How Crucial are Dispensing Skills for the Optician?

Consider the following question that just might be on your ABO test:

Under which circumstance is a patient more likely to tolerate glasses that are made incorrectly?

  1. When the myope is given more minus power
  2. When the hyperope is given more plus power
  3. When horizontal prism has been added
  4. When the glasses come from the prescribing doctor
  5. When the glasses are fitted comfortably

If you answered “5” you know your stuff! Patients are far less prone to complain of problems if their glasses fit properly, if they feel good. Many of them already expect to have to “get used to” their new glasses. If the glasses are made to fit them comfortably most of them will try to do that… and may well succeed.

That is certainly NOT an endorsement for passing bad jobs! Yet it does illustrate the importance of fitting and adjustment. ALL opticians should do a proper fit on ALL patients. If we fail to give good service the patient becomes displeased. He looses faith in us. Unlike the happy patient with the well-fitting but wrong glasses this poor, uncomfortable patient may think everything about his glasses is wrong! And if there really IS an error in his prescription or its fabrication, not only will he notice it, but you may ultimately lose more than money.

The Optician and Customer Service

Each one of us is an ambassador for our profession. Opticians may have a variety of skill levels and practical training but the patient doesn’t know that. To them, YOU are the only representative for the craft that matters, because YOU are the one that’s helping them. Your performance is crucial, not only for that patient, but for the next optician they encounter.

One of the most frustrating, and even heartbreaking, events is when a patient returns her glasses because they don’t fit, but when you offer to adjust them, she won’t let you do it. Another optician has tried and failed, so now she thinks they CAN’T be adjusted. The patient has lost faith. The entire job is defective. And even if you can plainly see how the wrong adjustment can be corrected you are powerless to do it. All you can do for this stubbornly unhappy patient is wipe the slate clean. You lose and so does she. So do we all.

Bad Service Hurts All Opticians

Ever wonder about the phenomenal success of those on-line eyeglass vendors? The knee-jerk response from many of us is: It’s the price. Yet the Brick-and-Mortar optical world has multiple low price options. Cost can’t be the only reason. Besides, really low cost, in anything, is often associated with low quality. Nobody really wants low quality glasses!

Part of the problem is cultural perception. Many people, especially the young, have the notion that on-line is the best way to buy ANYTHING. Shopping on-line is easier. You don’t have to go anywhere. You can shop for glasses while watching TV. You can do it on your phone. As long as you view eyeglasses as just another fashion accessory like shoes or handbags, this idea makes sense. Many people have no idea why they would need an optician, or even an optometrist! They think they can do it all themselves. But why is that?

Could we have caused this ourselves?

The Optician’s Responsibility

How many times have we run into patients who don’t realize that glasses CAN be adjusted, much less that they need to be? Think of the customers who try on every frame in your shop looking for the one that “feels good.” Even if you explain very patiently that you can adjust most frames to make them fit, these customers don’t believe you. They know what they know, darn it! Sometime in their past, some optician let them down and they’ve never forgotten it.

I see thousands of patients every year who react with surprise, and even alarm, when I check their temple fit at dispensing. What am I doing? they seem to be thinking. Why am I touching them? Most of them have worn glasses before, but they obviously have never been properly dispensed to. The last optician they saw probably just handed them their specs, asked them how they felt (and most patients will say “fine!”) and then smiled beatifically and said “Good!” without ever checking to see if what felt good at the moment wouldn’t cause problems later on.


And don’t assume that this is all the fault of the optical “chains” because it happens everywhere. What about all the optometrists who don’t employ dispensing opticians or the independent opticians who staff their stores with family and friends? That’s not to say that receptionists and family members can’t learn dispensing techniques! Many of them do. But how many of them don’t? And who is teaching them, letting them know when they get it wrong, and insisting that they do it right? Legions of experienced opticians enrich the optical chains because private practices either won’t, or can’t, afford to hire them. This problem belongs to us all.

