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RED HOT EYEWEAR & SUNWEAR / PAGE 6 — 2013 EQUIPMENT SUPPLEMENT November 2013 • Volume 7, Issue 71 •



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Vol. 7 Issue 71

Features 6

RED HOT EYEWEAR & SUNWEAR Spice up your frame boards and offer the latest in red eyewear and sunwear. by ECP Staff


RETHINK YOUR DISPLAYS Listing some simple and effective ways you can improve your dispensary displays.


by Lindsey Getz


SELLING YOUR PRACTICE, PART II What you can do to increase and maintain the value of your practice over the long term. by Cliff Capriola, Practice Management Consultant


GIVING BACK...PERMANENTLY An optician who sold her practice and moved to New Orleans to help people full time. by Ginny Johnson, LDO, ABOC



CLEANLINESS The lack of hand washing among ECPs after seeing patients is a cause for concern. by Anthony Record, ABO/NCLE, RDO


STAFF MOTIVATION Some easy to implement tips to help you gain a more motivated dispensary staff. by Corrie Pelc


On The Cover:



EDITOR / VIEW ....................................................................................................4


MOVERS AND SHAKERS ..................................................................................15 DISPENSING OPTICIAN...................................................................................26 OD PERSPECTIVE..............................................................................................32 SECOND GLANCE..............................................................................................34 INDUSTRY QUICK ACCESS..............................................................................40 ADVERTISER INDEX .........................................................................................41 LAST LOOK .........................................................................................................42



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EDITOR / VIEW Jeff Smith, Publisher



Will 3D Printing Make ECPs See Red? OF ALL THE TOPICS we have covered over the years in this publication, the one that gets the most attention (based on web reads) is the threat posed by online eyewear retailers. We all know of internet companies like and Warby Parker and their low cost/ limited service business model. They have been able to lower the price of their eyewear by designing them in-house, with consumers picking from a range of preset frame designs. But now the advent of an even newer technology, 3D printing, could mean even more competition for the consumer’s eyecare needs. Protos Eyewear is a startup 3D-printed frame company. Also know as additive manufacturing, 3D printing is the process of making a three-dimensional solid object of virtually any shape from a digital model. By recognizing that everyone’s face is unique, Protos hopes to tailor each specific pair to the individual. The company reached its target of $25,000 on its Crowdhoster (fundraising) website, and now currently offers 24 different frame styles that can be altered on the fly to cater to each customer’s needs. Interested buyers email in two pictures of their faces, and Protos’ algorithm alters the frames’ design before sending the information to the 3D printer. The algorithm can rapidly make changes to the 3D models, allowing for more flexibility and less production time. The frames are made of a proprietary hypoallergenic bioplastic. They charge $299 for a stock (non-printed) frame with Rx lenses, and $399 for a custom printed frame with Rx. All lenses are polycarbonate with anti-reflective coating, but interestingly, they are unable to offer Rx sunwear, because their algorithm doesn’t work with the base curvature of their sunglass designs when they have a prescription lens in them. In traditional manufacturing, frame companies need to mass produce thousands of the same exact frame. But now digital fabrication technologies like 3D printing allow people to ‘print’ objects from digital files. So as the process becomes cheaper and more efficient, it will be interesting to see how this powerful revolution in physical manufacturing changes the market, with potentially wide-ranging implications in pricing, product development, fashion, and even counterfeiting. I

Publisher/Editor. . . . . . . . . . . . . . . . . . . . . . . . . Jeff Smith Production/Graphics Manager . . . . . . . . . . . Bruce S. Drob Director of Advertising Sales. . . . . . . . . . . Christina Perrotta Contributing Writers . . . . . . . . . . . . . . . . . Mary Armstrong, Judy Canty, Cliff Capriola, Paul DiGiovanni, Elmer Friedman, Lindsey Getz, Renee Jacobs, Ginny Johnson, Jim Magay, Corrie Pelc, Anthony Record, John Seegers, Jason Smith 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

EDITORIAL OFFICES 111 E. Pennsylvania Blvd. Feasterville, PA 19053 (215) 355-6444 • Fax (215) 355-7618 EyeCare Professional Magazine, ECP™ is published monthly by OptiCourier, Ltd. Delivered by Third Class Mail Volume 7 Number 71 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.

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.

For Back Issues and Reprints contact Jeff Smith, Publisher at 800-914-4322 or by Email: Copyright © 2013 by OptiCourier Ltd. All Rights Reserved For Subscription Changes, email: Scan this barcode with your smartphone to go to our website.



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Red Hot Eyewear 1. eyeOs eyewear The circle ‘O’ is a universal symbol of the circle of life encompassing the past, present and the future. Sherlock, by eyeOs premium reading eyewear, embodies the timelessness of the circle. Inspired by the past, this retro look reflects the present with edgy current touches and will still rock in the future with its timeless design.

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2. Dea Eyewear Dea Eyewear offers attractive styling for women with eye sizes up to 60mm. Along with extended temple lengths, Dea is constructed to offer all day comfort and flexibility for those individuals who seek more spacious eyewear choices. The countless selections give you red hot choices from subtle to dramatic.

3. Adlens® The Adlens® John Lennon™ Collection – endorsed by Yoko Ono – is the second generation of Adlens®’ variable focus eyeglasses based on fluid-injection technology. It was designed to provide a simple way of achieving instant prescription (-4.5 to +3.5D) and immediate dispensing, particularly for those in need of improved eyesight in the developing world.




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4. Hilco Leader ® Rx Sunglasses Collection is Hilco’s smart optical solution to the price barriers and optical limitations of 8-base wrap sunglasses. We’ve combined great wrap styling, affordable frame pricing, and a design that delivers the superior optics and low cost of standard Rx lens processing. The collection consists of 12 plastic styles, including our best selling style, Circuit.


5. XX2i Optics The new France2 introduces new, larger lenses for increased visual acuity and protection while greatly expanding the line with many new colors, including the all new Fire Engine Red with Red Flash Lenses. Fully adjustable nose and temple tips ensure a custom and precise fit, while easily Rx’d optics provide perfect vision for all.

6. Marcolin The Tom Ford ‘Linda’ (FT324) women’s sunglass is made from acetate with shiny light ruthenium at the temples. The style is distinctive and elegant, with a soft rectangle, easy-to-wear shape. 68F colorway is a gradient pearl/transparent red with gradient brown lenses.





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ic! berlin

ic! berlin has long been known for their innovative hinge system and superior design from sustainable materials. The Linearity in Rough Red is an ideal frame for the daring amongst us who really want their frame to showcase their personality. This frame’s sleek design reflects a modern interpretation of vintage charm.

Trevi Coliseum


LINDBERG Strip 9800 blends style details from LINDBERG acetate and titanium plate designs, with the upper rim featuring more pronounced curves, and the unique screw-free front where the lenses fix the acetate front to the titanium frame. The range is our only ‘combi-style’ frame, distinctive for its subtle curvaceous appearance and fashion-forward fifties inspired design.

Best Image Optical

Trevi Coliseum Clark 832 is constructed from the highest quality Mazzucchelli zyl with silver metal temple inlays for added style. It defines the concept of fashion and beauty. Available in 3 beautiful colors: red (shown), black and blue. Made in Italy and backed by a two year warranty. Sold exclusively in North America by National Lens.

The 2013 Plume Paris collection offers signature looks influenced by Europe’s landscapes, architecture, and art. Style Albi in Matte Black/Red is designed with a chic, slender silhouette made from an innovative, stainless-steel. Such bold colors, as red & black, frame the eyes and temples and adorn the brow-bar in a checkered pattern for a look that pops.

JF Rey JF2519: The new STRUCTURE line explores the fashion and textiles fields in the autumn/winter seasons. Using laser engraving technology, with an extremely thin work design, the brand succeeds in creating some outstanding touch and textile effects. Scottish tartan, dog tooth pattern and sophisticated weaving bring a pure and smart silhouette. The stainless-steel work allows subtle light effects to enhance the frames. JF Rey – JF2519: The new STRUCTURE line



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Cruise through Summer with KODAK Lenses Winners Announced Signet Armorlite, maker of KODAK Lenses, announced the winners of the Cruise through Summer national promotion for KODAK Progressive Lenses. From April 1 through August 31, ECPs were invited to participate for a chance to win a cruise vacation or cash prize and earn gift card rewards by redeeming KODAK Progressive Lens purchases from participating laboratories. More than 400 ECPs registered for the promotion, of which 15 practices were selected in random monthly drawings to win a cruise vacation or cash prize, and more than $15,000 in gift card rewards were distributed. The eyecare practices winning a cruise vacation or alternate cash prize include: Advanced EyeCare, Bowling Green, MO; Envision Optical, Evansville, IN; Five Points Optical, Corpus Christi, TX; Valley Eye Care Center, Phoenix, AZ; Tempe Eyecare Assoc, Tempe, AZ; Dr. Terry Friedman, Miami, FL; Lens Mart Optical, Osage Beach, MO; Eyecare Specialties, Lincoln, NE; EyeWorks, Lumberton, NC; Barnes Jewish Hospital, St. Louis, MO; Fairway Eye Center, Fairway, KS; The Eye Place Optometry, Midlothian, VA; Southdale Optical, Edina, MN; Hills & Dales Vision, Canton, OH; Wilkins’ Opticians, Spartanburg, SC. Dr. Chrisagis and staff of Tempe Eyecare Associates, Tempe, AZ



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Morel Eyewear

Revolution Eyewear

Coral II: Koali delves deeper into the mysteries of the ocean with the release of the Coral II concept. Differing from the original concept, Coral II features straight temples which imitate branches of the anemone while triple-layered acetate provides movement and volume. Coral II is available with two-toned metal pressed fronts which provide similar depth to the triple-layered acetate fronts.

