Dear Ms. Specs in the City,

A patient had our doctor’s prescription made at another optical shop. She returned to us because she was having a problem with the glasses. We found an obvious error in how the glasses were made. How can I explain this to the patient without seeming to criticize the other shop and possibly having the patient feel like she is being shuffled around and losing her trust in both places?

Uncertain in Upland


Dear Uncertain in Upland,

Thank you for your excellent question! I applaud you on your impeccable manners… Judith Martin would be proud!

Your instincts are correct: Under no circumstances may we publicly state negative things about another optical business (or anyone for that matter). Remember our dear mothers’ sage advice: “If you don’t have something nice to say, don’t say anything at all!” This applies to business as well as personal etiquette. But how do we let the patient know that the eyeglasses are wrong without stating that they are wrong? This is where our optical ingenuity (and a little acting) goes a long way.

Ms. Specs suggests the following: “Dearest patient (insert your preferred greeting here), XYZ Optical has a wonderful reputation. Let’s get to the bottom of what might be going on.” Then, pull out all the optical tools/instruments (calipers, lens clock, manual lensometer, grid chart, pupilometer, etc.). Even though you just checked the glasses and know the problem, do it again in front of the patient. SHOW the patient what you are doing and invite them to look for themselves. All the while, even when you find a large discrepancy, either sphere, cylinder, axis, add power, measurements… underplay it in front of the patient.

It is easy to show the patient how to look in the lensometer, with the prescribed Rx versus the final product. Just show the sphere or cylinder mires, or the axis, not to go into detail, but to show them that there seems to be a slight difference, and we all want the outcome of the best possible vision. For example, let’s say that the sphere or cylinder is off by +/- 0.75 Diopters, or the cylinder axis is off by more than 12 degrees, or a combination thereof. I am aware that I might be exaggerating a bit, but just to continue the conversation, show them what a clear target in the lensometer looks like: Sanitize the eyepiece and ask them to look in. Then slightly tweak the power drum to show them what blur looks like. While this is not an actual optically-sound experiment, it will at least show the patient the differences in the lensometer reticle/target.

Then, more acting, or “optical malingering.” State that the discrepancy is not large, but the optics are not perfect. There is no need to show the patient the actual dioptric values on the power drum. They need reassurance that all will turn out well. Ask the patient if you can call the other optical business on their behalf. Emphasize that they have a wonderful reputation, and this small (even if it is large) optical deviation can happen from time to time. The important thing to remember, is that even if we stretch the optical truth to the patient to maintain dignity to our optical colleague, it is worth the professional courtesy. One never knows if we could accidentally be on the other side of this scenario.

Then, the call to XYZ Optical: “Hello XYZ Optical, this is Ms. Specs from 20/20’s Pro to Pro. Our shared patient, Ms. Fabulous is here at our practice, as she is having trouble with her eyeglasses. I checked the parameters and found the following…” State the actual details/discrepancies that you found so they can write it down. “I want to assure you, that even though this/these discrepancies are large, I told Ms. Fabulous that it is a very slight deviation, but not perfect. I stressed to her that your optical business has a wonderful reputation, and that these slight errors can happen from time to time. We all want her to have the best visual outcome possible. May I assist her in scheduling a time to see one of your opticians with the eyeglasses that she purchased from you?”

In this scenario, everyone wins. You went above and beyond to help solve the patient’s optical dilemma. XYZ Optical wins, as they can do the remake while maintaining professional dignity. Most importantly, as you well know dear readers, is that the patient wins. She feels heard and understood, the correct lenses will soon be in her possession, and she can get on with her fabulous life.

See Well and Be Well,
Ms. Specs in the City
Laurie Pierce, ABOM

Do you have a question for Ms. Specs? Please send your question to [email protected], and we may feature it in a future column.