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ECO-FRIENDLY EYEWEAR / PAGE 6 A PRACTICE MANAGER’S TO DO LIST / PAGE 16 February 2011 • Volume 5, Issue 38 •



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Vol. 5 Issue 38

Features 6

Courtesy of Spectacle Eyeworks



ECO-FRIENDLY EYEWEAR Do your part for the environment and offer your patients the latest in Eco-Friendly Eyewear. by ECP Staff


ASPHERIC LENSES Aspheric Lens Designs have many features that can offer superior optics to patients.


by Carrie Wilson, BS, LDO, ABOM, NCLE-AC


A PRACTICE MANAGER’S TO DO LIST Essential tips on how to better manage your practice while avoiding past mistakes. by Anthony Record, RDO


TARGET MARKETS Spend your advertising dollars wisely by understanding the target market you are trying to reach. by Warren G. McDonald, PhD



GEARING UP FOR THE EXPO Having a successful trade show takes a lot of planning, research, and discipline. by Judy Canty, ABO/NCLE


SYNTHETIC CORNEAL IMPLANTS Significant technological gains have made corneal transplants a more successful procedure. by Elmer Friedman



Departments EDITOR/VIEW .....................................................................................................4 MOVERS AND SHAKERS.................................................................................10 MOBILE OPTICIAN .........................................................................................26 PRACTICE MANAGEMENT.............................................................................30 THE MODERN ECP ..........................................................................................34 ADVERTISER INDEX .......................................................................................46 INDUSTRY QUICK ACCESS............................................................................47 LAST LOOK .......................................................................................................50



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Editor / view


by Jeff Smith

Expo Efficiency ision Expo East is right around the corner (March 16-20 in NY), and for those of you who might have missed the last few Expos, now is the time to get back in the trade show loop. According to the Center for Exhibition Industry Research, trade show attendance was up 6.6 percent nationally in the 3rd quarter of 2010 compared with the same period the year before. So for those attending, I have provided what I hope is a useful refresher course in show survival.


Once you walk into the exhibit hall, it’s easy to be overcome by the all the “latest and greatest” products, presented by an ever–increasing number of suppliers and manufacturers. But to take full advantage of the limited time you have, a little planning is essential. Before starting out, think about the type of patient you have coming into your practice. Remember, if you are shopping for frames, they are for your patients, not yourself. While it is true you should be excited over any new product, the style must fit into your demographics.

Publisher/Editor . . . . . . . . . . . . . . . . . . . . . . . Jeff Smith Production/Graphics Manager. . . . . . . . . . . Bruce S. Drob Director, Advertising Sales . . . . . . . . . . . . Lynnette Grande Contributing Writers . . . . . . . . . . . . . . . . . . . Judy Canty, Dee Carew, Harry Chilinguerian, Timothy Coronis, Elmer Friedman, Lindsey Getz, Ginny Johnson, Jim Magay, Warren McDonald, Anthony Record, Jason Smith, Carrie Wilson Technical Editor . . . . . . . . Brian A. Thomas, P.h.D, ABOM Internet Coordinator . . . . . . . . . . . . . . . . . . . . Terry Adler Opinions expressed in editorial submissions contributed to EyeCare Professional Magazine, ECP™ are those of the individual writers exclusively and do not necessarily reflect the opinions of EyeCare Professional Magazine, ECP™ its staff, its advertisers, or its readership. EyeCare Professional Magazine, ECP™ assume no responsibility toward independently contributed editorial submissions or any typographical errors, mistakes, misprints, or missing information within advertising copy.

ADVERTISING & SALES (215) 355-6444 • (800) 914-4322

Also check over a map of the exhibitors, marking locations of must see exhibits. Don’t forget to visit the booths of distributors who already service you. Often they will have frames on display you haven’t yet seen, and if you are serviced by one of their reps, you can arrange for an in–office review. Whenever possible, it’s better to expand a current line, or take on an extra line from the same rep, than to open a new account with a distributor who may have similar frames.

111 E. Pennsylvania Blvd. Feasterville, PA 19053 (215) 355-6444 • Fax (215) 355-7618

If you’ve decided you need to expand in some categories, for instance low–end and high–end frames, plan on visiting those distributors first. Take your time to look through the collections and get whatever pamphlets they might offer. Make notes on the literature, and after you’ve visited your list of exhibitors, get away from the hall and go through your material ... preferably that evening in your hotel room. Weed through the collections that don’t fit your demographics or style, and then revisit the booths, perhaps making appointments to speak with a representative.

No part of this magazine may be used or reproduced in any form or by any means without prior written permission of the publisher.

Unless you are very sure the collection is going to fit your marketing strategy, it is best not to make a buying decision at the exhibit. Remember, the displays are set up to portray the collections in their best light, you will probably be dealing with an upper–level sales manager, and the excitement is contagious. While they might offer special savings, the caveat still applies: A sale is no bargain if you don’t need the item being sold! At the same time, though, there are great deals to be made, and if the collection fits, now might very well be the best time to purchase. Enjoy your time at the show, but remember, despite all the fun and excitement, it is serious business. (For more on gearing up for the Expo, please see Judy Canty’s article on page 24) 4 | EYECAREPROFESSIONAL | FEBRUARY 2011


EyeCare Professional Magazine, ECP™ is published monthly by OptiCourier, Ltd. Delivered by Third Class Mail Volume 5 Number 38 TrademarkSM 1994 by OptiCourier, Ltd. All Rights Reserved.

OptiCourier, Ltd. makes no warranty of any kind, either expressed, or implied, with regard to the material contained herein. OptiCourier, Ltd. is not responsible for any errors and omissions, typographical, clerical and otherwise. The possibility of errors does exist with respect to anything printed herein. It shall not be construed that OptiCourier, Ltd. endorses, promotes, subsidizes, advocates or is an agent or representative for any of the products, services or individuals in this publication. Purpose: EyeCare Professional Magazine, ECP™ is a publication dedicated to providing information and resources affecting the financial well-being of the Optical Professional both professionally and personally. It is committed to introducing a wide array of product and service vendors, national and regional, and the myriad cost savings and benefits they offer.

For Back Issues and Reprints contact Jeff Smith, Publisher at 800-914-4322 or by Email: Copyright © 2011 by OptiCourier Ltd. All Rights Reserved



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1. Kayu Design Rawa sunglasses feature 100% UV gradient lenses framed elegantly in bamboo. Bamboo is one of the fastest growing materials and is grown without the use of pesticides or fertilizer. Gaya frames are 5.75� (measured temple to temple). For every pair purchased Kayu funds one sight-restoring surgery in the developing world.


Eco-Friendly EYEWEAR

2. Amy Sacks Eyewear All bamboo used in the production comes from sustainably harvested bamboo farms. Masa Bamboo is available in 7 colors ranging from subtle Storm (shown) to vibrant Tangerine. This frame combines richly colored acetate fronts with hand carved sustainable bamboo temples. The classic styling suits men and women while the subtle details of the natural material set it apart.



3. Urban Spectacles With over a dozen woods to select from, each spectacle frame (Arizona Desert Ironwood is pictured here) starts as a solid block that is then transformed into the desired design. Using wood for the material, each piece will always have its unique grain pattern, without the possibility of exact duplication. No trees are harvested for consumption, rather the wood is collected from naturally felled trees.



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4. Spectacle Eyeworks Spectacle Eyeworks Inc., the Canadian design house, pays homage to Canada with five new premium, wood designs. Crafted out of sustainable and certified Canadian maple wood, the frames use a rimless wire mount behind the wooden frontpiece, with lenses mounted from the bottom. Each design is available in three natural wood shades, including chocolate and true maple.



5. Smith Optics Nearly all Smith sunglasses like the Collective now use Smith's bio-based Evolve frame material in lieu of petrol-chemically based nylon. Evolve is made using a resin derived from non-GMO, organic castor plants, which are highly renewable and non-food stuff. This material has identical tensile strength to nylon and maintains its shape well in extreme cold and hot environments.

6. Kenmark Group Every Jhane Barnes frame is shipped with corn demo lenses that break down into water and carbon matter, eco-friendly by products that reduce waste. Each frame also comes with a case made from 100% recycled material and organic cotton that is fully collapsible. All frames are shipped with backing cards printed on recycled paper.




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Modo Recycled frames are made with a minimum 95% content of recycled materials, certified by UL Environment, the leading agency in the industry. In addition, through its One Frame One Tree project, Modo will plant a tree for every frame sold. Modo also created a system by which consumers can donate their unwanted frames to charities. Shown is the 8002, a unisex semi-rimless frame.

Blue Planet Recycled Eyewear

Sires Eyewear

Sires Eyewear is an eco-concious company focused on customized eyewear with 6 classic styles (Dylan Thomas is shown), and over 20 different woods (an equal mix of FSC certified and rare woods). All the hinges are OBE swiss hinges with either a spring hinge system or 5 barrel. The RX frames have UV protection with A/R backside coating. All the frames can be ophthalmic or RX.

