- And good morning.
Not one single person out here in my audience
is going to remember a show called
The Gong Show, showing my age,
was one of my favorite things when I was a kid,
and the emcee for The Gong Show always used to say
and that shtuff
so, today we're gonna talk about some shtuff,
before we move on to the rest of our prism stuff.
(static)
- Gotta be kidding.
(audience laughter)
Wow.
We'll be right back with more "shtuff",
right after this message.
(upbeat music)
- Number one.
The prescription for prism,
isn't really our problem.
That's up to a doctor,
a refractionist, a practitioner,
someone who has the tools and the knowledge necessary,
mostly a phoropter, to determine what a person needs
in order to have everything aligned correctly.
There are some really good examples
on the OpticianWorks website,
I once had a sponsor that gave me access
to a professional artist, or illustrator,
there's some really good stuff there.
I would encourage you to check out that section,
and you'll pick up there
a whole lot more about the
how we write a prescription, where that stuff comes from,
why we use it, and all those things,
because that, again, is not really our problem.
Number two then, is what is, then, our problem?
Some things that we're going to cover in the next
couple of video segments, again, believe it or not,
tiny little baby steps again,
before we go jumping in to Prentice's formula,
and solving and the math and all that good stuff.
We're gonna talk a little bit about the language of prism.
What does that stuff that's written
on the prescription mean?
Things like base in, base out,
base up, base down,
compounding, canceling, resultant,
all the terminology that goes with it.
We're gonna talk about that.
Then we're gonna talk about what is there,
what prism is present in a pair of glasses,
you have a new customer,
that amount is unknown,
and this is so important,
because somewhere along the line,
someone's gonna hand you a pair of glasses, and say,
is there prism in here?
It'll tell you so much about the competency of an optician
how they respond to that question.
So we're gonna talk a whole lot about that.
Then we have what is there when we know
what is supposed to be there, that's verification,
we get a pair back, prescription called for prism,
is it there, is it in the right place,
is it the right amount, how are these glasses gonna work
for that customer or patient.
This is one of the few places I use patient over customer
because there really is a heightened sense of a relationship
between the doctor, practitioner and the patient,
to get that prescription just right
so that it works for them.
We need to talk about what is created by an error.
When an error is made, how much prism is created,
and is it enough to kick the job out,
is it enough to have the job fail an inspection?
This is when we'll start using
a little bit of Prentice's formula.
I always like to point out
over and over, because it really kinda bothers me,
to be honest with you, that we spend so much time on this,
and that whole, verification thing,
and you'll get all those questions for ABO prep on it,
if a job is wrong, send it back.
If I get a pair of glasses in, and I'm doing verification,
and I'm looking at them, they stink, the PD's off,
the imbalance is this where one OC's here, one's here,
I'm not gonna go through all this rigamarole
and work Prentice's formula and say
well it comes within tolerance,
no it's made wrong, send it back.
Just always keep that in the back of your mind.
Next is what can we do to create wanted prism?
There are a couple of different things.
We can have it done by the lab,
sometimes we can just do it with a lens that we
pull off the shelf.
We'll talk about that.
And then, kinda connected to one, and our last one here,
our little monkey brain down here.
Don't make yourself crazy over this stuff.
I don't wanna sound sarcastic, or mean, or anything,
but the prism patient does have something off,
and something's not right, okay,
one eye sees things one way,
and the other eye sees them another way.
Don't beat yourself up if you have a remake.
If something just doesn't quite work,
if they put them on and say,
no that's not quite right kinda stuff.
Sometimes there's a little give and take here.
Sometimes it's a relationship between the prescriber,
the doc, the patient, and you in between.
I'm not gonna spend a whole lot of time here
on the language of prism.
We will look at it,
it's gonna just develop,
you're just gonna kinda pick this up as you go.
You should also of course, have already been through this
stuff on the OpticianWorks website,
so you should be familiar with it.
Let's just talk about it a little bit
and I'm gonna wrap up this particular piece with
something really important.
The universal sign for prism is
the little triangle right there.
If you need it, it's actually in your symbols
and your word processing and stuff,
so you can find it there
if you need to use it in a document or something.
Prism will always come with an amount,
and a direction.
There's no such thing as an amount without a direction,
or direction without an amount.
As instance, two diopters base out.
The B's, BI, base in, BO, base out,
BU, base up, BD, base down.
What is that related to?
To your schnoz, to your nose, to your beak.
Pair of glasses, nose,
up, down, in, out.
Two words, two things that you should be
familiar with already, but are extremely important here
the OC and the MRP idea.
The OC, the optical center of the lens,
is the point where the two prisms meet,
either apex to apex or base to base.
At that exact point,
the perfect center of the optics of the lens,
if I place that directly in front of the pupil,
or the visual access of the eye,
person experiences only the prescription value,
no prism at all.
