A patient reports head tilt when looking through a bifocal. On a metal frame, which adjustment should be made to raise the glasses?

• A. Move the temples outward
• B. Tighten the screws
• C. Bring the nosepads closer
• D. Widen the bridge

Answer: (C)

Raising the glasses to align the bifocal means increasing the vertical position of the lenses on the face. On metal frames with nose pads, this vertical placement is controlled by how the nose pads sit on the nose. Bringing the nose pads closer together makes the frame sit higher on the nose, which lifts the lenses and moves the bifocal segment up to align with the pupil when looking straight ahead. The other adjustments don’t raise the lenses in the same direct way: moving the temples outward affects tilt and front-to-back fit, tightening screws doesn’t change height, and widening the bridge can alter fit but doesn’t reliably raise the lenses. So, narrowing the nose pad spacing is the adjustment that raises the glasses.