The complaint of a headache after the final prescription of glasses are not heard that much but it exists. A patient is prescribed glasses and he/she is sent home satisfactorily, but after some days that patient comes with a complaint of a headache. In such a case, how can you pinpoint the diagnosis?
What can be done from the part of an Optometrist/Ophthalmologist?
Incorrect prescription: Even a slight error of power especially a cylindrical power or a wrong axis of glass may cause a headache. Proper care must be taken while prescribing the power to any patient, especially those who are involved in reading, writing, watching television for long hours and working on computer and laptops.
If the refractive error has been overcorrected or undercorrected. Rectification of prescription should be done accordingly.
Some patient may not like using spectacles. So, he/she should be explained the merits of using glasses and should be encouraged to use glasses.
What can be done on the part of an Optician?
- In case the power of spectacles does not match the prescribed power, change the glasses as per the prescription.
- Change in size of glasses sometimes makes the patient uncomfortable. The patient should be explained about the cause and the frame should be selected accordingly.
- If the glasses are not centred properly they cause discomfort. So proper centring should be done i.e. the optical centre of the glasses should be the pupillary centre.
- Tilting of lenses introduces cylindrical power and changes the effective power of a lens and that ultimately becomes a source of trouble.
- If a patient complains of glare, Anti-glare glasses should be prescribed.
What can patients do themselves?
- In aphakic or high myopic patients, the power of glasses is high and that will cause a peripheral distortion of the image. The patient should be advised to look through the centre of the glass and not through the periphery of glasses, sometimes need other optical correction such as contact lens, secondary IOL placement for an aphakic patient, depends upon the case.
- If Best-corrected visual acuity (BCVA) is less than required by the patient. Example: Due to ARMD or anisometropia or amblyopia, a patient might face some problem in doing near work for long hours.
- A beginner will take time to adjust with bifocal and multifocal (progressive) glasses. Patient himself/herself should know that it will take time to adjust. However, some patients fail to adjust even after all the efforts. In that case, it is better to use the separate pair of glasses for distance and near.
- The sudden change in power certainly causes problems. Give time for adjustment.
Hypermetropic usually take time to adjust to glasses. So, wait and watch for some time.
The patient should wear the glasses properly. It shouldn’t be worn too low or too high with the nose pads of spectacles on nose. - Patient with exophoria needs muscle exercises. Such a patient usually complains of a headache while doing near work. Convergence exercises should be advised.
About the author: Ajay Shahi (Shakhil), Optometrist