Lee Allen Eyewear

Blue Planet Eyewear features recycled frames and first quality lenses. We use lead-free paints, dyes and colorings, and nickelfree metal plating so that disposal isn’t toxic to the Earth. During the manufacturing process these safety considerations are also a top priority to us. To top off our earth friendly glasses, we use at least 65% post consumer materials in our boxes, inner packaging, outer packaging and hang tags. We strive to be leaders in the march to take care our delicate planet.

DRIFT Eyewear DRIFT Eyewear’s new patent pending technology, PressureFLEX uses a stainless steel core between layers of wood to create the most durable, balanced, and comfortable fit available. DRIFT takes advantage of this innovative design by offering unique woods and shapes never before possible. They take it a step further by using FSC certified woods, naturally derived acetate fronts, and organic packaging. They also give back through organizations such as 1% For the Planet.

“For Pascal” is made in the USA from handcrafted buffalo horn. Our buffalo horn eyewear is custom produced to the unique requirements of our clients. For centuries buffalo horn has been used as a natural material for spectacles and the excess shavings are used as a natural fertilizer.



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Exquisitely Hand Crafted Italian Eyewear by TreviColiseum速 Distributed exclusively in North America by National Lens. Tel: 866.923.5600

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Leybold Optics USA Leybold Optics GmbH has announced that George Kim has been appointed president of Leybold Optics USA, Inc. Effective immediately; Kim will oversee the sales and service operations for the Americas region (North and George Kim South America) for Leybold Optics. Kim is a 14-year veteran of Leybold Optics and has extensive technical expertise in vacuum technology and thin film coatings. Kim succeeds Antonio Requena who has been promoted to general manager of the global Optics Division for Leybold Optics GmbH.

VSP Vision Care VSP Vision Care announced that it has appointed Cecil Swamidoss as director of federal policy. Based in Washington, D.C., Swamidoss will help develop and implement VSP’s Federal lobbying efforts to ensure the Cecil Swamidoss company’s 55 million members will retain access to stand-alone vision care services under the new national healthcare reform legislation. Swamidoss has more than 10 years of Federal legislative experience, and most recently served as vice president of Dutko Worldwide.

REM Eyewear REM Eyewear has announced the launch of a new accessories division spearheaded by Christopher Allen. As director of sunwear & accessories for the new division, Allen will lead the building of a diversified sales channel for Christopher Allen REM Eyewear outside of the optical arena and nurture the company’s already established relationships with national department stores and e-tailers. Allen comes to REM with international experience, most recently from Mirage Eyewear in Italy. The company also announced the promotion of Julie Chi to assistant designer within the Product Development division. Julie will drive the Lucky Brand Spectacles and Lucky Kid design, while still fulfilling her responsibilities Julie Chi as Product Development manager. She has spent the past two years at REM working closely with Mike Hundert and Creative Director Nicolas Roseillier, learning hands on the creation and development of eyewear.

industry, Sepanek will apply his global experience to guide Signature’s growth strategy. He joined Signature in 2008 and had been their director of business development. Sepanek will continue to drive the men’s side of Signature’s Jim Sepanek brand portfolio focusing primarily on the expanded relationship with the Hartmarx Group and the launch of Hickey Freeman and Bobby Jones in the spring.

SoloHealth Rick Voight, former national sales manager of retail publishing at Hewlett-Packard, recently joined SoloHealth as vice president of channel development for the self-directed health care company. In his new position, Voight is Rick Voight responsible for market penetration and distribution of the company’s SoloHealth Station health kiosks, which include vision tests as well as blood pressure and body mass checks.

Pro Fit Optix Jonathan Schwartz, a long-time optical industry veteran, recently joined Pro Fit Optix as vice president of manufacturing. His responsibilities include overseeing the building and operation of the company’s new free-form labJonathan Schwartz oratory, scheduled to open in phases beginning in this year’s first quarter; the cutting and edging facility will open first, with free-form lens production to begin later in 2011. Schwartz most recently was director for the Ultimate Optical Laboratory in Fort Lauderdale, Fla.

Maui Jim Maui Jim has appointed two new vice presidents; Linda Glassel has been named the vice president of marketing and John Sanchez has been named vice president of technical product development for Maui Jim Sunglasses. In her Linda Glassel new role, Glassel will manage the strategic marketing and visual direction for the Maui Jim brand worldwide, and develop and execute a clearly defined marketing and communication strategy. Glassel previously oversaw the marketing efforts of Prince Sports in Bordentown, N.J. as the VP of global marketing.

Signature Eyewear Signature Eyewear has named Jim Sepanek vice president of business development. With nearly 20 years in the optical 10 | EYECAREPROFESSIONAL | FEBRUARY 2011

John Sanchez

Sanchez will work to develop new products and introduce new technologies for the Maui Jim brand worldwide. For the past eight years, he has been the VP of strategic sourcing and engineering for Bushnell Outdoor Products.



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Prior to Bushnell, Sanchez was employed for four years by Serengeti Eyewear where he was VP of operations.

Kenmark Group The Kenmark Group honored its top Territory Managers for outstanding performances in 2010. Territory Manager of the Year was awarded to Steve Mount for his dedication to Kenmark and strong performance in Steve Mount sales throughout the year. Consistent Exceptional Performance was awarded to co-winners Pat Gantt and Carla White for their on-going dedication to Kenmark and strong performance in sales. The Pioneer Award was given to Loreen Armaolea for opening the most new accounts. The Rookie of the Year was awarded to Don Payiva for an outstanding first year at Kenmark.

Vistakon Vistakon has named Cristina M. Schnider, OD, MBA, FAAO, as senior director of Medical Affairs. She will be responsible for providing Cristina Schnider strategic direction and leadership for Medical Affairs in the area of specialty contact lens products. Schnider joined the company in 1999 as manager of Claims Substantiation and Product Assessment, Research & Development and was named Director of Professional Affairs in 2003. She recently returned to Vistakon from a threeyear assignment in Tokyo, leading the Professional and Medical Affairs team.

Bausch + Lomb Bausch + Lomb has named Rick Heinick as corporate vice president, Global Human Resources and Transformation. Heinick most recently Rick Heinick served as a senior partner with Schaffer Consulting, where he advised executives on organizational transformation and people issues. A member of Schaffer’s leadership team, Mr. Heinick was an advisor to a number of multinational companies in the health care sector during his 15-year tenure with the firm, including Bausch + Lomb.

Silmo Guy Charlot, president of the Silmo Association, has announced a new management structure under which a new position, president of the Silmo Paris Exhibition, will be created. While Charlot will maintain his Guy Charlot role, the new position of President of Silmo Paris Exhibition will be Philippe Lafont. Charlot will remain active as president of the Silmo Association which runs the exhibition and his focus will be on a strategy to develop the exhibition and increase its international standing, promoting optics and the eyewear sector and training, via his role as chair of the Silmo Academy, which he will continue.



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Through the Lens Carrie Wilson, BS, LDO, ABOM, NCLE-AC

Going Premium: Providing your Patients with the Best in Aspheric Lenses IN TODAY’S TOUGH MARKETPLACE, it is important to differentiate the professional optical dispensary from one in which just orders are taken. One way to do this is to offer premium products to the patient. In order for this to happen, one must be knowledgeable of the latest in lens technology. One such technology is aspheric lenses.

Creating the Aspheric Lens Design

Aspheric Lenses Aspheric lenses -just like the name implies - are not spherical. In other words, instead of one curve on the front of the lens, and one or two curves on the back of the lens, the front curve of the lens is designed to have a gradual power change from the center of the lens to the periphery. This has multiple benefits to the patient. It minimizes or eliminates the blurry images created when the eye rotates away from the optical center of the lens, also known as marginal astigmatism. It also allows the lens to have a flatter profile. This creates a better looking lens that not only doesn’t compromise optical quality, but actually enhances the optical quality. The result is a lens that is flatter and thinner, has a wider undistorted field of view, fits better in most frames and reduces the magnification and minification of both the patient’s eye and their retinal image size.

