janet Stone.

X
 Index
A F
Accommodation 79 Final fitting of spectacle 62
Aspheric lens 67 Frames 41

C
H
Cataract 79
High index lens 67
Choroid 75
Ciliary body 75
Compliance 68 L
Contact lenses 69 Laws of reflection 3
advantages 69 Lens grinding 51
contact lens manufacturing bifocal 57
techniques 72 cylindrical 54
contact lens materials 71 new system of 58
contact lens terminology 70 spherical 53
oxygen permeability 70
Lens power to meridian values 19
sagittal depth 71
Lens verification 60
thickness 71
water content 70 Geneva lens measure 60
gas permeable lens 71 lensometer 61
hard lens 71 neutralisation 61
instruments for contact lens Lenses 6
verification 73 classification 6
patient selection for contact lenses concave 7
72 convex 7
Curvature of lenses 46 cylindrical 9
spherical 9
D Lensometer 12
Dioptre 8
Light 1
Dispensing spectacles to children 64
reflection of 2
accurate pupillary distance
measurement 65 refraction of 4
lens tips for children 67 velocity of 4
problems associated with
dispensing glasses to kids 65 M
proper frame selection 64 Mechanism of vision 77
solving problems while fitting Meridian values to lens power 21
eyewear to children 66 Meridians 12
E
Eye 74 N
structure of human eye 74 Near vision notation 93
100 Optician’s Guide

O coats of the 74
Ophthalmic lens materials 12 refractive media of 76
crown glass 13
flint glass 13 T
high-index glass 13 Transposition 19
plastic lens 14 transposition rules 22
polycarbonate 14 Troubleshooting 80
Optical centre 8
Optical medium 2 U
Useful terms 89
P aberration 89
PAL designs 37 adaptation 89
PENTAX OLH-1 lensometer 18 amblyopia 89
Polycarbonate lenses 67 anisometropia 90
Presbyopia 79 aphakia 89
atrophy 89
Prescription 27
binocular single vision 93
Prism 15
blink 90
application of prism in optics 16
bubble 90
detection of prism in a lens
caliper 90
using lensometer 18
canada balsam 90
detection of prism in an optical colour blindness 93
lens 17 cycloplegia 90
prism and lens decentration 16 datum line 90
Progressive addition lens fitting 48 decentration 91
diplopia 91
S dispersion 91
Soft lens materials 72 distortion 91
Special types of lenses 29 dominant eye 91
access lens 35 dry eyes 91
anti-reflection coated 33 floaters 91
aspheric 30 haloes 91
blended invisible bifocal 34 lap 92
fused bifocal 34 night blindness 92
lenticular 32 parallax 92
photochromatic 29 proptosis 92
polaroid 31 ptosis 92
scotoma 92
progressive addition lens 36
UV rays 92
tinted lenses 39
visual acuity 93
Spectacle frame fittings 41
base of the bridge 42 V
front fitting 44 Verification of progressive lens 63
length of the sides 43 Vertex distance calculation chart for
other measurements 45 contact lens fitting 96
temple width 44 Visual acuity scales for distance vision
Structure of the eyeball 74 93