# Optical Forums > General Optics and Eyecare Discussion Forum >  "When I cover one eye, it's blurry!" How to deal with this?!

## tdj

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## Yeap

just my suggestion..

1. glasses is mean for you to use as both eye open as we have dominant eye. sometime the non-dominant eye may see not as clear that is just the same as your hand.. the hand you use for daily task is the dominant how if i want you to use the non dominant to do daily task? if will not feel so great, right? same thing happen to your eye. so just don't compare..

if you think your patient has no interest then just tell him off.. you have bought 2 lenses why you insist to use only 1?

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## Ginster

I work for an Ophthalmolgy Practice and yes we do get this alot from our Geriatric patients. I simply explain we all have one doninate eye and one eye thats weaker, Prescriptions are written for both eyes to work together. so just relaxe and focus using both eyes. If they keep doing that I say " you don't walk around liket that do you?" that usualy does the trick and they stop qustioning becuase they suddenly realize how stupid they look doing that.

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## TLG

Six years ago I started management of an optometry practice and realized in a very short time that I was seeing an inordinate number of PDs noted as 33.5 in one eye. Sure enough, upon checking the pupilometer I discovered it needed to be repaired as you could move the sliding buttons quite a bit without changing the readout. You may try checking yours.

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## scriptfiller

Ask them how well their car drives with only the right side of wheels.

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## Wes

Tell em to close the other eye.  Voila!  The blurriness goes away...

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## uncut

@misslindsay:

Keep the explanation simple.....Tell them its like listening to AM versus FM radio........

or mono versus stereo.

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## calirider07

I try to explain in dollars and cents..especially if they have any imbalance...it works well!  ex:
-1.25sp
-2.00sp
+1.50 add
i will tell them: your right eye has a dollar twenty five for correction and your left has two dollars, so it will see a little different than the right eye...and with both eyes open you have enough for lunch!  ..j/k ....you should see better with both eyes open, that's how your eyeglasses are designed to work.  This explanation always gets a chuckle and helps them visualize how their eyes work.
Hope it helps :)

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## TLG

Devils Advocate - Seriously folks, if _you_ got a new pair of glasses and the vision was blurry in one eye, would you not think there was something wrong?

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## uncut

> Devils Advocate - Seriously folks, if _you_ got a new pair of glasses and the vision was blurry in one eye, would you not think there was something wrong?


Yes, maybe someones phoropter needs cleaning.

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## varmint

when I cover one eye I can't see out of it at all!!!

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## tdj

edit

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## Yeap

usually for geriatric cases, i think they deserve more caring and time from the practitioner to explain and comfort them.. i even have a patient that know himself have diabetes retinopathy and his vision has reduce but he insist that my Rx cause his blur vision even though i have explain before the Rx given. but after sometime of consultation and redo all the test he manage to accept that. what a relieve. 

regarding the contact you can try to do a over-rx with the contact lens. see what the best result you can get. secondly are you left eye dominant?

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## tdj

> usually for geriatric cases, i think they deserve more caring and time from the practitioner to explain and comfort them.. i even have a patient that know himself have diabetes retinopathy and his vision has reduce but he insist that my Rx cause his blur vision even though i have explain before the Rx given. but after sometime of consultation and redo all the test he manage to accept that. what a relieve. 
> t 
> regarding the contact you can try to do a over-rx with the contact lens. see what the best result you can get. secondly are you left eye dominant?


I don't want it to sound like I'm a jerk to these people at all. I love older people, and I don't simply go "get used to them and get over it" I try to explain eye dominance, binocular rx'es etc and if all else fails I tell them to try for 5 days and if it doesn't work, I will arrange an SRX recheck (only if their dr is reticent on it, and I've never had one refuse to re-refract) and a free rx redo on our part in that case (as is only appropriate)

Also I have answered both your questions in my last post, yes I am left eye dominant and I am not willing to give up my ctls for an inferior material or wear spex on top (why bother with the $75/box ctls then) even if my left eye is a little inferior (I still have 20/20 binocular vision with them, I just know it's not as good as it could be with spex)

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## TLG

misslindsay I think you need to reread your original post. "In *the past week or so* I've had a* sudden rash* of patients with..." sounds suspiciously like something has changed somewhere, somehow. I wonder if you won't find the answer to your dilemma by trying to figure out why "a sudden rash" of this has happened "in the past week" rather than trying to find out "how to better explain to these pts" why. I believe you may be trying to solve your problem through the wrong channel. 

