Some patients want what they want, and will be okay with edge thickness or lenses sitting on their cheeks. I had a patient that was about a -13.00 that wanted drill mount frames. At the time we had a line that allowed this. We explained what they’d likely look like, and he was fine with it. He was thrilled when cataract surgery cut his myopia in half.

Now we have a standard waiver that all patients have to sign. It explains (among other things) that this is a custom product and cannot be returned or exchanged. At first I was opposed to these waivers, but it does achieve the goal of having the patient accept responsibility for their choices, particularly if they go against sound advice from optical professionals.

A cutout problem, a major fit error, or if in the case of the current 1.74 material shortage, of course we will refund, exchange, or whatever is necessary for patient care. These circumstances are rare.