Computer programs are needed to create the gradually changing, multi-curve surface of an aspheric lens. These computer programs use a polynomial, mathematical equation to determine the rate of flattening the lens surface will have. The reason each lens manufacturer has a different asphericity in their lens design is because each one uses different coefficients in their polynomial equation. Most aspheric lenses are either a true aspheric or semi-aspheric. In a true aspheric lens the change in curvature begins at the optical center. The curvature can begin steep or it can begin at a more gradual rate. In a semi-aspheric lens, the lens has a spherical center in widths varying from 10mm to 45mm. Although a semi-aspheric lens is not as cosmetically appealing as the aspheric lens, it is still thinner than a conventional spherical lens and is more forgiving if the fit is off. Fitting Aspherics Although accuracy is important when fitting any patient, aspheric lenses are not as forgiving as some other lens designs. Therefore, it is important that the ECP brush up on his or her fitting skills when designing a pair of glasses using aspheric lenses. Rules to fitting aspheric lenses include: Following the manufacturer’s recommendations – Because each manufacturer designs their own proprietary computer systems to create their lenses, each one has unique fitting guidelines. Know and utilize the guidelines for each aspheric lens that you use. Continued on page 14




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Use a pupilometer – Take monocular PDs. Center the eye – The frame selected should have the eye in the center of the lens, both vertically and horizontally, as much as possible. However, the majority of the time you will find that the eye sits above center vertically so try to limit the asymmetry. Measure the optical center – This is the point most ECPs either forget to do or perform improperly. First, dot the pupil just as one would do when measuring a progressive lens. Measure, and then drop the height 1mm for every 2 degrees of tilt, but do not exceed 5mm. If it exceeds 5mm, refit the patient with a better frame for him or her. The alternative method is to have the patient raise his or her chin until the glasses are perpendicular to the floor, have the patient look at the ECP and then dot the pupil while the patient remains in that position. Both of these methods are done to help reduce the amount of induced spherical or cylindrical power in the lens. Adjust, adjust, adjust – Good frame adjustment is key, both at the fitting and the dispensing. Ensure that the frame fits properly, is comfortable and has the correct amount of pantoscopic tilt and face wrap. It does not matter how much time was taken in measuring for the lens if the frame does not fit properly. If the frame is crooked, too tight or too loose, the optical center will not follow the optical axis and the patient’s vision will be off. Proper adjustment is crucial both at the time of fitting and at the time of dispensing. Make sure that the weight is distributed properly along the fitting triangle of the bridge of the nose and the top of the ears. It is important that the frame front is level and is placed at good vertex distance from the eye. Adjustment to the temple and along the temple bend will keep the lenses stable in relation to the optical axis. Also, make certain that the pantoscopic tilt is proper for the OC placement. Use Anti-reflective Coating Most aspheric lenses are flatter than conventional lenses, so they create a highly reflective, mirror like surface. Also, aspherics are generally manufactured with high index materials, so increased internal reflections are also a consideration for the eye care professional. One way to help with this is to utilize a multi-layer AR coating. The use of a multi-layer AR coating can bring the amount of light transmission into the eye to 99.5%, thereby improving visual acuity. Also, a multi-layer AR coating reduces the amount of reflections that can occur from the flatter lens surface. Premium AR coatings should be scratch resistant, as well as repel oil, water and dust. Comprised of a series of layers, the AR coating consists of metal oxides, adhered to the lens in thin films. Each film is designed to cancel out a specific light wavelength. The more layers of film on the coating, the more wavelengths that are blocked and the higher the light transmission of the lens. Working by the prin14 | EYECAREPROFESSIONAL | FEBRUARY 2011

ciple of destructive interference, multi-layer AR causes the light that reflects from the inner and outer surfaces of each film layer to become equal yet exactly opposite and thereby canceling each other out. In addition to the metal oxide layers, premium AR coats have: • Oleophobic layers that make multilayer coatings more effective by reducing smudges. • Hydrophobic layers that are applied as thin layers of silicone on top of the AR. It provides a smooth surface that decreases the wetting angle of the lens. The result is that liquids form small beads and can be easily removed from the lens. • A secondary top coat that is a result of the seal that occurs when oleophobic and hydrophobic layers are used together. • An Anti-static or Electro Magnetic Interference (EMI) layer that is placed on the lens to prevent static build up. By reducing static on the lens, airborne particles are a lot less likely to be attracted to the lens and adhere to it. Conclusion Patients go to a practice because they expect the best, and it is the job of the eye care professional to give it to them. It is imperative that the patient be offered the best in lens technology to fit his or her needs. Aspherics are an excellent tool for the ECP to use to give the patient the thin, lightweight and visually superior lens he or she desires. ■ With contributions from Brian A. Thomas, P.h.D, ABOM

EyeMed Survey Indicates 40 Percent of EyeCare Consumers Prefer Evening/Weekend Hours A new survey commissioned by EyeMed Vision Care indicates that while 60 percent of consumers responding to the survey said they prefer to access vision care services on weekdays before 6 p.m., the remaining 40 percent expressed a preference for other times. In the survey, nearly 25 percent of the respondents said they prefer to access vision care on Saturdays at locations with all-days hours. Another 12 percent said they prefer weekday evenings after 5 p.m., while 4 percent said they prefer Sundays. “Accessibility to care for our members drives EyeMed’s goal of promoting overall health and wellness,” noted John Lahr, OD, medical director for the company.



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Managing Optician Anthony Record, ABO/NCLE, RDO

A Practice Manager’s To Do List – 2011

“Anthony, I just wanted to say thank you. I was very hesitant signing up for this class, but a lot of the things we’ve talked about have inspired me. I am resolved to become a better boss for my employees in 2011.” “That’s great,” I replied. And without any agenda or sarcasm, I innocently and almost automatically asked, “What are you going to do?” “What do you mean?” he asked. He had a perplexed look on his face. “I mean: What are you going to do differently? What are you going to start doing? What are you going to stop doing?” His silence was deafening. Then I asked the entire class a couple of questions. “How many of you feel like John (the name has been changed to protect the innocent), that this seminar has been a worthwhile investment of your time and money, and it’s inspired you to try to become a better practice manager this year?” Gratifyingly, it looked like all 53 attendees raised a hand; one woman raised two! Then I asked, “How many of you have written out a specific plan about things you are going to do in order to achieve that goal?” Unbelievably, only six people raised a hand. So even though they all had invested two days out of their life, and hundreds of dollars of their money, fewer than 10% of them had bothered to create an action plan. That’s when I made a decision to quickly change how I had originally planned to spend our final hour together. I did three things I hadn’t planned to do.

At a recent two-day practice management seminar I had the honor of facilitating, things were winding down. It was quiet in the room, and with about an hour left to go, the attendees were filling out the evaluation forms. That’s when an optometrist raised his hand. His comment and his reply to my follow-up question to his comment inspired this message to you. Here, to the best of my memory, is how it all went down: “Yes, sir?”

First, I reminded them of two old aphorisms that I had shared early on the day before: If you always do what you’ve always done, you’ll always get what you’ve always got; and…A goal without a plan is simply a wish. Second, I chided them for having such short memories. Third, and finally, I broke them into small groups and gave them 15 minutes to decide on and write down at least five specific things they intended to do, as individuals, in order to become the best practice manager they could be. We then spent 30 minutes or so debriefing the exercise and sharing individual plans with the whole group. Why? Because when an attendee shared an idea, inevitably another attendee Continued on page 18




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Global Study Reveals Patients’ Vision Care Priorities Patented Hyaluronate-Gel Technology attracts water so continual hydration lubricates the eye. As a result, wearing times are extended and dry eye problems are alleviated.

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In a recent global study to determine the hierarchy of vision-corrected patient needs, seeing better was the most important consideration for selecting eye care products.

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The Needs, Symptoms, Incidence, Global Eye Health Trends (NSIGHT) study surveyed 3,800 spectacle- and contact lens-corrected subjects, 15 to 65 years of age, from seven different countries (China, Korea, Japan, France, Italy, United Kingdom, United States). The current analysis aimed to determine a hierarchy of patient needs in the selection of eye-related products, based on respondents’ scoring of 40 features representing eight categories of potential product features. The NSIGHT study revealed that product benefits relating to vision quality are highly important to patients all around the world. When patients are asked to trade off various functional needs relative to eye care products, comfort becomes only half as important as vision quality. “NSIGHT validated that clear, crisp vision is a top priority for our patients,” commented Carla Mack, O.D., F.A.A.O., director, Global Medical Affairs for Bausch + Lomb. The eight categories of eye care product benefits, in descending order of importance to patients, were vision, health, environment, eye condition, convenience, comfort, personal performance and personal appearance. Surprisingly, comfort came in sixth out of eight possible categories.

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would say, “Oh yeah, that’s something I need to work on too,” and then he or she would add it to their action plan.

give daily feedback about how things are going. The number one rule of performance evaluations should be “No Surprises.”

It is in that spirit that I wish to share with you some of what I heard. Perhaps you feel you should add one or two of these actions to that list of things you have resolved to start or stop doing this year, or things that you have resolved to do differently, so that you can become the best boss you can be in 2011. Here are some of the comments that were shared:

“I have always had the opinion that if I tell someone to do something, they should just say yes ma’am, and by God, go do it. Thanks to this seminar I’ve realized that that’s old school thinking.” That’s really old school thinking. Not only should a practice manager be less dictatorial in this day and age, she should also proactively ask for input on how to best do things. This woman should also explain the “why” behind her decisions a littler more than she does now.

