ECO-FRIENDLY EYEWEAR / PAGE 6
ABO LEVEL II – CE CREDIT / PAGE 30 February 2013 • Volume 7, Issue 62 • www.ECPmag.com
VEE | new york 15.-17. march 2013 stand # G376
finest wooden eyewear . handcrafted in tirol . austria www.rolf-spectacles.com
Features 6 12
Courtesy of Panda Sunglasses
Vol. 7 Issue 62
ECO-FRIENDLY EYEWEAR Do your part for the environment and present your patients the latest in Eco-Friendly Eyewear.
OFFERING “GREEN” FRAMES The benefits in offering environmentally responsible eyewear make it more than just a fad.
by Corrie Pelc
ONLINE DISASTER STORIES There has been a disturbing lack of quality and workmanship with many online frame purchases. by Anthony Record, RDO
INDUSTRY OUTLOOK Discover what some of the key issues facing the optical industry are in 2013. by Lindsey Getz
ABO LEVEL II – CE CREDIT Construct a Colored Lens Power Number Line for Office Use Only – also available at: www.ecpmag.com/ce by Renee Jacobs, OD, M.A.
VOLUNTEERING The well rounded ECP should make volunteering an important part of their optical arsenal. by Elmer Friedman, OD
On The Cover: Rolf Spectacles www.rolf-spectacles.com
Departments EDITOR/VIEW......................................................................................................6 MOVERS AND SHAKERS.............................................................................17, 29 MOBILE OPTICIAN ...........................................................................................24 OD PERSPECTIVE..............................................................................................42 INDUSTRY QUICK ACCESS..............................................................................46 ADVERTISER INDEX .........................................................................................48 LAST LOOK .........................................................................................................50
EYECARE PROFESSIONAL 3
EDITOR VIEW Jeff Smith
Birth of the Bionic Eye HERE IS NOTHING more devastating for an ECP than to have a patient completely lose their vision. Though not as well known as some other ailments, around 100,000 Americans have retinitis pigmentosa (RP), an inherited eye disease that causes retinal degeneration and eventual blindness.
But a group of researchers, who have been working for two decades to create the world’s first “bionic eye,” are one step closer to receiving U.S. approval to market their device, which could not only help those with RP, but also severe macular degeneration. Last month, the FDA recommended approval of Second Sight’s Argus® II Retinal Prosthesis System for use in the United States. The retinal prosthesis bypasses the dead or damaged cells in the eye needed to detect light. Instead, the Argus II reroutes visual data via an implant to the parts of the eye that still function. It employs a video camera embedded in a pair of eyeglasses to collect visual input in the form of light and transmit it to the implant as an electrical signal. These electrical pulses stimulate the retina’s cells to produce visual patterns of light in the brain that allow blind patients with retinitis pigmentosa to regain some visual function. The technology tested to date lets the wearer primarily see in black and white. It is most useful for seeing sharp contrasts, such as the painted white line of a crosswalk on a dark road. But scientists hope that they can improve the detail to eventually enable color vision in its wearers. The first patient to receive a Second Sight “bionic eye” — the Argus I — was about 10 years ago and the California based company has been testing its newest device in a small number of patients in a clinical trial that began in 2007. If the approval comes, it will signal more than 20 years of work in the field, two clinical trials, more than $100M in public investment by the National Eye Institute, the Department of Energy, and the National Science Foundation, and an additional $100M in private investments. The Argus II was approved for use in Europe in 2011 and the Retinal Prosthesis system is the first of its kind in the world. Let’s hope that this exciting new advancement can give the gift of sight back to those who have lost it. ■
Publisher/Editor . . . . . . . . . . . . . . . . . . . . . . . Jeff Smith Production/Graphics Manager. . . . . . . . . . . Bruce S. Drob Director, Advertising Sales . . . . . . . . . . . . Lynnette Grande Contributing Writers . . . . . . . . . . . . . . . . . . . Judy Canty, John Dick, Paul DiGiovanni, Gary Fore, Elmer Friedman, Lindsey Getz, Renee Jacobs, Ginny Johnson, Jim Magay, Warren McDonald, Corrie Pelc, Anthony Record, Jason Smith 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.
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EDITORIAL OFFICES 111 E. Pennsylvania Blvd. Feasterville, PA 19053 (215) 355-6444 • Fax (215) 355-7618 www.ECPmag.com editor@ECPmag.com EyeCare Professional Magazine, ECP™ is published monthly by OptiCourier, Ltd. Delivered by Third Class Mail Volume 7 Number 62 TrademarkSM 1994 by OptiCourier, Ltd. All Rights Reserved. No part of this magazine may be used or reproduced in any form or by any means without prior written permission of the publisher.
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Vision Expo East, Booth G510
1. Vinylize Vinylize have re-imagined a design classic by re-using vinyl records. The warm texture and color of the vinyl makes the concept practical, interesting and best of all, sustainable. Sunglasses made from vinyl records in a vintage retro-style with a futuristic twist. www.vinylize.com
2. Airborn AIRBORN sunglasses are manufactured by hand from historic airplane material that has flown for decades and seen many people and countries. The making is similar to the production of airplanes with sheets and rivets. Every piece comes with a certificate that tells its story and is delivered in a wooden box that was made from the floor of an airport in Ukraine. www.eyebizz.de 2
3. iwood All iwood frames are hand made in America from the finest exotic woods â€” Bubinga, Macassar Ebony and Sapele Pommele â€” reclaimed from industrial veneer manufacturers. All are Forest Stewardship Council (FSC) certified and harvested by sustainable methods. Models include metal temples imported from Italy and optical quality lenses by Carl Zeiss. www.iwoodecodesign.com
4. GROWN Eyewear Because GROWN eyewear is made from bamboo or wood, each pair has a completely unique grain pattern, and no two pairs are identical. For every purchase that is made, sight-restoring surgery for one individual or diagnostic eye examinations for 12 children will be fully funded. www.growndesigns.com
5. Rolf Spectacles Passionate about cars, as well as eyewear, classic automobiles are the foundation for everything the ROLF team designs. The sculptured frame COMMANDER is as classical as the legendary car, very lightweight, and the different types of wood are polished to perfection. COMMANDER has won the GOOD DESIGN™ award, which was founded in Chicago in 1950 and remains the oldest and the world’s most recognized program for design excellence. www.rolfspectacles.com
6. ic! berlin
ic! berlin’s acetate frames are made with anti-allergic, eco-synthetic plastic consisting of organic fibers and in the true spirit of quality assurance all frames are handmade. Our rough/eco collections won the Silmo Award in 2011, highlighting how perfection can be born from imperfection. www.ic-berlin.de
Gold and Wood
Gold and Wood brings distinctive design and exclusive know how to this beautiful object that will embellish the eyes of trendy luxury lovers. Shown is B25.3, in Nutmeg wood and satin black metal. www.gold-and-wood.com
Rigards frames are constructed of select African water buffalo horn, by the hands of a single artisan from start to finish, with an aluminum logo, and branded custom spring hinges that are made in France. The textured Sanjuro surface treatment, named as a reference to a samurai’s sword slashes, is carefully conducted by hand, this process is impossible to reproduce using machinery. www.rigards.com
Wooden Specs are for those who can appreciate the art and detail of these intensely handcrafted wood frames. And they make people look great – naturally! www.woodenspecs.com Seriously handcrafted bamboo frames with exotic wood inlays. Sealed with a bees wax based protectant that has superior finish. With Carl Zeiss TAC polarized lenses. Nature and technology balanced perfectly so that they are also Rx compatible. www.greinoptics.com
Kees Wennekendonk Dutch designer / artist Kees Wennekendonk produces hand-made, one-off spectacles from sustainable materials. He uses abstract descriptions as well as the portrait of the individual commissioner for his designs. The materials used are buffalo horn, wood and mammoth tusk, all waste-products meant to last for many years. Shown on velvet is model “Robert” buffalo horn. www.keeswennekendonk.nl/occhiali
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The Canadian design house pays homage to natural material and creates a wood and horn design. It contains metal inserts for easy lens insertion and plastic temple tips for ease of adjustment. The result is a fusion of the raw and organic with the sculpted and polished. Each design is available in three natural wood shades, including chocolate and true maple. www.spec-eyeworks.com
Wood and aluminum amalgamate to produce a truly unique, hand-made collection. Seven plys of wood together with two thin sheets of resistant aluminum are the core, providing flexibility, resistance and light weight. The absence of hinges, added to flexible temples, is a technical device that spreads weight not only on the nose but also the sides of the head, thus guaranteeing almost a perfect fit and total comfort. www.w-eye.it
The concept for DRIFT has always been to create fresh, beautiful products with an emphasis on responsible sourcing. Handmade using Mazzucchelli M49, vegetable-based acetate: 100% biodegradable and 100% recyclable. The temples are available in different sustainable wood combinations, including our most recent Delta Blues (100 yr. old Sunken Cypress from the Louisiana Delta). www.drifteyewear.com
eyebobs Reading glasses go green with eyebobsâ€™ Oh Shoot/Gone Fishing. Fashionably retro frames feature sustainable bamboo temples for the ultimate in eco-chic style. www.eyebobs.com
Coliseum 120 Luxury Wood Frame is constructed of the finest quality materials including fully adjustable spring temples. This eco-friendly style is available in 3 semi rimless Wood Color combinations, C1 Silver/ Ebony Wood (Ebenaceae family very dense Black wood) C2 Bronze/ Mahogany Wood (Meliaceae family, Dark colored Hard Wood) C3 (Shown) Gun/ Bubinga Wood (Leguminosae family, African Rose Wood) backed by a two year unconditional warranty. Sold exclusively in North America by National Lens. www.national-lens.com
ECOLOGICAL ECP Corrie Pelc
gold & wood moon2
Eco-Friendly: Eyeing the Future Lately it seems that everybody is turning a shade of “green.” From cleaning products to building supplies, manufacturers are putting a lot of effort into showing they are environmentally friendly by using sustainable materials or processes. ccording to the report, “Sustainability Nears a Tipping Point,” released in January 2012 by the MIT Sloan Management Review and the Boston Consulting Group, 70 percent of companies have placed sustainability permanently on their management agendas, and two-thirds of respondents said sustainability was necessary to being competitive in today’s marketplace.
