Frame and facial measurements

Definition table image

Why are glasses custom made?

- for patients who need tailor made glasses
- facial abnormalities in babies or deformaties
- for patients who require tailor made lens which a standard off the shelf frame may not be able to house
- patients who like to have an exclusive product

What measurement is needed for custom made glasses?

Measurements of the patients facial profile

What are the benefits of custom made glasses?

- customised to the patient so the frame will fit well
This is vital in babies and children wearing glasses for correction

- customised to the lens choice so the overall cosmetic look of the spectacles looka good

- individuality ans exclusiveness

- can be rewarding

Advice to patients for custom made lenses?

- it is wise to discuss with the patient or guardian of availability of the custim made frames

- it is rewarding to ensure the patient with abnormality has been dispensed correctly so it improves rheir vision and thay it is comfortable

Patients with Down syndrome and custom made lenses

- compaines like ERINS world and Zoobug now make specialist frames
- the umage on the right is a custom made lens and dits more comfortably and the eys are mire centred

What is Crouzon syndrome?

- the skull appears too tall amd overally flat from the middle part of the face upward
- small cheeks and a curved concave (curved inward) facial profile)
- a prominant nasal bridge
- children with hearing aids are also common and spectacles will need to be modified to fit better around the hearing aid and the front.

Hearing aids adaptation for glasses to fit better

Wide padded headband with cuts to allow comfort and fo allow hearing aids to sit comfortably.
- plastic frame with fixed nose bridge for contact around the nose
- ensure the frame is not too wide for temple / head width

Treacher Collin syndrome

- there is an abscencd or underdeveloped ears -
- downward slanting eyes
- ectropian (lower lid looks pulled down)
- wide flat bridge
- low and small ears
- using headbands with looped ends would be suited

What is cherubism?

- main effect is to the jaw
- can extend up to affect the eyes (exophthalmia)
- maxialla and zygomatic bones are depressed leaving an upward gaze
- ptosis
- dipopia/ possible large amounts of prism needed

What is miller fisher syndrome?

- downward slanting of eyes with associated ptosis
- uneven ear levels and irregular bridge
- downward slanting eyes

What is Jouberts syndrome?

- very wide forhead
- ptosis, generally bilateral
- require large angle of side (approx 20 degrees)
- low muscle tone/ poor eye control
- poor communication
- often present with moderate learning difficulties

Equipment required for facial profile measurements

Relationship between facial measurements and the frame

- when taking the patients facial measurement think about what relarionshio this has with the frame
- what part of the frame sits on a certian part of the face?
- think about how the measurement will affect the fitting
- be mindful when adjusting or repairing a frame, what measuremnts are affected?

Facial measurements that can be used to specify frame measurements

What is crest height?

This measurement determines how high or low the frame sits on the face
- it is the distance between rhe lower eyelid and the basal cresr

What is the splay angle?

- this angle determines the angle of the pad bridge or pad on arms in the horizomtal plane

What is the frontal angle?

This determines the angle of the pad bridge or pad on arms in the vertical plane

What is the bridge projection?

- determines how far away the frame sits from the frame in relation to the eyelashes when they are in their most protuding position

What is the head width?

- this measuremnt is the horizontal distancs from ear point to ear point

What is temple width?

The horizontal distance from temple to temple is measured. The frame measurement is taken 25 mm from the front

What is Pamtoscopic angle/ tint?

This measurement determines the angle of the sides of the frame when the eyes are in the orimary posiitob gaze

What is the length to bend ?

This measurement determines how well the side arm of the frame fitd around the ears to provide comforatable stability
- it is emasured from the dowel point of the frame to the point where the tip would start to bend.

Dispensing pearls

- make a temolate before ordering
- each custom frame costs £300
- hold the facial gauge in position the final frame will fit
- try relaring the measurements to the frame measurements
- when taking measurements ensure you find the patients natural resting place on the bridge

What would you adjust case scenario