A patient reports they have to lower or tilt their glasses to see clearly in the distance when wearing progressive lenses. What is the likely issue?

• A. The prescription is incorrect
• B. Lenses are not progressive enough
• C. They are sitting too high
• D. The frame is too small

Answer: (C)

In progressive lenses the distance portion sits at the top of the lens, so proper frame height is essential for the eyes to line up with the correct part of the lens. If the frame sits too high on the nose, the pupil ends up looking through the lower part of the lens for distance, so the wearer must lower or tilt the glasses to bring their gaze into the distance zone. That’s why the patient reports needing to lower or tilt the glasses to see clearly at distance—the frame position is misaligned with the lens’s zones. To fix it, adjust the frame height (and nose pads if needed) so the eyes align with the distance portion. The other options would produce different symptoms: an incorrect prescription would blur across distances, lenses not progressive enough would blunt intermediate zones, and a frame that’s too small would limit field of view rather than causing this specific alignment issue.