The eyeglass frame industry is no exception. The last few years have seen a number of companies launching ecofriendly frames, from those made of recycled plastics to frames completely made of wood. And eco-friendly frame manufacturers believe this segment will continue to grow. “There will no doubt be more frames available using eco-friendly materials in the future,” says Chris Mantz, founder/designer of eco-friendly frame manufacturer DRIFT. “Advances in design and materials are allowing products to be better made and more environmentally responsible.” Not to mention consumers are looking for green products. The 2009
GMA/Deloitte Green Shopper Study found that of the more than 6,000 shoppers surveyed, 95 percent would buy green, and 63 percent are looking for “green” products, but were unable to find them. Pierre Fay, CEO of North America for MODO Eyewear – which makes the Eco eyewear line – believes one day all frames will be made eco-friendly because that is what consumers want. “People are starting to realize the importance of global warming, they are starting to really understand that every single small step contributes to the overall well-being of our plant, and consumers are looking for it,” he explains. “So a retailer today that puts green products on their board is responding to the need of the consumer and is gaining compared to his competition.”
Make It Green So what is it about eco-friendly frames that makes them, well, “eco-friendly?” First off, it’s the materials – such as sustainable resources like wood and bone or recycled materials – and the processes used to make the frames. Tipton Eyework’s Vinylize
12 E Y E C A R E P R O F E S S I O N A L
For example, Sire’s Crown q.v. hand-makes its frames from about 100 different types of wood, from bubinga to Italian ebony to walnut, that are sustainable, salvaged or reclaimed, says co-founder Chris Erven. “The cool thing about it is all of them are unique considering they’re coming from a live material – you never have two pieces alike,” says Erven. The process they use to create the frames took six years to develop, and allows them to use a thinner wood veneer put together with a cotton fiber and wood pulp substrate, making the
the records in the frames, says Paul Murphy, head of marketing. “The company was started by Zack Milaskey who wanted to make eyewear on a recyclable basis and he experimented by making old vinyl records into frames,” he explains. “The process has been refined over a number of years into quite a sophisticated product.”
And for its Eco line, MODO uses 95 percent recycled materials, says Fay, including pre-consumer recycled acetate leftover from the manufacturing of plastic frames, and post-consumer recycled stainless steel from old appliances, cars and electronics. Additionally, the frames are manufactured in an ecofriendly factory that follows energy-saving procedures, Fay adds.
For a Cause
The “green” aspect of a frame also extends to how they are packaged, shipped and marketed. For instance, MODO Eyewear ships its Eco sire’s crown q.v. frames in recycled paper pouches, not boxes, so each frame takes up less volume in a shipment, helping to reduce transport. Additionally, the frame cases are all foldable, which also cuts down on volume, and all the packaging is made of recycled materials.
frame flexible for thin prescription lenses. Another company using wood is Panda Sunglasses, which is made from sustainable bamboo, according to founder Vincent Ko. “Bamboo is strong, flexible and lightweight, so it is the perfect material for sunglass frames,” he explains. “Bamboo is the fastest growing plant on the planet and a great renewable resource.” Panda Sunglasses – which also use recycled polycarbonate lenses – are sourced and handmade in an ethical factory in China. “The handmade nature of the product makes each pair unique to its owner,” he adds.
from a 100 year-old sunken cypress from the Louisiana Delta.
The aforementioned DRIFT handmakes frames using 100 percent biodegradable and recyclable Mazzucchelli M49 vegetable-based acetate, explains Chris Mantz. And the temples are available in five different sustainable wood combinations, including their Delta Blues line, which used wood
Then when it comes to the POP (point of purchase) materials, Fay says the entire
At Wood Optic Diffusion, frames in the Gold & Wood line are made from wood and horn, says CEO Maurice Leonard. He explains that the wood for their frames comes from an FSC (Forest Stewardship Council) certified supplier, guaranteeing the right and proper monitoring of the wood’s traceability by an independent certification agency. “Its raw woods, from a controlled provenance, come exclusively from regions of the world where systematic reforestation is in effect and monitored by local authorities,” Leonard adds. At Tipton Eyeworks, the Vinylize frame line is made from recycled vinyl records. In fact, you can see and feel the grooves of DRIFT EYEWEAR E Y E C A R E P R O F E S S I O N A L 13
with the eco movement is just educating them, educating all the people that are selling so they can convey the proper message to the customers,” he adds. “And 99 percent of customers will appreciate it — they’ll feel like you’re not just a salesperson.” ECPs should also make sure their staff knows the story behind the frames, says Mantz. “Eco-friendly frames usually have great stories behind them – where the raw materials are sourced from or how it is made are unique selling points,” he explains. “Being able to speak knowledgeably about the process and materials can add more value to each frame sold.” PANDA SUNGLASSES’ NELSON
display – including counter card and name plaque – is shipped flat in pieces in an envelope made of recycled cotton. “The displays are in the shape of trees, made of recycled cardboard,” he explains. “You can assemble the tree by sliding two pieces together and it becomes a display. All the POP is actually shipping in a flat envelope, again drastically reducing the shipping cost and the shipping footprint.” Tipton Eyeworks uses stands made of old records as their face displays for the Vinylize line, and always reuses packaging and filler materials, Murphy says. At Panda Sunglasses, all the sunglasses come in a sustainable bamboo case. The company uses plantable businesses cards and eco-friendly marketing materials. Additionally, Panda has tied itself to a charitable cause as part of its marketing. According to Ko, each pair sold “gives the gift of vision” – a pair of prescription lenses and an eye exam – to someone in need through their partnership with the TOMA (Tribal Outreach Medical Assistance) Foundation.
about 750,000 trees so far and we are looking to hit 1 million trees as soon as we can,” Fay says. And having a charitable cause tied to a frame line can also be a selling strategy. According to the 2010 Cone Cause Evolution Study by Cone Communications, 85 percent have a more positive image of a product or company when it supports a cause they care about, and 80 percent of Americans say they are likely to switch brands, similar in price and quality, to one that supports a cause.
Sell it So for ECPs looking to add eco-friendly frames to their optical, how can they best market these products to their patients? First off, Erven — who has been an optician for the past 15 years — advises training employees to know the differences between eco-friendly and non ecofriendly products so they can communicate these facts to their customers. “The main thing with getting people on board
When marketing eco-friendly frames, Ko suggests ECPs focus on the sustainability aspect and how the patient’s purchase positively impacts the environment. “The world is evolving and individuals are more aware of ethical consumerism,” he adds. “The ideal Panda customer cares about the environment, social causes, and ethically-sourced products — our customer doesn’t compromise integrity for style.” And Fay even suggests ECPs take it one step further and do what they can to turn their practice into a “green” practice. To help practices do this, Fay says MODO is planning to offer a training process that will help ECPs position themselves as a “green” practice in their community, showing they are sensitive, caring and responsible. “By doing that, they are certainly capturing the interest of their community ... (and) I think there is an opportunity for the ECP to raise their standing in the community by being environmentally conscious.” ■
Sire’s Crown has also tied its eco-friendly frame line to a charitable cause. Erven says for every frame they sell, they plan a tree for the future. “This past year we planted over 10,000 trees with this company,” he adds. MODO Eyewear also does something similar through the Tree for the Future Program, which has been focusing on planting trees in Africa. “We have planted
MODO’S SAO PAULO
MANAGING OPTICIAN Anthony Record, ABO/NCLE, RDO
Online Shopping Shockers When it comes to writing and ranting about purchasing prescription eyewear online, frankly, I thought I was done.
resulted in the loss of his eye. Only luck kept that tragedy from happening.
s optical online shopping began to take hold a few years back, I immediately expressed my concern about patient safety, along with my wonder as to whether or not the whole idea of buying eyeglasses sitting in front of a computer monitor – as opposed to an educated, experienced, living and breathing eye care professional (ECP) – would actually take hold. While the former has only grown, the latter is no longer in question. Online shopping for glasses has continued to grow.