Revolution Eyewear continues to raise the bar with a new combination of zyl and titanium. This fashion forward style will feel weightless on your face. Featured is Matte Rose, other colors include Dark Tortoise, Sky Amber, and Turquoise. Size is 50-21-140 with a generous B measurement of 40.8 for those needing progressives.

REM Eyewear

Modern Optical

The Tumi Barrow brings beauty and elegance to the classic aviator. Tear drop shaped frames are accentuated with metal and pattern etched details on the temple. Comes with Tumi signature end caps that look like a zipper pull. This frame is fitted with a Tumi ZR3 lens developed by Zeiss and comes in a steamy burgundy color that will turn heads.

Chill is anything but relaxed! This retro style utilizes color blocking to achieve maximum impact. With spring hinges and unisex design, Chill is perfect for any fun-loving personality. Temples are also available in blue, lime, pink, purple, and white.

Tifosi Lore becomes legend! Introducing the Tifosi Lore, styled to transition seamlessly from sport to casual wear. Featuring an open lens frame, vented lenses to decrease fogging, and an adjustable nose pad for a perfect fit.

Tifosi Lore



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Clariti Eyewear

Konishi Flex Collection KF8262 – The combination of innovative design offered in a striking Matte Burgundy, Classic Black or Brown, and cutting edge Memory Metal Flex-Titanium technology makes this pair the ideal selection for a modern trendy look.

R & R Eyewear

R&R Eyewear adds the aggressive Cassandra frame in a bold new red color to the collection. The top of the eye wire has dozens of crystals embedded in it for an elegant look. Wearing the Cassandra is a bold fashion statement for any woman and is sure to turn heads.

Luzerne Optical Releases First Premium Glass Free-Form Lenses in the USA

Luzerne Optical Laboratories, Ltd., the largest single location, family-owned and operated independent wholesale optical laboratory in the United States, is proud to announce the release of its CrownView™ lenses, the first premium glass progressive and single vision free-form lenses in the United States. CrownView has a soft progressive design with smooth power changes for effortless adaptation and increased patient comfort. CrownView progressive lenses offer the lowest minimum fitting height in glass progressive lenses and can accommodate smaller frames to decrease weight. They offer larger diameter progressive lens blanks for greater cut-out availability. CrownView is also available in an aspheric/atoric single vision design. A Lab to Lab program is available and inquiries are welcome at



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Rethink Your Displays


Part of the fun of walking down any big city street is checking out the window displays. Everyone can appreciate a well-thought out display and for optical shop owners, it can be excellent fodder for practice display ideas. However, with a busy optometry practice to run, and many patient needs to take care of, dispensary displays are often at the bottom of the to-do list. That can be a detriment to the practice’s bottom line since creative and well-planned displays can help sell frames. Even if it’s a job you need to delegate to a staff member, putting attention into your frame displays needs to be done. We’ve rounded up five simple tips to help make your displays pop. Let there be Light It may sound simple, but the lighting in your dispensary is absolutely critical to the success of your displays. Have you evaluated the lighting in your dispensary and are you certain it’s up to par? Even if there’s just one corner of the dispensary that is not well-lit, that is selling space that is lost. Patients may be intentionally—or even just subconsciously—avoiding that area, particularly if they have low vision. Take a look around and see which displays need better lighting—then consider the options. If you have overhead lighting in the dispensary and it’s not working for certain areas, perhaps you need to consider something else. For example, you may need wall sconces or something else in a particular area that is lacking good lighting. You could have the best display in the world but if it’s not properly lit it

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Is it time for a change? We’ve rounded up some simple ways you can improve your dispensary displays might not be getting the attention it deserves. Changing your lighting may be the first step to improved success of your displays. Get Organized It can be overwhelming to a patient to view an entire wall of frames. Of course it can be hard to get away from that layout if you have a lot of inventory to display. To make the selection process easier for your patients, be sure that your frames are grouped into categories. This is likely something that you’ve already done, but it never hurts to re-evaluate the categories you’ve selected. Are they working for your patient base? Is brand very important to the clientele you service? If so, you should consider grouping frames by brand. You

may also want to consider grouping frames by the lifestyle they serve—such as keeping sports frames together. It’s also important to avoid a cluttered look. Crowding your frames together also has the potential to overwhelm the patient. This means being diligent about replacing frames that patients have removed from the display to try on. Don’t allow a bunch of frames to be lying around out of place. Even if it was your patient that took them down, make it a point to have a staff member periodically do a dispensary walk-through and return frames to their proper location. A wellorganized dispensary makes it much easier to shop. Continued on page 14

Omni Style Dispensary – Fashion Optical Displays



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FEATURING Patented Shadow Reduction Technology Panel Locking & Non-Locking Systems Wide Variety of Finishes & Hardware Integrated Halogen or LED Lighting

8 0 0 - 8 2 4 - 410 6


W W W . FA S H I O N O P T I C A L . C O M







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Get Creative Shelves and frame boards are a necessity for practices that carry a lot of inventory. But that doesn’t mean that you can’t get creative with your display area. Even if it means pulling five or six frames from a category and setting up a unique display in front of your frame board, adding a creative touch can go a long way. You may not have a storefront window but you can pull ideas that may be used in a storefront display and put them in your dispensary. Think about interesting ways to hang frames or interesting objects to display frames on top of—or even just near. For instance, to promote sunglasses that might assist your patients on the golf course, why not bring in a few golf balls to display near the frames. It’s simple but effective! It just may prompt some of your golfing patients to inquire about the frames and give you the opportunity to discuss how a good pair of golf frames should be impact resistant and 100-percent UV protective. You could bring up how they can protect the eyes from glare

from bunkers and water, and that photochromic lenses can help the wearer read the hills and valleys of the course more easily. That’s a whole conversation that might not have happened if it weren’t for a creative display! Get ideas for your creative displays online. Pinterest has a wealth of great ideas to pull from. Update Regularly Nothing says “outdated” like walking into a dispensary that never changes, year after year. Whether you see patients on an annual or semi-annual basis, if they come in and continually see the same POP materials or the same frame displays, it can create the idea that your inventory is outdated—even if it isn’t. To keep things fresh, try to find the time to change up the displays. Even a simple change can go a long way. It could be with the season or on a whim, but making changes keeps patients interested and lets them know that you’re a practice that is keeping up with the latest styles. A patient who is returning for a re-check may notice something they didn’t on their last visit simply

because you moved things around or created a fresh new display. POP material is definitely a way that your dispensary can quickly become stale. If you have up posters or other displays featuring celebrities or athletes that are no longer culturally relevant, it sends a negative message to your patients. Be sure to regularly review the materials you have on display to be sure they are doing the job they’re meant to do—which is sell frames. Think Seasonally One way to update your displays is to change them with the season. Some practices enjoy getting into the holiday spirit. In the fall they might use small pumpkins and gourds to display frames on. You could use skulls instead of mannequin heads on a shelf or simply put up some Halloween decorations to make the dispensary more fun and festive. In the winter, some optical shops add a Santa hat to their mannequin heads. Positioning sunglasses coming out of wrapped gift



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boxes might give patients the idea to buy frames as gifts for holidays like Christmas or Hanukah. Come spring and summer, you have the opportunity to really promote your sun wear lines. The start of spring might be a good time to set up an outdoor sports eyewear display. In climates that are seasonal, your patients might be looking forward to playing Frisbee, golf, or tennis again. Bring in some props to pique their interest. An eye-catching display could be

as simple as hanging a tennis racquet and stringing some frames through it. It might raise patient questions like “how could those glasses improve my game?” and give you the opportunity to make a sales pitch. Even just a few small changes can go a long way in improving the success of your displays. The key is staying fresh and exciting in the eyes of your patients. With just a little bit of thought, you can boost your sales with better display techniques. I

Some great dispensary design companies include: Fashion Optical Displays Frame Displays

MOVERS & SHAKERS Prevent Blindness America

The Cooper Companies

Zyloware Eyewear chairman, Bob Shyer, and vice chairman, Henry Shyer, have been chosen as the 2014 recipients of the PBA Persons of Vision Award by Prevent Blindness America. The award will be presented at the PBA Person of Vision Dinner on the eve of Vision Expo East next Bob Shyer March. The award recognizes an individual or corporation for outstanding leadership and dedication in the field of vision and eye health. According to PBA, Bob and Henry Shyer have been chosen due to their continuation of Zyloware Eyewear, the oldest independent family owned frame supplier in the U.S., and for their contributions to the vision industry.