I work for an OMD and my 30 years of dispensing has taught me that when people say they can't see as clearly as they think they should, they're right. When my patients complain that one eye is clearer than the other I grab their chart, check the VA's and if they are both similar - for example 20/20 - I send them back to see my doc or one of his techs whom are always happy to reevaluate. Almost inevitably we get them back to where they wanna be.

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## FVCCHRIS

> Six years ago I started management of an optometry practice and realized in a very short time that I was seeing an inordinate number of PDs noted as 33.5 in one eye. Sure enough, upon checking the pupilometer I discovered it needed to be repaired as you could move the sliding buttons quite a bit without changing the readout. You may try checking yours.


I told you to stop smacking those people on the head with that instrument, it was sensitive! And do you remember this?.....People...PEOPLE!...we're supposed to be learning this Maximeyes thing!!.....

Edit..And oh yes, make sure the fuzzy eye isn't the one they have covered.

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## Yeap

Sorry if my previous post sound offended on you.. anyway what is your patient respond when you explain the eye dominance to her? she able to accept it or she still take it as you mistake?

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## braheem24

Omd patients are the only complainers.... 

Same office?
Same omd?
Same tech?

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## cleyes

A good start would be to find out what best corrected VA is in each eye.  Many elderly patients have issues causing poor VA: cataracts, ARMD, BRVO, CRVO, corneal opacities, diabetic retinopathy......the list goes on.  The average patient ASSUMES new glasses will eliminate their blurry VA.  Often, lack of communication at the time of exam, and lack of understanding  by the patient is the root of YOUR problem.  Once you can inform the patient that the doctor reports his best correction is unequal, the onus is off you. They simply don't understand glasses can't "fix" all visual problems. Life would be much easier for all of us if  ALL  RX's listed the VA!

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## TLG

> I told you to stop smacking those people on the head with that instrument, it was sensitive! And do you remember this?.....People...PEOPLE!...we're supposed to be learning this Maximeyes thing!!.....


The only thing I really remember was how happy I was the day I walked out the door for the last time....I'm sure you can relate ;)

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## tdj

It seems to be two ophthalmologist practices in particular, but one employs several different MDs and the rx'es are signed by different MDs that I am having trouble with... I wonder if they have the techs refract at that one . . . maybe they have a problem with one particular tech.

Problem with calling them and giving them the heads up is that the line from MDs offices is always . . . "it MUST be YOUR glasses" . . . because we know that refractions are always idiotproof RIGHT??? ha ha

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## uncut

misslindsay:  Is there enough of a pattern in the complaints,  to say it's always the O.S. acuity?

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## tdj

Yes, it is ALWAYS OS... btw checked pupilometers today, they are fine

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## uncut

> Yes, it is ALWAYS OS... btw checked pupilometers today, they are fine


     ;)

 :Cool: Just a hunch...if there is something going on in the practice the RX's are coming from, like renovations, office politics, stress.  The techs, or the MD's are likely to "rush" in completion of the refraction, and quite probably refract the O.S. first and hurry the O.D. result, thus not refining it as much as the O.S.  The reason why I say this is that whenever a war, or renovations is breaking out in local refractionists offices......we start querying ALL RX's carefully, because their minds aren't on the task at hand!