Now don’t get me wrong. I am a government-only-as-necessary kind of guy. Having said that, unless specific regulations and restrictions are enacted, I believe the number of prescription eyeglasses purchased via computer will begin to grow exponentially. If you doubt that statement, consider the most recent statistics that I could find: According to the Vision Council of America (www.visioncouncil.org), nearly 2 million pairs of prescription eyeglasses were bought online in 2010. That represents just under 3 percent of the nearly 70 million pairs that were bought in the United States that same year. My concerns about patient safety were, at first, merely instinctual. My concerns were reinforced as I began to see firsthand the lack of quality and workmanship with some of the products I saw that were
purchased on the Internet. This included frames falling apart, incorrect prescriptions, and paid-for lens treatments that had mysteriously disappeared from the time they were shipped and the time they arrived at the consumer’s doorstep. Perhaps my greatest concern was about lenses that failed to meet impact resistance standards. This concern only heightened when I was asked by a patient to replace a lens that had shattered in a three-piece drill mount he had purchased online. The lens was not polycarbonate or Trivex. I’m not even sure it was CR-39. What I do know is that it was plus prescription with a nearly knife-edge thickness of less than 0.5 mm. Luckily, the lens had shattered when it was accidentally dropped on the floor by my new-found patient. It could just as easily have shattered as result of a foreign body striking it while he was wearing it. That, in turn, could have
My concerns reached their pinnacle after reading an article that appeared in The Chicago Tribune on February 22, 2012. The article’s author, Julie Deardorff, summarized the problem in her opening two sentences: “Armed with a prescription and some patience, consumers can save hundreds of dollars – and maybe some time – by buying eyeglasses online,” she said. “For most, the major concerns are cosmetic ones. But an important risk is overlooked: the quality and safety of the lenses.” She goes on to explain that researchers had purchased 200 pairs of prescription eyeglasses from the 10 most popular online optical retailers. The results were truly shocking. Deardorff goes on to report that researchers had found that nearly half (that’s right...half) of the prescription glasses they bought online either had been processed incorrectly or most incredibly, “didn’t meet the standards for impact testing, meaning the lenses could crack or [even] shatter, according to a small study published last year in the journal Optometry.” Continued on page 18
16 E Y E C A R E P R O F E S S I O N A L
MOVERS & SHAKERS The Vision Council At its annual Executive Summit, The Vision Council officially inducted its 2013 officers and board of directors. Raanan Naftalovich of Shamir Insight has been named chairman. He will be joined by Martin Bassett of Walman Raanan Naftalovich Optical as vice chairman, Dick Russo of Safilo as secretary/treasurer and Jamie Shyer of Zyloware Eyewear as immediate past chairman. Also elected were directors at large Doug Hepper of Vision Ease, Claudio Gottardi of Marchon, John Corsini of Super Systems, and Andrea Dorigo of Luxottica.
Transitions Optical Transitions Optical, Inc. has promoted Renee Himel to a newly created role of Director, Brand Experience for North America. She will be responsible for overseeing long-term opportunities focused on engaging both consumers and Renee Himel eyecare professionals to experience the Transitions速 brand and family of products. Himel has held positions of increasing leadership responsibility since joining Transitions Optical in 2007, serving as Senior Marketing Specialist, Retail and Business Manager Channel Marketing and, most recently, Associate Director, Channel & Communications Marketing.
QSpex Technologies QSpex Technologies has named Brian White, CPA, as chief financial officer. White has 20 years of experience, both domestic and international, throughout diverse industries including retail, manufacturing, logistics and banking. Most Brian White recently he was CFO of Books-A-Million, Birmingham, Ala., a leading retailer with $500 million in sales and 250 locations.
SynergEyes, Inc. has announced that James Kirchner, OD has been named to the position of senior vice president of clinical and professional services. In this role, Kirchner will provide professional leadership of product development and product management.
Prior to joining SynergEyes, Kirchner was chief professional officer for Eyefinity/OfficeMate, a VSP Global company. He has also been a chief executive of over a dozen start-up companies, many of them outside the ophthalmic industry.
Assuming that online purchasing has even only slightly increased since 2010, if you do the math (and since the United States ranks 34th in the world in math I’ll do it for you), that means more than 1 million Americans are put at risk, every year, by receiving unregulated, unrestricted, and seemingly unchecked spectacles. If that statistic doesn’t get your attention, consider Deardorff ’s final paragraph: “1 in 4 pairs of children’s eyewear failed impact resistance testing...the study also showed that almost half of the glasses surveyed didn’t provide the stated prescription or had issues with impact resistance testing.”
“I began to see firsthand the lack of quality and workmanship with some of the products I saw that were purchased on the Internet. This included frames falling apart, incorrect prescriptions...”
Which all begs the question: What can we (ECPs) do about it? In my opinion, the answer lies in the analysis of Deardorff ’s first couple of sentences, by taking to heart the grim findings regarding the lack of impact resistance as reported, and by not standing idly by. First, if consumers are flocking to online sellers to “save hundreds of dollars...and maybe some time,” why not address those two issues as they relate to your day-to-day practice of opticianry? Reexamine your price structure. Is it fair? How do you determine your margins or markups? Do you place a retail price of $195 on a frame that cost you $9.95? Do you inflate your prices only to offer an unbelievable Buy One Get One Free ad in your local newspaper? Do you lure your patients with an ad that says “$69 complete” only to offer half a dozen frames (none of which you’d be caught dead wearing) at that price? It is those kinds of practices, along with others, that sometimes cause brick-and-mortar patients to make their purchases elsewhere. What about the issue of saving time? Rethink your hours of operation. Do you offer hours that are most convenient for working people? Maybe it would make sense to be open on Sunday and close on Wednesday. Is your staff trained not only in optics, but in customer service, communication, and time management? From a patient’s perspective is buying glasses from your practice an obligatory ordeal she has come to dread, or a pleasant experience she looks forward to? Do you schedule appointments so that a patient is seen on time, or in such a way that the doctor can squeeze in as many patients as he can (to extract as many dollars as he can), the result being
that patients are rarely seen on time and routinely complain about their wait? Second, regarding the impact resistance issue: educate, educate, educate. Spread the word about the problem to anyone not only the people you meet at work who will listen. I actually went online (ironically), found the article I have referenced here, made five copies, had them laminated, and have displayed them around my office. Finally, don’t stand idly by. It is possible to make a difference. To that point, I give you the FCLCA (Fairness to Contact Lens Consumers Act). While it was not the perfect solution to Internet contact lens purchases, it certainly shows that when people speak up, change can occur. Have you reported your experiences with Internet-bought eyeglasses to your Congressman, the FDA, the FTC? Have you emailed your state or federal legislator to voice your concern? As I write this article I am watching the ceremonies of President Obama’s second inauguration. While he has many bigger fish to fry, I think I might write a letter to him to convey my concerns. Maybe it will get someone in his Administration’s attention, maybe not. Mine will only be one letter after all. But I bet if over the next few months he received thousands of letters on the issue, it would indeed, get someone’s attention. What do you have to lose? I’ll tell you: 15 minutes and the cost of one postage stamp – 46 cents as of January 27. On the outside chance you have 15 minutes and 46 cents to spare, President Obama’s address is: 1600 Pennsylvania Avenue, Washington, DC, 20500. ■
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ECP ECONOMICS Lindsey Getz
Industry Outlook Now that we’re into 2013, let’s take a look at what some of the key issues may be for the eye care industry
ith the election over and a fall over the Fiscal Cliff at least temporarily averted, 2013 is beginning with a bit more “clarity” than last year. Still, some of that unwanted uncertainty remains—such as what exactly will happen with the nation’s growing debt. Coupled with the fact that many companies took a beating during the recession, most optometric businesses seem to be focused on cautious optimism for 2013. Though business does seem to be picking up, and there appears to be some room for growth, many businesses are choosing to take it slow.
Slow to Grow Ted Massaro, chartered financial consultant with M Financial Planning Services in Marlton, N.J. says that the difficulties experienced by businesses during the recession and recovery have caused lingering doubts about growing— despite the fact that 2013 is looking to be a brighter year. “Most business owners I talk to are anticipating higher sales and revenue in the New Year—economic indicators and consumer confidence seem to indicate a ‘cautious confidence,’” he says. “However, the lessons of the last few years were hard-learned so I think that cutting corners is still going to be front-of-mind for many decision-makers, as evidenced by business purchases not quite picking up yet.”