The Cooper Companies, Inc. announced the appointment of Daniel G. McBride to executive vice president, chief operating officer and general counsel. He most recently served as vice president, general counsel and chief risk officer and has held positions of increasing responsibiliDaniel McBride ty within the legal organization. Prior to joining Cooper in February 2005, McBride was an attorney with Latham & Watkins LLP concentrating on mergers and acquisitions and corporate finance.

Salus University Michael H. Mittelman, OD, MPH, FAAO was inducted recently as the sixth president of Salus University, established by the Pennsylvania College of Optometry. Prior to his appointment by the Salus University board of trustees, he was deputy Surgeon General of the Navy and had Michael H. Mittelman achieved the rank of Rear Admiral. In addition to being a highly decorated naval officer, he is a Fellow of the American College of Healthcare Executives and a Fellow of the American Academy of Optometry (FAAO) as well as a Diplomate in the FAAO Section in Public Health and Environmental Vision.

UC Berkeley School of Optometry John Flanagan, MCOptom, PhD, a professor of optometry, ophthalmology and vision science, will take over as dean of UC Berkeley’s School of Optometry in June 2014. To serve for a five-year term, he will succeed Dennis Levi, OD, PhD, who has led the school since 2001. Flanagan graduatJohn Flanagan ed in optometry and vision sciences from England’s Aston University in 1980, and earned his PhD there in 1985. He now serves on the faculties of the School of Optometry and Vision Science, University of Waterloo, and the Department of Ophthalmology and Vision Sciences, University of Toronto.

Optos Medical retinal imaging company, Optos plc has appointed Rob Kennedy, currently interim CFO, to the position of CFO, effective immediately. Prior to assuming the interim CFO role, Kennedy had served as group director of finance and company secretary since joining Optos in August Rob Kennedy 2011. He joined Optos from the University of Dundee where he had been the director of finance since 2007.

Kenmark Kenmark has announced the promotions of Steve Mount and Carla White to Regional Managers. Both Mount and White have been with Kenmark for more than 20 years and have been integral in the company’s sales growth. In their new positions, Mount will oversee the Great Steve Mount Lakes Region consisting of Michigan, Ohio, Indiana, Illinois and Wisconsin and White will oversee the Northeast Region, which includes Connecticut, New York, New Hampshire, Massachusetts and Rhode Island.

Opti-Port Opti-Port recently expanded its member recruitment efforts, welcoming optical industry-veteran Kristi Johnson to its account management team in July. Johnson boasts over 18 years of sales, training, recruiting and management experience within the optical, pharmaceutical and medical industries.

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PRACTICE MANAGEMENT Cliff Capriola, Practice Management Consultant

Selling your Practice

Part II

Last month we looked at the basics of valuing an independent eye care practice for sale in the near future. N THIS SECOND OF TWO PARTS, we examine the steps a business owner can take to increase the value of an eye care practice over the long term.


Unfortunately, many business owners do not consider an exit strategy or value of their practice until they are nearing retirement. By then it’s usually too late to significantly increase practice equity in a short time span. As we noted in the first article, independent eye care doctors are slowly increasing market share compared to optical chains and big-box retailers. One effect of managed care has been to weed out the poor-performing eye care practices. The days of simply hanging out a shingle and coming to work every day are long gone as working smart is far more important than working hard. For the independent doctor willing to engage in long-term planning, reinvest in

their practice, and continually monitor certain practice metrics, the future can look very bright indeed. Let’s examine the opportunities: Opportunities 1. Expand medical eye care services Expanding the scope of an optometric practice is a great way to increase gross profits and create a sense of loyalty to the practice. Let’s face it, the reimbursements for the traditional refractions and optical services have been steadily declining for the past twenty years. An experienced OD may need additional training for medical services; or they may need to hire a younger associate. Currently, medical eye care only accounts for 15-20% of revenue, but the potential for growth is very high as an increasing numbers of states have granted more medical privileges to optometrists. At the same time, many practices do not even have office processes in place to bill and

collect for many procedures that fall under medical eye care. Currently your patients are being educated by consumer advertising done for ophthalmic prescriptions... wouldn’t it be better for you to control that marketing by providing it as part of the patient experience in your practice? Here are the numbers as they currently stand: Medical Eye Care in Independent Optometry Practices Median % of annual patient visits 18% Median % of practice revenue 15% Medical eye care visits per 1,000 active patients 73 Pharmaceutical Rx’s per 1,000 active patients 53

Consultants estimate that a revenue number of around 30% is attainable for most optometric practices. In other words, a practice grossing $500,000 annually which increased its medical revenue from 15% to 30% would see annual revenue grow by $75,000 with virtually the same patient base. 2. Adopt electronic medical records Optometry continues to lag behind many other medical disciplines in adopting new technology. Aside from the government incentives, electronic medical records improves the monitoring of patient data, streamlines the patient flow in the practice, and assists in patient retention. 3. Increase revenue per patient Easier said than done, but in almost every practice there is a niche market that is not being filled for their patients. Every practice should keep a patient profile of each patient, where they list their occupation as well as non-work activities they participate in. A good dispenser will match unfilled patient needs with products available in the practice. A good example is Plano sunwear.

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Most independent ODs gave up on that market years ago because they were available cheaper at other outlets. We are all familiar with the Bausch & Lomb survey from 15 years ago where 90% of new contact lens patients purchase Plano sunwear in the first 48 hours after being fit with contact lenses for the first time. But how many doctors have bothered to place an affordable Plano sunwear display in the contact lens fitting area? Back in the last century (1989 or so) a very smart optometrist in the Snow Belt, south of Buffalo, proudly showed me his new sunwear display, which took up a close to a third of his board space. Outside, it was a very dark and dreary January day with snow falling about a foot every 2 hours. The doctors’ reasoning? His patients visited the practice for maybe an hour per year, and it was his goal for his patients to understand that there was nowhere else they ever needed to go for any eye care need! 4. Increase the frequency of patient eye exams While almost all practices recommend yearly eye exams, in reality 75% of patients only return every two years. This is due partly from patients seeing no change in their vision, partly from token efforts to recall patients, and partly from increasing demands on household budgets. Obviously, you can control only one of these factors. Lately I have seen many practices scheduling the next patient appointment at the

time of checkout this year. There is little or no resistance to this (who can predict they are going to be busy that certain day in 12 months?), and it creates an obligation in the patient’s mind to keep that appointment. As always, follow up, follow up, and follow up until that patient walks in your door. Notice how many of these opportunities work with each other...increased medical eye care services creates another reason to keep that appointment, if only for monitoring of eye health. 5. Increase contact lens penetration Soft contact lenses may dominate the market, but specialty RGP lens fittings are steadily increasing. Topography-guided lenses can provide highly refined vision on otherwise hard-to-fit patients. New software can improve initial lens fittings by predicting fit characteristics and allowing the doctor to make changes in lens design before the lens is ever placed in the eye. Professional fees for topography-guided RGP lens fittings are appropriately higher than those for soft contacts. In addition, contact lens patients as a rule generate more income per patient because they have more frequent exams and pay higher exam fees. 6. Electronic patient communications A good practice management software system will allow increased patient communication via email. Not only recalls can be processed this way, but you may wish to

inform all of your glaucoma patients of a new drug therapy, or you may wish to remind patients with a plus Rx about the increased availability of aspheric lenses, or you may wish to send out a patient newsletter in Adobe Acrobat form to advertise a trunk show for a frame manufacturer. Keep your patients informed about what’s new the eleven months out of the year they don’t visit your office. 7. Keep your technology current This is pretty self-explanatory, and an important part of any practice valuation. Two or three year-old equipment is much more valuable than equipment in lanes outfitted during the Nixon administration (don’t laugh, they are out there). 8. Measure your key practice metrics monthly Surveys and papers with recommendations for practice metrics are widely available on the web and from consultants. There are some universal metrics which apply to any practice; just be sure that some of the other numbers available actually apply to your practice. For example, a store like Target or Wal-Mart pays close attention to numbers like profit per square foot; whereas the same number does not mean much to an OD renting space in a strip mall. Let’s take a look at the most important metrics, followed by others helpful to most doctors. A. Gross Receipts – otherwise known Continued on page 18