“I realized that I’ve sort of lost touch with many of my staff members, so I’ve decided to really embrace that MBWA you taught us – manage by walking around.” Good idea. Spending your down time sequestered in your office checking out the Dow Jones average or the latest gossip in Maxim will not improve you relationship with your team members. Spending quality time among them just might. “I have to let go. I’m too much of a micro-manager. I have decided to delegate at least three things to my staff members.” Probably a good idea – especially if you do it right. Plan comprehensively. Choose the right tasks for the right people. Make sure the task has some personal value for the person who will be doing it. “I’m going to tell my wife she can’t come in the office like a whirlwind once a week and boss everyone around.” That’s probably a great idea and I’m sure your staff will thank you. Of course, I have three words for you: tact; good luck. “I’m too much of a soft touch. I realize that sometimes I make my decisions based on wanting everyone to like me. Then I regret it when things go wrong. I told my receptionist she could have a day off, even though we had a full slate of patients. We fell behind, patients got mad, and Doc was furious. I have to be more of a hard ass.” I don’t know about that, but I would say it is a good idea for a practice manager to learn to say no. Real leaders aren’t always liked, but they are respected. “I’m not going to put things off. I got in a big argument with one of the ophthalmic techs because I gave her a bad performance evaluation. She got furious, because from her point of view I had not said anything to her about what I saw as problems.” That’s the idea! Realize that the best practice managers

“I’m going to have more fun.” Sounds like a plan! An eye care professional should never confuse stodgy and boring with professional and effective. Likewise, having fun, cracking a joke, and smiling once in awhile are not signs that you don’t take your job seriously; quite the opposite. “I’m going to stop throwing money at a problem to make it go away.” Your money will thank you. Hopefully this optician realizes that if a problem exists with regard to employee performance or morale, throwing money at the problem will have, at best, a temporary, superficial effect. Making sure that the value and worth of their actions is clearly communicated to staff members will have a much more lasting effect, as will appreciation and recognition. Perhaps the most memorable comment was the one I chose to end the seminar on. A young office manager who had been fairly quiet for two days timidly raised her hand. “I only have one thing on my list, but I know my staff will be glad if I do it. It’s going to raise morale, increase retention, and probably even increase sales in the long run.” I was impressed, so I asked what she was going to do. “I’m going to fire Kathy!” After the laughter died down, she explained her rationale, and after she did, everyone in the room agreed that firing Kathy probably was the right thing to do. And so I leave you with two pieces of advice. First, assuming that you’ve exhausted all other possibilities, sometimes the best thing to do is cut your losses and let someone go. Second, if you’re in hiring mode and will be conducting interviews in the near future: Beware of all applicants named Kathy. ■ 18 | EYECAREPROFESSIONAL | FEBRUARY 2011



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The 21st Century Optician Warren G. McDonald, PhD Professor of Health Administration Reeves School of Business / Methodist University

Marketing the Optical Practice: Understanding Target Markets MPORTANT TO ANY SUCCESSFUL practice is marketing. We have described various components of the marketing concept in previous articles, but one thing is certain, marketing comes with specific costs. One major goal is to minimize the costs and to maximize the outcomes. We do that by fully understanding our target market. The target market we serve defines who our patients/customers truly are, which surprisingly, many do not really know. They think they know, but when pressed about simple things like how far the average patient is from their office, we often get blank stares, or some grandiose comment indicating that patients come from thousands of miles away for their examination and glasses. Neither of these is very helpful when attempting to help design a successful marketing program for these practices. We must better understand the potential patient population to determine a number of things. We will discuss that concept further along in this article.


Marketing Defined Marketing conjures up images of media advertising, which is a component of any successful marketing plan, but it is so much more. According to the American Marketing Association (2007), marketing is “an organizational function and a set of processes for creating, communicating, and delivering value to customers and for managing customer relationships in ways that benefit the organization and its stakeholders.” Kotler and Bloom (1984) define marketing as, “The analysis, planning, implementation, and control of carefully formulated programs designed to bring about voluntary exchanges of value with 20 | EYECAREPROFESSIONAL | FEBRUARY 2011

target markets for achieving the organization’s goals.” It relies heavily on meeting the target markets needs and desires through the use of effective pricing, communication and distribution to inform motivate and service the markets. The way the staff dresses, the location we select and a multitude of other considerations are important. Marketing is far more than media advertising, but since that is an important component, let us evaluate some things related to advertising for your consideration. Advertising Advertising requires some research on your part. First, you must know who your target market is, and how best to reach them. The Super Bowl costs $2 + million dollars for a 30-second spot, and would let the world know your message, but is that a good buy for the average independent? Of course not, unless you have a substantial national presence, so you must know the appropriate media for your message, and then direct it appropriately towards the target population. You must know who your patients are and where they live. Market analysis and some research can easily answer this question. Review things like addresses and zip codes, area codes, etc. You can then understand which media may be most successful in reaching that population.



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My Experience In my own practice, I enjoyed using a variety of media. I was located primarily in a military town and the Yellow Pages were a great media for me, because the troops in need of my services could find me there easily. This media may not be best for you, particularly since print media today is declining somewhat, but it was a great medium for the transient nature of my community. I also used some radio that played the music most of my patients listened to regularly. As I expanded to several locations, I used a large FM station that provided coverage for all my satellite locations in surrounding communities as well as my main office. For a single location, a cheaper, more localized station may be best for you.



Also important to the mix was Cable TV, targeted to the market. Again, the market was very young, with an average age of 27, so we used MTV and ESPN to reach them with appropriate messages in the ads. The Home and Garden network was not a good media buy for my particular situation. I found cable cost effective for my small practice, and it may be a good medium to reach your target population. Over the years we also used some limited direct mail and regular small ads in the local newspaper to round out our message. I found this mix appropriate. It may not meet your needs, but I think you get the idea. You must find the mix that works best for by knowing who you are trying to reach, the best time to reach them, and what to say in the ads to get their attention. One thing I will say is important in all markets is to be consistent. Do not expect big things from your advertising program if you are not willing to invest in a planned program on a regular basis. There are folks to assist if you need guidance, but do not expect to see a large jump in sales if you place a small ad in the local paper. Plan a program to reach your patient base and then provide adequate coverage to stimulate their interest.


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It is imperative we recognize not just where our potential patients live, but a number of other demographic considerations are also important. We must provide the products and services the patients in our target market need and desire, so knowing the demographics is all important. Age, gender, income and other specific information can be found in patient records, and if no records exist (new practices, for example), we should consult things like the local Chamber of Commerce and the colleges and universities in the area for assistance in finding that information. It is not hard if you just look. We also need to understand other important aspects of the population. Do we seek to serve the high-end market, or are we value oriented? Questions like this are important as well to developing our marketing program. But the patients we serve are not the only “customers” we serve. Continued on page 22

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Physicians and Optometrists; Referral Sources It is important to know the prescribers in the area. If you want to start out completely independent and not have refractions services available, getting to know them is imperative to getting any kind of referrals. If you want to have a refractionist on premises, which is necessary in many places, you still need to know the competition. Either way, at some point in time, we may need to interact with some of these folks, so having a positive working relationship with them, even if they dispense, can be important to your practices.

MARKETING “an organizational function and a set of processes for creating, communicating, and delivering value to customers and for managing customer relationships in ways that benefit the organization and its stakeholders.” Third-Party Plans Today, insurance is a big part of the eye care industry. Most doctors’ offices take a large portfolio of insurance plans, and understanding this type of reimbursement can be beneficial. While some plans like VSP literally eliminate opticians from participating, there are some, like EyeMed, that do not. Understanding the provisions and reimbursement levels may

be a source of income for you, and so developing a relationship with these plans can be important. Some are seeking niche markets that increases their competitive advantage in the marketplace and do not accept insurance of any kind, but this is a business decision that should be weighed appropriately so that a sound decision can be made. Conclusion Understanding our target market is important. Just as a television spot on the Super Bowl is probably not a good buy for the corner optical shop, advertising to the wrong market will not generate the results you seek. My young Marines were not watching Home and Garden, but were into MTV and ESPN. The right media and message will bring folks in the door. Just hanging out a shingle will give you little chance of succeeding in practice, but just throwing out advertising content will not either. You must know who the target population is and reach them in a cost efficient and effective manner. If you are uncomfortable with this task, there are folks who can help you, but make sure to have an independent guide you through the process, not someone selling a particular type of media. Marketing is important. Be sure to maximize your potential by being fully aware of your target market. ■



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Dispensing Optician Judy Canty, ABO/NCLE

It’s Almost March! IT’S THAT TIME OF YEAR AGAIN. Time for the annual trek to the Big Apple to see and hear what’s new in the optical world. In the past I’ve advocated making a detailed list of what you need, what you want and what you can afford to bring into your practice. That’s still my advice. Going into the big show without a plan is like entering a huge wholesale club without a list. You either need or want everything you see or there’s nothing in the building that you care about. You should have been making notes on patient requests and interests, products that you’ve heard or read about and equipment that you’ve dreamed about owning. Take the time NOW to make appointments with the people you want to work with, use the floor show map to plot your day and make the most efficient use of your time.

than on face-to-face contact with patients, so we find ways to restrict access. We hate the internet when our patients begin to shop for their eyewear online. Rather than wail and gnash your teeth, gather information from the classes offered on that subject. Sit quietly, take notes, read the handouts and decide how you can address the attributes that make the internet purchase of eyewear attractive. Decide how or if internet marketing can benefit your practice as a tool to attract new patients and retain current ones. Staffing. Your staff is the heartbeat of your practice. Uneven performance from your staff is as dangerous to your practice as an irregular heartbeat. Rather than trying to put out fires every day, find the experts and the classes they offer. No one person has all the answers, so take a variety of classes to develop a staffing strategy that will work for you. Expert staffing isn’t only about who and how you hire, it’s also about how and when to terminate a staff member. You think you have the best staff already? Then find out how to retain them. Most of the experts will tell you that it’s not always about the money, so you need to find other positive ways to motivate and stimulate the people you depend on to keep your practice healthy. When you’re planning your trip, are there classes that your office manager, lab manager or insurance specialist would benefit from? Would taking your key staff members to the show be the best benefit you could offer? Check with your accountant about the financial rewards or tax incentives this advanced training opportunity may offer.