Although optometry, as a field, wasn’t as hard-hit as some other industries (patients still need their eyewear and many still attended to their eye health), the truth is that some patients were more likely to “skip” their annual eye exam when times got tough. In 2009, while many were still struggling from the effects of the recession, a survey from the American Optometric Association (AOA) revealed that 36 percent of Americans said they were limiting their doctor visits because of the recession. When asked which doctors they are visiting less, the majority indicated the dentist (63 percent), followed by the primary care physician (59 percent), and then the eye doctor (52 percent). Only eight percent said they would stick to their regular health schedule. More women than men said they would limit doctor visits. And in terms of specific doctors, women were more inclined to cut back on seeing the eye doctor than men. Unfortunately, even as we’ve begun to see an upturn from the recession, research seems to indicate that some patients are forgoing their eye exams. In 2011 a survey from the CDC showed that a large number of people who have problems with their eyesight don’t visit the eye doctor because of cost or lack of vision coverage.
In a study involving 11,503 adults age 40 or older, who were considered having moderate-to-severe visual impairment; nearly 40 percent said they had skipped seeking eyecare in the past year because of costs or lack of insurance. That says that even though we seem to be turning a corner, cutting costs is still at the forefront of many minds. Financial experts like Massaro say that what “comes out of Washington” has a lot to do with what the general public does with their money. When people see the rapidly growing national debt they begin to get anxious about spending their own money. They start thinking about their own debt. And even though a fall over the Fiscal Cliff has been temporarily averted, many Americans are still thinking about rising taxes. All of this makes them more likely to cut back and it seems that eyecare may be one of those areas where cutbacks occur.
Optometry Concerns for 2013 Of course optometry also has some industry-specific issues to deal with that may make 2013 a challenging year. The continued growth of national chains is still a concern for many eye care profesContinued on page 22
20 E Y E C A R E P R O F E S S I O N A L
sionals and will remain an issue for 2013. Many small practices still feel the stress of competing against large chains that move into their area. As patients become more concerned about the bill for their eyecare, some fear they may be more likely to move their care to a discount chain.
While many would have liked to see a bigger turnaround by now, many financial and business experts say there are still reasons to remain positive in 2013. Times have changed and that means that businesses—including private practice optometry—need to adapt. But many are learning to do so and are finding ways to be successful. While it’s easy to get caught up in the doom and gloom that lies in “uncertainty” the truth is that things do appear to be turning around. While consumers may not be spending as much as they used to, economic reports seem to indicate they’re spending more than they were in past years.
As more patients become familiar with online shopping, eye care professionals are also increasingly concerned about losing contact lens and eyewear business to the Internet. This concern remains at the forefront of 2013. The best weapon that eye care professionals may have against both of these issues is ramping up their educational and marketing tactics in order to ensure that patients recognize the benefits of receiving their eyecare—and their eyewear— through a highly reputable practice. Developing loyalty with patients also goes a long way. Build relationships with your patients and you will do a tremendous service to your practice by encouraging them to continue coming back. Of course another concern in 2013 remains proposed healthcare changes. In fact, changes to vision care plans asso-
ciated with President Obama’s Affordable Care Act are currently at the forefront of industry concerns. Currently there is a lot of uncertainty as to exactly how this issue may affect the eye care industry but we know that change is on the horizon.
If eye care professionals can continue to find ways to adapt to the “new norm” then they should be able to continue to build strong practices. Ramping up marketing efforts and taking more time to build patient relationships in order to retain the current base will all pay off by keeping practices strong, despite a variety of changes taking place in this New Year. ■
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THE MOBILE OPTICIAN Ginny Johnson, LDO, ABOC
Yummy, Yummy, Yummy I’ve always had reservations about using the good, better, best lens menu approach with patients.
It’s obvious when patients are feeding me a bunch of junk: My glasses were on my nightstand and I woke up and they were broken. I always clean my glasses like you told me to and look how scratched my lenses are. I never leave them in a hot car so I can’t imagine how my lenses got so warped.
on’t get me wrong, I want to make sure our patients are aware of the finest ingredients we use, I just prefer using the brunch menu. It’s shorter and sweeter, offering the best first with basic on the back burner. Setting the dispensing table with good intentions and serving up your best can put a lot on your plate.
Even though sometimes I’d like to feed them a mouth full right back, my bewildered look is usually enough. Figuring out how to cater to every single patient is similar to standing on your head while eating soup broth using your toes and a pair of chop sticks. It’s impossible to cater to everyone.
When patients are invited into the dispensary the last thing I want to do is overfeed them.
Design your space to be parallel with your menu. Fast food and fine dining aren’t usually under the same roof. If you attempt to do both then you need to be a top chef and not a kitchen witch.
For those who’ve had terrible experiences elsewhere, I like to stir up the pot and get to the bottom of it. I won’t ask for the name of the establishment unless our head chef requests it. It doesn’t matter who burned them, what matters is how and if we can help them without getting burned.
Fast food patients want to get in and out while spending as little time and dough as possible. These patients already know what type of frames and lenses they want. They dictate how much their bill needs to be. Some are expecting fine dining menu items at fast food pricing. If they have a bad taste in their mouth
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about a previous tab or menu item they may become frozen in time and never thaw out. Here’s a fast food scenario: Would you like to super size your eyewear order today with our best apple pie AR? Sir, I can barely hear you, please speak up. Was that a “no”? Are you still there? Please drive around to the window. How are you doing today? Did I hear you say that you don’t need AR? Let me just repeat your order. You want the basic lenses without AR because the AR is a big waste of money in your opinion. OK, now I see why you are saying that. You have the fry grease AR on those lenses. If you weren’t in such a hurry today, I could probably help you. I’ll be right back with your order. Have a great day. Come back and see us when you are ready to order the real deal. Fine dining patients are hungry for excellence and crave the best items on the menu. Some may be picky eaters and have questions about how the items are prepared. Others will order exactly what you recommend without hesitation. These patients don’t have food fights with your pricing. Continued on page 28
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A la carte pricing may work well for restaurants but it adds up quickly when discussing eyewear. Use package pricing to avoid giving them food poisoning. Quote one price for the combination of menu items needed to fill their eyewear order. You will find that package pricing is easier for patients to digest and less time consuming. If patients are using vision insurance then package pricing may be a little trickier. With all of the different plans and co-pays you have to cook by using many different recipes. Don’t be so quick to grab your calculator every time these patients have pricing questions. It’s bad table manners and not always medically necessary. Using a calculator and adding up co-pays for menu items and services
not yet rendered, is like a waiter bringing your bill to the table before the meal is even served. A la carte pricing promotes the process of elimination in eyewear sales. If you add the cost of each lens enhancement separately, expect to get choked up from time to time. The value of each menu item can come across as worthless. Suddenly the cool pair of eyewear they loved a moment ago, costs too much for them to fall in love with. They decide they don’t need any lens enhancements and will settle for less or leave empty handed. We all know there are many recipes to follow for success. Asking your patients questions similar to the ones that Food Service Managers use can lead us in the right direction.
How is everything? Are you enjoying your meal? Is our staff taking good care of you? Would you recommend us to your family and friends? Is there anything we can do to better serve you? Whether patients are stopping by to check out your menu or calling ahead to make reservations, they should feel like they are being treated special. Don’t let those self serve, take-out places gobble up your patients. I
MOVERS & SHAKERS Viva International Group
American Academy of Ophthalmology
Viva International Group has promoted Celina Huizar Fouts to the position of sales director for Viva’s eastern U.S. division. Based in Atlanta, Huizar Fouts will oversee the sales efforts in the east coast region of the country, Celina Huizar Fouts and she will join Barry Jones and Kelly O’Grady who lead Viva’s central and western divisions, respectively. Huizar Fouts joined Viva in 2006 as a Gant sales consultant and she was promoted to regional sales manager for the southeast in 2008.
Paul Sternberg, Jr., MD has begun his term as president of the American Academy of Ophthalmology. Dr. Sternberg will hold office for one year as the 116th president of the AAO, as elected by the Academy’s 32,000 members. A Paul Sternberg nationally recognized ophthalmic education and research leader, Sternberg currently serves as the G.W. Hale professor of ophthalmology and chairman of the Vanderbilt Eye Institute of the Vanderbilt University School of Medicine in Nashville, Tenn.
Surgical Eye Expeditions International
Surgical Eye Expeditions (SEE) International has named Brian D. Stenfors vice president of advancement. With more than 25 years of fundraising experience, Stenfors comes to SEE International after seven years as manager of Brian D. Stenfors affiliated campaigns for the Cottage Health System. Associated with the Family Service Agency of Santa Barbara, SEE International and Fielding Graduate Institute, Stenfors was also president of the Santa Barbara/Ventura County Chapter of the Association of Fundraising Professionals.