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as production, deposits, collections, or receipts. Just be sure that you accurately measure revenue deposited. B. Income – the best sign that a practice is operating efficiently. C. Doctor Hours Worked – a number needed to figure profit per doctor hour. Also a great example of how the metrics affect each other. If you increase patient recalls and capture rate you will most likely increase hours worked. If so, be sure that gross receipts show a comparable increase. D. Percentage of New Patients to Established Patients – a key metric if you are actively seeking to increase your patient load. There are no accepted recommendations here as all practices are different, but a ratio of 75% established to 25% new is excellent for growth. E. Recall Percentage – 70% patient return from the same month the previous year is a good goal. F. Capture Rate – the percentage of Rx’s written who fill their prescriptions in your practice. There is a wide variation between OD and MD practices in this number. 60% is acceptable for an MD practice while anything below 85% in an OD

practice is an indicator of problems in the practice. G. Accounts Receivable – a good goal is to have 90% of the AR less than 30 days old. Practices with continuing AR problems should consider outsourcing their insurance filing and billing procedures. H. Inventory Management – a good rule of thumb is that your frame inventory should turnover three times per year. Train your sales reps to work for you – they start out with a certain number of frame slots and make them responsible for placing only products which sell on your boards. Let them know that they will lose those slots if their product does not sell. I. Percentage of Contact Lens Patients – contact lens patients tend to visit the practice more often and have higher exam fees. Plus, they also need at least one pair of glasses (and sunwear!) J. Patient Flow – the best way to measure this is to examine how long patients wait – how long they wait to see the doctor, how long to see an optician, to check out, and the turnaround time of glasses from your lab.

higher the % of proprietary products sold, the higher profit per patient. Look for comparisons such as % of anti-reflective lenses, % of poly/hi-index lenses, and % of second pair sales. L. Established Community Outreach – usually by the doctor but can be provided by the staff. This can range from speaking to seniors about monitoring their glaucoma to the local health club recommending your practice for sport goggles to sponsoring and providing sports eye wear for a Little League team. First, set goals on a monthly and annual basis for each of these metrics and measure performance monthly. Share both the goals and ongoing performance with your staff and hold them responsible for working with you towards meeting the goals. Remember – sustainable practice net cash flow is the biggest factor in determining practice value. Cash flow pays bills, services your debts, and provides your personal income. Long range planning and performance monitoring can go a long way in ensuring that when the time does come for you to sell, you get the best possible price for your practice. I

K. Optical Percentages – the best indicators of a well-trained office. The

When what to my wondering eyes should appear… Twas the month before winter, when who would have thought That winter inspired lens care could be bought. For all lens types, AR too, what you need Is a trusted lens cleaner known as Ultra Clarity. From Ryan the Reindeer to a Snowflake or two We’ll personalize the 1oz bottle just for you. Whether a peaceful Winter Wonderland or a gift To You, From Me Through clear lenses your patients will see.


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Stockinrg Stuffe a or simply y way to sa




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WHEN ONE DOOR CLOSES, yeah yeah, I hear ya, another one opens. Sometimes it may take a while, but it will open. What’s the definition of awhile? I don’t know for you, but for me, a few months. You may be tugging on the knob and nothing is happening, but hang in there, it might just mean you’re at the wrong door. The last door that closed for me was on June 28th of this year. I stepped away from the optical industry that I have known and breathed since 1992. My role as a Licensed Optician in today’s medical world had started to alter my personality and not in a way that I was happy about. I’ve always kept a couple of extra passions in my back pocket, so by July 4th, I had 60 items up for auction on eBay and some cleaning gigs lined up.

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For the past few months, the 14 months that I spent in New Orleans volunteering for Hurricane Katrina has been frequently popping up in my mind. Thoughts of how some of the survivors I met were doing and hoping they were still cheering on their great city. I wonder what happened to the elderly man who lost everything he owned, except for the lawn chair he was sitting in, when I handed him a free home-cooked hot meal. I have told a few of my closest friends that I have not had that day-to-day feeling like you’re really making a difference in the lives of the less fortunate as I felt back then. It’s not that I wish a hurricane on anyone; I just dig life-changing stuff. In May of this year I visited New Orleans with a dear friend of mine and we played tourists. We kept a non-stop agenda for the few days we were there. The Jazz Festival was amazing and I hung out in the Gospel Tent most of the day. As I people watched, I was reminded that the locals

really have a genuine love for their city and what it has to offer. Great music, incredible food, bone chilling music and a laid back swag that you can’t find anywhere else. To make a full recovery from the devastation that Katrina caused in New Orleans is impossible. But you would not have recognized that if you had witnessed the determination I saw in those people after the storm. I wish I would have kept a journal during those 14 months I was there, I guess I did but just not on paper. I did not know from day-to-day what I would do or who I might meet. Each night I went to bed though, I knew I helped someone, even if only to get a grin or giggle from my jokes about Katrina being a home wrecker that levied assets. Humor is a wonderful thing to be blessed with. If all else fails, just make yourself laugh. You should practice laughing every single day. No excuses. Fake it ‘til you belly ache it.



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For the past two months, the ad that I placed on Craigslist, which was similar to the one I used for Katrina work, has found me several safe, life-changing, organizing gigs. Of course, I could not have done all of the work without the help of my best gig friend, Susan. We are polar opposites but challenge us to do a home project and we are on it. After years of experience in our own different ways, Susan said we should call ourselves Girls Gone Organized and so it is. Susan, who has been in the optical industry Monday through Friday for 33 years, is a good sport to play optical on some weekends. She and I helped set up the Dream Center Clinic’s charitable vision program in 2009. Twice a month we would climb aboard a big, orange RV that was remodeled into a mobile eye care clinic. Free eye exams and eyeglasses were provided to the medically underserved residents of North Charleston. Patients would camp out, meaning they would arrive at 5:00 am, since it was first come, first served. Susan and I felt like we were being chased by the paparazzi when we pulled in the parking lot around 10:00am, which was the time the clinic opened. Donations began to pour in and the vision clinic has been able to serve thousand of eye care patients. Once again, I experienced those great life-changing feelings of helping others. In the past year, I have not been an active volunteer for the vision clinic. It’s a door that’s partially

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closed for me to prepare for the next door to open. During my May trip to New Orleans I visited the New Orleans Dream Center and met with the Executive Director, Diane Amos. Diane gave me a tour and introduced me to medical professionals that were serving patients that day. Something was missing. Out of all the professions that were represented there that day, there were no eye care providers. My wheels were spinning and I had a glimpse of that life-changing feeling. In December 2001, I made the decision as a business owner to call it quits. For 10 years, I owned and operated an optical franchise with a close friend of mine from high school. Many nights I would leave work and by the end of the night be suffering from double vision. I guess that’s to be expected when your tolerance for alcohol exceeds 12 beers a day. The experience of going belly up had a dual meaning for me. I filed for bankruptcy and got sober all within two weeks of closing the business down. Through the years of being in the optical industry I have accrued quite a few eyeglass frames as well as inherited some. Next month I will be celebrating 50 years on planet earth. It’s just a number to me, possibly the half way mark through life. My grandmother lived to be 101.5 years old so maybe I will do the same. My birthday wish is not complicated. I simply

want to be a part of a life-changing vision experience. I want to donate and deliver 1,000 eyeglass frames to the New Orleans Dream Center. I want to stay in New Orleans as long as it takes to help them recruit the optical volunteers and vendors that are needed to share this vision. I promise to write in my journal this time and keep you up to date with the many doors this will open. I actually already have finished my first journal entry. Thank you so much Southern Smarts! They are an online magazine who heard about my birthday wish from a high school friend that I recently reconnected with. They contacted me, posted my story on their blog and donated round trip airline tickets to the cause! “ is very grateful to Ginny for sharing her story, and we look forward to supporting her dream for vision care for the needy. If you have a similar story you would like to share please feel free to contact us.” So let’s get this open invitation party started in New Orleans and see our way around the world! I For more information about how you can get involved please contact: Ginny Johnson



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Cleanliness is Next To... What?

phone call from a listener asking, “Hey man, can you play something by Britney Spears?” it is not unusual these days for an attendee to approach me before my presentation begins and ask, “Hey Anthony, remember that slide you once showed about Acanthamoeba keratitis? Can you put that up on the screen sometime today?” Uh...okay.

It’s been said that cleanliness is next to godliness. I know for a fact that’s not true.

More often than not though, I receive requests to once again share slides I created a few years ago about a joint study conducted by the American Society of Microbiology and the National Soap and Detergent Association. It was an extensive study that attempted to discover the general hygiene, and more specifically the handwashing habits of the American people. After talking to and monitoring the habits of more than 3,000 people, statistics relating to all kinds of factors were reported – things like age, race, geography, and many more. It probably comes as no surprise: Our hygiene habits are alarmingly abysmal!

Ophthalmologist doing surgical scrub before cataract surgery

How? I looked it up. In Webster’s New Twentieth Century Unabridged, Second Edition – Deluxe Color dictionary, cleanliness is next to claviger, which is “someone who keeps the keys to a place.” For what it’s worth, godliness is next to goggle-eyed. But alas, I digress. As you can imagine, in my line of work (teaching continuing education for eye care professionals), it’s rare that I get a request. Believe it or not though, beginning a few years ago I actually started to get requests from my audience. Much like a radio morning-show disc jockey might get a

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One of favorite findings is the disparity between genders which was revealed by the research. When they were simply asked about their hand-washing habits, 89% of the men surveyed claimed to wash their hands every time they used a public bathroom. As it turns out, only 66% actually did. What about women? When they were asked about their hand-washing habits, 96% of the women claimed to wash their hands every time they used a public restroom. It turns out that 88% of the women actually did. Now I guess there are many things we could extrapolate from those statistics, but here’s my take: When it comes to the whole hand washing and hygiene thing, the women are way cleaner than men, but guess what? The men are a whole lot better at lying! (I can hear some of you women out there saying, “Tell us something we don’t know already, Anthony.”) Okay... I’ll try.

