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Reading time 5:09


During my first year on staff at the Cleveland Clinic, I learned a valuable lesson from a first year resident in ophthalmology. I was responsible for teaching the residents the basics of primary eye care. That included optics, refraction, contact lenses, low vision, and anything else that came up.

 I was fresh out of school and ready to tackle the world.  Little did I know how much more I had to learn. 

One of the residents was asking me about ready-made readers and what I tell my patients about them.  I considered for a moment and then said I would say that custom glasses are better for you.  

The resident had an interesting addition to my response that I had not considered before.  She said that she first reassures patients that ready-made readers won’t hurt their eyes, but then points out that custom made pairs are better.  It’s a small distinction, but an important one. Keep in mind this was in the 1970’s long before transparency became such a priority in communication.  As it turns out, trust and honesty have always been important to building a practice.

Her argument was if you try and convince people that ready-mades will harm their eyes- it’s a losing proposition in many ways. For example- you have just completed a full exam and pronounced their eyes healthy except for presbyopia.  Then the patient asks you about the ready-made pairs.  Let’s say your response was negative and you told the patient how much harm ready- made readers can cause their eyes. 

But let’s take the story further.  What if that patient has actually been using readers for years and just doesn’t tell you about them.  You just pronounced their eyes healthy. And in the same breath, stated they will harm their eyes with ready-made readers.

You have just lost this patient’s trust and respect.   You now look like a liar and an opportunist trying to sell them expensive glasses.  Once you lose a patient’s trust on something so basic, it’s hard to ever get it back.


The resident’s response made so much sense to me that it changed the way I speak to my patients.   I want my patients to always trust me and know that I will always be honest with them. I want my patients to come to me for advice about their eyes and not go somewhere else. This conversation took place in 1978 long before Google, the internet and social media.  This was a time when patients were not playing as active a role in their care as they are today. I think honest communication is even more important now.

Now when I am asked about readers, I confess that I actually have several pairs laying around my house. I use them for emergencies if I don’t have my progressives on. 

I do tell my patients that ready-made readers won’t hurt their eyes. But I point out the reason they are cheaper is the quality of the lenses and frames are not as good as what we use in custom eyewear.   I explain that readers may have increased aberrations and distortions that can result in headaches and eye strain.   

I also point out that ready-mades assume that a person’s correction is the same in each eye and that the patient has no astigmatism. Then I honestly share if I think their prescription might create any problems for them in using ready-made readers. I offer my opinion on whether they will work for them. But, I never say or imply that they will harm themselves.  

Most people treat ready-made readers as disposables and have multiple pairs.  Almost everyone knows someone who uses ready-mades. And most people who use readers will also admit they have some pairs that give them a headache or eyestrain.  This supports the information I give my patients about the decreased optical quality of these lenses.  


The public has a basic distrust of us because of the high cost of premium optical products.  They look at the ads and wonder how the cost of glasses can be so different from one office to another.  I believe patients want to understand why there are such discrepancies. If you don’t use this opportunity to educate them, their natural conclusion is that the doctor is making a huge profit. 

This is where transparency can be helpful.  The less explanation you offer, the more they will assume the worst.  I know that others may disagree about discussing the cost of these glasses.  But I feel my willingness to discuss the wide range in pricing helps patients understand the differences and builds their trust in me as their doctor.  

I often use the analogy that there are different qualities of TVs, computers, and cars.  People understand that. They know that there is a difference in the quality and reliability of a reputable product versus a cheaper one.   We have all learned this through painful and expensive lessons.  We know we get what we pay for.  

This discussion also allows you to offer the importance of proper frame selection, optical measurements and adjustments of a frame to best serve each patient.  And that can lead into information on warranties and how your practice stands behind any glasses you dispense.


When you’re honest, you keep your patients’ trust. You don’t look like you’re just trying to make money off an unnecessary expense. Realize that patients may not have the money for new glasses now.  Presenting them with options in an honest and open way allows them to make choices and understand the differences. Demonstrating the difference in the readers vs. their custom made set shows your willingness to help them make the right decision.  Often they will notice the difference themselves and make the right choice. You can also offer them other options such as multifocals, computer glasses and contacts.


Something else to consider. What advice do you give contact lens wearers who are beginning to notice presbyopia? They may be just having a little intermittent trouble at near.  They’re not ready yet or don’t want to be refit in mono-vision or a multifocal contact.  Don’t you tell them to pick up a pair of ready-made readers? 

Don’t be a hypocrite. What do you imagine your patient will think when they know that you told their relative or friend to not wear any ready-made glasses?  Now, for the contact lens wearer, you’re telling them to go get a pair. Honesty and consistency are always the best.


In my practice, we always had some readers on hand to use with people in our office.  Patients could use them to fill out forms if they forgot their glasses. Ready-mades were also useful if a patient needed to read something while they were dilating.  We would even loan them out if our patient had to return to work. We wouldn’t charge the patient anything if they returned the glasses in good condition.   If the readers weren’t returned, the patient was then charged for them. Our patients appreciated this and did not abuse this benefit.

We also offered ready-made readers for sale. I got tired of seeing so many patients using readers and buying them outside my office.  Since people look at them as disposable anyway, there is not a lot of adjusting or repair required if you decide to inventory them.   You can also offer better readers or ones with anti-reflection coatings.

It has always bothered me when someone else makes a profit off of readers when I am the most qualified person to see to my patient’s visual needs. Though I don’t have the data to prove it, I really don’t think we lost many sales of custom eyewear by having ready-made readers available.  If a patient wants ready-mades, they will just go somewhere else and find them if they’re not available in your office.

I know that my ideas may be controversial or unacceptable to some. Everyone has to decide what works best for them. But, I do hope that this blog at least makes you think about what, and how, you answer your patients’ questions.

How do you handle questions like this in your practice?  Do you place yourself in your patients’ position and try to imagine what they’re thinking? What is your opinion on having ready-mades available in your office? Leave a comment below on how you handle the question of ready-made readers with your patients.  Or leave a comment on the best ways to communicate with your patients. We would love to hear your ideas.

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