Focus on Fundamentals

Opticians need a well-equipped toolbox of knowledge and instruments for precise measurements and adjustments. Knowing essential measurements and using the right tools ensures excellent eyeglass adjustments when misalignments happen.

Measurements

Taking accurate measurements with the right instruments will lead to the patient having confidence in the finished product even before they try them on.

➤ Pupil Distance (PD) Measurement: The optician measures the distance between the pupils, known as the PD. This measurement is crucial for positioning the optical center of the lenses. PD can be measured using a pupillometer, a penlight and marking pen, a ruler, or a digital measuring tool such as an Eye-Ruler 2.

➤ Optical Center and Segment Height Measurement: Taking the vertical optical center of the lens will always lead to a better visual experience for the wearer, even if it’s for a single-vision prescription. This measurement can be done with a marking pen and ruler, smart mirror, or digital measuring tool such as an Optikam, Spark Mi Up (Shamir), or Spectangle Pro (Hoya).

➤ Vertex Distance: Adding the vertex distance measurement to an Rx lens order—especially with high prescriptions, progressive, and wrap frames—will ensure that the visual acuity achieved in the exam chair will translate to the prescription lenses when worn by the patient. Vertex distance can be measured with a distometer, ruler, or digital measuring tool.

Tools of the Trade

➤ Pliers: Opticians can become overwhelmed with plier choices. Using the correct tool for the task will result in a more precise adjustment without damage to the frame. Here are a few of the most used for frame adjustments:

• Nose pad arm adjusting pliers: These pliers reach tight spots to adjust nose pads. This type of plier fits securely around all major pad arms and allows for easy maneuvering.
• Inclination pliers (round): One tapered conical jaw and one nylon protected jaw allow accuracy and protection while adjusting. This type is perfect for eye wires, endpieces, or bridges when a rounded shape is required.
• Double nylon pliers: A multipurpose tool for delicate frame adjustments: bridge, endpiece, and temple with dual-sided protective pads to ensure the frame remains unscathed.
• Slimline chain nose pliers: Precision point, all-purpose pliers for shaping and holding tasks. These pliers can be used to adjust bridges, pad arms, and temples. They feature a smooth, flat jaw with a round outer surface tapered to a fine point.
• Rimless eyewear pliers: For handling rimless frames, opticians may use them specifically for rimless designs.

➤ Screwdrivers: Small screwdrivers in different head sizes and styles are essential for tightening or loosening screws. Using an incorrect screwdriver can damage the small head of the screw and cause the screw to become lodged or broken inside the barrel.

➤ Frame Warmer: Applying gentle heat to certain parts of the frame makes it easier to adjust and bend the material without risking cracking or breaking.

➤ Lensometer: A lensometer is essential to confirm the optical centers of the Rx lenses mounted in the patient’s glasses. This will create the bull’s-eye that you will use to adjust the glasses to align with.

The Step-by-Step Guide to the Perfect Adjustment

1. Before you begin, clean the client’s glasses, preferably in an ultrasonic cleaner. This removes dirt, debris, and face oils from all the nooks and crannies of the frame. It also prevents any cross contamination of germs on a client’s glasses to the tools or ECP’s hands.
2. Inspect the glasses. Make sure you look for cracks and weak points on the frame. This gives you an idea of the fragility and can bring it to the customer’s attention before the adjustment begins.
   • Metal frames: Look for areas where the finish or paint has worn off. Look at the solder points and check the screw barrel and temple hinge for cracks.
   • Plastic/acetate frames: Look for frame dehydration (when it appears to have a white finish). Check for cracks at the temple hinges and on the temple tips.
3. Bring the glasses back to standard alignment.
   • Alight frame to have proper face form.
   • Ensure frame is not twisted from the side angle.
   • Check for four-point surface contact when the glasses are placed top-down on a flat surface.
   • Adjust pantoscopic angle to eight to 12 degrees.
   • Create a 90-degree angle from frame front to temples.
   • Fold frame closed and confirm temples close over one another and do not come in contact with the lenses.
4. Tighten screws.
5. Put the frame on the patient’s face. Look at how the nose pads or saddle bridge is coming in contact with the bridge of the nose and how the temples are resting on and behind the ears.
6. If the frame has nose pads, adjust the angle, splay, and position to create even contact without visible pressure points.
7. Ensure the temple bend is not too premature or too long. Make sure the temple tips are not pressing into the head or splaying out and coming in contact with the outer ear.
8. Look at the patient and ensure the glasses are sitting symmetrically.
9. Lastly, remove the glasses. Be sure to clean the lenses and wipe down the frame.
10. Put the frame on the client’s face and ask how it feels. Some clients like their glasses very tight, others might prefer them looser than the ECP prefers. Ultimately, a perfect adjustment is one that is most comfortable for the wearer.

Don’t be shy to make multiple minor adjustments. It is a sign you are committed to doing it right. Many ECPs might be shy and think that it makes them look unskilled, but in reality, it makes you a perfectionist caring about a job well done!