What should be done if the segments seem too high?

When segments appear too high in a bifocal or multifocal lens, increasing the pantoscopic tilt is a relevant adjustment to consider. Pantoscopic tilt refers to the angle at which the lenses are tilted forward from the top to the bottom when viewed from the side. This adjustment can help lower the effective position of the optical center of the segment due to how the lenses align with the face, potentially reducing any perceived heightiness.

The other options, while they may impact the fit and positioning of the eyewear, do not specifically address the problem of segments appearing too high as directly as adjusting pantoscopic tilt does. For example, adjusting the pads closer together can affect the fit on the nose and change how the frame sits, but it may not effectively lower the segment height. Similarly, increasing vertex distance, which refers to the space between the lens and the eye, could have implications for visual performance, but it does not directly correct the perceived height of the segment.

Therefore, increasing pantoscopic tilt is the most effective way to address the issue of segments appearing too high, making it the correct choice in this scenario.