Vision Source has announced that Jim Greenwood will assume the position of president and chief operating officer. He joins the executive team after serving as CEO of Concentra for more than five years. He will Jim Greenwood report to Vision Source CEO and founder Glenn Ellisor, OD. Greenwood serves on the board of directors for Epic Health Services, Inc. and the Baylor University Healthcare Administration Program’s Advisory Council.
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Construct a Colored Lens Power Number Line for Office Use Only One Simple Strategy to Increase Business Revenue By Renee Jacobs O.D., M.A.
LEARNING OBJECTIVES Gain experience with one method to manage sales of high index lens materials. Understand benefits of an office standard including:
Have you noticed that some of the most brilliant business ideas are amazingly simple! Superb ideas earn trust and loyalty from patients who are already in your office, plus they are easy to implement. Ultimately, earned trust is what secures present and future revenue per patient, plus word of mouth referrals.
• consistent lens material recommen-
dations between professionals within one office • an easy method for educating those who cross train into optical • a simple method to manage sales as lens material availability evolves and lens technology advances Renee Jacobs O.D., M.A. is backed by exceptional academics and life experience. In addition to her Doctor of Optometry degree from the University of California at Berkeley, Dr. Jacobs also has a Master’s Degree in Curriculum and Instruction, a Bachelor of Science in Biochemistry, plus experience as the owner and administrator of a Learning Center. Dr. Jacobs grew a state of the art optometric practice for 13 years. She writes for professional trade publications and presents at International Vision Expo. She develops curriculum and provides live interactive training as the Director of Practice Management Depot. CREDIT: This course is ABO approved for 1 CE Credit, General Knowledge Level II, $9.99, Also available online: www.ecpmag.com/ce
30 E Y E C A R E P R O F E S S I O N A L
One simple and deceptively powerful business idea is to construct a Colored Lens Power Number Line for Office Use Only. This colorcoded tool illustrates the preferred Index of Refraction for any lens power (See Figure 7). Once you have defined your office standard, you can provide Index of Refraction advice with each written prescription. This information will help your patients make purchasing decisions best for them. Furthermore, you can measure increasing business revenue. Empower your patients: • Armed with Index of Refraction advice, smart consumers will make fair comparisons. They are less likely to be enticed by price advertising for inferior lens materials. • Informed consumers can take personal responsibility for poor decisions. For example, a patient might accept responsibility for buying polycarbonate lenses from your competitor, though you recommended 1.70 high index lenses. It is not your fault when the resulting lenses are thick, and heavy, with poor quality optics. • Savvy consumers might do their own research, and then return to your office to make their eye wear purchases. These patients become advocates for your business.
Inconsistent Product Messages Can Decrease Business Revenue Inconsistent product recommendations can erode a patient’s trust. If ignored, the consequence is decreasing business revenue: • A patient might experience different advice from professionals within your office. Imagine that one optician makes an Index of Refraction recommendation. Then the patient leaves and returns a few days later with a frame, meets a different optician in your same office, and receives different Index of Refraction advice. From the patient’s perspective, are you credible or even trustworthy when professionals within your office disagree? Patients can get the impression that Index of Refraction is arbitrary or a way you inflate your prices. After all, they can walk down the street and purchase “featherweight lenses” for an advertised low price. Business suffers when you create doubt and distrust. • Junior staff, and those cross training into optical, often don’t know which Index of Refraction to recommend. Patients buy less when opticians fail to advise. • Some doctors fail to recommend Index of Refraction in the exam room. The reasons are numerous: º Some don’t thoroughly understand new lens technologies. They can’t recommend with authority, because they lack knowledge. º Some believe the exam room is the safe
place for confidential healthcare conversations, and “selling” diminishes the integrity of the doctorpatient relationship. º Some do as little as possible to earn a paycheck. With no vested interest in the optical, they provide prescriptions without product recommendations. Regardless of the reason, when a patient leaves your office with an Rx in hand and no written product advice, your business is set up to lose revenue. Don’t feel indignant or outraged when your patient purchases inferior products from a competitor, then returns to you for help. You became obligated to provide free troubleshooting when you released that Rx without an Index of Refraction recommendation. It is expensive to first lose the sale and then provide free care! Each patient trusts the doctor to provide an accurate prescription, and solve the problem if vision is not clear through that Rx. If you violate trust, then you risk losing the patient, their referrals of friends and family, plus revenue from current and future sales.
One Simple Solution Empower your patients to make informed purchasing decisions. Help them select the Index of Refraction best for their prescription. Standardize your recommendations, and then provide consistent advice with each written prescription. Opticians and doctors can work together to create your office standard. Create a color-coded tool that illustrates the preferred Index of Refraction for any lens power, a Colored Lens Power Number Line, unique and true for your office (See Figure 7). Begin with action steps.
Pre-Construction Action Steps Knowing that eye-care providers hold strong positions developed through years of education and experience, take steps toward facilitating effective collaboration. Create a positive environment by estab-
lishing a shared group identity, plus clear objectives including goals and guidelines.
• We are thinking of an average frame size and a patient with an average PD.
Establish Shared Identity Use the following statement as a draft for individual and small group discussions. Modify it to suit your business environment.
• Budget is not a consideration. This is not WHAT we would recommend, if we THINK the patient can afford it. This is WHAT we believe is BEST, the minimum Index of Refraction appropriate for each prescription number.
We are better than our competition. We help our patients make the best possible decisions because we understand optics and we are great educators. After acknowledging a common identity, confirm common goals. Establish Goals Use the following statements as a draft for individual and small group discussions. Modify them to suit your needs. • Our ambition is to always recommend what is best for the patient. • We desire to provide our patients with consistent product recommendations, doctor to doctor, doctor to optician, and optician to optician, from the sale all the way through a multiple pair dispense. • We want the flexibility to exercise professional judgment: º If a doctor has a patient who is weight sensitive, a doctor can recommend the thinnest and lightest materials.
• We are standardizing our baseline recommendation. Patients will always have the option to purchase lighter and thinner materials. • We are standardizing the general rule for the average patient, so that all doctors and opticians are in agreement. • We realize there will be exceptions. After establishing guidelines, and before customizing your Index of Refraction criteria, each can practice plotting prescriptions on a Lens Power Number Line. Practice Using a Lens Power Number Line Begin by thinking of each prescription as a lens cross. For minus prescriptions, plot the thickest edge. For example: - 2.00 - 3.00 x 090OU, (See Figure 1): Figure 1
º If a patient selects a small frame, we know small lenses have less ophthalmic plastic, therefore less weight and thickness. Therefore, an optician can use professional judgment, recommending a slightly thicker material. After defining goals, review general guidelines. Establish Guidelines Use the following statements as a draft. Modify them as needed. • We are building Index of Refraction recommendations for plastic lenses, not glass. • As we construct our Lens Power Number Line, each number will represent the lens power of a spherical lens blank.
This lens is the thickest along the horizontal meridian. Plot -5.00 on the Lens Power Number Line (See Figure 2). For plus prescriptions, use two steps. For example +3.00 -6.00 x 090 OU, (See Figure 3):
E Y E C A R E P R O F E S S I O N A L 31
Figure 2 They recommend 1.70 or thinner for minus lenses higher than -5.50 and for plus lenses higher than +5.00.
We are better than our competition. We help our patients make the best possible decisions because we understand optics and we are great educators. After completing pre-construction action steps, build your office standard.
Construct a Colored Lens Power Number Line for Office Use Only Figure 3 Step 1: Plot the most plus major meridian, the meridian that will determine center thickness. In this example, plot +3.00, on the Lens Power Number Line (See Figure 4). Step 2: Notice if minus cylinder will add significant weight and thickness, and use professional judgment. In this example, notice that -6.00 cylinder power will significantly increase edge thickness along the horizontal meridian. For this reason, consider a material that is thinner than you would typically recommend for a +3.00 spherical lens. If plotting prescription powers along a Lens Power Number Line is confusing, review a lesson on lens crosses. Every optical professional should glance at a prescription and immediately identify the meridian that determines center thickness and the meridian with the thickest edge. This ability differentiates us from our competitors. Remember:
Provide Materials Provide each participant with colored pencils, a copy of the blank Lens Power Number Line (Figure 5), and the grid shown on the following page (Figure 6). Together, look at the grid. Notice that each color, positioned down the left side, represents an Index of Refraction for a lens package. Provide Examples See example #1 (Figure 7). Each color designates the material of choice for a given lens power. Remember the guidelines. As we construct the Colored Lens Power Number Line, we are thinking of spherical lens blanks, an average patient, an average frame, and an average PD. Plus we are thinking of plastic, not glass. This colored line illustrates that this office generally recommends Trivex (shown in green) as their material of choice for prescriptions from -4.00 to +3.00. They recommend 1.67 (shown in orange) from -4.00 to -5.50 and from +3.00 to +5.00.