Why? Because this year I’m advocating for education. You have successfully navigated your practice through the most difficult and challenging economic waters in recent memory. However, there are still challenges out there and you should be planning on how to respond in the most profitable and responsible way. The Internet. We love to hate the internet. We love the convenience of ordering online. Most insurance plans require that we place orders and file claims online. The idea of electronic medical records is tempting, as is the idea of a “paperless” office. We’re afraid that our staff will spend more time on Facebook


Systems. If your staff is the heartbeat of your practice, then systems are its backbone. Certainly your computer system and programs are a key element, but a systematic approach to practice operations is absolutely necessary. There are numerous classes being offered on practice management, patient and staff retention, practice benchmarking and a host of hands on workshops and expert roundtable discussions all designed to help you develop the practice of your dreams. Technology. I decided to count the number of new lens designs, lens treatments, frame collections and accessories offered up in 2010. I gave up sometime last March. If you think



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you can keep up by only reading trade publications or simply meeting with manufacturers reps, you’re crazy. There’s too much new stuff and too few hours in the day to stay on top of everything. If you believe that one or two manufacturer’s have a lock on every new development, you’re kidding yourself. Talk with your staff and choose courses that will either enhance your current understanding of the latest technology or introduce you to something new and different. You can’t possibly attend every class on every new development, but you can schedule some in-office time to meet with a rep or schedule a training meeting for the entire staff. Make your meeting/training appointments while you’re at the show because you’re going to be inundated with “show mail” in the weeks that follow. Technical Skills. The “Boot Camp” courses offered during Vision Expo have grown from a single 2-hour course to 4 separate sessions delivered over 3 days. Contact lens courses have expanded as well. A poorly fitted pair of eyeglasses or contact lenses can torpedo the best exam in record time. Your dispensary is a major profit center in your practice and requires a very specific skill set. As the practice owner you may have the background to train your staff, but you probably don’t have the time necessary to do a thorough job. If you rely on a senior staff member to provide training, then it is essential that he or she is constantly upgrading and refining those skills. I’ve seen enough “7”-shaped temple bends to know that attending a “Boot Camp” will benefit everyone from your patient to your accountant. So what’s the best use of your time? First, thoroughly analyze your practice statistics from 2010. What were your strengths and where is there room for improvement? Was your marketing plan successful or is it time for a new approach? Is your inventory turning at an acceptable rate or does it need to more accurately reflect your practice demographics? Are your lens options current or are you offering the same options you’ve always offered? Is your office hardware and software up-to-date or is it negatively affecting your office productivity? What does your office décor say to your patients? Is it current and hip or comfortably familiar? Does your staff present themselves as eyecare professionals or just employees? When you have the answers to these questions, you can begin to make your plans for both the exhibit hall and the classrooms. Yes, I know the parties are fun, but they don’t add to your bottom line and they won’t benefit you, your practice or your professional staff. You say you’re not going to New York? OK, then cut out this article and staple it to your calendar for August because there’s always Vegas, baby! ■



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The Mobile Optician Ginny Johnson, LDO, ABOC

Words Do you hear me? Do you (eye)care? My lips are moving and the sound is coming out The words are audible but I have my doubts That you realize what I just said What are words for when no one listens anymore?

What are some common qualities that patients search for when choosing a vision care provider? Reputable doctor, courteous staff, value, friendly place to do business, vision insurance provider, ample selection of eyewear, convenient hours and location. It’s great to have the best location, best doctor, best equipment, best inventory but none of that means squat unless everyone is working on the patient’s behalf.

come in every year. We’re just that good. You could blindfold us and we could wait on them. They aren’t going to change. Why waste precious time trying to bring them into this century? And the last time they purchased eyewear from us they were unhappy. We even noted it in their chart: Patient spent $750 on a pair of eyeglasses We were busy and they were in a hurry when they came to pick up Handed eyeglasses to patient at front counter Told patient to try them for a week

Every patient that walks into your practice is searching for EARS and SHOES. Sorry about the CAPS (yelling). I just want to make sure I have your attention.

Patient called back two days later complaining

I know we all have patients that we would like to totally tune out for one reason or another. The problem lies when we find ourselves just going through the motions or we get into a patient care assume rut. For those established patients we already know what they want, expect, and will spend when they

He said he would tell me in person


Asked him how long he tried wearing them

Told him to come in but there would be a wait Patient lives 30 minutes away so I suggested he get here ASAP Continued on page 28



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Seated in reception area patient starts a misery loves company conversation with another patient Patient then moved to the dispensary He is being rather loud about his complaints An empty exam room is the next stop for him Patient can’t explain exactly what is wrong Says he feels like he is walking upside down ECPs ask questions and double team him while talking in code to each other One of the ECPs leaves the room with the eyeglasses Patient is starting to get cranky and says dollar store readers are fine with him and at this price he could own 750 pairs

Wonder how many other people have had this happen to them? Seems dangerous to me and they act like it is no big deal Glad I didn’t trip and fall or wreck my car Wait until I tell my wife, I will never hear the end of it I bet she tells me to go back and get a refund I should let her handle it since she is the one that made me go there They are messing with people’s eyes This is serious stuff They should have to deliver the glasses to my office It’s not my fault they messed up I understand people make mistakes but it’s the way they handled it

Suddenly the eyeglass problem has been discovered as ECP returns

Or should I say the way they didn’t handle it

The eyeglasses need to be remade

If we practice putting ourselves in the patient’s shoes every single time with every single patient, I believe our patient care skills will greatly improve.

Not sure what or how this happened Sorry about that Mr. Patient We will have the lab start the job over immediately It will take about 5 business days for the new ones to come in We will call you as soon as they are ready Hang on to those readers until then We’ll make sure your lenses are correct this time There’s no charge for today Patient leaves extremely irritated Can you believe he is so mad?

If you can think about the shoe being on the other foot and you being the patient in every circumstance do you need to work on treating patients differently? Or are you a happy patient? There are many ECPs that practice walking daily in their soul-sosoft shoes and their patients love them. If the shoe fits, wear it. However, if you have flip flops, loafers, slippers or steel-toe boots ECPs working in your office then you should change your dress code policy. A flip flop ECP is laid back, a bit noisy and has the “it’s my day off ” approach to work.

We said we were sorry and will remake them...some people

A loafer ECP is lazy, could care less, whatever happens happens, as long as I get my paycheck.

How often do you practice taking your shoes off and walking in your patient’s shoes?

A slipper ECP likes to slide on by so they can get back to chillin’.

What do you think is going through this guy’s head after all that?

A steel-toe boot ECP will walk all over you and nothing stops them.

I can’t believe my new glasses were wrong and they didn’t know beforehand They wanted me to try them for a week I spent $750 for crying out loud Now I have to wait 5 more days I will need to set aside time to make another trip across town to their office I can’t believe they were so nonchalant about everything 28 | EYECAREPROFESSIONAL | FEBRUARY 2011

Make it a mandatory dress code policy for the entire staff to start walking in soul-so-soft shoes. Patients deserve our full attention and for us to listen to their side of the story especially when things go wrong. Listen and don’t interrupt them even if you don’t agree. Let them vent. As hard as it may be at the time, let them finish before you speak. Be careful not to step on their toes. If anything, we should practice walking a mile in their shoes. To do that every practice needs to keep the best EARS and SHOES in stock. ■



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Gerber Coburn Announces New Finishing Product Line Gerber Coburn, a leader in providing innovative, endto-end customer solutions to the world’s ophthalmic lens processing industries, has announced the introduction of its new, complete line of finishing systems. Alex Incera, president of Gerber Coburn stated “In connection with the acquisition of Gerber Coburn by Coburn Technologies, Inc., which was completed December 31, 2010, the time is right for us to present our new line of finishing systems to the market. We are very pleased to launch this new line of products and look forward to the opportunities that will now be possible for our customers to provide the highest quality finished lenses to their clients.” Wayne Labrecque, vice president of sales added, “The new Gerber Coburn Excelon finishing line offers our customers unmatched performance at highly competitive market pricing. We are excited about the value we can offer our customers through this powerful new product line.”

“Our market research indicates that customers are looking for advanced finishing products, but with a lower overall cost of ownership. The new Excelon finishing line from Gerber Coburn addresses these needs and includes several affordable product levels from high value to high-performance. Backed by Gerber Coburn’s global service and support team and our new long-term warranty program, our customers can operate their finishing business with confidence,” stated Curt Brey vice president marketing and business development. For more information about this exceptional new product line visit or call Gerber Coburn directly at 800.843.1479. About Gerber Coburn: Gerber Coburn is a leading international developer, manufacturer and service provider of lens processing technologies for the ophthalmic industry. The company is headquartered in South Windsor, Connecticut.



