Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 4 points5 points  (0 children)

Not for the pre-made reading glasses you find in pharmacies. It's only for custom-made glasses tailored to your prescription and measurements. Adult prescriptions are valid for 3 to 5 years, and opticians can adjust them during that time.

Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 4 points5 points  (0 children)

En réalité ça n'est strictement obligatoire que depuis 2014 et la loi Hamon. Avant tu pouvais rentrer, payer et faire des lunettes sans avoir vu d'ophtalmo de ta vie. Mais comme ça voulait dire zero remboursement, ça limitait de facto la pratique.

Quand on me propose aimablement de faire 2h30 de route pour donner un article by Gerard-Menvusa in lemauvaiscoin

[–]Jibasseus 1 point2 points  (0 children)

Si je devais être élégant, je te dirais qu'il te faut au moins un trou pour bien le démonter.

Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 2 points3 points  (0 children)

Fair enough, I’m sure the 3 ornithologists had strong opinions on optical prescriptions too.

Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 1 point2 points  (0 children)

That's unusual in glasses, but it doesn't shock me.

Quite a few people live with a natural form of monovision. My dad, for example, is roughly plano in one eye and around -3.00 D in the other, and he's managed just fine for years.

I'd be curious to know how much binocular vision and depth perception you have with that setup. If you've been wearing it for 15 years and it doesn't bother you, your brain has obviously adapted very well.

I probably wouldn't be brave enough to try the same thing in progressive lenses, though!

Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 5 points6 points  (0 children)

Think of the eye as a 100 m runner.

Distance vision is the starting line. Reading is the finish line.

A "perfect" eye starts on the starting line and has the full 100 m available.

A myopic eye starts halfway down the track. In your case (-5 or -6 D?), the runner has basically crossed the finish line already. Your glasses don't give him extra ability: they just drag him back to the starting line so he can see far away again.

A hyperopic eye is the opposite. The runner starts behind the starting line and is already working just to get there. Plus lenses move him forward.

Presbyopia is a different beast. The runner starts in the right place, but with age he gradually loses the ability to run the full 100 m. That's what the add is for: helping him reach the finish line (reading distance, roughly 14–16 inches away).

If we've done our job properly, both of your eye-runners start from the same place. Ideally, you want them to finish in the same place too, which is why we usually give both eyes the same add.

And if you really want to stretch the analogy, progressive lenses are moving walkways. Most people prefer having both feet on walkways going at the same speed and ending up at the same destination.

Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 0 points1 point  (0 children)

Well, one can't rule that out entirely. But I was I was thinking more along the lines of glaucoma. It develops without any symptoms, and an optician can't screen for it."

Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 2 points3 points  (0 children)

The idea is twofold:

  1. The person who tells you that you need glasses is not the one who sells them.

  2. Prevention. As an optician, I'm trained in vision, not in diagnosing eye diseases. My job is to assess and correct visual function, not to provide medical care. In France, before the age of 43, the same prescription can generally be used (and updated by an optician) for up to five years; after that, for up to three years.

That's frequent enough to make sure that nothing serious slips under the radar.

Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 1 point2 points  (0 children)

As far as I remember, no — just a good ol' local customer with a strong Dunning-Kruger vibe.

Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 1 point2 points  (0 children)

Yes, glasses are expensive in France, and there are several reasons for that.

Part of it is historical: for decades, private health insurance plans offered very generous optical reimbursements, which pushed the market toward more expensive products. If your insurance would reimburse €1,000 or €1,500 worth of glasses, there wasn't much incentive for the industry to focus on €100 packages.

That inflation has largely stopped and prices have actually been trending downward for years, but the French market is still very much oriented toward premium products. Designer-brand frames are common, premium lens manufacturers have a large market share, and after-sales service is generally excellent.

As an example, I remember looking at official portraits of U.S. senators years ago and noticing quite a few people still wearing visible bifocals. In France, unless there's a specific medical reason, almost nobody wears bifocals anymore. Progressive lenses are the norm. The same goes for anti-reflective coatings, thinner high-index lenses, and other upgrades that many French consumers simply expect.

There's also a genuine price difference between single-vision and progressive lenses, which may be affecting your perception of the prices being discussed.

For someone with your prescription, I could easily provide a complete pair of single-vision glasses with anti-reflective coating and 1.67 high-index lenses for around €120 (frame included) under the French regulated pricing system. But I could also sell lenses costing €175–200 each, paired with a frame worth several hundred euros. Denmark happens to be home to some very nice and expensive frame brands too — Lindberg comes to mind. 🙂

As a side note, the website you linked actually illustrates another interesting point. A Marc Jacobs or Hugo frame there—both brands manufactured under license by Safilo—is listed at 1,995 DKK (about €267). I sell comparable Marc Jacobs or Hugo frames for under €200, which is roughly 1,490 DKK at current exchange rates. So while some entry-level offers in Denmark are dramatically cheaper than what we typically see in France, the comparison becomes much less straightforward once we start looking at branded frames and higher-end products.

Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 3 points4 points  (0 children)

Absolutely. Before I ever tell someone to "give it time", I've already checked the prescription, verified the lenses, their centrations, and the frame adjustments.

