I've seen this guy annually for the past few years. Always comes in not wearing his glasses. I always ask if he has them, he says he does but not with him, I refract him to 20/20, he picks out and then picks up glasses with decent-looking high-index lenses, and then the next year, same thing, he comes in not wearing his glasses. I keep forgetting to just straight up ask him why he doesn't wear them; maybe next year I'll remember. Highest rx of a patient I can think of who chooses to walk around 20/400 all of the time.