In order to maintain a healthy environment and prevent the spread of germs and disease, according to the Centers for Disease Control (CDC) in Atlanta, Georgia, for the category of healthcare workers in which ECPs fall, it is considered standard of practice to wash our hands in between each and every patient encounter. I conducted an informal survey of roughly 1,000 opticians in 2013, and I discovered that only around 15% of them could make the claim that they did just that – wash their hands between each and every patient encounter. What were some of the opticians’ reasons for not doing do just that? Many were unaware that the standard existed. Some cited the inconvenience or lack of facilities in their dispensary. Being too busy and/or understaffed was a common excuse. Some of the less-common excuses included: Washing my hands too much makes my skin dry, and an attitude of what’s the big deal? According to Dr. Kelly Reynolds, a researcher and public health educator at the University of Arizona, a typical office like an optical dispensary can be a pretty germy, if not dirty place. Consider the findings of her study reported in The Huffington Post (February 3, 2013). After purposely releasing materials that simulated the bacteria and germs that could cause people who come in contact with them to become sick all over the office, after four hours more than 50% of all of the tested surfaces tested positive for the germs. By the end of the day, 70% of all surfaces were “infected.” Apparently office workers are very efficient and productive when it comes to spreading germs. Dr. Reynolds explained that people who came in contact with these surfaces ran a 40-90% risk of infection from the exposure. It’s clear that by not washing our hands in between each and every patient encounter we are putting our patients and ourselves unnecessarily in harm’s way.



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A 2011 study conducted by Kimberly-Clark listed the environments and devices that most contained the kinds of germs that can most easily make us sick. In order, they are: • Playgrounds • Bus/Airport Armrests • Public Bathrooms • Shopping Cart Handles • Escalator Handles • Furniture • Vending Machine Buttons • Restaurant Menus • Public Telephones • Elevator Buttons In a typical office environment, some of the surfaces you might want to avoid include break room sinks and faucets, microwave door handles, computer keyboards, telephones, and vending machines. In addition to washing our hands in between patient encounters, it is also be considered standard of practice to disinfect the surfaces of all equipment that comes in contact with our clients – again, before or after each individual use. This would include things like pupilometers, PD sticks and other gauges, distometers, tonometers, and phoropters, just to name a few. Outside of work, the CDC says we should wash our hands: • Before, during, and after food preparation • Before eating • Before and after caring for someone who is sick • Before and after treating a cut or wound • After using the toilet • After changing diapers • After blowing your nose, coughing, or sneezing • After touching a pet or animal • After touching garbage Which leaves only one thing to consider – how do I do it? What is the most effective way to wash your hands? According to the CDC, the most effective way to wash your hands is to wet your hands with warm or (interestingly) cold water, after applying a generous amount of antimicrobial soap. Rub your hands together to make a good lather; scrub well. Scrub the backs of your hands, your fingers, in between fingers, your nails, and even your wrists. This type of rubbing should continue for at least 20 seconds, which according to the CDC (and all the billions of government dollars it took to figure it out) is equivalent to the average person singing “Happy Birthday to You.” Twice. Use a clean towel or air dryer to dry your hands. If no water or other necessary facilities are available, use a waterless hand sanitizer that contains at least 60% alcohol. This will, according the CDC, “Reduce the number of germs, but not all germs.” It is also never advisable to use the waterless hand sanitizers when the hands are visibly dirty. When using the waterless method, apply the sanitizer to the inside palm of one of your hands, then rub your hands together. Continue rubbing the hands until all surfaces are dry. Happy washing. I



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VISION PROTECTION: Eye Strain from Digital Devices When we think about damaging our vision, eye injuries that occur on the job, during sports or while working around the house come to mind. However, we often overlook a less obvious but more frequent danger to our eyes, digital eye strain, and the overuse of digital devices. We are living in an extraordinarily digital age. Thanks to technology, often small enough to hold in one hand, we can video chat across oceans, stream lectures to thousands and read entire books on one screen. The digital age has shaped the way our world works, learns and socializes. But this digital world poses a potential risk to our eyes. A 2012 report conducted by The Vision Council surveyed nearly 10,000 adults across the U.S. and found that nearly 70 percent experience some form of digital eye strain while using their electronic devices. More than a third of adults reported spending four to six hours a day with digital media or related electronic devices, while another 14 percent spend 10 to 12 hours per day. Children are mirroring their parents’ behaviors, spending unprecedented amounts of time in front of digital technology. Studies suggest that children are now a leading impetus for purchases of consumer electronic products. As digital use increases among all ages, eye care providers are becoming ever more concerned about the potential short and long-term consequences. Because computer tablets, smartphones and other hand-held products are designed for reading and close range use, eyes must constantly refocus and reposition to process graphics and text. After spending two or more hours looking at a digital device, many individuals experience dry eyes, blurred vision, irritation, eye fatigue, headaches, and neck and back pain. One or more of these symptoms signals digital eye strain. For many Americans, digital eye strain is a normal aspect of their everyday lives; 34 percent of adults have a profession that requires prolonged use of digital devices. Today, digital eye strain is the most common computer-related repetitive strain injury, surpassing carpal tunnel and tendonitis. Reliance on technology is only going to increase, making now a tremendous time for eye care professionals to inform patients about digital eye strain and discuss strategies and products available to help ease the strain. The Vision Council’s survey also revealed a general lack of knowledge about digital eye strain as a real health issue. Fewer than one in five adults have ever heard the term and only 23 percent were aware that special digital-use eyewear exists that can help reduce symptoms.

Respondents regularly use digital media devices: Television (83%) Desktop computer (67%) Laptop computer (65%) Smartphone (45%) Video game system (30%) Tablet or e-reader (26%) On a typical day, respondents use digital media devices: 3 hours or less (20%) 4-6 hours (33%) 7-9 hours (22%) 10-12 hours (14%) More than 12 hours (10%) Respondents experience vision problems and related issues after using digital media devices for a prolonged period: Neck and shoulder pain (34%) Eye strain (32%) Dry eyes (20%) Blurred vision (20%) Headache (18%) Other (2%) To relieve symptoms, respondents have tried: Changing their sitting position (58%) Looking away from their screen (51%) Changing their lighting (32%) Modifying their work stations (31%) Wearing special digital-use eyewear (8%) Other (4%) None of the above (17%) With these findings in mind, the eye care professional plays an important role in informing patients about digital eye strain and providing them with the proper computer eyewear. The Vision Council’s report encourages adults to speak with their eye care professional about wearing computer eyewear, which is available in both non-prescription and prescription lenses. Computer eyewear products use single vision lenses prescribed for the mid-distance range of a digital screen and an anti-reflective coating to eliminate reflections of light. For individuals with prior vision impairment, computer glasses can be designed as occupational progressive lenses, which correct near, intermediate and distant vision. No one knows how digital technology will evolve in coming years. But it seems certain that tablets will get smaller, phones will have more apps, new devices will be invented, and our eyes will spend even more time staring at screens during work, school and play. Comprehensive eye exams can address digital eye strain while also identifying sight-threatening diseases. With this reassurance and advice, individuals can be more confident of a comfortable and productive digital and visual future. The Vision Council is working with eye care providers and member companies to educate consumers about the problems associated with digital eye strain.



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Protect Their Vision. Diversify Your Revenue. It is estimated that more than 2.5 million eye injuries occur each year. By using the “Inquire. Inform. Introduce.” strategy you can help protect your patients’ vision while at the same time expanding your patient base and diversifying your revenue stream.  Ask: What are you doing to protect your vision?  Consider: Job-specific tasks and hobbies  Discover: Your patients’ daily activities Providing accurate information and solutions begins with asking your patients the right questions. Learn how to ask the right questions at

helping you to grow your practice



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It’s about the

EXPERIENCE not the Price

And finally, that they were undermining countless small businesses, including MD, OD and Optician-owned practices, independent laboratories and other vendors who support them. I received the electronic version of a form letter thanking me for my input. My plan is to keep sending the same or similarly worded complaint on a weekly basis, if for no other reason than to keep my focus on finding ways for my accounts to prosper in spite of the pressures of mass marketing and misguided consumer information. In the midst of this brouhaha, I found a thoughtful nugget. It’s the experience, not the price that will carry our industry forward. You see, we are now living in a world that is becoming increasingly isolated from real human contact. We work in cubicles. We shop online. We find friends online. We have our books and newspapers delivered wirelessly. So, on the occasions when we decide to venture into the real world, we are looking for more than just convenience or low prices. We’re looking for the experience of real live human contact and we are willing to pay for it. According to CNNMoney, the average cost to attend an NFL game has risen 50% over the past decade. The decade that included the biggest financial meltdown since the Great Depression. Parking fees have more than doubled and the price of beer has risen 35%. NFL fans are willing to shell out serious money for the experience of attending a game because the NFL owners recognize the deep need for human contact and shared experiences. “We are always looking, whether its ticket prices, concessions or the overall experience, how do we make that a good value and affordable for our fans?” said Jets president Neil Glat.

