When a patient collects their first pair of spectacles, they may look to the optical assistant (OA) for advice. So what should you discuss?
There are restrictions in place regarding supervision when collecting spectacles for under 16s and low vision patients, so it is important you are aware of, and follow, these rules.
It is important to remember that the patient may be experiencing many different emotions, ranging from anxiety to excitement and everything in between. Don’t rush the collection, as time taken at this stage in the patient journey can make all the difference for a patient’s adaption to their new spectacles.
Remember, always have the patient record in front of you to check you have the right patient. Check the records to see what the spectacles have been prescribed for, and what standard of vision the patient is expected to see. It is advisable to explain to the patient that you might make some minor adjustments to the frame in order to obtain a perfect, bespoke fit – and that you will do this before you check their vision.
The patient can quickly become unhappy if they put the frames on and they slide straight down their nose. You can either ask the patient to put the spectacles on, or you can put them on the patient for them. I like to put them on the patient – as with your experience you can tell how they are fitting by feel, which gives you a good starting point for any adjustments.
Remember to compliment the patient on their frame choice, as they may be anxious that they have made the right decision. “I love that colour on you” and “The shape of the frame really compliments your face shape” are just two examples, but always be honest and genuine with the patient.
Once you have adjusted the spectacles to fit, you can ask the patient how they feel, and how their vision seems. If the spectacles are for reading and the patient could only achieve N10 in the consulting room, do not show them N5 print and ask if they can see it. They may become worried that they are not able to see what you are showing them. Sometimes, especially for a first time wearer, the patient may say the spectacles and their vision feels strange.
We will now look at a few common adaption problems.
Common adaptation problems
If the prescription is a single vision myopic correction, the patient may say things look too clear, or that when they look at the floor, their feet seem further away than usual. If you ask the patient to look into the distance, particularly at something specific such as a road sign, or even bricks on a wall, they should report that everything is clearer and sharper.
If the prescription is a single vision hypermetropic correction, depending on the age of the patient, they may not see an immediate improvement to their vision. Younger patients may have been able to accommodate to see clearly without spectacles, and so their benefits may not be immediately obvious. Patients may say that things appear closer or more magnified, and so advise that care should be taken when moving around, especially when going up and down stairs.
If the prescription is a first time astigmatic correction, the patient may find straight lines appear tilted or curved, or the floor appears to slope. They may also say round objects appear more oval.
All these effects can be disturbing to patients, and reassurance is needed that the vision should settle down within a few days, although it can sometimes take longer. Usually, the more the spectacles are worn, the faster the adaption period will be.
Ideally, the patient will have been pre-warned during the eye examination that adaption may be needed. By reiterating this advice on collection, you will gain the patient’s trust and confidence – and they may be more likely to be willing to take the spectacles away to try them.
Parting advice and guidance
It is important that all spectacles are double checked before the patient leaves the practice with their new spectacles. If the patient has any concerns, you should consult with a qualified member of staff to confirm that any issues are to do with adaption rather than anything else.
Once you are confident the issues are due to adaption, you should advise the patient to wear their spectacles for a few days. However, if after this time the problems are not improving, they should be advised to return to the practice.
It is also important to advise the patient to wear their spectacles in familiar environments, such around the house, until they are comfortable with their vision before undertaking any activities such as driving.
Finally, provide the patient with some advice on caring for their spectacles. This should include always taking them off with both hands, how to look after and clean the frames and lenses, and to return to the practice for adjustments if the spectacles become uncomfortable in any way.
In next month’s article, we will look at collection advice for multifocal spectacle lenses.
Sue Deal FBDO R is a practising dispensing optician, ABDO College examiner, senior tutor and supervisor for dispensing opticians. She is also a practice visitor and external moderator for ABDO. She was recently awarded the ABDO Medal of Excellence for her outstanding services to the profession.