Lesson 25 - Optician Review

Question 1

Processing Eyewear Order - Step 1: Current prescription

Answer 1

Now, many opticians think that they should start with the frame style, but actually you need to look at the prescription first so you have an idea what size frame you would need to accommodate the lens style. Remember that a progressive lens needs a slightly larger B measurement? Also remember that if the prescription is high, you should avoid really large, heavy frames, right?

The first thing you need before you can discuss a new eyewear order with a patient is their current prescription. This will give you a starting point to put on your thinking cap and start thinking about what recommendations you would make for lenses style, frame style, and how many pairs of eyewear they would need. Make sure you check the prescription date and make sure it’s not expired. This is a legal medical document, and you should not order any eyewear from an expired prescription.

Question 2

Processing Eyewear Order - Step 2: Lifestyle

Answer 2

Get to know your patient and ask when they will be wearing their glasses. Do they need it for driving? If so, they’ll need two pairs: one clear pair for night driving, and one pair of sunglasses for daytime driving. Do they need it for sports? Construction work? Then perhaps they will need three pairs: one separate pair of sports or safety prescription glasses, a clear pair, and sunglasses. Do they need it for reading? Do they use a computer? Do they play cards? Do they fly an airplane? Ask as many questions as possible to help them decide what lens designs are best.

Remember that presenting the benefits of every lens and frame feature will add value to the patient’s perception and they will be more likely to follow your recommendations for their specific eyewear needs.

Question 3

Processing Eyewear Order - Step 3: Check material compared to lifestyle.

Answer 3

Remember that both polycarbonate and Trivex are impact resistant, but polycarbonate has the highest impact resistance, and Trivex has less chromatic aberrations, which will make a difference with vision in higher prescriptions.

Question 4

Processing Eyewear Order - Step 4: Record the prescription.

Answer 4

Remember when you are recording the prescription into the eyewear order, double-check (or triple-check) that you recorded all the information that was on the prescription.

Use 3 places for all numbers.
For example: O.D.: +3.50 -0.25 x 070
O.S.: -0.75 – 1.25 x 010
ADD: +1.50

You should remember the “0” in +3.50 and not just write +3.5.

For -0.25, you should remember the “0” in front of the .25.

For the axis, always write a 3-place number. So, for axis 070, don’t write “70”.

For the axis 3, you must write 003.

Also be sure to record the “+” or “-“ signs.

Question 5

Processing Eyewear Order - Step 5: Look for Prism in the Prescription.

Answer 5

Watch for and record any prism written in the prescription. This will cause your patient vision issues if it is missed!

Question 6

Processing Eyewear Order - Step 6: Allergies

Answer 6

Ask your patient if they have any allergies to metals, rubber, or silicone. You should avoid those types of frame materials and those types of nose pads. The frame reps or manufacturing companies have this information.

Question 7

Processing Eyewear Order - Step 7: Diopter sphere (D.S.)

Answer 7

Remember, if there is no cylinder or axis in the prescription, write D.S. or sph after the number to eliminate the chance that there is something missing from the prescription.

Question 8

Processing Eyewear Order - Step 8: Medical Records

Answer 8

Some offices allow you to scan the prescription into the electronic medical record (EHR). You might also want to photocopy it for the patient’s chart or keep the original. Follow your office’s protocol for patient privacy regulations.

Question 9

Processing Eyewear Order - Step 9: Patient Preferences

Answer 9

If the prescription specifically states progressive lens, bifocal, or trifocal, the doctor must have a reason for specifying that. If the patient doesn’t want the specified lens type, you should call the prescribing doctor to notify them that the patient wants something other than what’s written on the prescription.

Question 10

Processing Eyewear Order - Step 10: Multifocal Considerations

Answer 10

If the prescription is a multifocal lens, remember that you need to adjust the frame on your patient before measuring for any seg height. You might find that your patient likes to wear their glasses really low, so don’t take the seg height measurement with the frame sitting high. When the lab inserts the lenses, the frame may get out of alignment, so make notes in their chart if needed about how the frame was adjusted when the measurements were taken.

Question 11

Processing Eyewear Order - Step 11: Check the Pupillary Distance

Answer 11

Make sure you take the patient’s pupillary distance (PD). Even if it’s written on the prescription, it’s a good idea to take it yourself.

Question 12

Processing Eyewear Order - Step 12: Attention to Detail

Answer 12

Placing the order also requires accuracy in recording or ordering the frame name, manufacturer, color, eye size, bridge size, and temple length.

Question 13

Processing Eyewear Order - Step 13: Insurance Coverage

Answer 13

Any insurance coverages or co-payments should be verified with the insurance company before trying to calculate the charges. Be sure that the insurance coverage has not expired. Make sure the charges are correct before presenting to the patient. There will be a need to present the usual and customary charges in addition to any insurance discounts and copayments.

Question 14

Processing Eyewear Order - Step 14: Patient Verification

Answer 14

Ask your patient to acknowledge that everything on the order is correct (frame selected, lens treatments, lens design) by signing the order. If you are billing the insurance, be sure that the patient acknowledges their coverage before and after insurance charges and that they are responsible for any charges the insurance does not pay.

Question 15

The first thing you want to do when you receive the order back from the lab is to what?

