Eyeglasses are more than jewelry for the face. They must be fitted correctly to benefit the patient.
The professional who does that is an optician. But many people don't know that opticians vary in training, experience, certification and the quality of care they provide. And many don't check an optician's credentials when buying glasses. Virginia opticians are licensed by the state after meeting certain standards, but in Maryland and the District of Columbia there are no licensing requirements.
"Advertising has made people think of eyewear as a fashion accessory when it is really a medical device," says Jacqueline E. Fairbarns, communications director for the Opticians Association of America. "Every pair of glasses is a custom product. Nobody else can pick up your glasses and wear them comfortably. While it's important to find a good [optometrist or ophthalmologist] who can write a prescription, it's just as important to find an optician who can fill it correctly."
Consumer advocates say that just as it's wise to choose a doctor carefully, it's prudent to find a board-certified or licensed optician. A skilled optician should be able to fill a prescription and advise consumers in selecting the right lenses, frames, materials and lens coatings for their lifestyle. To give the best optical acuity and assure that the glasses fit properly, the optician takes a variety of measurements of the eyes, facial features, frames and lenses.
Most opticians today do not grind lenses. That process requires expensive machinery, so they generally order the lenses from wholesalers who do the grinding according to a prescription written by either an ophthalmologist--a medical doctor who specializes in eye care--or an optometrist, who is not a medical doctor but is a professional trained to examine the eyes and prescribe glasses.
Once the optician receives the lenses, he cuts them to go into the frames. This is critical because the lenses have to fit so that the contour provides a corrective effect. Then the optician makes sure the lenses fit the user, adjusts the frame and gives the patient instructions on using and cleaning the lenses.
Eyeglasses, which can run from $200 to $800 a pair, are one of the larger out-of-pocket medical expenses for many consumers. An estimated 82 million Americans bought eyeglasses last year, generating $15.8 billion in retail sales, according to Jobson Optical Group database and Magnivision Marketing Research. Sixty percent of sales are made in independent opticians' stores or the offices of optometrists and ophthalmologists. Chain retail stores snag 38 percent of eyeglass sales, while HMOs and school dispensaries account for only 2 percent.
Finding a skilled optician can be tricky. It is important to check out the training of the optician.
Douglas Corby, an optician at Annapolis Opticians and a past president of the Opticians Association of Maryland, remembers receiving a call from a local wholesale club because one of his customers had gone there for another pair of glasses. Because Corby had the customer's prescription on file, a young employee of the wholesale club called him to get the prescription.
"I get my records and I'm starting to read off the numbers that is usual and customary and the person on the other end of the phone responded with bewilderment," Corby recalls. "She said, 'What does that mean? Can you tell me where on this form I should write the numbers down?' It was standard information, and anyone who knew anything at all would have no problems writing the numbers in the correct places. I said to her, 'Do you mind my asking how long you have been an optician?' She said, 'I've never worked in the optical department before today.' Then she said she'd normally worked in the tire department, but because the regular optician was sick, they had transferred her to the optical department."
Hildrun Rowe, 37, of Cabin John, knows the importance of finding a qualified optician to fill her prescription for eyeglasses. A couple of years ago, she took her prescription to a large optical retailer and asked for both regular eyeglasses and sunglasses.
"I got two different prescriptions," she recalls. When she returned with the glasses, explaining that one was wrong, the store personnel told her "there was nothing they could do," she recalled. They blamed it on the lab, she said, but refused to fix the glasses or refund her money. "Basically, I wasted my money on one pair," she says.
How can consumers protect themselves against unskilled opticians? In areas where opticians are not required to be licensed, consumers should select an optician certified by the American Board of Opticianry (ABO), which is based in Fairfax, because it "is some kind of assurance the optician has minimum training," says Gary R. Aiken, president of the Opticians Association of America.
An ABO-certified optician has passed a written exam on interpreting prescriptions, analyzing eyewear needs, taking accurate measurements and verifying that the eyeglasses are made properly, Aiken says. Certified opticians aren't required to take a practical test, he says.
In Virginia, opticians are licensed by the state Board for Opticians. They must pass a written and practical exam after completing a two-year degree in opticianry or a three-year apprenticeship program administered by the state Department of Labor and Industry.
"The license must be posted in plain view of the public," says Nancy Taylor Feldman, assistant director of the Department of Professional and Occupational Regulation in Virginia. "If you don't see it, ask for it. Don't deal with that person until you see it."
Anne Sumers, an ophthalmologist in Ridgewood, N.J., and spokeswoman for the American Academy of Ophthalmologists, suggests asking your doctor for referrals. "I see people who come back with problems. I know who the good opticians are."
Friends and relatives often provide references, too, says Lucia B. Miller, a board-certified optician at Personal Eyes Opticians in Silver Spring. "Word of mouth, that's where the business is tallied," Miller says. "Rarely do you have someone ask if you're board-certified."
Increasingly, people get their eyes examined and order their glasses at the same place. Some optometrists and ophthalmologists employ opticians in their offices, offering customers one-stop service for exams and glasses, and some opticians, especially large optical chain stores, contract with an optometrist in or adjacent to their offices.
Butch Mann, owner of Personal Eyes Opticians and Olney Opticians, says he hired an optometrist for his stores three years ago because referrals were dropping as both optometrists and ophthalmologists opened their own optical dispensaries. "Customers want eye exams, eyeglasses and contact lenses all in one place," he says.
Consumer advocates point out, however, that wherever people go for an eye exam, they have the right to get their prescriptions filled elsewhere. A federal law, called the Prescription Release Rule, requires that optometrists and ophthalmologists give patients the prescription immediately after completing the exam. A customer should not have to ask for it, says Fairbarns.
Miller, of Personal Eyes Opticians, says a good optician should "look at the prescription first and then show [customers] frames. An optician who doesn't look at the prescription first could fit the person with the entirely wrong frame. Not every frame is appropriate for every prescription."
For example, Miller may suggest that a customer with a bifocal prescription try progressive lenses, which offer a gradual, invisible change in lens power from top to bottom, without lines.
"The frame has to have a certain depth [from top to bottom]. It's stylish now to have small eyeglasses. Progressive lenses might need a frame with more depth than the ones they have their heart set on," Miller says.
Expect a good optician to ask a lot of questions, says Fairbarns. "He'll ask, 'What kind of life do you lead? Do you read in bed?' Nowadays, lenses have gotten so specialized they can provide lenses for whatever you are doing."
Says Sumers: "The more you can tell the [optician] about your life, the better he can do for you."