INITIAL ADJUSTMENTS - Place the glasses on the patient for the initial adjustments. This keeps you in control and speeds the adjusting process. Then, ask the patient to put them on. This ensures that they will be where they are going to be worn and that helps adjusting for straightness and temple fit.
TEMPLE TENSION - Place the frame on the patient and adjust for slight temple tension without indenting the head. For plastic, heat the endpieces or bridge slightly and open the angle, let it cool and try again. For metals use pliers and be sure that they are covered so as to not mar the frame finish. For rimless, use a bracing and post/covered plier.
PANTOSCOPIC TILT - Raise or lower the temples to adjust pantoscopic angle. About 10 degrees these days is right given the high use of progressive lenses. Use a wide angling plier or parallel jaw pliers. For some frames pliers may be required to stabilize the front while the temples are bent up or down.
STRAIGHT - Straighten the front by adjusting for different ear heights. To raise the right side of the frame, lower or increase the pantoscopic angle of the right temple (lowering the temple raises the front of the frame on that side). For plastic, open temple slightly and angle the hinge. For metal, brace the front and angle the endpiece using a wide angling or parallel jaw plier. For rimless, a bracing and double covered plier.
TEMPLE LENGTH - Ask the patient to put the glasses on. Adjust temple length to the ear. Create about a 45 degree angle at the crest of the ear. If the temple bend is too short, the temples will ride up. If too long, the glasses will slide down the nose. Also, look behind the ear and contour the temple for angle and touch. The more temple contact, the more secure the fit.
SQUEAKY CLEAN - Clean the glasses again and ask if they feel comfortable, straight, too tight, too loose.