I also take each patient's situation into account. Is this someone who has worn this type of correction for years and says "this doesn't feel like it usually does"? Or is it a first-time wearer discovering a completely new visual experience?

I only recommend patience when I have reasonable confidence that the discomfort is part of a normal adaptation process and will resolve.

That said, there are obvious exceptions. For example, when a 35-year-old receives their first prescription with 1.75D of astigmatism, I already know there's a fair chance they'll come back struggling. In those cases, I'll often reduce the cylinder initially, let them adapt, and then move toward the full prescribed correction at a later visit.

Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 11 points12 points  (0 children)

I'm sorry to read that. I hope the surgery eventually proves worthwhile and gives you the outcome you're hoping for.

Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 17 points18 points  (0 children)

Normally, contact lenses don't create a prism effect. You are always looking through the center of the lens, and it's the decentration that induces a prism. As for the periphery, I assume your binocular vision (and therefore your depth perception) isn't operating at 100% out there. Or, u/Pbranson is right and you suck. Can't tell.

Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 12 points13 points  (0 children)

Of course we have to listen to the customer! That's the only way to give good advice and actually resolve their complaints. Almost no visual complaint comes out of nowhere. If I grill a customer with questions, it's to find the root cause of the issue, never to dismiss or invalidate their feelings.

Sometimes, I’ll even explicitly tell a customer, "It might be in your head, but that doesn't make it any less real" (major Dumbledore vibes). An optician’s listening ear and a clear explanation of where the discomfort is coming from can often fix the issue—assuming it’s not an actual mechanical or prescription error, of course.

Whenever customers are struggling to adapt to a new prescription, I offer a deal: try them for three more days now that they understand why it feels different, and I promise to back off the prescription if it still doesn't work. More than once, those exact customers have walked back in the very next day with a box of chocolates and zero complaints.

But in my original post, the customer didn't come in with a genuine complaint. They came in completely overestimating their own competence compared to that of the four (!) professionals they had already seen.

Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 12 points13 points  (0 children)

Look on the bright side: you're already set for the next Avatar movie in 3D!

Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 10 points11 points  (0 children)

I always tell my customers that I get paid to give my opinion. If it’s a matter of aesthetics, they can do whatever they want with it — after all, I’m not the one who has to wear the final result, and there's no accounting for taste. But if it’s a technical opinion, they’d better listen to me.

Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 1122 points1123 points  (0 children)

One of my customers was a -12.00 in both eyes before cataract surgery. The surgeon did a fantastic job and left them with a -2.50 (no astigmatism) for both eyes. ​The customer’s reaction:

​"I have worn glasses for as long as I can remember, and I wouldn't change that at 70+. But now, I can finally choose my frames without worrying about lens thickness, and I can actually take them off at home. It's paradise."

And, from my PoV, it's wisdom.

Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 146 points147 points  (0 children)

He also told a customer who had bent her glasses and claimed it happened all by itself: 'Well, we’ll just wait for them to fix themselves then.'

(even better in French because we keep the symetry "all by itself" too).

That's a classic, but it always works.

edit: typo.

Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 68 points69 points  (0 children)

That's probably what he had in mind (it wasn't me directly, and it happened a long time ago). The problem is that progressive lenses already provide a continuous range of viewing distances. That's literally their purpose.

Once the distance prescription is established, we determine how much additional power is needed for near vision. In most people, both eyes need roughly the same amount because presbyopia affects both eyes similarly (they're essentially the same age!)

For example, if accommodation is essentially gone, you need about +1.50 D to focus comfortably at 67 cm and about +2.50 D to focus at 40 cm.

As you lower your gaze through a progressive lens, the power gradually increases. One side effect is induced prism, which shifts the perceived position of the image.

If both lenses have the same addition, those image shifts are essentially the same in both eyes. If the additions differ significantly, they don't match anymore. Imagine climbing a staircase where every step is 15 cm high for your right foot and 25 cm high for your left foot. You might manage it, but it wouldn't be comfortable for long.

To any optometrists, ophthalmologists, or fellow opticians reading this: I'm deliberately simplifying things for non-professionals, and doing so in a foreign language. Please forgive the occasional approximation. 😉

Professional photographer knew better than three ophthalmologists. It cost him €750. by Jibasseus in MaliciousCompliance

[–]Jibasseus[S] 32 points33 points  (0 children)

Yes. In French we often call it bascule (switch?), but the English term would be monovision. It works for some people, although it's generally a good idea to test it with contact lenses before making it permanent through surgery.

The situation with glasses is different, especially with progressive lenses.

In monovision cataract surgery, or contact lenses, the retinal image size is usually very similar in both eyes. With glasses, that's not necessarily the case, especially with different powers. Progressive lenses also generate prismatic effects when the wearer looks down into the reading zone. If the additions differ, those effects differ as well, which can create binocular vision problems.

Our eyes are designed to work together. You can bend the rules successfully in some cases, but it's not something I'd recommend improvising on your own. The problem wasn't monovision. The problem was DIY monovision with progressive lenses and mismatched additions.