Spotlight on Standard 1: Client-Centred Practice

Standard 1 describes how the optician ensures that every aspect of service delivery is centred around the client’s immediate and ongoing visual needs.

Case Study #1
Client-centred care

A client has been referred to see you, a Licensed Optician, for his eyewear needs. He has a new prescription for presbyopia and is unsure what eyeglasses he needs. First, you look at his prescription, which shows he has a minor distance correction and an Add of +1.50. You begin by asking the client some questions to help determine his lens and frame needs.

  1. When do you wear your current eyeglasses?
  2. What is your occupation? What is your typical day like?
  3. Have you experienced any eyestrain, headaches, double vision, or blurred vision? 
  4. Do you find it hard to read? If so, when, and how often?
  5. Have you tried using a pair of reading eyeglasses to help alleviate the eyestrain (if applicable)?
  6. What do you do outside of work and on the weekend? What are your hobbies?
  7. Do you find it hard to read street signs in the daytime? At night?

The client is a graphic designer; he advises you that he experiences most of his vision problems when he is working on a computer screen. He wears his current eyeglasses when driving at night and watching movies. 

First, you explain to the client that he is an early presbyope—this is why he has noticed some difficulties with reading and close-up work. You explain that he is most likely to encounter these difficulties when the lighting is poor and also when he is tired or has been staring at a screen for hours. You offer him two suggestions of lenses that might assist him.

Your first suggestion is a pair of computer glasses.
You explain that computer glasses are designed to help a person see their computer screen without straining their eyes, which may assist in alleviating eyestrain. You advise the client that computer glasses are strictly for computer work or mid-range distance activities. 

Your second suggestion is progressive lenses that work for distance, intermediate, and close range. 
You explain that progressive eyeglasses are great for all-day wear. They are ideal for those who do not want to put on and take off their glasses for different activities throughout the day. You explain that the lenses do not have any lines across them but have multiple different focal distances, making them suitable for all work.  

The client asks why he might consider computer glasses over progressive lenses, or vice versa. You explain that progressive lenses will work on his computer, but eyeglasses specifically for computer use have a wider field of view with the computer, which some people prefer.

You take your time to explain and demonstrate the advantages and disadvantages of both options. You are mindful that this is all new and unfamiliar to him, so you check in with him periodically to ensure he understands. You give him time to take in the information and you answer all of his questions.

Once the client chooses an option, you complete his service by following the appropriate steps to dispense eyeglasses. You document his choice—as well as his reasons for making that choice—in his client file.

When the client returns to the store for pick-up, he tries on the eyeglasses. You adjust them as required and assess his vision. You educate the client about eyeglass wear, including (but not limited to) the use, expected results, limitations, adaptation period, and maintenance requirements of eyeglasses. You respond to the client’s remaining questions before finalizing the sale.  

How is this an example of a client-centred practice?

You made recommendations to the client based on his needs, lifestyle, and budget. You presented multiple options, explained the benefits of each option, and answered all of his questions. You educated him on how each lens type would need to be used. The client was able to make an informed decision about his vision care needs.

Case Study #2
Personal motives

You are a Licensed Optician assisting a new client. The client has a new prescription for presbyopia and plans to purchase new eyeglasses. 

You notice an Add power and assume that the client has been prescribed progressive lenses based on the prescription. You advise the client that he needs progressives and suggest top-of-the-line lenses. You explain the benefits of these lenses and advise him that you wear them yourself. You have been happy with the lenses and have not had any difficulties seeing distance, nor reading up close.

You are confident the client will like these lenses as much as you do—and if he does make the purchase, you’ll be halfway to your sales goal for the day.

How is this NOT an example of client-centred practice?

In this scenario, you have not asked questions to uncover your client’s needs and have instead assumed his needs based solely on his prescription. Since you are also motivated to meet your sales goal, you have unconsciously chosen not to present other options that might work for the client. Just because you like your progressive lenses doesn’t mean they are the best option for others.

It is part of your role as an optician to delve into your client’s needs, lifestyle, and budget—all of which are crucial to determining what solutions will work best for them. You have the skills, knowledge, and expertise to select and present appropriate lens and frame options to the client. An important part of client-centred practice is communicating with the client to ensure they make an informed choice about their care.

Case Study #3
Continued care

Your client is having a hard time adjusting to their new progressive lenses since picking them up a week ago; they’ve returned to ask for your help. Although you provided instructions on how to wear progressive lenses last week, you acknowledge that this client has never worn them before and the experience is still very new.

You start by listening to your client’s frustrations with the new lenses. You empathize and validate the difficulty they are having adapting. Based on what they are telling you, you identify some steps that you can take to assist them. You let them know what you would like to try, and you give them the opportunity to consent and to ask questions beforehand.

With the client’s consent, you begin your troubleshooting. You explain each step as it is performed, being sure to educate the client on why that step is important. You ensure that they feel comfortable to ask for clarification throughout the process.

The following are suggested troubleshooting steps when a client is struggling to adapt to progressive lenses:

  1. Ask open-ended questions to identify the issues. 
  2. Take all the necessary steps to verify that the prescription is correct and that the eyeglasses align with the prescription.
  3. Ensure that the lens measurements and frame adjustments are appropriate.
  4. Assess the client’s visual acuity.
  5. Re-educate the client on head position and where to find the different focal distances in their lenses.
  6. Use your professional judgment to determine if the prescription needs to be reassessed or if the client needs to take more time to adapt to the lenses.

As always, you must document the issues and the steps you are taking in the client’s record.

Client-centred care does not end when a client picks up their eyewear. The client needs to know that you will continue to be there to help them as needed.

You advise this client that you’d like them to try wearing their lenses for another two weeks to see if they are able to adapt. You provide more information about the adaption process and what they should expect. You also advise the client of the warranty and exchange policy for your business and let them know that there are other options available if they cannot adapt to these lenses. This helps the client to make an informed choice about what’s best for them and their vision care needs.

For more information on the standards, please review the Standards of Practice page on our website.