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## tdj

> A good start would be to find out what best corrected VA is in each eye.  Many elderly patients have issues causing poor VA: cataracts, ARMD, BRVO, CRVO, corneal opacities, diabetic retinopathy......the list goes on.  The average patient ASSUMES new glasses will eliminate their blurry VA.  Often, lack of communication at the time of exam, and lack of understanding  by the patient is the root of YOUR problem.  Once you can inform the patient that the doctor reports his best correction is unequal, the onus is off you. They simply don't understand glasses can't "fix" all visual problems. Life would be much easier for all of us if  ALL  RX's listed the VA!


IF ONLY!!!

That sure does nip it in the bud doesn't it... and reminds the patient right at fitting that "oh yeah, I have a horrible cataract in that eye, that is why, the doc TOLD me that"

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## tdj

> ;)
> 
> Just a hunch...if there is something going on in the practice the RX's are coming from, like renovations, office politics, stress.  The techs, or the MD's are likely to "rush" in completion of the refraction, and quite probably refract the O.S. first and hurry the O.D. result, thus not refining it as much as the O.S.  The reason why I say this is that whenever a war, or renovations is breaking out in local refractionists offices......we start querying ALL RX's carefully, because their minds aren't on the task at hand!


very interesting!! Will have to keep that in mind.

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## opty4062

> In the past week or so I've had a sudden rash of patients with the "when I close/cover one eye, it's blurry!" :hammer: issue. (Not my OD's issue -- mostly ophthalmologists' patients, actually)
> 
> I try to explain binocular Rx'es and the like, troubleshoot when they are super insistent, but the bottom line with these pts (as you all well know) is that YOUR GLASSES ARE MEANT TO BE USED WITH BOTH EYES OPEN, SHERLOCK!
> 
> They simply act as if I am feeding them a crock of s**t and that my glasses are crap.
> 
> Any suggestions as to how to better explain to these pts (most of whom are 70 year old women -- I have a mostly older clientele) that no, the glasses are not wrong, you just aren't supposed to be walking around with one damn eye shut? Because it's really driving me insane.


My favorite response to this statement is this: "Yes, and you'll notice you have a hard time walking on only one foot as well."  :)

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## rocwilder36

When i read the title of the thread i thought this was a posting about Amblyopia(which I have). My vision in one eye is of course extremely blurry but I never thought that is normal in healthy eyes that can be corrected to 20.20.

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## cleyes

Rocwllder36  From one novice to another.....Wilkommen
Problem: Few patients reporting poor VA os with new glasses when OD occluded.
Question: Bad Rx or patient with poor BEST corrected VA OS
And no, it is not normal to have blurry vision with an eye that was previously 20/20 corrected, but as opticians we are not privy to that information on the written Rx.  We, as does the patient, ASSUME  the VA is perfect OU, dominance  aside, what does the patient mean by blurry?  We don't know because WE DON'T KNOW BEST CORRECTED VA.  This results in a phenomenal loss of time and goodwill defending the perfectly made glasses the patient now wants to return, convinced we are incompetent .  
Misslindsay: What have you found out?

Rocwilder36:  I do believe I have been snookered...thought this was a dumb question from a rookie optician. On further reflection and more coffee....Get thee gone, you impostor.

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## kaypaula

A lot of the geriatric patients, which is the bulk of my pt load, have been wearing glasses for "years and years" and this may be the first time they have experienced less than perfect vision after getting a new pair of glasses.  This will happen to them more and more as they develop cataracts, AMD, dry eye, etc etc.  Just as the rest of our bodies start to break down (my knees just can't handle that anymore), our eyes do too.  Duh, right?  But find a sensitive way to explain that to the pt.  Especially after you get the "I've been wearing glasses for 50  years" statement.

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## cleyes

Rocwilder 36:  Politely told you to go away......you are not an optical professional,  respect the rules of our Board.....go away.

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## Pvtcjhalo

My mantra is "eye glasses do not correct everything" Most of our patients have DM that give us that line.  I simply tell them that the same thing that happens in their ankles is happening in their eyes, and they will never get thier vision back.  Kinda harsh but......

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