Focus on Fundamentals

An eyecare professional can truly set themselves apart and showcase their expertise with the magic touch of a proper eyeglass adjustment. As with any skill performed repetitively, it’s easy to drift away from the fundamentals of proper frame adjustments and rely on personal habits or shortcuts. While experienced opticians often have a practiced hand, revisiting the basics can elevate adjustment techniques to new levels of excellence. For those new to the profession and trying their hand at adjustments, it’s crucial to start by mastering the process of bringing a frame—whether brand-new or well-worn—into standard alignment.

Pre-Patient Adjustments

Standard alignment is bringing a frame into factory-fresh adjustment, independent of the wearer/individual for whom it will be adjusted. This is an essential first step even for new glasses that have not yet been worn.

Each tweak or bend to a frame will influence a different part, so it is best to begin at the center point of the frame, the bridge, and work your way outward toward the temples. This can minimize the need to return to parts of the frame that have already been aligned.

If the frame is plastic, it will require heat prior to any adjustment, or there is a high risk of cracking the frame.

→ Using a hot-air blower is always favorable at the bridge. Apply heat in short bursts, and keep the frame moving. Using your hands to cover the lenses will ensure you do not overheat the frame. It is essential to keep lenses away from direct heat.

→ Once the frame has flexibility, use both hands to grasp the lenses on either side. Slowly bend at the bridge, ensuring that both lenses are horizontally aligned (making sure one lens is not sitting higher than the other).

→ Flip the frame forward and ensure that it has vertical alignment. A ruler should sit flush across the back surface of the frame front, with four points of contact from hinge to bridge to hinge.

→ Open the frame and set it brow line or top down on a flat surface. Ensure the frame sits flat on the surface from frame front to temple tips.

→ Look at the frame from above and see that the temples are straight at a 90-degree angle. Minus-powered lenses have a flat surface and tend to pull a frame front flat, splaying the temples even before the wearer has put them on, and plus-powered lenses with a higher base curve can pull the frame front into a greater curved shape, causing the temples to curve in. Apply light heat at the temple hinge with a blower or salt pan (or pliers for metal frames). Gently align the temples to 90 degrees.

→ Look at the temples from the side to see that they are aligned with one another and pantoscopic tilt is between 5% and 15%.

Patient-Specific Adjustments

→ Place the frame on the patient’s face and assess if the frame is straight. If the frame is sitting higher on the right side, adjust the temple hinge up on the right side. If the frame is still not sitting quite straight, you can adjust the left side down to level.

→ Give the frame a gentle tug by grasping each side of the frame front. This will allow you to feel how much give there is on either side, help to feel for a patient’s asymmetry, and give the starting point for the temple curve point behind the wearer’s ears.

→ Using a salt or bead pan or blower, apply heat to the temple tips, keeping the tip shallow in the heat and constantly moving.

→ Once the temple tip is warm to the touch, use the top of your thumb to gently curve it downward; avoid creating a hard angle.

→ Place your thumb on the interior of the temple curve and gently curve so that the temple tip curves toward the interior of the frame.

→ Place the frame on the patient and check behind their ears. The bend starts at the natural top of the ear; nothing is pressing into the outer or inner ear.

→ Give the frame a gentle tug once more. It should have a small amount of give—a couple of millimeters of movement.

→ After all adjustments, ask the patient if the glasses feel good and make sure there is no pinching or discomfort.

Overcoming Bad Habits

Issue: Rushing can lead to misaligned frames and poor fit.

Solution: Take time with each adjustment. Small changes add up to a perfect fit.

Issue: Adjusting acetate without warming it can result in breakage or warping.

Solution: Use a frame warmer or salt pan to heat the material gently before adjusting.

Issue: Attempting an adjustment on a frame that is very badly bent or is beyond your expertise, which can result in damage or breakage.

Solution: Don’t be shy about asking for help. A patient won’t be bothered to wait if you are honest about the adjustment needing a more experienced hand.

Issue: Skipping communication with a patient about concerns, where the glasses are bothering them, or how they feel post-adjustment can lead to missing key cues.

Solution: Ask questions about how the glasses feel, if they are hurting anywhere, and if it is affecting the patient’s vision. Discussing the wearer’s habits also leaves room for recommendations on how a patient can make an adjustment last.

Practice makes perfect. Becoming skilled at frame adjustments takes practice, patience, and continuous learning. By ensuring a proper fit through adjustments, an ECP improves vision and the aesthetic appeal of the glasses, all while extending the life of the glasses by preserving their shape.