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Practice Management Lindsey Getz

Being more eco-friendly is the hot trend—and it’s certainly something you can do in your business. More and more people are considering how they can make their homes and lifestyles more green—and we’re not talking about money—though that’s an additional benefit to going green. What we’re talking about is being more eco-friendly. And the same changes that can be made at home can definitely be made at your eyecare practice. The effort can be something as simple as trying to reuse paper. That’s something that Benjamin Ticho, MD, an Illinois-based ophthalmologist does routinely, by using the opposite side of the paper. Of course he says this is not something to do with paper that contains patient-sensitive information, in order to remain compliant with HIPPA. Going eco-friendly could be also be as complex as making actual renovations to the office building, such as installing wind turbines to get the building off of the energy grid. No matter how little, every effort does make a difference. The latter—installation of wind turbines—is something that Carl May, Jr., MD, of the Hanover, Pa. based May Eye Care Center & Associates, has looked into doing at his own practice. It would certainly be a large undertaking, but it’s one that has caught his attention. May has been researching ways he can make his office more eco-friendly and that was just one possibility he has taken into consideration. “We’ve also been looking at solar power opportunities,” says May. “There are currently some good state and federal tax breaks so now is a good time to get involved with either of those efforts. We’re still researching the possibilities and seeing if they’re right for us.” 30 | EYECAREPROFESSIONAL |FEBRUARY 2011

May says he became interested in going green purely out of personal concern for the environment and the direction that this country might be headed if more people don’t start caring about their use of energy. “In general I believe our whole country needs to be more energy-conscious and less dependent on foreign oil,” says May. “Any little thing we can do with our businesses, to make them more energy-efficient, can make a difference.” Within the last few years, the practice has also gone completely paperless. Like any change, it took some adjustment, but May says it’s been a positive effort. Beyond the obvious environmental benefits of using less paper, patients have expressed appreciation because it offers an additional level of privacy for their information. Patient records are much harder for unwarranted visitors to access than when the practice used paper charts. In addition, the medical technicians at the practice enjoy the convenience and efficiency a paperless system offers while the doctors say it increases accuracy and precision of patient charts. Over time, May also sees it as a money saver. “The cost of paper does eventually add up—plus we had cardboard folders for every patient,” he says. “Now we’ve eliminated all that. We appreciate not having to use all of that paper. And this has streamlined everything, making us more efficient.” Recently, May Eye Care moved its practice into a new facility, which May constructed with some eco-friendly factors in mind. The office incorporates a number of massive windows that let in more natural light, along with several skylights to really maximize that advantage. “We no longer rely on so many lights,” says May. “And often, if I come in on the weekend, I don’t even have to turn the lights on. It’s nice not to have to



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walk into a completely dark office building. And there’s definitely a cost savings there. We’ve also had patients comment on the fact that they like the natural-lit areas.”

ting patients know you care about the environment and May says he may start sharing the news with some of his patients who might appreciate the eco-friendly changes.

All of the office rooms make use of motion sensors so that lights automatically go off when nobody is using the room. “That way if someone forgets to turn off the lights, they still go off,” says May. “And when someone comes in, they automatically go on.”

Simple changes that can be made in the home are the same sort of eco-friendly changes that can be made at the office. These include switching out ordinary light bulbs for energy-efficient ones, turning off lights (or using motion sensors like May does), and using a timer thermostat in the office. The latter is another effort that Ticho says his office has used that is both energy efficient and ultimately a money-saving change. You can also encourage your employees to be more eco-friendly by reusing paper, using coffee mugs instead of Styrofoam cups, or starting a recycling program in the office. These are all very simple changes that can be incorporated easily.

Making Changes May says that going eco-friendly doesn’t have to be difficult. Some eyecare practitioners may be put off by the cost, but many of these opportunities can save money in the long run. “There are definitely upfront costs, but if you’re in the practice for the long haul or are just starting out in this field, these are all important things to consider,” advises May. “They will eventually pay off.” And as the public begins to embrace a more green lifestyle for themselves, they’ll begin to appreciate patronizing businesses that do the same. Currently May does not market the fact that he’s “going green” to his patients as he has made the efforts more for personal reasons. But there’s certainly a benefit to let-

There are plenty of resources online and in bookstores that can help give you ideas about how to be more energy efficient. Check out The National Geographic’s Green Guide to get more information about what it takes to be more eco-friendly both at home and at the office ( Discovery’s Planet Green is another great source of information ( Once you start making some simple changes and witnessing the benefits, you’ll only want to consider doing more to go green. ■



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T he Acclaimed MBA Featured at International Vision Expo & Conference


















Conference: March 16 – 20, 2011 Exhibition: March 18 – 20, 2011 New York, NY | Jacob K. Javits Convention Center







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Transitions Names 21st Century Optics and Advance Optical MVP Partner Labs ®

Transitions Optical announced the winners of the 2010 Transitions Partner Labs, Most Valuable Partner (MVP) Lab of the Year award. Advance Optical—for the small/medium lab division—and 21st Century Optics— for the large lab division—were honored during a ceremony held at Essilor’s National Sales Meeting in San Diego, Calif. on Jan. 5. The Transitions MVP Lab of the Year award celebrates the two Transitions Partner Labs that have shown the highest level of commitment to growing their businesses with Transitions Optical’s Family of Products and programs over the past year. All nominees are judged on several factors, including overall growth of Transitions lenses; innovation and creativity in executing marketing programs and promotions; quality of education provided internally and to eyecare professionals; and overall passion for and devotion to the Transitions Brand. In addition to earning the Transitions MVP Lab of the Year title, both 21st Century Optics and Advance Optical and will receive $5,000 in business-building funds to support continued growth throughout 2011.

Toledo Optical Named 2010 Transitions Lab of the Year Transitions Optical has named Toledo Optical Laboratory its 2010 Transitions Lab of the Year. Making optical industry history, Toledo Optical is the first U.S. lab to earn the Transitions Lab of the Year title three times. The 20th annual award was presented before an international audience of more than 1,400 industry professionals Tuesday night during the 15th annual Transitions Academy at Rosen Shingle Creek in Orlando, Fla. The Transitions Lab of the Year award is presented to an independent lab that has shown the highest level of commitment to growing its business with Transitions Opticalís Family of Products and programs over the past year. In recognizing Toledo Optical again, Transitions Optical said the lab, located in Toledo, Ohio, has consistently incorporated the Transitions brand into all of its messaging, from education to its staff and customers, to promotions and special events.



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The Modern ECP Gary Fore, ABOC

Staying Focused Staying Updated My father was fond of saying, “Getting old is hard.” I usually responded, “Actually, getting old is easy; just wait and it will happen to you. Staying young is what’s hard.”

N MUCH THE SAME VEIN, it’s easy to get into a routine where we are comfortable with what we recommend to the patient and even how we sell the products we offer. What’s hard is staying focused on the patient’s lifestyle needs and staying updated on the products we can offer to meet those needs.


Lifestyles change as we age. With return patients, for example, they may not be out on the ski slopes like they were ten years ago when they first became your patient. They also may have become more of a computer person than before. If we don’t keep asking about their lifestyles, we will likely miss opportunities to recommend a different lens to them that will enhance their eyesight and make their tasks easier for them. That’s a key: what makes it better for the patient – not just easier for us. Many opportunities for second and subsequent pair sales will go right out the door with the patient if an optician doesn’t ask the patient about how much time they spend in front of a computer each day or if they spend time out on the lake or are experiencing difficulties with glare while driving. Each question could result in a discussion about computer lenses, polarized eyewear and anti-reflective treatments. Those opportunities are missed when there is a lack of focus on the patient’s current lifestyle. It’s vital to keep focused on the patient by continuing to ask those lifestyle questions. The other side of the coin is keeping updated on what’s available to meet those lifestyle needs.

There are new lenses and treatments coming out almost monthly. What are the latest lens offerings? How do those lenses enhance the patient’s vision? What are the lifestyle needs addressed by those lenses? It would be difficult to know about all the lenses coming out from every manufacturer but, at the very least, we can be current when it comes to the offerings from our trusted lens manufacturer. Our practice recommends mostly Essilor products because we trust their lens designs and quality. We have very few patients who return to say that their lenses don’t produce good eyesight for them because of lens design or quality. Lens manufacturers regularly produce literature, either in print or electronically, which they are more than happy to get to a practice in some form that will be read. After all, they know that if we will read them, we are more likely to try their product. Why not take advantage of their willingness to provide information and match that with our desire to keep updated about which products will possibly enhance our patient’s vision? Even with those two things, it would still be easy to get comfortable in a routine and recommend, for example, a Physio® Enhanced lens for someone who uses their computer eight hours per day. It’s a great lens and it can work behind a computer but it would be a much better solution for them to purchase an Essilor Computer lens for work and another lens for the other times of the day. The patient may complain about the cost but, if we’ve stayed updated, we can explain to them the advantages of those task specific lenses and how much better they will make their work experience or their outdoor life. Continued on page 36