Answer 15

The first thing you want to do when you receive the order back from the lab is to verify that the frame is the correct one ordered by the patient. Very rarely the lab might put the lenses in someone else’s frame! This is the first thing that the patient will notice—“This isn’t my frame!”— even before they try on the glasses.

Question 16

If you use a manual lensometer to verify the glasses prescription, always do what first?

Answer 16

If you use a manual lensometer to verify the glasses prescription, always focus the eyepiece first.

Question 17

Truing a frame before dispensing it is to do what? You can use what to start? Also check that the ___ and don’t scratch the lenses.

Answer 17

Truing a frame before dispensing it is to pre-adjust it to a standard alignment. You can use four-point touch to start. Also check that the folded temples and don’t scratch the lenses.

Question 18

Don’t forget that when reading the add power of a multifocal lens, you have do what?

Answer 18

Don’t forget that when reading the add power of a multifocal lens, you have to turn the lens around and place the front of the lens away from you and read it from the back of the lens.

Question 19

Remember when a progressive lens comes back from the lab, it will have what on it?

Answer 19

Remember when a progressive lens comes back from the lab, it will have Major Reference point markings on it similar to these shown below. Some labs draw on the lens; some labs apply a sticker on the lens.

Question 20

When adjusting the frame, remember to check the ___ behind the ear

Answer 20

When adjusting the frame, remember to check the temple fit behind the ear

Question 21

You can give the patient a ____ to check their near vision, and ask them if they are comfortable seeing in the distance. If they are having issues with their vision and it’s the afternoon, you might ask them do what? If there is still a problem, they can see the doctor.

Answer 21

You can give the patient a reading card to check their near vision, and ask them if they are comfortable seeing in the distance. If they are having issues with their vision and it’s the afternoon, you might ask them to wear their old glasses the remainder of the day and try the new ones in the morning after their eyes have rested. If there is still a problem, they can see the doctor.

Question 22

Instruct the patient how to ___ for their glasses and how to ___ them before they leave the office with their new glasses.

Answer 22

Instruct the patient how to care for their glasses (keep them in the case when not wearing them) and how to clean them before they leave the office with their new glasses.

Question 23

Try to know the lens tolerances in the ANSI standards. For lens powers above +/- 2.75, there is a tolerance of ___ for the PD.

Answer 23

Try to know the lens tolerances in the ANSI standards. For lens powers above +/- 2.75, there is a tolerance of 2.5 mm for the PD.

Question 24

Assess the alignment angle of the nose pads how?

Answer 24

Assess the alignment angle of the nose pads by looking at the nose pads from the top of the patient’s head and looking down at the pads on the patient’s nose.

Question 25

T/F? If the patient’s prescription is expired it is illegal for an optician to fill it or change the date.

Answer 25

True. You should never use an expired prescription or tamper with it.

Question 26

Many people would agree that first impressions are the most lasting ones. Whether the patient is coming in for the first time or they have been a regular patient, you should do what?

Answer 26

Many people would agree that first impressions are the most lasting ones. Whether the patient is coming in for the first time or they have been a regular patient, you should greet them with enthusiasm and a smile, as if they were your best friend and you haven’t seen them in years. Other recommendations have been to greet patients as if they were the only patient you will have all day. A welcoming greeting can set the tone for the rest of the office visit.

Question 27

Now, sometimes a patient may not be in a good mood when they arrive at the office. Don’t assume that it’s due to something that involves their glasses. The reason might have nothing to do with their eyewear. What should you do?

Answer 27

Introduce yourself first, smile, and ask, “How can I help you today?”

Be a good listener. Don’t interrupt, and be patient. After the patient is through explaining the problem, always thank them for returning to bring the problem to your attention.

You can summarize and try to repeat what you understood them to say so that they are sure you heard them. You can also ask them what they think would solve the problem for them. Ask them if they have questions.

Try to maintain a pleasant and polite tone of voice. Address the person by name several times. If the patient is unhappy about their glasses, they may raise their voice, but you should maintain a calm and steady voice.

Show or make recommendations about how you would solve their problem, and ask them if they would like you to proceed or if they want to try something else. The doctor may be able to help with problem solving as well.

Engage with your patient and get to know them. If you show an interest in people, they will often want to engage, and you will get along better.

Question 28

5 Essential Listening Skills

Answer 28

1. Give full attention
2. Keep an open mind
3. Engage
4. Avoid interrupting
5. Summarize what you’ve heard

Question 29

Tips for working with coworkers

Answer 29

Show respect, and you will be respected. Pay attention to the other person without facial or body language that says, “I want to leave!”

Treat others as you would want to be treated.

Provide and receive feedback with grace and respect.

Ask questions. Be open minded. Agree to disagree.

Give appreciation often; say please and thank you. Be complimentary.

Be positive, flexible, empathetic, and patient.

Avoid sharing too much personal information. Find something in common to discuss.

Avoid office gossip.

Be dependable. If you commit to doing something by a certain deadline, make sure you fulfil your commitment.

Use humor in stressful situations.

Begin your conversation with “I,” instead of “you.” Example: “I think this is what you said,” instead of, “You said ______.”

If there is a disagreement, you may want to discuss it in private or talk it over with your manager. Coworkers do not need to be best friends. Just focus on your job and be professional.