Dispensing interactive 1

Closing Date: 25/03/2022

Clinical Practice Professionalism Clinical Practice Professionalism

Our ability to manage patients who present with intolerance to newly prescribed and dispensed spectacles demands consideration of both clinical practice measures, such as confirmation of the accuracy of the correction and the way it has been dispensed, and professionalism in the way the situation is managed both candidly and with due regard for the patient.

In this first of a series of interactive exercises, you are asked to consider a case where a patient is not able to get on with progressive power lenses, the first they have ever tried. Before attempting you discussion with a colleague about the case, you are required to read the recently published CPD article on progressive power lenses (Optician, 18.02.22, pages 16 to 25). A link to this source material is to be found with the interactive exercise in the CPD area of opticianonline.net. 


Case Scenario

A patient has the following refraction:

  • R. +5.75 / -3.00 x 60 (6/5)
  • L. +5.25 / -2.50 x 135 (6/5)
  • Add +1.25 (N5/N5)


They are a first time progressive power lens (PPL) wearer and have been recently dispensed with a high-quality freeform PPL in a conventional (not personalised) design, back surface progressive. The corridor length was 14mm and the fitting height was 24mm.

On collection, the distance visual acuity was 6/5 binocularly, and the near acuity N5 both eyes. The patient returned after two weeks complaining that their eyes felt tired since wearing the new spectacles, especially after reading for long periods. They also felt that the vision with each eye (monocularly) is better for near than the near vision with both eyes together when reading.


  • Assuming that the spectacles were manufactured correctly and verified before collection, what steps would you try to solve the problem and what might the problem be?
  • Would you admit to any error having been made if it was established that the spectacles had not been made to the right refraction or measurements?


Interactive CPD Instructions

In order to be able to log one provider-led interactive CPD point to your MyCPD account, this is what you need to do:

  • Make sure you have read the article ‘Fundamentals of ophthalmic dispensing – 25’
  • Arrange a time to undertake a discussion on the subject with a similarly qualified registrant; another optometrist or dispensing optician.
  • Read the case scenario and questions (above) and use them as the basis for the discussion with your colleague. Note, the discussion needs to address each of the questions outlined above and must be for longer than 10 minutes. 
  • When finished, you then need to send an email to opticiancpd @markallengroup.com as follows;
  • Subject box should state ‘DISPENSING INTERACTIVE 1’
  • Please state your name and GOC number
  • Please state the name and GOC number of the person your discussed the matter with
  • Please confirm you had read the source material
  • Please then include a summary of your discussion, explaining your views and thoughts on each of the three discussion questions
  • Each submission will be read individually and, where needed, feedback will be given directly. Where the submission meets a required standard, you will receive an email confirming this that you can then use as evidence of completion allowing you to log one distance learning interactive CPD point. 


  • A summary of the responses and discussions will appear in a future issue of Optician together with some thoughts by the author.