Many patients may be going to the on-line dispensers because they honestly don’t know what they’re missing. To them, the optician is just the guy/gal who is SELLING them a pair of glasses– like any other merchant, or any other sales clerk. If all they see of your practice is the fashion value of the frames (most of what goes into lens fabrication might as well be magic to them!) they won’t find a problem using an on-line merchant who appears to do the same. If they can’t understand the value of your service as a dispenser, your value as an optician will be unimaginable.

Many opticians balk at adjusting glasses which were bought on-line. I see it as an opportunity. When I take the time to professionally adjust bad fitting (and sometimes not even bench aligned!) spectacles I am showing them what they didn’t get on-line. I’m showing them what their REAL experience should have been. Yes, there will always be patients who will use you and not care, but a lot of them will eventually make the connection between service and value. These are our FUTURE patients. It’s a long term game, but we play it right, we will win!

A Job Well Done is Satisfaction and Profit

Good dispensing can save your practice and help it to grow. And it isn’t just fitting the ears either. How a pair of spectacles fit overall can effect how they perform. Part of a good dispense is making sure that all the elements of a good fit: vertex distance, pantoscopic and parabolic tilts, as well as fitting height are checked to make sure the patient sees optimally. Do it right and there will be less troubleshooting later. Do it wrong and the patient may go somewhere else to have it done… and you will lose them!

Catch someone else’s bad dispensing error, and you can GAIN them. We’ve all had the rewarding experience of making an optical “save,” and it truly makes your day!

A patient comes in to buy a new pair of glasses because the ones she has are horrible. She’s never seen right out of them, and they’ve never felt comfortable either. She points to marks on her nose, complains about pain behind her ears, and further laments over the fact that they don’t stay on her face. She hands you her new prescription. Can you help her?

You make sympathetic sounds over her bad fitting experience, look meaningfully at her script, and introduce her to your frame display. Then you offer, while she is looking at the frames, to see if you can do something with the nasty glasses she hates. Maybe you can make them fit her better…

She hands them to you with a dubious expression. She’s had them adjusted numerous times and it never did any good, but she allows you put them back on her face to analyze the problem and to take them back into your lab to work your magic. Sometimes, to them, it really does seem like magic!

You bench the fame and then heat and mold the temples. Next, since you notice that the lenses are progressive, you add some pantoscopic tilt and make sure that the nosepads are not only angled comfortably for her but are adjusted to allow a closer fit. Then you clean them and bring them back to the patient. The reaction is instantaneous.

“What did you DO?” she asks incredulously. “I can actually SEE out of these!”

Rejoicing inwardly, you keep your expression humble. All you did was give them a proper adjustment. Now that they are fitting correctly, the lenses can work as prescribed. This conveys to the patient that you know what you’re doing, you do it routinely, and that… unfortunately… her former optician (you hope it’s her former optician now!) doesn’t and didn’t. You don’t want to just make a sale. You want to add a client. The patient is now happy enough with you for both.

Dispensing Questions on your ABO Exam

Will there be dispensing questions on your Certification Exam? You bet your Registration Fee there will be!

According to the ABO/NCLE official website, about 23% of the exams is devoted to ophthalmic products, which would include frames and their handling. Yet, dispensing questions could easily be incorporated into the other categories of tests questions as well. 34% of the questions will be about ophthalmic optics, which includes vertex distance compensation as well as the effect of pantoscopic tilt on OC and seg height. There could well be dispensing/adjustment questions in this category. Instrumentation comprises another 16% of the questions. The tools you use in dispensing/adjustment, and HOW you use them make for important test questions. And then there is the implied extra 20% of unassigned questions ( read my article: What Should You Study for the ABO Exam?) which could ALL be about dispensing…

Yes, you can count on dispensing/adjustment questions. That’s what our job is all about, isn’t it?

The best course of action is to study the theory of dispensing as well as PRACTICE it every day, and when it come to exam preparation, take practice tests. The unlimited practice tests available at have hundreds of dispensing questions in their 5,000 question database, and if you answer wrong, we can explain WHY your answer was wrong, and why the correct answer is right!

Practicing with us can help you PASS YOUR OPTICAL BOARDS in optician dispensing!