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Many patients, when offered the opportunity to leave behind their tired, dry eyes and aching neck will opt to pay for that extra pair. Recommend what’s best for their vision needs, not just what brings the best commission. Staying updated means that the optician and the Dr. remember to read the latest information about the lenses they can offer, knowing their best uses and their limitations. Doctors have many areas to address to stay updated, from pathology to lens offerings. It’s easy to keep recommending the same products each week and those products may not be bad ones, either. However, I doubt that we would want to go to a surgeon and have him or her cut us open when a newer option might eliminate that open surgery option. Why should it be any less so for our eye doctor? Patients expect their doctor to be current. In fact, many patients are aware of the very latest offerings because they have searched the web before they come to the practice. Our reputation suffers when the patient is more current that those who present themselves as a professional in the eye care business. Staying focused and updated is not easy but when has being a professional been easy? The reward for staying focused and updated comes with a sense of personal pride at being a professional and the thanks from the patients who come to us and use the best products for their best eyesight. Both of those will likely produce and increase in both patient satisfaction and practice growth and profitability. How do we stay current and focused on patients needs? One way to accomplish both would be to devote some of the staff meeting time to updates on lenses and role-playing lifestyle interviews. Role playing may seem too structured and lacking in reality. However, during these sessions, there is an

opportunity to get comfortable hearing the words come from our mouth so that it will seem more natural during an actual conversation between us and our patient. Situations can be developed from last week’s encounters with patients, asking the question, “How could I have better presented other lens options?” When other staff members get involved in the discussion, there is the opportunity to see a viewpoint we missed or hear a suggestion that would spark yet another idea about how we could delve into the patient’s lifestyle needs more effectively. Not all role playing turns out like we hear on training videos so, go ahead and be the obstinate patient who just keeps on saying, “I just want what my insurance pays for.” That, too is valuable experience in keeping a calm demeanor and planting the seeds that may yet spring to life another week. We never know when that patient will have some extra money to spend and how our conversation today will be remembered next month and drive them back to our practice saying, “You know, last month you talked about sunwear and I couldn’t afford it. This week I can, so could you show me again what you were talking about?” When they leave with polarized lenses with a backside antireflective treatment in a nice frame, both of you will be glad you had that seemingly unproductive conversation. Enlisting one of your trusted employees to become your training officer and charging them with keeping the staff updated and focused on patient lifestyle needs might just ensure you meet you’re annual goals for patient growth and satisfaction. Staying focused on patient needs and updated on lens offerings is worth the investment to make sure your office is staffed with professionals who can be trusted to make your patients confident that your office is the best place for them to trust their eye health. ■

US Optical Announces Deal with PixelOptics to Manufacture First Electronic Eyeglasses US Optical have signed an agreement with PixelOptics to manufacture emPower!, PixelOptic’s patented electronic eyeglass lenses. “US Optical is pleased to be at the forefront of innovation in the eyewear industry,” stated co-owner Ronald Cotran. “We were among the first to launch High Definition (HD) Freeform prescription lenses three years ago, and with emPower!, the first electronic eyeglasses, we are thrilled to be part of this incredible invention, manufacturing launch and game changing eyeglass technology!” emPower! is the world’s first electronic focusing eyewear which will focus as fast as the blink of an eye. It provides vision correction for all ranges of sight: far, 36 | EYECAREPROFESSIONAL | FEBRUARY 2011

near, and in between. It offers three modes of operation: automatic, manual on and manual off. It also provides an electronic invisible near reading zone when desired with the ability to turn the reading power electronically on and off. It is the latest innovation for consumers suffering from presbyopia. Consumers will be able to purchase emPower! from US Optical’s customers located in the Southeastern US region starting in April 2011. emPower! will be available in other regions later in 2011. For more info go to: or call 1-800-4GLASSES.



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Second Glance Elmer Friedman, OD

SIGHT RESTORED with SYNTHETIC CORNEAS OLLAGEN BASED CORNEAL IMPLANTS may prove to be a successful alternative to cadaver corneas. Preliminary experimental tests demonstrated that a tantalizing possibility exists to restore vision as effectively as the latter and did not require any rejection therapy. Experimental lab created corneas were implanted in 10 patients who lost vision due to inflammation and scarring. The use of cadaver corneas requires the use of anti rejection drugs and presents a risk of infection. Plastic corneas have also been used when standard cadaver transplants have failed, but other problems arise in that modality.


are affected by corneal damage from ulceration and trauma. In the U.S. about 42,000 cadaver cornea transplants are performed each year and another 10,000 corneas are exported to various countries of the world. For more than a century doctors have considered transplantation of corneal tissue from deceased donors to be the best treatment. First performed in 1905, a corneal transplant at that time consisted of a procedure that replaces the damaged cornea with donor tissue. The surgeon removes the cornea from the donor eye. The new cornea is then implanted in the patient’s eye with tiny dissolving sutures which hold the new cornea in place.

The new artificial corneas were first produced 10 years ago. They use collagen produced in yeast as a base that allows cells from the receiving eye to grow into the graft so that it mimics the original tissue. A two year preliminary test showed that that the biosynthetic corneas restored vision as effectively as cadaver or human donor corneas. Anti rejection drugs were not required and normal corneal touch reflex and tear production continued to function. The cornea is the window that allows light to enter the eye. It needs to be transparent and so it has no direct blood supply. It derives oxygen from its tear fluid on the exterior and the aqueous fluid on the interior. Executive officers of the Cornea Research Foundation announced that while they consider this development to be a “huge breakthrough”, additional studies will be needed to test efficacy.

Using this method, nearly 50,000 corneal transplants were performed in the United States. Patient selection is usually based on the following criteria: vision should not be better than 20/400 and blink and tear mechanisms should be reasonably intact. The retina should be in place and there should not be extreme optic nerve cupping. The opposite eye has reduced vision, and nasal light projection is intact. Consider a shunt if the patient is suffering from an advanced stage of glaucoma. The healing process following a transplant is long and may take a year or longer. The time from surgery to the removal of the sutures is commonly 6 to 18 months.

Corneal damage is the second biggest cause of blindness world wide, affecting nearly 10 million people annually. There are approximately 5 million people in the world who suffer corneal damage from trachoma, an eye infection caused by the bacterium Chlamydia trachomatis. Another 1.5 million to 2 million

The patient may be on steroids for months. Initially following the surgery the donor button is swollen and even following the healing the button is usually thicker than the corneal bed in which it rests. Graft rejection signs are reported to occur from one month to 5 years following surgery. The rejection rates for bilateral grafts are higher than if only one eye is grafted in surgery. If the second eye is to be grafted, the wait is usually a period of at least a year between grafts. If signs of rejection Continued on page 40




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1:04 PM

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occur, an aggressive treatment with steroids is begun. Usually the reaction is overcome and the graft remains clear. Over 90% of grafts are successful with some studies reporting 97% to 99% success rates at 5 and 10 years.

ful. She claims that the goals are to regenerate the cornea from within. Dr. Per Fagerholm of Linkoping University in Sweden implanted a cornea in one eye of each of 10 patients who suffered from central corneal scarring.

Large amounts of astigmatism are common following keratoplasty. One study found an average of 5.56 diopters of cylinder correction required following surgery. Therefore, the patient’s spectacle prescription may fluctuate for some months after surgery. Refractive changes and keratometry or corneal topography can be used as indicators to follow the healing process. Though the rate of success with keratoprosthesis is high, in rare cases, certain serious complications could occur, such as glaucoma and extrusion of the implant, sudden iritis or inflammation of the ocular tissues.

Soon cells that lined the healthy portion of the cornea started growing in the collagen material. Vision improved from 20/400 to 20/100, meaning that they could see objects four times farther away than before the operation. The reason they all didn’t see better immediately was that the sutures used in this study resulted in roughness on the corneal surface. The contact lenses compensated for surface roughness resulting in improved vision. Less disruptive sutures will be used in the next clinical study which should correct the problem. The researcher found that after two years, no complications had developed and with the prudent use of contact lenses, vision was as good as with cadaver transplants. It should be noted that contact lenses were commonly used as an adjunct with cadaver corneas, as well.