The standard is for Office Use Only. Individual professionals can exercise flexibility appropriate for a patient. In some cases, the accepted standard includes qualifiers. See example #2 (Figure 8). This office generally recommends CR39 (shown in white) as their material of choice for prescriptions from -4.00 to +3.00. For that same power range, they recommend Trivex (shown in green) for children and for safety. They use Polycarbonate (shown in yellow) only when price point becomes an issue for a budget conscious patient. The qualifiers are documented in the EXPLANATION column (See Figure 9): Each Participant Constructs Their Current Standard Ask each participant to illustrate their current practices, guided by individual life experience, education, and beliefs. Color their own number line, showing the minimum Index of Refraction appropriate for each prescription power, best for the average patient. Then document qualifiers in the EXPLANATION column of their grid. Write criteria that influences their Index of Refraction recommendations. Collaborate to Create Your Office Standard After everyone has completed their own Colored Lens Power Number Line, the group can collaborate to create the most acceptable office standard.
Post-Construction Action Steps Figure 4
Distribute Once you have your office standard, put colored copies in predictable places for easy reference. Place them in each exam room and at each dispensing table. Measure Sales Indicator The greatest benefit of setting the office standard is providing consistent advice that earns patientâ€™s trust. The next, most important benefit is the capability to
Exam can also be taken online at www.ecpmag.com/ce 32
1 ABO CE Credit, General Knowledge, Level II, $9.99 Figure 6
work unless the office uses it. Also product messaging must be convincing, so that patients trust professional advice and purchase accordingly.
Provide Consistent Product Advice Build trust through consistent practices. Empower patients with product knowledge so they can make fair comparisons. Always include the Index of Refraction recommendation along with the spectacle Rx. Grow loyalty. In the event a patient ignores good advice, and buys thick, heavy, lenses with poor optics, then you can re-educate regarding the importance of purchasing an appropriate Index of Refraction. Patients will appreciate you, instead of blaming you for their bad experience.
measure. You can measure if patients purchase what opticians recommend. Each participant can measure by reviewing their patient orders. Evaluate each prescription and the Index of Refraction ordered â€“ compared to your Colored Lens Power Number Line. Notice if patients consistently purchase the recommended Index of Refraction or thinner. If invoice review is evidence that all opti-
cians are implementing the Colored Lens Power Number Line to guide their recommendations, and patients are buying products best for them, then Great for Patients! Great for Business! If instead, invoice review proves that patients are NOT buying the recommended Index of Refraction, or thinner, then talk individually with optical professionals. Certainly the office standard wonâ€™t
Finally, measure. You can use the method of invoice review to determine if patients, who purchase lenses in your optical, are buying according to your office standard. For each invoice, compare the patientâ€™s Rx to your office Colored Lens Power Number Line. Count the number of patients who purchase the recommended Index of Refraction or thinner. Count the number of patients who purchase lenses that are thicker than recommended. Use this method to determine if patient education effectively persuades patients to purchase products best for them. Improve sales by improving communication. Modify the message. Change what you say to patients, the pictures to illustrate key messages, and demonstrations. Modify the message until sales indicators prove that patients make appropriate purchasing decisions. A Colored Lens Power Number Line is one amazingly simple business idea. The tool can help your business improve product messaging to increase sales and empower patients. Save yourself the expense of losing a sale and then providing Free Care too!
E Y E C A R E P R O F E S S I O N A L 33
Questions: 1. When you consider Index of Refraction guidelines, which statement is most appropriate? a. We are thinking of a large frame size and a patient with a wide PD. b. We are constructing Index of Refraction recommendations for plastic lenses.
d. We don’t expect junior opticians to provide expert advice or achieve high sales numbers.
a. We always sell the most expensive lens we can convince a patient to purchase.
d. Our office standard is influenced by what patients can afford.
b. We use the standard for most cases, yet can exercise professional judgment.
a. We are standardizing the most profitable recommendation. b. Standards are rigid and there will be no exceptions. c. Standards help doctors and opticians communicate consistent recommendations.
c. Any lens order that differs from the Index of Refraction office standard must be approved by management.
6. For the prescription: - 1.00 - 3.00 x 180 OU, what is the lens power along major meridian A (See Figure 10):
d. -3.00 9. For the prescription +5.00 -3.00 x 090 OU, what is the lens power along the major meridian B (See Figure 10): a. +5.00 b. +2.00 c. +8.00 d. -3.00 10. For the prescription +5.00 -3.00 x 090 OU, which meridian will determine the center thickness of the edged lens (See Figure 10):
c. 135 Oblique Meridian d. 180 Horizontal Meridian 11. Effective collaboration requires all except:
b. Patients are more likely to be enticed by a competitor’s advertised low price.
a. Optical professional share a common identity.
c. Patients will blame the doctor if they do not see well through glasses purchased online.
b. Only senior opticians will know what is best for each patient.
b. 045 Oblique Meridian
a. Patients know optical professionals disagree regarding the best material for an Rx.
a. Doctors should never provide general product advice in the exam room.
a. 090 Vertical Meridian
3. Consistent product recommendations are important so that:
4. Identify a statement toward facilitating effective collaboration:
d. It is best if patients do not understand Index of Refraction.
d. Standards reduce the need for documentation in a patient’s file.
d. Each patient is empowered to purchase the Index of Refraction appropriate for their Rx.
8. For the prescription +5.00 -3.00 x 090 OU, what is the lens power along the major meridian A (See Figure 10):
5. Which statement describes an appropriate common goal?
c. Each number, on the number line, represents lens power in the meridian of the thinnest edge.
2. Which statement is true regarding Index of Refraction standards?
a. -1.00 b. +2.00 a. -4.00 d. -3.00
c. Together, we help our patients make the best possible decisions because we understand optics and we are great educators.
a. -1.00 b. +2.00 a. -4.00 d. -3.00 7. For the prescription: - 1.00 - 3.00 x 180 OU, what is the lens power along the major meridian B (See Figure 10):
b. They have well defined goals and guidelines. c. All will listen to honest opinions. d. Some are unwilling to voice honest opinions. 12. The Colored Lens Power Number Line is for Office Use Only because: a. Most patients already know how to use a lens cross to analyze a prescription. b. Most patients can use the tool without an optician’s help.
Exam can also be taken online at www.ecpmag.com/ce 34
1 ABO CE Credit, General Knowledge, Level II, $9.99 having an office standard regarding material recommendations?
c. It helps staff members, but it is not a great tool for patient education. d. All office standards should be secret.
a. A junior optician will not know which Index of Refraction to recommend when a walk-in patient provides an outside prescription.
13. A Colored Lens Power Number Line can be modified. Choose the worst reason to modify your office standard.
b. Patients will notice that Index of Refraction recommendations are arbitrary, a strategy to inflate fees.
a. A new optician is consistently recommending Trivex material for patients with prescriptions that should have 1.67 Index lenses according to your office Colored Lens Power Number Line.
c. Those who cross train into optical will not recommend the appropriate Index of Refraction.
d. Use your Colored Lens Power Number Line to explain the office standard to an optician who will provide temporary coverage during your vacation.
d. Doctors will feel comfortable recommending a baseline Index of Refraction in the exam room.
b. Your lab has a production problem and one Index of Refraction is on indefinite back order.
15. Which of the following IS NOT part of Invoice Review:
c. Your office has decided that Trivex should replace CR39 as the material of choice for prescriptions between +3.00 and -4.00.
a. Evaluate each prescription and the Index of Refraction ordered – compared to your Colored Lens Power Number Line.
d. One of the lens materials is not compatible with a new top tier AR treatment.
b. Notice if patients consistently purchase the recommended Index of Refraction or thinner.
14. Which of the following is caused by
c. Determine if your words, illustrations, and demonstrations convince patients to purchase the Index of Refraction that is best for their prescription.
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E Y E C A R E P R O F E S S I O N A L 35
Springtime Brings Increased Risk for Eye Injuries Outdoors by THE VISION PROTECTION COMMITTEE OF THE VISION COUNCIL
SPRING IS A GREAT TIME OF THE YEAR. It brings a season of beauty, a turn toward warmer weather and plenty to do outdoors. Unfortunately, the spring season can also present a higher risk of eye injuries. Lawn care and gardening are just two examples of springtime activities that can increase a patient’s chance of an eye injury. According to the American Academy of Ophthalmology, nearly half of all eye injuries in the United States occur annually around the home. Despite the fact that 90 percent of these injuries could be prevented by using protective eyewear, a recent survey by the American Optometric Association showed that only half of survey respondents reported wearing protective eyewear when performing home or yard maintenance tasks.
