New Dispenser/{ feature: FRAME FITTING }
From the Field
Top tips from frame fitting and dispensing pros
BY KARLEN MCLEAN
We asked some veteran opticians with decades of hands-on experience for some of their fundamental fitting tips.
GET CENTERED: “Make sure that the customer’s eyes are centered in the frame,” says Roxanne Harless, ABOC, NCLC, dispensing optician at Andersen Eye Associates in Saginaw, MI. “Then the lenses will not have added thickness due to decentration”
PUT A HEX ON IT: Use hex nuts and long screws on temples—and especially on drilled rimless frames—to help keep the connections tight. Be sure to cut the screws with a clean-edged cutting tool.
BE NOSY: “With many customers purchasing plastic frame styles, be sure you have good bridge-to-nose contact,” Harless advises. “Otherwise, the customer will not be happy with constant frame slippage.”
GET DIRECTIONS: “This is the tip I tell all of my new opticians as I train them: ‘in with in, up with up, down with down, out with out,’” explains Helen Hall, ABOC, CPOA, office administrator with Baker Vision Clinic, a Vision Source practice in Baker City, OR.
“The translation is this: If the frame is sitting too high (or up) on the right, that means the right temple needs to come up (up with up),” she says. “If the frame is sitting so that the right lens is closer to the cheek than the left lens, that means the right temple needs to come in (in with in). It was always my easy way to remember which way I had to move the temple to adjust for whatever problem the patient might be experiencing.”
DUCK, DUCK, GOOSE: “Frames with gooseneck pad arms should be adjusted prior to taking lens measurements. Or, if the frame isn’t going to be used from stock, the seg height can be measured 1mm higher,” recommends Sandra Shannon, LDO and manager at the Veteran’s Administration, Ocala, FL.
“Gooseneck pad arms that aren’t properly adjusted may cause seg heights to be about 1mm lower than measured, throwing off the lens power,” she says. “To adjust gooseneck pad arms, bend the pad box straight up (at the top of the arm), then move up so the pad arm is parallel to the frame. It’s also a perfect way to lower the seg when a patient is complaining it’s too high.”
SECURE THE FIT: “A fluid give-and-take between dispenser and patient is always a must. When delivering new glasses, teach the patient to securely place them on their face with temples behind the ears firmly and completely,” recommends Dianna Finisecy, ABOC, president of Wagner Opticians in Washington, D.C. “If we adjust glasses as tightly as most patients like, when the frames are slipped on they tend to not fall into place, but rather sit up on top of the ear, causing the glasses to slip down with any activity. Eyewear may momentarily fit well, but eventually will work off the ears and down the bridge. Placing glasses securely on the face where we most want them to stay allows the frame to mold to the contour of the patient’s head, fitting even better as time goes on.”
MASTER IT: “Don’t underestimate the power of a proper frame adjustment,” concludes Finisecy. “If you can become a master at good adjustments, word gets out and patients return to you as much for your quality work as for your ‘touch’ and adjustment expertise.”
A STUDENT TALKS FRAMES
Amanda Klasen, an opticianry student at Benjamin Franklin Institute of Technology in Cambridge, MA, plans to graduate in May 2016. She’s already learned a lot, including how to fit frames. Here are her top 10 frame-fitting pointers.
1. Select a frame that’s going to work well for the patient’s taste and their prescription needs. Consider what kind of lenses will be going into the frame, and guide them toward a frame that will not need excessive adjusting to fit them well.
2. Look at how the frame front meets the brow line. It should complement the brow line, not compete with or hide it.
3. Be sure the bridge suits the nose and will set comfortably on the face. The patient should feel as if the bridge were made just for their face. A keyhole bridge can sometimes be best for a prominent nose, while those with a more delicate shape may look better in something straighter or with a more subtle curve.
4. No matter what’s chosen, the frame’s weight should be distributed evenly over the face.
5. Follow the curve behind the ear to fit the temple. The ear bends should rest against the occipital bone, directly behind the ear, but not pressing so hard as to be uncomfortable.
6. People who are accustomed to wearing glasses are used to a fair amount of pressure there, while it might feel strange to those wearing glasses for the first time. The ear bend should not rest against the soft, fleshy spot behind the ear.
7. When asking a patient to look down and shake their head, the glasses should stay in place.
8. There may be an adjustment needed to shorten overall temple length. Children’s metal frames often have a removable temple bend that allows the entire temple to be shortened. If it’s a plastic frame, there’s little that can be done to alter temple length, so be sure it’s a good fit to start.
9. When using a heater to adjust plastic frames, it’s generally best to remove lenses before adjusting the frame to be sure the lenses aren’t damaged.
10. The key to adjusting plastic frames is to go slowly, working a small amount of change at a time. Making big adjustments all at once can cause the frame material to become brittle.
HOW TO SAY NO
“It’s OK to tell patients the frame they love is not the best choice for them,” explains Roxanne Harless, ABOC, NCLC, dispensing optician at Andersen Eye Associates in Saginaw, MI. “A little education to the consumer can go a long way. You’re the expert, so don’t be afraid to use your knowledge.”