It was my first day as the lead optician at a large prestigious 3-O practice. I was excited about the opportunity to work with retinal, corneal, pediatric and contact lens specialists. What a learning opportunity! Immediately upon introduction to one of the ophthalmologists, he took me to a patient who had returned several times because she couldn’t see well with her new glasses, and no one could figure out why. Uh-oh! I had barely hung up my coat when I was hit with a challenge, and from the doctor’s look, my continued employment likely hinged on solving the patient’s problem.

Knowing nothing more about the patient, I reviewed the records from the beginning. The doctor had rechecked the prescription. The opticians had verified the progressive lens power and measurements. All seemed to be correct, but the patient was experiencing difficulty with reading and peripheral distortion. To buy some time to think, I adjusted the glasses to add face form and pantoscopic tilt. Problem solved! The patient left smiling and didn’t return until her next exam, and I continued to work for the practice for 16 more years.

There’s a saying in diagnostic medicine, “When you hear hoofbeats, don’t look for zebras,” meaning that diagnosis begins with the simplest, most likely answer and proceeds in a methodical way. Only after eliminating the obvious should one probe for something more rare or unlikely. I suspect that those who tried to solve the patient’s problem before me may have been looking for zebras to explain the simple solution they had overlooked.


Solving patient problems takes assurance with what you know, and a methodical analysis of the patient’s problem and the glasses. So many factors are at play when it comes to eyewear, from patient expectations to regretting a frame choice, to the nuances of technically advanced lenses and materials, that problem solving becomes a multifaceted process. The problem may be one or a combination of factors. Patients frequently cannot express their issues in “opti-speak,” so we need to be able to translate their difficulties into an issue we can act upon.

Identifying the issue is the beginning. The action you take is of critical importance. You know what the problem is, now take the steps to solve it, no matter what it takes. I have seen many patients whom we may have been at risk of losing become loyal customers after experiencing the care and effort put into giving them the vision and comfort they deserve. You can learn about a system for problem solving and more with our CE, “Problem Solving 101: How to Troubleshoot Like a Pro,” in this issue.

Linda Conlin
Pro to Pro Managing Editor
[email protected]