A recent feature aired on a nationally recognized news program highlighted how consumers can save “real money” on eyewear by visiting a wholesale club for eye exams and using the services of internet optical retailers for eyewear. As you can imagine, a segment of our optical world was enraged. Others yawned and gave it no attention at all. Like many, I’ve seen and heard this before. This time it was the proverbial last straw. I went to the program’s website and voiced my thoughts. First, that the researchers failed to find the Pacific University College of Optometry’s study that found a 50% failure rate on the accuracy of online eyewear. Second, that the content of the feature was a direct contradiction of their vaunted “America Strong” segment highlighting those businesses who proudly produce their products in the US.

By the way, the New York Jets dropped ticket prices this season by 7%, following a losing season last year. Even so, most NFL games are sold out regularly. Does the “experience” of an event or a product necessarily equate to high price? Perhaps not. Mercedes-Benz is debuting the all-new 2014 CLA. According to Fast Company Magazine, MB is chasing a new breed of customer: one with less money. In his interview with Fast Company, M. Bart Herring, Product Manager for Mercedes, is not concerned about diluting the luxury image of his brand with a unique design at a price point comparable to the high end of nonluxury brands. “We feel like there’s a great opportunity for a customer to be able to move on up to a luxury brand...a Mercedes is always going to be an emotional purchase—if you look at the car, you won’t find any corners being cut.” How did Mercedes reach this new consumer? “You hit the social media very hard with a car like this because that’s where these Continued on page 28

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“So, on the occasions when we decide to venture into the real world, we are looking for more than just convenience or low prices. We’re looking for the experience of real live human contact and we are willing to pay for it.”

customers are hanging out. We did a YouTube video series...and we’re also doing an Instagram production, which is really cool. I might be going out on a limb here, but designing and marketing a new car is not a knee-jerk reaction to a changing market. In a completely different product offering, there’s Keurig vs. Nespresso. Both systems brew your morning cup of joe, but that is where the differences end. Nespresso only brews espresso, although in many different gourmet forms and flavors. Nespresso never discounts its products. Its customer service team, which accounts for half of the company’s employees, will contact machine owners regularly to remind them to reorder. Nespresso owners are members of the Nespresso Club. It may just be a coffee brewer, but the experience is designed to make owners members of an exclusive group. The opening price point...$99.00. An affordable luxurious experience indeed. Keurig, on the other hand, will brew everything from coffee to tea to cocoa to soup. Keurig is available almost everywhere and always seems to be discounted for one reason or another. The Keurig experience is all-inclusive and that is working very well for the brand. The entire family can use its products, even customizing them with

refillable K-Cups. The basic price is the same for either brand, the design of the experience is not. Apple figured out the “experience” factor long ago by creating products that were simple and elegant. Apple spends about $200 per square foot to create the experience of visiting their stores. They know that allowing customers to play with the products for as long as they like gives those customers time to “fall in love” with the products, despite the certain knowledge that there will be glitches and problems to solve with each new rollout. Writing for Retail Systems Info News, Jessica Binn says, “As the retail store takes a place of prominence in the omnichannel experience, retailers are working steadily to ensure that shopping in their stores is memorable for all the right reasons. Research indicates that creating compelling shopping experiences is a top priority for many retailers although they’re lagging when it comes to putting their dollars where their mouths are. Take advantage of location-based services, and leverage them wisely. Create and push out relevant, compelling mobile marketing offers. A majority of women would love to receive a personalized offer on her smartphone while shopping in-store, according to Swirl Marketing. Explore the idea of using gamification to draw shoppers into your stores, associating your brand with an interesting, differentiated experience. The

Millennial generation, inherently a social and game-oriented demographic, is particularly well suited to engagement of this kind...Stores no longer are simply places of commerce — they’re places for shoppers to connect, discover, share and personalize their experiences.” As optical retailers we are in the unusual world where technology and fashion connect, yet we continue to resist looking beyond the office walls. We talk among ourselves and feed the fear factors of online eyewear, restrictive vision care plans, bigbox retailers and mass merchandisers, when we should be looking beyond those walls to see where other retailers are headed. We are too shy to ask our patients, even the “inactive” ones, what or if we can do better. The ability to communicate with patients is probably already at your fingertips. EHR Practice Management software, like My Vision Express will help you initiate and expand that essential contact with your entire patient database using the same social media outlets that successful retailers are already maximizing. Those among us who are unafraid to examine the successes of other seemingly unrelated retail strategies will succeed. They will not allow their vision to be compromised by a poorly researched news feature. I “Focusing The World’s Eyes on Your Business” 28 E Y E C A R E P R O F E S S I O N A L



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Easy Ways To Get Your Staff Motivatied quarter go off site for a longer meeting. “Close the business down for half a day or a (full) day, and really dig in and get into the meat of subjects,” she says. During staff meetings, Manso says its important for the owner or manager to remember that communication is a two way street and to make sure they take the time to listen to their staff. “I would suggest they have two ears and one mouth – listen twice as much as you speak,” she says.

AS A BUSINESS OWNER or manager, you already have tons of things to do during your day, and you expect your staff to come in on time, do a great job, and repeat that process each day. However, part of the job of being a business owner or manager is making sure your staff is happy and motivated to do a great job. To not do will hurt your business. “Patient retention is directly correlated to an effective, happy staff — if the staff is happy, you will retain patients and will grow your practice,” says Mary E. Schmidt, ABOC, CPO, founder of EyeSystems. Schmidt says it’s like any business you interact with — if you don’t receive good service from the staff you are most in contact with, you are less likely to go to that business again. Valerie Manso, BA, ABOC, FNAO, president of Manso Management Resources, says its in the best interest of a practice owner or manager to take the time to motivate their team because a

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motivated team is one that will help you achieve your goals and objectives. “Imagine a rowing team and we’re all putting our oars in the water at different times – you’re not going to move forward very fast,” she explains. “You’ve got to be well-coordinated, and that means we have to be involved and in sync.” The following are some easy-to-implement tips to help you on the path to having a more motivated staff. Tip #1 – Communication is Key It starts with communication, says Manso — as the leader, the practice owner or manager needs to have very strong communication skills and the ability to clearly articulate their vision of what they want to create. And the way that it is communicated has to be appropriate for your team and your environment. Manso suggests practices have at least a weekly team meeting, and then once a

Schmidt recommends giving different staff members different areas of responsibility, making them “authorities.” For instance, the front desk receptionist would be in charge of reporting on aspects of the practice regarding patient scheduling — how many patients are coming in, what’s your insurance ratio, what’s the collection rate, what’s the no show rate. “Anything that is important to the doctor — someone on staff from each department should be collecting and gathering that information and reporting on it,” Schmidt explains. “Then they can offer solutions or suggestions of different ways to handle things because they’re the expert and they know. They feel like they’re important, they feel like they matter, and that makes them motivated to do a good job.” Tip #2 – There’s No “I” in “TEAM” Once good communication between the practice leader and staff is in place, a more solid team can be built, leading to increased staff motivation. Manso says that once you can fully convey your visions and goals to your staff, get them excited about it through collaboration on how you’re going to get there. “As adults, we’re a lot more likely to succeed if we are



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somewhat involved in developing the process and how we’re going to get there,” she adds. Manso adds that trust is also important when it comes to developing teamwork. “Teams develop with trust, so you’ve got to give trust in order to get trust, and that means as a business owner you have to open up a little,” she says. “If you open up, people open up and it becomes reciprocal and it feeds itself, and grows and grows.”

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One test of trust could be to give your staff a satisfaction survey, just like you would give patients, Schmidt says. “It’s a risk because if your staff isn’t happy and you survey them, you may get hit with information you didn’t expect,” she explains. “But if you really want to change your culture and put a team together that is motivated and does care and is supportive, you need to know how they feel about the work environment and be willing to make changes to improve it.” Schmidt says make sure your staff feels valued. “They are the foundation of the practice — communicate that, tell them how much you appreciate the work they do, and how much you value them,” she adds. And if you have to give criticism to a staff member, Manso says to do it behind closed doors and be specific. “One can criticize a particular action and then give some suggestions and have it be positive without someone feeling like they did something wrong,” she explains. “So even criticisms can be motivating.” Tip #3 – Celebrate Good Times, C’mon! Now that you’re communicating well with your reinvigorated team, you may want to consider offering some sort of incentive or award to communicate a job well done. And this can be anything from a physical award to a financial incentive to a literal pat on the back to convey a job well done. Manso says whatever you decide on; make sure it works for the culture of your particular business. “The opportunity to say good job and we did it together is a very powerful tool,” she adds. Schmidt says that practice leaders should also be aware that one type of incentive may not work for all staff members as different things motivate different people. For instance, some employees may respond well to receiving a gift, while others prefer an “act of service” where the practice leader brings in pastries for the staff or takes the staff on an outing. And still other staff members are motivated by the practice owner taking the time to talk to them and ask them about their own motivations and dreams. Schmidt recommends business owners read the book “The 5 Languages of Appreciation in the Workplace: Empowering Organizations by Encouraging People” by Gary D. Chapman and Paul White. “It’s a great tool for doctors and managers to become aware of who on their team do they slip a gift card to, who do they give a cup of coffee too, who do they sit and chat with — it’s all a mix of all of those things,” she explains. I

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Marijuana, THC, CBD and Glaucoma drug that can lead to the use of more addictive drugs such as cocaine and heroin.



