Ms Virgilia Readett, optical dispensing educator, explores ethical dispensing considerations, examining how duty of care, informed consent and product knowledge guide responsible lens and frame recommendations.
As optical dispensers, our recommendations are influenced by many factors, including customers’ needs, their preferences, and our own product knowledge. But do we pause often enough to ask: what should we dispense, as opposed to what we merely can?
This distinction lies at the heart of ethical dispensing. It is not simply about right and wrong, but about our professional obligations: informed consent, duty of care, and upholding standards. To achieve informed consent, customers need clear information about outcomes, risks and alternatives. Duty of care means avoiding omissions or actions that could cause harm. And ethics guide our choices on frames, lenses and coatings – ensuring recommendations are backed by justifiable reasoning, not assumptions or convenience.
Duty of care in everyday dispensing
Few scenarios highlight ethical responsibility more clearly than night driving. Reflections, headlight glare and streetlights are common complaints, and students at the Australasian College of Optical Dispensing (ACOD) often suggest filters, tints or multicoating as solutions. But which of these are ethically defensible?
Australian/New Zealand standards (AS/NZS 1067.1:2016) stipulate that only category 0 tints (3–20%) are suitable for night driving. Contrast filters, such as copper, yellow or olive, may improve depth perception in daylight, but at night they reduce light transmission and fall into category 2 – unsuitable by the standards. Drivewear lenses, for example, are marketed specifically for daylight conditions, not night driving.
The safer recommendation is multicoating or anti-reflective coatings, which reduce the flare of headlights without compromising visibility. As ACOD’s CEO Mr Chedy Kalach explains: “Due to tints of any colour (yellow included) reducing light transmission, we do not recommend they be used when driving at nighttime … However, if an optometrist recommended a tint for night driving for medical reasons, it would be permissible for a category 0 tint.”
Other examples highlight the same principle. High-index lenses provide real comfort for higher prescriptions but recommending them for a mild -1.00D is difficult to justify. In such cases, a smaller or lighter frame material may achieve the desired comfort without unnecessary cost. Similarly, occasional requests for glass lenses demand careful consideration. While patients may believe glass provides superior optics, the minimal benefit in Abbe value compared with CR-39 is outweighed by its fragility, heavier weight, and higher injury risk. As Professor Alexander Holden (University of Sydney) points out, providing a product after advising against it effectively makes the dispenser responsible for any resulting harm. Polycarbonate or Trivex provide safer, more responsible alternatives.
Duty of care often means saying “no” to unsafe or unsuitable options – even when requested – and guiding patients toward solutions that balance safety, function and comfort.
Moving beyond assumptions
Ethics in dispensing also means resisting assumptions about a patient’s means or preferences. Consider the senior gentleman in a low-socioeconomic area who has always purchased low-cost single-vision lenses. If you assume he only wants a mid-range progressive, you risk failing to meet his actual expectations. Upon further questioning, you may discover he is a retired bank manager who values premium freeform progressives and occupational lenses.
The difference between assuming and asking is not just a better optical outcome – it can be the difference between losing trust and building loyalty. Open lifestyle questions ensure recommendations are tailored, justified and aligned with the customer’s goals.
The same applies to frame selection and coatings. A titanium frame may be more suitable than a cheaper alloy because of its lightweight strength, while multicoat may enhance vision and appearance for many, but not all, occupations. Upsells, when justified, are ethical. What matters is that the recommendation is informed, explained, and tailored.
Ethical dispensing is not about limiting choice; it is about ensuring those choices are informed, safe and defensible. By applying our product knowledge, rejecting unsafe or unnecessary options, and taking time to understand each patient’s needs, we fulfil our professional obligations while also building trust and credibility.
What we can dispense is broad. What we should dispense is narrower – and far more important for the wellbeing of our patients and the reputation of our profession.
About the author
Virgilia Readett holds a Certificate IV in Optical Dispensing, Certificate IV in Training & Assessing, and a Bachelor of Arts majoring in Communications.
