If “homicide by optician error” exists in the legal code, it almost happened to me. 

Be extra careful when ordering prism glasses as some opticians have no idea what to do with strabismic patients and may calculate their own pupillary distance (PD) measurement that will not be the same as the developmental optometrist’s PD. The difference in the PD measurement can have disastrous effects on your prescription.

Although chain store says they’ll change their training programs for their opticians after my incident, I don’t know if they really will. Make sure the optician doesn’t override your doctor’s prescription because of the “Standard Operating Procedure” for measuring PD. 

I am not exaggerating when I say that what I experienced could have been fatal. Below is the description of what happened to me. 


After two and a half LONG years in VT, I finally got a prescription for prism glasses in mid May. I went to the local office of a major optical chain store to fill the prescription and after a long delay in making my lenses, I received a pair that almost caused me to crash my car because the pupillary distance was incorrectly calculated by the optician. 


Effect: I had to drive with one eye closed because my left field of vision moved faster than my right field. The divider lanes on the left doubled at a 20 degree angle into my lane, causing me to get confused as to where my lane was. At night, the extra divider lane was not only at a 20 degree angle but it was sometimes elevated above ground. If you’ve ever had to drive with an eye closed, you know how hard it is.

I couldn’t look down when descending a staircase because the end of the step would also double at a 20 degree angle, making it hard for me to see where the end of each step was. Other lines, whether they be on sidewalks or my kitchen floor, would double or be distorted. 

Problem: After another pair of glasses which also were wrong, the chain store’s optometrist compared my developmental optometrist’s original prescription with what was entered into the computer. 

My doctor, on May 15, had prescribed a PD of 60 mm. The optician, following “standard operating procedure” for, measured my PD per each eye with a measuring device (pupilometer?), and came to a total PD of 56mm. She overrode my doctor’s PD calculation and entered her PD measurement into the computer prescription. The missing 4mm in the PD altered the horizontal prism in the glasses and made my life extremely difficult. 


Those 4mm could have caused a car accident because of my distorted vision. 



Blood boiling, I had to call the corporate headquarters to rectify this matter as the local store treated me like garbage. After I put up quite a fight, including threatening them with a medical malpractice lawsuit, they reimbursed me for my various doctor’s office visits because of the incorrect glasses and are paying me for damages as I’ve lost two months of my VT. Unfortunately, the major optical chain store didn’t take me seriously until I told them that I had discussed the issue with an attorney. 


If this happens to you and the optician and optician’s supervisor don’t treat you with respect and reimburse you for your visits, you can tell them that you will report their mistake to the Medical Board, the state agency which issues licenses for opticians and optical dispensaries. The words “medical malpractice lawsuit” tend to make people return your phone calls. 


Impact on strabismics and amblyopes:


The chain store says they’ve informed their optician trainers about the issue. (Their legal department is also aware as they are handling my case.) But I will never find out if the opticians will indeed ever get any training on how to measure the PD for strabismics. An estimated 5% or so of the population has misaligned eyes. Since not everyone in the general population requires corrective lenses, but almost all strabismics and amblyopes do, more than 5% of any optical store’s potential clients have my condition and could be at risk of causing accidents if wearing glasses that are incorrectly measured by opticians. If this major optical chain store doesn’t train its staff right, I wonder about all other opticians in the country. Could they all be incorrectly measuring PD and dispensing harmful glasses? 


6 responses »

  1. paul says:

    2mm difference between the two eyes will not cause what you are talking about. you must of gotten the glasses on line…
    where they dont even botther measuring you for distance between the pupils.

    • It was a 4mm difference in the PD and that difference indeed caused major double vision at a 20degree angle. When I got the glasses redone at the correct PD, I still had double vision while driving but it wasn’t nearly as bad as with the incorrect prescription.

      I most definitely DID NOT buy the glasses online. My multiple trips to Sears Optical and to my doctor are proof of that.

  2. Lynda Rimke says:

    Wrong PD was an issue for me when I first got progressive lenses at Sears. I too had to get a second set, and I basically figured out what was going on and corrected the issue myself.

    With progressive lenses, the prescription follows an hourglass shape in the center of the lens, and distance acuity is sacrificed due to distortion on the right and left sides of the lens.

    Back then, to find out where my pupils were, relative to the lens, they asked me to look at their eyes while they placed dots on the fake lenses of the frame I had chosen. The first time, I had simply looked at both her eyes with my right eye. She marked the turn-in of my suppressed left eye. I didn’t think about what was happening at the time, and she didn’t catch the turn in.

    The second time, I made sure I switched eyes and looked at her with the left eye when it came time for her to mark the left lens.

    I knew this was the issue, because I could only see clearly through the left lens in the right half of the lens and not the center. With the second pair marked with my left eye straight, the funnel of clarity was back in the middle of my center of the lens, where it belonged.

    I can’t imagine how easily they could screw up prism! I didn’t dream of going to Sears with my prism script … and I’m on my second set of lenses through my Developmental Optometrist. Even with the extra knowledge my DOT brings to the table, the physics of my prism (base to the right on both lenses to correct my visual center that has shifted to the left since my BRAO) is messing with the acuity I need to read road signs while barreling down the highway. We switched to the new Shaw lenses the second time around, and while they are not as hyper-sharp as my old progressives, they are at least 20/20. I’m less than thrilled with the distortion of the bifocal (I switched to bifocal from progressives) but I’m able to live with it.

  3. Optoguy says:

    Most of the time if the doctor does a pd measurment they use a ruler and kind of just give a close but not true Pd. I am curious to know if under comments or other on your rx card if the doctor wrote specifically “use 60mm Pd”, the pupilometer is the most accurate way to measure your pd due to it giving individual measurments for each eye rather than a single pd unless you have the new computer measuring tools but often a optician will disregard a doctors pd because they handle exams and eyes where we do the glasses and are held more accountable by the patient for satisfaction of product. I realize this does not relieve the optician of their responsibility but it might help to explain the mix up.

    • For strabismics and amplyopes, from what I am told, the pupilometer is not accurate because those of us with asymmetric eyes will shift the gaze of one eye when the other eye has to focus on something. I had told the optician that I was cross eyed so she should have known better. The doctor didn’t circle his PD measurement but it was there. I see what you’re saying but the optician should have known how to deal with strabismics.

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