By Linda Conlin

If you don’t remember George Carlin’s “Seven Words You Can Never Say on Television,” we can’t help you because we can’t print them. However, we can print the “Seven Words You Can Never Say in a Dispensary.” Here’s the first…When a patient expresses a problem with their new glasses, you can never say, “You’ll have to get used to them.” When you say this, the patient hears, “I’m never going to see well with them.”

The patient is alerting you to an immediate problem that’s our responsibility to solve. It’s entirely possible that there has been a prescription change that requires adaptation, but if that’s the first and only response, we can be in for some unhappy patients. We always need to dig deeper.


Whether a doctor, optician or car mechanic has to identify a problem, they go through a list of questions to get clues to the issue. Perhaps it’s more of a flow chart, but we need to take the time to go through the questions with the patient.

To start, ask the patient, “Is your vision clear but just feels funny?” It sounds a little vague, but a “yes” from the patient tells you that the Rx is probably correct but as you know, any new Rx changes the patient’s perception of the size and shape of their world. To adapt again, takes a little time. Of course, check the change in prescription to be sure, but some additional frame adjustments usually make the patient more comfortable and demonstrate your attention to their problem. Other possibilities are change in frame size, or lens material and style. Sometimes you’ll find that the patient has decided they no longer like the frame they selected. That’ll be another column topic.

If the patient answers that their vision isn’t clear, then we need to take a more technical tack. Did you ever call tech support for a computer issue? The first question they ask is whether the device is plugged in and connected properly. Aha! Problem solved. Similarly, the first thing on our troubleshooting checklist is whether the lenses match the prescription and measurements.

Next, is the patient using the glasses correctly? Is their distance vision unclear because the prescription is for computer work? Okay, everything checks out, but we still don’t know what’s causing the problem. Keep going! What about base curve? Would this patient benefit from a free form lens?

You can find great information on base curves and free form lenses with our CE course The Evolution of Single Vision at Use your knowledge and skills to change those ‘seven words’ to, “I can help you to see better.”