Another area of great concern is sports-related eye injuries, especially among young athletes. School-aged competitors are particularly prone to eye injuries since their athletic skills (hand-eye coordination, balance, reaction time and speed) are still being developed. Under most circumstances, 90 percent of sports-related eye injuries are preventable with the proper use of protective sports eyewear.
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With soccer and baseball season upon us, it’s more important than ever to encourage patients to invest in and regularly wear protective eyewear. Eyecare providers play an important role in educating consumers about the need for and proper use of eye protection. Regardless of the season, taking the responsibility to inform your patients of the need for vision protection can be a practice enhancement. In your office, you can practice the “Inquire. Inform. Introduce.” strategy. Since eye injuries can occur in a number of scenarios, including around the home or while playing sports, start by considering all of your patient’s daily activities. Note the activities that present a potential for eye injury and follow-up by offering your patient relevant, preventative solutions. By providing recommendations for the best vision protection and performance solutions, you can educate patients in your office about proper vision protection. This strategy also presents an opportunity for second pair sales. The Vision Protection Committee of The Vision Council is dedicated to creating awareness for vision protection among eyecare providers and their patients. During 2012, members of The Vision Protection Committee published articles on specific aspects of vision protection, including sports eyewear, the American Society for Testing and Materials (ASTM) International standards and the importance of fog-free lenses. To learn more, visit www.thevisioncouncil.org/ecp.
SECOND GLANCE Elmer Friedman, OD
Volunteering: The Best That You Can Be Each year governors and mayors throughout the country proclaim one week a “Volunteer Appreciation Week.”
his will mark the community’s recognition of the many hours of time and energy donated by thousands of volunteers in various endeavors that enrich the lives of their fellow man. The responsibilities of the new graduate, in particular, as well as the well established practitioner, can give rise to a myriad of involvements that will contribute significantly to the promise of success for any practice. Activity need not necessarily be related to the eye care professional’s occupation.
In addition to the accepted responsibilities of our chosen profession to provide optimum professional eye care to the public, there are also areas of life that will become exposed to us as we mature. We will be concerned with the political, civic, social and community facets of our lives. Specifically, we charge the neophyte practitioner as well as the established practitioner to be a special kind of provider – a complete provider; one for all seasons. We envision this kind of provider as being professionally excellent, socially aware, active in the community and politically informed. All of this must be engaged with an attitude of self sacrifice, enthusiasm and good judgment. Computerization, automatic refraction and amazing changes in electronic and digital advancements of instrumentation need not intimidate us nor distance us
from our patients. There is a residual sense of controversy regarding the change in our lofty tradition of doctor-patient relationship that requires buttressing. There is a hunger for identity esteem and humanization that the public desires so desperately. A socially conscious practitioner is one who utilizes educational benefits other than trained skills, to enhance the lives of the neighbors in the community. The public looks to us with respect and confidence for leadership and expect us to act with wisdom, compassion and humility. Perhaps the most significant aspect of our complete provider is the one who becomes civically active as a volunteer. This refers to the one who not only contributes money to a cause but personally becomes involved by joining and supporting a local service club or a civic group
which is working on behalf of the welfare of the community. Lip service alone doesn’t cut the mustard! Drowning problems in an ocean of information is not the same as solving them. There are a large number of volunteer organizations that exist and people volunteer for an endless variety of reasons. Many people wish to gain volunteer experience, acquire extra skills, and meet new people. They can expand their network of contacts as a way to attract new patients. The new practitioner, in particular, would do well to heed these matters. But remember, it’s not about the money. We just want to give back to the community, to help a neighbor or promote a worthwhile activity. It’s plain and simple. We do this because it makes us feel good. As a volunteer your value lies in creating a vibrant civil society which is dynamic, engaged and self reliant. Our eye care professionals do not take a back seat in these matters. Volunteer opportunities abound. Some examples are: the International Agency for the Prevention of Blindness and OneSight, a Luxottica Foundation which is a family of vision care charities dedicated to providing healthy vision, eye wear and sun Continued on page 40
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protection to those in need worldwide. The Lions Club, Kiwanis and Rotary organizations all have eyewear and vision programs that have existed for many years with integrity and energy. VOSH Inter-national facilitates the provision and sustainability of vision care worldwide for people who cannot afford or obtain such care. Students at optometry schools have organized trips to such places as Haiti to provide services and eye wear for destitute people there. Every eye care professional belongs to a local society that has regularly attempted to respond to appeals for relief of disaster victims. One cannot forget the ravages of “Sandy” and the toll it took on human life and the horrible condition of so many communities in its wake. The Red Cross and The Salvation Army are constantly in the forefront of volunteerism in the USA. We need not seek national or international connections to satisfy our desire to volunteer. Our local professional organizations have many helpful leads for us. The Eye Care Volunteer Registry connects eye care professionals with organizations and institutions seeking ophthalmic volunteers.
Volunteering can be rich and diverse. Being an eye care provider need not exclude you from the ranks of thousands who assist in minor league sports, shelters for the homeless, aid to seniors, cleaning up a local stream bed, or just holding someone’s hands in a hospice. A volunteer performs spontaneous acts of kindness, like helping a neighbor to shovel his or her walk, coming to the aid of a stranded motorist or just helping an elderly person to cross the street. These large and small acts, given freely, are what bind you to the community. Volunteering is helping, not hiring; and giving, not taking. Currently, alienation in this era seems to be based on a belief that important things can be accomplished only by big business, big government and big labor. But volunteerism says to the individual, “You can.” Not many others are making that statement. If you see the value of volunteering as an antidote to the materialism that seems to attempt to dominate our daily lives, you may want to check out a few tools available online. There may be as many as 70,000 opportunities on existing websites that users can follow by general interest or specifics like education, homelessness,
and hunger. Family subjects are covered in areas of interest such as animals, environment, seniors and healing. Our respective houses of worship and religious organizations are a primary source for finding the niche that suits each individual. By this time the reader can understand that in order to join the new breed of “ye complete eye care provider” one must be prepared to change some attitudes. Prejudices and preformed notions will have to be placed aside. New ideas should rise like a Phoenix out of the ashes of past mistakes with the purpose of aiming at a better future for all. Particularly, the recent graduate, as well as the established practitioner, will gain the most from new opportunities to be seized and relished as an appropriate challenge. It provides us with the avenue to enable us to care for the vision problems of our respective communities and, at the same time, to be identified as important cogs in society’s wheels. “Volunteers are the only human beings on the face of the earth who reflect the nation’s compassion, unselfish caring, patience and just plain love for one another.” —AUTHOR, ERMA BOMBECK ■
OD PERSPECTIVE Jason Smith, OD, MS
Cataracts: When is the Right Time for Surgery? One of the most common questions ECPs hear from patients is: “Do I have cataracts?”
other. Several factors can cause cataracts, including long-term exposure to ultraviolet light, steroid use, exposure to ionizing radiation, secondary effects of diseases such as diabetes, hypertension, and advanced age, or trauma. They are usually a result of interference with the normal metabolic function of the lens.
t seems that many patients have received information on this subject that has been misleading, inaccurate, or scary.
