Facial Measurements, Hand Made/Special Purpose Frames

Where is temple width measured?

25mm behind the back plane of the front. The red dots are placed IN THE SPECTACLE PLANE.

Head width

Ends of gauge placed at the EARPOINTS. Widest part of head.

Bridge measurements

Most important - as when fitting frames from stock. Gauge always placed on face in position frame would occupy

Crest height

no facility for negative height (crest below lower lid/centre line). can only specify single value, even if eyelids different positions! Bridge height = Crest height + 5.

Plausability

DBR at 10mm below MUST be less than at 15mm below. Temple width MUST be less than head width.

Angle of crest

Describes the slope of the nose, and must be measured in the area where frame will rest. Hold short edge of gauge at pantoscopic angle. Take measurement at bearing position

Ordering a hand made frame

May simply modify existing frame, rather than starting from scratch. Practical notes lists the “appropriate” frame measurements required. These frame dimensions are derived from FACIAL MEASUREMENTS

How we order hand made frame

To get greatest bearing surface at bridge make plastic, regular bridge frame. Copy an existing style - you are not trying to be a frame designer, Frame needs to be simple design, single colour, little ornamentation. Must be made from cellulose acetate (flat sheet, not moulded)

Lens shape and size

Trace inside (to get shape) and outside (to show  joint/lug position) rim. Mark horizontal centre line, and nasal side on shape. Size is not enough without shape - both below the same. Give H and V lens size. H lens size written on frame. DO NOT TAKE NOTE OF DBL AS INCORRECT.

Measurements needed

DBR at 10 and 15 below. Apical radius. Angle of crest. Crest height. Bridge projection (remember sign). Head width (order 10mm less than actual value – “compensated”). Length to bend - or, more accurately, front to bend. Angle of side

Half eye

Fitted with top rim at lower lid/limbus (as bifocal segment). Or half-glazed (also possible with supra cord)

Make up

For highly-hypermetropic contact lens wearer

Reversible

A much simpler version could be hand-made in plastic with central “regular” bridge and straight sides.

Recumbent spectacles/prisms

Single prism better since less risk of misalignment Which would lead to double vision.

Ptosis spectacles

Traditional/lundi loops

Trigeminal spectacles

Damage/disease affecting 5^th cranial nerve (trigeminal). Removes corneal sensitivity. No protective blink reflex. Need protective spectacles. Often one side only. Edges of side shield often padded because of loss of facial sensitivity.

Temple Rest

Various “off-the-nose” designs are possible.

Cheek rest

Using Usden crutches

Prosthetic

To camouflage results of exenteration (removal of globe, orbital contents, eyelids, muscles).

Enucleation and prosthetic eye

Any asymmetry in size could be helped using “spectacle magnification” (plus lens to make eye look bigger, minus lens to make it look smaller).

Hearing Aid

Front must be heavyweight to maintain position. End of side can be changed to normal drop-end if only one aid needed.