HE FACT is that marijuana possession, use, and distribution is illegal on a federal level. There are conflicts that have developed because many states are seeking to decriminalize or legalize the personal use of marijuana. Several states have enacted state laws that allow people to grow marijuana for personal use without the fear of being arrested. Many state governments are working with companies and with individuals to grow medical marijuana as well as to personally use marijuana. But there are too many legal conflicts with marijuana use in individual states as well as nationally. Marijuana use is still illegal on a federal level and is illegal in most states. The federal government regulates drugs through the “Controlled Substances Act” which does not recognize the difference between medical and recreational use of marijuana. The federal government places every controlled substance in a “schedule” which is based on the drugs’ potential for abuse as well as its medicinal value. Marijuana is classified as a Schedule 1 drug which describes it as highly addictive with no medicinal value. If arrested for marijuana use, possession, or distribution, the penalties may include serious fines or imprisonment. In the year 2013, the federal laws and the states that

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have enacted legalization or decriminalization are truly a source of conflict and disagreement. The difference between recreational and medical usage is a topic that brings passionate debate to both sides of the argument. There are medical, psychological, health and safety risks with the use of marijuana. Marijuana can be smoked, eaten, or inhaled which will affect the user’s medicinal benefits or psychoactive affects. Smoking can cause lung damage. There has been evidence that the use of marijuana can cause paranoia. Smoking marijuana has been linked to damage in the brain, the heart, and the immune system. Marijuana use can impair learning and can interfere with memory, perception, and judgment. Smoked marijuana contains cancer causing compounds and has been implicated in a high percentage of automobile crashes and workplace accidents. Many opponents of marijuana use believe that it is a “gateway”

There are other schools of thought that marijuana use can be beneficial. For someone with an appetite disorder or someone who is undergoing chemotherapy resulting in weight loss, the use of marijuana may be a good thing. Marijuana use has been known to reduce the nausea affects caused by chemotherapy. The most dramatic improvement in one’s health that I have seen was on Dr. Sanjay Gupta’s CNN presentation. A young girl was near death, suffering over 300 seizures a week. A form of marijuana which uses more of the component CBD and less THC reversed many of her seizure disorder problems and resulted in her leading a more normal, seizure-free life. She was not smoking the marijuana but was using a liquefied form that was given by mouth. The results were remarkable and life changing. The 43 minute CNN program can be viewed on YouTube by searching under the keywords “Gupta weed documentary.” There are two main active components in marijuana called THC and CBD. THC is the psycho-active ingredient in marijuana called tetra-hydrocannabinol which is what creates the “high” when marijuana is smoked, eaten or ingested. CBD is cannabadiol which has more medicinal benefits and has less of a psychoactive response in users. CBDs are less psychoactive and are considered by researchers to have a wide range of medical applications including treatment for Parkinson’s, epilepsy, multiple sclerosis, anxiety disorders, bipolar disorder,



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schizophrenia, nausea, convulsions, and inflammation. Some marijuana growers are trying to genetically alter the amounts of CBDs in order to increase their medicinal value. Here is a summary from the American Glaucoma Society, entitled “The Position Paper on Marijuana and the Treatment of Glaucoma”, by Dr. Henry Jampel: “Glaucoma is a disease of the optic nerve that can result in vision loss and blindness. Although many factors, some only partially understood, contribute to the optic nerve damage in glaucoma patients, it has been definitively established that the level of intraocular pressure (IOP) is related to the presence of damage, and that treatments that lower IOP reduce the risk of developing initial damage, and slow the progression of pre-existing damage. Therefore, the mainstay of treatment for glaucoma patients is lowering the IOP. There are three modalities in widespread use for the lowering of IOP: medications, laser treatment, and operating room surgery. Although historically, systemic medications in the form of oral carbonic anhydrase inhibitors had an important long term role in lowering the IOP, their side effects have resulted in their almost total replacement by many classes of effective eye drops with many fewer side effects. Despite the treatments available for lowering the IOP, there are some individuals for whom these treatments are either not tolerated due to side effects or in whom the IOP is not sufficiently lowered. In these situations, both glaucoma patient and physician look for alternative therapies.” One of the commonly discussed alternatives for the treatment of glaucoma by lowering IOP is the smoking of marijuana. It has been definitively demonstrated, and widely appreciated, that smoking marijuana lowers IOP in both normal individuals and in those with glaucoma, and therefore might be a treatment for glaucoma. Less often appreciated is marijuana’s short duration of action (only 3-4 hours), meaning that to lower the IOP around the clock it would have to be smoked every

three hours. Furthermore, marijuana’s mood altering effects would prevent the patient who is using it from driving, operating heavy machinery, and functioning at maximum mental capacity. Marijuana cigarettes also contain hundreds of compounds that damage the lungs, and the deleterious effect of chronic, frequent use of marijuana upon the brain is also well established. Other means of administering the active ingredient of marijuana, THC, include oral, sublingual, and eye drop instillation. The first two avoid the deleterious effect of marijuana smoke on the lungs, but are limited by the other systemic side effects. In one study in which doctors offered some of their patients with worsening glaucoma the option of pills containing tetra-hydrocannabinol and/or smoking marijuana, 9 of 9 patients had discontinued use by either or both methods within 9 months due to side effects. Given that glaucoma is a lifelong disease, commonly requiring treatment for decades, these results strongly suggest that systemic use of THC is not a reasonable treatment option for such patients. The use of eye drops containing THC, or related compounds, has been investigated, but it has not yet been possible to formulate an eye drop that is able to introduce the drug into the eye in sufficient concentrations due to the low water solubility of the active ingredients. Although marijuana does lower the IOP temporarily, IOP lowering is only one consideration in slowing the optic nerve damage of glaucoma. For instance, there is a growing body of evidence that inadequate blood supply to the optic nerve may contribute to glaucoma damage. Since marijuana given systemically is known to lower blood pressure, it is possible that such an effect could be deleterious to the optic nerve in glaucoma, possibly reducing or eliminating whatever beneficial effect that it conferred by lowering IOP.

cannot be recommended without a long term trial which evaluates the health of the optic nerve. An exciting finding in the past decade is the discovery of receptors for the active components of marijuana in the tissues of the eye itself, suggesting that local administration has the possibility of being effective. Furthermore, there is evidence from research in the brain that there may be properties of the cannabinoid components of marijuana that protect nerve cells like those in the optic nerve. This raises the hope that marijuana or related compounds could protect the optic nerve not only through IOP lowering but also through a neuro-protective mechanism. However, unless a well-tolerated formulation of a marijuana-related compound with a much longer duration of action is shown in rigorous clinical testing to reduce damage to the optic nerve and preserve vision, there is no scientific basis for use of these agents in the treatment of glaucoma. The legislative, legal and financial battles that the topic of marijuana presents is in its infancy. The research necessary to determine if this drug can improve people’s lives requires many more years of investigation. Until the federal laws change, which would allow states more freedom to hold clinical trials on a larger scale, the potential for a positive outcome on many fronts may take more time. There will always be opponents of medical progress who still believe that marijuana use of any form will lead to the culture of 1936 when “Reefer Madness” was the topic of conversation for years and marijuana use would lead to anti-social behavior and insanity. Research must be allowed to occur because if the United States does not take the lead in this important area, countries in Europe and Asia (and Israel) will be leading the way, as they are now. I

For this reason, marijuana, or its components administered systemically,

E Y E C A R E P R O F E S S I O N A L 33



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SECOND GLANCE Elmer Friedman, OD

I’m Proud to be an Old Timer

reversed the tension cycle and thereby did myself a wonderful favor. I sold my lab equipment and bench accessories to the first offer rendered. I do not possess the faculty of lapsing into a state of ecstasy over a smoothly running piece of machinery. In answer to the cold, calculating patronizers of mechanical contrivances, I say that the challenge and joy of solving a human being’s problem is the spark that turns on that certain rapturous feeling for me. Trust me; the feeling will be as good for you as it was for me. Allow me to present some of the sordid facts underlying my decision. First of all, I am a “people person.” I couldn’t care less about how beautifully a lower cam fits into an upper sprocket or whatever a lower cam fits into. In this advanced age of technology I should be able to assume that, as advertised, the machinery should behave itself the way it was designed to perform. However, my experience has been that at the very moment when I pat “Old Paint” on his withers and whisper tender words of encouragement into the lens chuck, all hell breaks loose. Three lenses later finds me in a comatose state, sweaty, swearing and removed from all senses of reality. It’s just me and that infernal machine doing battle!