A cataract is a gradual, progressive clouding that develops in the crystalline lens of the eye or in its lens capsule. This cloudiness can vary in degree from slight to a complete opacity. The resulting impact on vision can also vary from minor to complete obstruction of the passage of light. Cataracts typically progress slowly to cause vision loss and are potentially blinding if untreated. The condition usually affects both eyes, but almost always one eye is affected earlier than the
Patients hear the word “cataracts” and may think that it is “cancer.” Patients have heard many unpleasant terms associated with cataracts. Words such as, “ripe, laser, pain, blindness, eye-drops, needles, hospital, retinal detachments, bleeding, Coke-bottle glasses, and hemorrhages” are commonly used when when discussing cataracts. Patients have heard that cataracts can “grow back”. Some patients think that they will need to be hospitalized for a short time while being immobile with sand bags on their eyes. Cataract surgeries that were done many years ago required patients to be in the hospital and to remain stationary after the surgery. There were no implants at that time. So many of the stories that grandparents told their children or grandchildren may still be fresh in their minds in 2012 and they have no idea what to expect from modern medicine. Many of these patients may have had a bad surgical outcome or heard of others who suffered a visual disability after cataract surgery. Many patients are unaware that Medicare pays for cataract surgery as well as a pair
of eyeglasses after the surgery. It is our job to educate and inform our patients and to reduce the level of misinformation and anxiety. Naturally, any surgery will always be scary and create anxiety for the patient and their family. If someone has heard that someone else has had a bad result or misinterpreted the facts, it is our job to give that patient the facts and to reduce that level of anxiety. 1960’s medical technology is not what is being offered in the year 2012. Eye surgery of any kind can create great fear for the patient and for those that need to care for that patient, especially if they are elderly. Cataract surgery involves an initial appointment with an ophthalmologist and a date for the surgery. Follow-up appointments for postoperative care of 1 day, 1 week, and 1 month must then be scheduled. Patients must receive medical clearance from their family doctor which involves another appointment. Preventive drops are needed before and after surgery including antibiotics, anti-inflammatories, and possibly glaucoma drops if the eye pressure goes up during or after the surgery. Eye shields and eye patches must be worn for several weeks when sleeping for safety after cataract surgery. Return appointments will be necessary with a primary care eye doctor if patients are being co-managed for refraction, biomicroscopy, pressure Continued on page 44
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checks, dilation, and any other postoperative care that is needed. Once one eye is done, the patient must repeat most of the same process as was done for the first eye at the time the second eye’s cataract is ready for surgery. Under most circumstances, cataract surgery is being performed with remarkable results. The surgery as well as the recovery time is quick. Patients can usually resume normal activities in a short time. Hospitalization is usually not necessary except for those higher risk patients. Sometimes glasses may not be necessary depending upon the type of implants and the skill of the surgeon, but generally there is a residual prescription. According to 2012 statistics at: www.statisticbrain.com/cataract-statistics, “the number of Americans age 40 and older who are affected by cataracts is 20.5 million people. The percentage of Americans age 80 and older who have cataracts is 50%. $3.4 billion is the annual amount of money spent by the federal government to treat cataracts through Medicare. The average cost of cataract surgery per eye is $3,279. 3,000,000 Americans have cataract surgery each year. The success rate of cataract surgery is 98% and the percentage of patients who have had no severe postoperative complications is 99.5%.” No surgical procedure is ever risk free or is without potential problems or complications, but this procedure has wonderful outcomes for the vast majority of patients. It is rare or almost unheard of for someone to die from cataract surgery. According to: www.revophth.com/content/ d/cataract/c/22936, “many medical procedures are considered to be low risk, particularly cataract surgery. However many cataract surgery patients are elderly. They are fragile and they may have a number of concomitant health issues; cardiac, pulmonary, renal, or metabolic, that put them in jeopardy of perioperative medical complications independent of the eye surgery. These patients are not healthy 20 year olds lying down on a table for LASIK surgery.”
Unfortunately, an Old Forge, PA gentleman died on May 25, 2011 as a result of medical errors made by two eye physicians during surgery to remove a cataract on his left eye on March 31, 2011. According to the lawsuit filed against the Department of Veterans Affairs Medical Center in Plains Township near WilkesBarre, PA, the patient was a poor candidate for general anesthesia due to heart disease and other serious unnamed medical conditions. Continuing to administer additional anesthesia caused the patient to suffer cardiac arrest and to suffer brain damage that left him in a coma until his death. The complications were reportedly caused by an overdose of anesthesia. More common side effects of cataract surgery include retinal tears, retinal detachments, vitreous detachments, glaucoma, posterior capsule opacification, dislocation of the intraocular lens, corneal edema and swelling, sub-conjunctival hemorrhages, ptosis, eyelid ecchymosis, infections including endophthalmitis, cystoid macular edema, glare, blurriness, and astigmatism. The latest advance in this procedure is the use of femtosecond lasers to aid in performing cataract surgery. Lasers are now allowing surgeons to reduce the need for surgical blades. Currently, four companies are developing lasers for cataract surgery in the U.S. including Abbott Medical Optics, LensSx Lasers, LensAR, and Optimedica. On March 9, 2012, LensSx Lasers announced that Dr. Stephen Slade of Houston, Texas performed the first laser cataract surgery in the U.S. using the FDA-approved LensSx femtosecond laser. The laser can create a corneal incision, which is the first step in cataract surgery. This allows the surgeon to gain access to the cloudy lens in the eye. The next step is to remove the anterior capsule of the lens. The surgeon creates an opening in the front of the capsule which is called an anterior capsulotomy. The lens is broken into smaller sections or fragmented so that it can be removed through the very small corneal incision. This is usually performed with an ultrasonic probe which can break up the lens material and then vacuum those
pieces out of the eye. The placement of an intraocular lens within the eye to replace the power of the cataract lens does not change with the use of a laser. In our role as primary eye care providers, it is important to educate your patients and never over-promise with “rosy” outcomes. It will be necessary to take time with patients, their spouses, and their family members to explain the basics of prospective cataract surgery. Handouts, videos, or on-line websites can aid in the educational process to make the patient more informed and more at ease with what to expect from the procedure. Medical clearance will be required to ensure that the health of the patient is at the forefront of any medical decision that needs to be made. Medications must be fully evaluated in order to determine what should be taken before surgery or after surgery. Sometimes good medicine, good health care, and good eye care may involve leaving well enough alone. This idea of not doing cataract surgery should also be fully evaluated for the pros, cons, and implications of any non-surgical decision. Depending upon the winter weather that can sometimes be a problem, the ability of family members to drive someone to the many needed appointments, and other personal issues, waiting to do eye surgery should always be mentioned in every discussion. Patients who are driving at age 75 may have a much more important safety reason to have cataract surgery. The patient who is in a nursing home that is in a wheelchair may have less of a reason to rush for surgery. Another patient in a nursing home may benefit from cataract surgery in order to improve their quality of life, their quality of care, the ability to help themselves during a period of rehabilitation or therapy, and to maintain some form of independence. Every patient is different and unique in their personal and professional needs as well as their medical problems. Hopefully every outcome will be to the patient’s utmost satisfaction and eye care professionals laying the groundwork is an important part of the entire process. ■
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15th Anniversary Celebration and Award Event The OWA 14th Annual Pleiades Award Honoring Marge Axelrad
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The OWA Pyxis Award Honoring Tiara Claxton VM:HĂ„SV<:(
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RSVP by March 7, 2013 @ www.opticalwomen.com Transportation services from the Javits Center 5:45, 6:00 and 6:15 Taking place during International Vision Expo East
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LAST LOOK Jim Magay, RDO
Mr. Roger’s Neighborhood What is your store’s neighborhood like? Mine is a 2-mile long thoroughfare connecting Worcester’s (MA) downtown with the suburb of Shrewsbury.
t’s a varied use area with residential zones, a commercial strip, an urban village area, and an industrially zoned region. There are a few historically significant structures like the D.A.R. building, some big companies like Hanover Insurance and small companies like mine.
Our Lincoln Street Area Business Association’s slogan is “Shop, Eat, Play, Work, Live” and with 16 restaurants, a shopping mall with a brand new Kohl’s, beautiful Green Hill Park, an artist’s cooperative called the Sprinkler Factory, The Joy of Music School, and large housing areas you can do all of those things within our 2 miles. Upscale? Not exactly. Beautifully manicured streetscapes? Well ... sure, near the Hanover Insurance campus and the Worcester Polytechnic Institute’s Biotech park development. There are times when I wish we could transport ourselves to the tonier west side of town, but then I realize we draw well from the eastern suburbs – and we have been an integral part of the fabric of Lincoln Street since the early 1950’s when my Dad opened the first mall optical in the country at Lincoln Plaza. In a recent issue of The New Yorker, Eric Klinenberg writes about how cities can be “climate proofed.” In it he outlines how cities and their “lifeline systems”
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(power, transit, and communications) are being redesigned in order to protect them from weather related calamities. What intrigued me about the article was the discussion about heat related problems in Chicago during the deadly 1995 heat wave. The author cites studies showing that certain neighborhoods fared better than similar ones (3 deaths, versus 33 per 100,000 in population). In the face of changing climate with its unpredictable extreme weather incidents – it is worth studying the reasons some communities do well while others suffer. The difference seemed to be strong social networks in place that encouraged support ... and survival. In addition, active street life – local shops, bars, restaurants, diners, and other places where folks can congregate and organize to assist each other in an emergency are essential to community health.
A sociologist at Harvard has been studying these two Chicago communities for nearly 20 years and has found that “the benefits of living in a neighborhood with a robust social infrastructure are significant during ordinary times as well as disasters.” In 1990 life expectancy in one of the communities was 5 years more than the other – the rough equivalent of having a working air conditioner in each room (a definite help during heat waves). The 1995 experience has led the city of Chicago to maintain a database of names, addresses, and phone numbers of old, chronically ill, and otherwise vulnerable people, letting city workers call or visit to make sure they are safe during stressful times. This aspect of community life is one we overlook at our peril, and shows the value of joining and promoting “shop local” networks, neighborhood “crime watches,” and interacting with other like minded shop owners to develop community ties. (It is one way we can out compete the big box and mall stores at their own game). ■
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Published on Feb 6, 2013
February 2013 Issue of EyeCare Professional Magazine. A Business to Business publication that is distributed to decision makers and particip...