Marianne O’Connor Price, executive director of the Cornea Research Foundation states, “The U.S. is very fortunate that everybody who needs a transplant here is able to get one, but there is definitely a shortage around the world. Even people here could benefit if there was a synthetic cornea that eliminated the chance of rejection.” The new study was reported in the Science Translational Medicine. It described the use of biosynthetic collagen that was produced by FibroGen Inc. of San Francisco. A team headed by Dr. May Griffith of the Ottawa Hospital Research Institute in Canada molded the collagen into an artificial cornea. Initial tests on animals were highly success-

This study is the first to show that an artificially made lens can blend into the human eye and provide regeneration of the corneal nerves and tissue. Dr. Griffith revealed that her group was now in the process of building a “clean room” to manufacture more of these remarkable corneas. She also hopes to initiate larger trial sessions after the first of the year starting with 20-25 patients. Continued on page 42




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In addition, researchers are working to improve plastic like artificial corneas and also to create stem cell treatments that could spur corneal growth (See Corneal Burns Successfully Treated with Stem Cells from the Aug. 2010 issue of this publication). Dr. Alan Carlson, cornea transplant chief at Duke University’s eye center was not involved in the research; however he expressed strong support for the project. He said, “I characterize this work as a major advance in the direction that we need to go. To make this mimic donor tissue to the extent that your own cells ultimately become incorporated in this tissue, I think that is the most exciting aspect.” Dr. Carlson cautioned that these were not full thickness corneal transplants. The lowest layer of the patient’s original cornea was not replaced. Patients who had problems with the outer layers of the cornea make up about 10 percent of the transplant cases. It is thought that the new biosynthetic corneas might be cheaper than donated corneas which average approximately $2,500 per eye with some documentation of fees reported as high as $35,000 in the U.S. Many patients seek reduced costs available in India or Singapore where the fees may be as little as 1/4 the costs in the U.S. or U.K. Prosthetic corneas made of synthetic plastic are used for patients who have experienced unsuccessful donor grafts. They are difficult to implant and are known to cause infections, glaucoma or retinal detachment. Dr. Walter Stark directs the center for cataract and corneal diseases at Johns Hopkins Hospital, Wilmer Eye Institute in Baltimore and is a professor of ophthalmology at the school of medicine. He also approves of the monumental steps taken toward the use of biotechnical created collagen. However, he agrees with Dr. Carlson as he refers to the complication that seems to exist when treating the lower layers of the cornea which are slower to heal and would require a rather thick application of this new material. Dr. Stark notes, “The outcomes of this study were not nearly as good as those achieved with human donor corneas. This may become an excellent technique, but right now it is not ready for clinical use.” Some of the conditions that may cause the need for a corneal transplant are: corneal failure following other eye surgery, such as cataract surgery, keratoconus, hereditary corneal failure such as Fuch’s dystrophy, scarring after infections, such as herpes, ejection after a first corneal transplant, scarring after an injury. An alternative method for corneal transplant procedure is the use of highly precise lasers. They use short but intense laser pulses thereby cutting and shaping corneal tissue to suit each patient’s eyes in a precise manner. The procedure is called Femtosecond Laser-Enabled Keratoplasty (FLEK). Dr. William W. Culbertson says, “This will rapidly become the gold


standard for corneal transplant surgery.” In the past two years Dr. Culbertson has performed nearly 50 FLEK corneal transplant procedures on a wide range of patients. Very good results with a faster rehabilitation period have been reported. However, a common problem is astigmatism. This may occur when a mismatch of the donor and the recipient takes place. Slightly asymmetric suture tension may cause astigmatism as well. These types of conditions can usually be corrected with contact lenses. Corneal transplant patients also run a risk caused by a sudden injury or impact to the head which might dislodge the new tissue. In that event the tissue can be reattached or a second transplant can be performed. “There had not been a major advancement in corneal transplantation techniques for the past 30 years.” said Dr. Sonia Yoo, a corneal specialist and associate professor of clinical ophthalmology at Bascom-Palmer. “We have been able to store donor tissue for longer periods of time and develop more effective anti-rejection medications. Now the use of lasers is a quantum leap to the next level. “Dr. Yoo and her associates feel that femtosecond laser technology opens the door to many new advanced options for cornea transplantation. The equipment’s sophisticated computer controlled software allows physicians to program a nearly infinite variety of three dimensional shapes and highly precise dimensions. This procedure is also used to perform partial transplants. A thin layer of damaged cells is peeled away on the front or back surface of the cornea and replaced with healthy donor tissue. Surgeons feel that this represents a revolution in corneal surgery since the cornea can be split into different layers depending on the patient’s needs. It is a more precise, controlled method than manual dissection of the cornea and reduces the risk of transplant rejection. In cases where corneal transplant tissue has failed several times, an artificial cornea may provide a different option for restoring vision. Today, corneal specialists can intervene earlier in the progression of some corneal diseases. Instead of watching and waiting until a significant amount of scarring occurs, a thinner slice of the anterior surface of the cornea may be removed and replaced with an exact matching, clear piece of tissue. This is an amazing option considering that the patient might have been forced to struggle with uncomfortable contact lenses and a lower level of function for many years in the past. Future patients in need of a corneal transplant procedure have the comfort of knowing that they will be the recipients of the momentous progress being made via techniques developing to attack the problem from several different points of view. ■



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The latest VisionWatch study of American consumers about how the internet is influencing and shaping their eyewear and eyecare decisions and purchases has just been released by The Vision Council to its members. The extensive report, which looks at consumers by age groups, income and other cross-tabulations, indicates that about 28 percent of people using the internet to assist in their last purchase of eyewear—which includes research on styles, price and possible locations—actually made the purchase directly online. Specifically, about 2.8 percent of recent eyeglass buyers in the survey panel used the internet to directly purchase eyeglasses. Only 1.9 percent of recent over-the-counter readers’ buyers on the survey panel used the internet to directly purchase readers online, while a higher percentage, 3.6 percent of recent plano sunglass buyers used the internet to directly purchase non-prescription sunglasses. In terms of contact lens buyers, about 15 percent purchased their lenses directly online. The Vision Council’s report stated, “Although it is difficult to use this data to project up to a national total of aggregate online purchase activity, it is likely that fewer than 1.8 million to 1.9 million pairs of Rx eyeglasses were purchased online during the 12-month period ending September 2010. It is also likely that about 900,000 pairs of over-the-counter readers and fewer than 3.3 million pairs of plano sunglasses were directly purchased online during this same time period.” The report, “2010 Vision Council VisionWatch Internet Influence Report,” was conducted in November 2010. Vision Council Research received 9.293 complete “valid” responses from adults, representing people who have purchased Rx eyeglasses, plano sunglasses, contact lenses and/or OTC readers sometime within the past six months. The tabulations in the report are not always based on this sample size but vary depending on the questions.




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EyeVertise has released a new Application Module that will allow patients to connect directly to the doctor’s website to learn the status of an order. Allowing the patient to visit the ECP’s website will make their practice more efficient and will free up staff. Dr. Steinmetz from Sauganash Family Eye Center in Chicago said, “This new development from EyeVertise has helped our practice immensely; it invites patients to interact with our website and has reduced calls from patients that want to check the status of an eyewear order.” Content development and innovative optical technologies makes EyeVertise the leading custom optical website developer in the United States and Canada. EyeVertise will continue to develop new technologies that will help ECPs reach, teach and keep their patients. EyeVertise optical websites for ODs and MDs provide patients with educational information and streamlines appointment scheduling along with HIPPA approved medical forms to be completed online by patients. For additional information contact EyeVertise at 1-800-943-1411 or go to



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Page 50

Last Look Jim Magay, RDO

“I’m Spending my Kid’s Inheritance!” OVER THE YEARS I’ve seen many friends retire; customers and colleagues alike. There is no parallel to be made. The style of retirement has been as different as the people themselves. I’ve known ECPs who sadly dropped over at their desks doing what they loved. Others have sold their carefully nurtured practice and pined away from afar. Still others came back to work breaking in the new management. One dear friend suggests continued ownership at a reduced salary and hiring a bright eyed young protégé at a good rate to actually do most of the work. Hard to know what is best. In the area of customers retiring – too many of them seem to have been poorly prepared for a new lifestyle. A big trip or two, take the family to Disney, and then what? A few have pursued adult education and travel abroad, staying in elder-hostels. Still others have started new careers based on deferred dreams when they were youngsters. Running B&B’s, managing Inns, and opening restaurants come to mind. One remarkable couple sold everything and became tour guides for the Wally Byam and the Airstream Caravan Club – living in their own Airstream and guiding tours all over the country! Sadly, too many end up with health problems and spend far too much time visiting doctors and hospitals with their significant other. Still others mindlessly make the weekly trek down to Foxwoods to blow their social security check, and a surprisingly large number of them have their kids and/or grandchildren move back in. 50 | EYECAREPROFESSIONAL | FEBRUARY 2011

A terrific newspaper – the Christian Science Monitor, did a major piece on retirement recently called – appropriately, “The New Retirement.” The article looked at worldwide trends in demographics; it called attention to the unrest in Europe over raising the minimum age for retirement, and had a lot of anecdotal evidence about how people all over the world are coping with this issue. A Japanese retiree driving a cab to make ends meet, a Chinese bookkeeper who plans on working into her 70’s, and an Alabaman city clerk who has no plans to retire even though she recently turned 64. Conclusion – We are all going to be working longer! The old model – a gold watch and off to Florida has definitely been scrapped as the present day model for retirement. Present day “Boomers” recoil at the idea of living with their parents retirement style – first of all we are living longer, we want to feel fulfilled, we need to keep the gray matter (and musculature) exercised to ward off Alzheimer’s, we want to keep up our active physical pursuits, and we desperately want to remain relevant to this rapidly changing world. Pension funds have been raided or under-funded, social security is in doubt for future generations, and the politicians’ keep playing chicken with solutions that might help (Think of “means” testing for benefits, a higher limit for contributions, a later starting age to collect, etc.) Most of these things are beyond our control as individuals; while society stews about them we must still go on living day to day. What are you going to do? Are you like the brokerage ad spokesperson who says, “I don’t want to hear about starting vineyards and buying yachts – lets get real!” or no plans at all? Let’s hear from you ECPs – what are your plans? ■




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EyeCare Professional Magazine February 2011 Issue  

February 2011 Issue of EyeCare Professional Magazine. A Business to Business publication that is distributed to decision makers and particip...