I AGREE WITH THOSE WHO SAY THAT MODERN LIFE IS CREATING STRESS. We experience the adverse effects of stress in our body and we feel the tension in our muscles. The causes are usually from the many obligations we have to handle in our daily lives. Everyone reacts differently to stress. Some withstand pressure better that others. The undertaking of more responsibilities than a person can handle is certainly a source of stress. As for me, I can only report my very own battle with this problem. Some years ago I

34 E Y E C A R E P R O F E S S I O N A L

At first, the equipment was located close to the examination area. During the most important and solemn moment of my case presentation, I was treated to the ultimate distraction: that familiar spine chilling screech when the end of a 62 eye lens, with an upswept pattern lingers at its point in the edger. I saw patients blanch and clutch the arm rests until their knuckles were white during the unpleasant caterwauling of an edge wheel in heat. If the practitioner who acts as a second string lab man tells you that his optical bench is a great convenience, you tell him for me that he grossly exaggerates.

Every morning I would approach my office with the hope for a smooth day so that I might concentrate my efforts on accomplishing great and good eye care works. If I had a morning schedule weighty with exams, I prayed for relief because the afternoons were sheer hell. All the efforts I had anticipated bestowing upon my patients were now being dissipated in anxiety and worry. Lab work was piling up and several of the jobs were due to be finished a half hour ago. Fantasies passed through my mind of violent patients demanding their spectacles and in their disappointment, performed various and sundry mayhem upon my body parts. Both patient and eye wear suffered from the perplexities of the situation I was enduring. I began to grind my teeth in my sleep and when I awoke, I could feel my emotions tottering. There were days I wished that I wouldn’t have any examinations scheduled so that I could satisfy the compelling demands of my lab. Some fun, eh what? Later, I moved my lab equipment to my home. I blithely and naively assumed that the work could be done in a leisurely, relaxed manner. It soon struck me that the relaxation for which I eagerly yearned at the end of the day was being foiled by the lab trays that were always waiting and biding their time to agonize me. Like a venereal disease, the initial pleasure had long since been replaced by an interminable suffering. To add insult to injury, I still consistently missed my preferred prime time TV programs. Furthermore, my favorite reading materials piled up to a height of unfathomable limits. With great disgust I remembered the chap who told me the colossal amount of money I would save. He forgot to tell me about the lost time, the exasperation of ruined lenses and many of the jobs that were adequate but didn’t come up as



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perfect as I expected. There is no amount of money that could be worth this aggravation. I envy those with mechanical talent who take to lab work like city pigeons to statues in the square. And so, I made a momentous decision. I raised my fees a bit, which was long due, and halted my lab activities. A well known lab with an excellent reputation now supplies my Rx needs. They are quick, accurate and fulfill all my expectations. I’m not sorry about the choice I made. I haven’t lost any income, my teeth are even and sound, my nerves are quiet; my mind is content and most of all, a genuine enthusiasm for my role as an eye care professional has returned. A pox on all your computerized, sophisticated programmed electronic controls and super duper machinery. Now my marriage has been saved and my children no longer call me “uncle.” My friends are returning my calls and I’m back to playing tennis again during my well earned spare time. I’m feeling mighty fine and happy to be doing what I know best. However, I have earned, from my younger, wet behind the ears colleagues, the title of “old timer” because I dared to step back from modern, complicated technology. Just because my hair is graying a bit and I have developed a small paunch where my flat abdominal muscles

once reigned, it shouldn’t mean that I’m no longer in the game. It doesn’t mean that I’m required to sit on the bench while the players are engaged on the field. My nose has been bloodied on occasion but I’ve been tested in the arena and my spirit and mood have not been extinguished in spite of all. Allow me, if you will, to speak on behalf of all us “old timers” who have fought on the front line for improvement toward providing better vision care for the citizens of our respective communities. It is our battles that have eased the burden for the eye care professionals now enjoying the benefits of those efforts. It may be true that we were not always familiar with the more sophisticated, later material that some of you have been blessed with. But gray hair and a paunch does not an old timer make. You can recognize an old timer because he/she is the one that can calculate a P.D. within one mm without a pupilometer or rule of some nature. You can tell an old timer by the way he/she can adjust a zyl temple by blowing hot, steamy breath on it and knowing exactly how much it will bend without causing any damage. A push and a pull and the temple falls into a perfect position. An old timer’s patients bring them cake, candy and other homemade

goodies, with love and appreciation. They lavish him/her with warmth, affection and high esteem. You can tell an old timer when you hear him/her address patients on a first name basis. These patients can be heard in the reception room boasting that “Dr. Wunderbar” has been taking care of me and my family for 35 years and we wouldn’t think of going elsewhere.” You can also recognize an old timer by the way the neighbors, friends, family and community groups often request advice on many different matters. An old timer has held many offices and positions of responsibility in clubs, religious institutions and community projects. An old timer can perform tests using a phorometer and trial lenses and yet obtain a final Rx that is consistently dependable and accurate. This is all performed with nimble fingers as they artfully maneuver the test lenses with the grace of a prima ballerina. No automatic refractor necessary, thank you. You can tell an old timer by the way he/she is neatly and immaculately dressed and groomed. And finally, last but not least, you can tell an old timer because he /she is always able to disguise exasperation and annoyance when referred to as an old timer. I


= ALL OF TH S IC N E G O T P O www.optogenic




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Women are disproportionately affected by vision problems. Recognizing the importance of educating women about how vision problems can directly impact their health, Prevent Blindness America established a unique, web-based resource and awareness campaign – “See Jane See: women’s healthy eyes now.”



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Transforming lives through the gift of vision Correction from the July 2013 issue: On page 20 of the article “There’s an App for That!” the mobile application “Seiko Digital MultiTool” was incorrectly stated as being available from Seiko Optical Products of America.



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Luxury Eyewear The state of great comfort and extravagant living sunglasses made with gold or platinum and diamonds. Cost 150,000,00 Euros Limited Edition Wayfarer with 18 Kt Gold Carl Zeiss Lenses – $18,165 Bentley Limited Edition Platinum Sunglasses – $18,000 Jonny Vavas – Custom diamond eyewear – $8,500 Porsche Sunwear – $6,670 Michele Robison – Handmade 18 Kt Gold with Diamonds – $4,000


’ve talked about luxury in the past, pre-Warby-Parker, pre-Internet mail order glasses, and even pre-massive conglomeration of our industry.

So, what exactly defines “Luxury” today? In this new day of the 1% against the world – “Luxury” is being redefined. Recently at a much hullabalooed auction, a rare 1955 Mercedes Benz W196 racing car (granted it had been driven by Juan Manuel Fangio) sold for over $29 million dollars. The record price for any car remains the $35 million given by a U.S. based collector for an apple green 1962 Ferrari GTO 250 racer that had been made for the British driver Stirling Moss. The private transaction, first reported by Bloomberg, took place in June 2012. The other day, in Portland Maine, I saw what I thought was a smallish cruise ship – turns out it was a private yacht (8th largest in the world), 463 feet long, crew of 45 taking very good care of 16 lucky people, 5 floors, private sub, two helicopter pads! Annual operating budget $12 million – 42 E Y E C A R E P R O F E S S I O N A L

cost to build – upwards of $200 million. Good to hear about cars and ships, but what about eyewear? Thanks to the Official Vision Web Blog posted by Sharon Chin, we learn eyewear is not (or ever has been) immune to ridiculous excess. The following is a compilation of the 25 most expensive eyeglasses:

Oakley’s Elite C Six Carbon Fiber Graphite Sports Performance Eyewear Moss Lipow – Ostrich Eyewear $3,800” But of course, there are dissenters, here is a comment about the above list and I have no reason to dispute this person’s claim:

Cartier 2010 Collection with Gold and Diamonds – $12,000-$60,000

“Your figures are incorrect. Look into the house of Cartier and you will find eyewear sold at over a HALF MILLION DOLLARS. There are several styles over 200K including opera glasses of solid gold encrusted with over 105 CT of diamond, sapphires and emeralds. With Cartier 60k isn’t even in the true luxury range. CHOPARD has created a sunglass estimated at over 400k. GUESS created a sun frame retailing at over 380k. Most of what you have listed doesn’t even deserve to be mentioned on this list. Thanks for the effort, but dig a little deeper and find the big boys of the eyeglass world.”

Lugano Diamonds and Barton Perreria have a large selection of solid gold with gemstones – Cost $27,000

Nice to know in the field of very conspicuous consumption – eyewear is still holding up its glittering head! I

“The top honor probably goes to Dolce and Gabbana – $383,609 pair of glasses that was launched in 2008 Luxuriator Diamond and 18Kt Gold Eyewear – $65,000 Gold and Wood – $65,000 Diamond and Buffalo Horn Eyewear Lotos Gold Spectacles has solid gold or platinum with precious stones

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Order your FREE poster and dispensing mat online at:

The Kodak trademark and trade dress are used under license from Kodak by Signet Armorlite, Inc. Š2013 Signet Armorlite, Inc.

EyeCare Professional Magazine November 2013 Issue  

November 2013 Issue of EyeCare Professional Magazine. A Business to Business publication that is distributed to decision makers and particip...

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