If that lens shifts in any way,
away from that optical center,
and we place it deliberately somewhere else,
it becomes the MRP, or the major reference point.
Those are pretty important things to keep in mind,
that's some of the language that goes with it.
When you are solving prism problems, particularly on paper,
and I say draw them out, always remember,
the thing that is going to let you draw them out correctly,
is that the eyes
don't move.
My eyes don't move, I can't take my eyes
and, you know, shift them in, out, left, up.
The physical position of them,
yeah I can roll my eyes and stuff,
I'm saying within my head.
I can't move them.
I can move my lens around,
and if my lens OC
lines up, no prism.
My lens OC doesn't line up,
it's over here, up here, down here, or whatever
because I'm moving my lens around that point
then no prism, prism, prism, prism, prism, no prism,
remember, the eyes don't move, the lenses move.
Draw your lens as a prism over that fixed eye
that doesn't move, and you'll get your questions right.
Do these glasses have prism in them?
What you do in response to that question
says almost everything about you as an optician.
If you don't know what you're doing,
you will probably first of all panic a little,
and then you will probably take those glasses
and head to the lens meter, and then just kinda stand there.
I wouldn't be surprised if there's at least one person
where you work with EBO cert who would do just that.
Not a good thing.
I'm gonna tell you what you should do,
why you should do it, and then we're gonna learn
the steps and why we're doing those steps.
The correct answer when somebody runs in and says,
do these glasses have prism in them?
You can always say yes.
Always, okay, 100 percent safe,
all glasses are made from lenses, lenses are prisms,
every single lens has the potential to produce prism,
depending on where it's worn.
So, every single pair of glasses on the planet
has prism, the potential to have prism, shall we say.
So, your first answer is always, yeah.
The second question that you ask is
Where is the customer?
Because you need to visit with that person.
Because the question of, Do they experience prism
when they wear that particular pair of glasses,
is all about where they look through the lens.
So you need to know that, before you go to the lens meter,
and try to figure out what they're looking through.
How do you do that?
Meet and greet, sit down at the dispensing table,
and you know what, just talk to them for a few minutes.
Say, I understand we have a concern
there might be prism in the glasses,
do you recall a history of that, can you tell me
anything about it, do you have an old script, who knows?
Talk a little bit.
Double check fit,
make sure they didn't just sit on their glasses,
make sure their grandkids didn't just
pull them apart and stuff them down
the furnace grate or something.
Make sure they fit like they normally do.
Dot them up,
dot them up is if you would be doing a progressive lens.
Dot directly in front of their pupil,
exactly where they are looking through that lens.
Take a PD, a nice, good, clean, monocular PD
with a pupillometer.
When you have gathered that information,
then you can head to the lens meter,
after having marked up the lens,
and there's tons of examples of that
on the OpticianWorks website, mark your monocular PD,
mark your OC height this way,
so you know exactly where they're looking.
Put that spot into the lens meter.
That is the point you're gonna work from
because that is the point where they are looking
through the lens.
We'll get into this in much greater detail,
but in the big picture, you put it in the lens meter,
it's right on target, it's right on target,
no, no prism, they don't experience it,
they're not wearing them funny, it's not prescribed,
it's probably just a prescription.
If you put it in at that dot,
and one of those targets is up here,
and one of them is down here, wherever it might be,
they are off, they're different,
yes, then you can start getting into your reticle,
reading the reticle inside the lens meter,
determining how much, what direction, if they compound,
if they cancel, all that good stuff.
That is what we were talking about, that unknown.
The new customer, new patient who comes in
and I guarantee sooner or later you're gonna
have that scenario, so you be prepared.
Is there prism, yes.
Number two, where is the customer,
three, where do they look through the lens,
once you've determined that, only then
do you head to the lens meter
and start figuring out what is in there, got it?
Good.
That was the unknown.
The known means, you know what you're supposed to have,
let's make sure it's actually there.
Let's say you had this script,
it was in your hand, literally,
you're checking the job in, says you're supposed to have
two diopters of prism, base up.
When the glasses are placed in the lensometer correctly,
right lens, sure enough your OC target
is displaced a perfect two diopters of prism,
second prism ring, straight up.
We're not gonna get into verification,
that's a completely separate lesson,
completely separate idea,
we will talk about vertical imbalance, OC errors,
which are part of the verification process,
we're not gonna do step-by-step verification here,
that's on the website, and that'll be coming up
in videos down the line.
That's all I mean when I say
the known versus the unknown.
You know what you're supposed to have,
does it show up correctly in the lens meter?
Yes it does, great, job goes out the door.
- The moral of this story is,
if you're getting warts, you're doing it fine.
(audience cheering)
We'll be right back, with more shtuff,
right after this message.
(jazzy music, audience cheers and whistles)