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LUXURY EYEWEAR / PAGE 6 — FIVE RESOLUTIONS FOR DISPENSERS / PAGE 14 January 2014 • Volume 8, Issue 72 • www.ECPmag.com
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JANUARY 2014
EYECAREPROFESSIONAL
Magazine
Contents
Vol. 8 Issue 72
Features 6
LUXURY EYEWEAR Appeal to your most fashion conscious patients by offering the latest in luxury eyewear. by ECP Staff
12
HIGH END SUCCESS Some tips on how to increase your sales in the burgeoning luxury eyewear market. by Lindsey Getz
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12
NEW YEAR’S RESOLUTIONS Listing five New Year’s resolutions to help get dispensers off to a great start in 2014. by Cliff Capriola, Practice Management Consultant
30
YEAR IN REVIEW FOR LENSES Reviewing the past year in lens technologies and innovations, and what to expect in the future.
24
by John Seegers, M.Ed., LDO
36
HEAD INJURIES, CTE AND VISION ECP’s should be aware that patients who have sustained head injuries may experience vision problems. by Jason Smith, OD
42
MICRO FIBER MANAGEMENT After years of trial and error, I think I discovered the best way to clean my patient’s lenses. by Jim Magay, RDO
30
On The Cover:
Departments
REVOLUTION EYEWEAR
EDITOR / VIEW ....................................................................................................4
1.800.986.0010 www.RevolutionEyewear.com
MANAGING OPTICIAN.....................................................................................18 MOVERS AND SHAKERS ..................................................................................21 DISPENSING OPTICIAN...................................................................................24 MOBILE OPTICIAN ...........................................................................................26 SECOND GLANCE..............................................................................................34 ADVERTISER INDEX .........................................................................................39 INDUSTRY QUICK ACCESS..............................................................................40
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EDITOR / VIEW Jeff Smith, Publisher
EYECAREPROFESSIONAL
Magazine
Anti-Reflective Awareness The benefits of AR Coating – both to the patient and the practice’s bottom line, are readily apparent to the average ECP. But something is clearly getting lost in translation during the dispensing process. This may not seem to be the case for your practice, but the numbers speak for themselves. According to The Vision Council, only around 30% of U.S. eyewear features AR Coating, compared to over 50% for the rest of the world. Years ago, the only coatings readily available were UV protection and scratch coat. With polycarbonate, and later many of the high index plastic lenses, these were either unneeded or considered a relatively expensive option. Unfortunately, that caused the development of an attitude of presenting these options as not really necessary, if at all. When AR was first introduced, there were several problems associated with it that gave the coating a bad reputation. They were prone to crazing (thin cracks), cratering (pits), and even peeling. They were difficult to clean and delicate, so special attention when cleaning the lenses had to be observed to avoid scratches. Advances in coating chemistry and manufacturing have all but eliminated these problems. The benefits of the coating are obvious when compared to a non-coated lens. The coated lens appears cleaner and clearer, in most cases dramatically so. Because little of the light is reflected back, the lens appears to disappear, and with the proper frame selection, the appearance of wearing glasses is almost eliminated. Another benefit, perhaps the most significant to the patient, is not so obvious until they actually wear the lenses. Because more light passes through the lens without being reflected off, overall vision is improved. Colors are more vivid, contrast is improved so reading is less tiring, and low light vision is improved. But if all that is not enough to convince you to recommend AR, there is one more benefit: when driving at night, the dangerous glare of incoming headlights is all but eliminated. While the headlight will still be bright, it will be a bright spot rather than a blinding globe. Tell that to a long time eyeglass wearer and you’ve got a sale. One of the keys to presenting these rather complex coatings is to keep the presentation simple, use language the patient can relate to, and take advantage of any demonstration aids you might have available. Of course, if you wear eyeglasses, they most certainly should have AR on them. Wouldn’t it be nice to be able to offer your patient clarity, cleanability, and scratch protection, all with a multi-year warranty? So, how do you sell premium AR? Simple – tell them the benefits! ■
Publisher/Editor. . . . . . . . . . . . . . . . . . . . . . . . . Jeff Smith Production/Graphics Manager . . . . . . . . . . . Bruce S. Drob Contributing Writers Mary Armstrong, Judy Canty, Cliff Capriola, 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 www.ECPmag.com editor@ECPmag.com EyeCare Professional Magazine, ECP™ is published monthly by OptiCourier, Ltd. Delivered by Third Class Mail Volume 8 Number 72 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: jeff@ECPmag.com Copyright © 2014 by OptiCourier Ltd. All Rights Reserved For Subscription Changes, email: admin@ecpmag.com
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EYEWEAR & SUNWEAR
3 1
3. MOREL
1. LINDBERG LINDBERG Precious consists of frames with solid 18-carat gold, platinum, diamonds and buffalo horn and is one of the most exclusive international eyewear collections. The frames are hand-made and individually crafted to fit the wearer’s face. The minimalist and lightweight design is particularly well suited for precious metals. www.lindberg.com
2. CLARITI EYEWEAR Monalisa STYLE M8876: The deep burgundy color with beautiful gold and crystal accents will highlight your classic elegance and adorn your signature style. www.claritieyewear.com
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LIGHTEC 2014 Sun Collection: stylish, polarized suns with high-tech credentials. This inaugural collection is made up of four models available in three colors each. Shapes are feminine and easy to wear and maintain an edgy, sophisticated appearance. Design and cutting edge technology are combined for superior protection and comfort. www.morel-france.com
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4. CAVIAR New in 2014 is the fabulous Caviar 1830, which has a classic “Princess Diana� feel. www.caviarframes.com
5. VIVA The MARCIANO Eyewear Spring 2014 collection combines finely crafted materials and luxurious styling creating chic and refined silhouettes. Abstract elements are seen in the handcrafted acetates adorned with exquisite Swarovski crystal detailing, while dual-toned metals and sleek designs express a simple elegance. www.vivagroup.com
6. BCBGMAXAZRIA BCBGMAXAZRIA Celeste: The lightweight, flat metal wayfarer is heavy on style. This retro inspired frame is modernized through a fashion forward stud bar design on its temporal edges. The rich & colorful temple materials make Celeste a standout beauty. Available in Black, Blue Slate, and Wine. www.cvoptical.com
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REVOLUTION EYEWEAR
SERENGETI
Robert Graham eyewear will offer high quality craftsmanship and sophisticated silhouettes, along with infusing iconic fabric and trim designs to reflect the essential characteristics of the brand’s American Eclectic spirit. There will be seven ophthalmic and ten sunglasses for the first collection. www.revolutioneyewear.com
Brera: The defining feature of the sunglasses in the new Serengeti Signature collection is a hinge made with an ancient practice known as lost-wax casting. A labor intensive, multi-step process that requires the use of the finest metals and alloys – in this case, copper beryllium – lost-wax casting allows for a level of finish detail nearly impossible to achieve with more common mass-production techniques. www.serengeti-eyewear.com
TREVI COLISEUM
MARCOLIN
Trevi Coliseum Eyewear Cotton Club Carbon Fiber Line is constructed of the newest space age materials and defines the concept of style, quality and luxury. Made of carbon fiber with rubberized temples for lightweight comfort, extreme strength and adjustability, Model CC280 is available in Black Gun, Black and White Black (shown). Made in Italy and backed by a two year warranty. Sold exclusively in North America by National Lens. www.national-lens.com
Montblanc brings the finest European craftsmanship to the classic aviator style, combining a shiny metal front and temples with authentic water buffalo horn (MB458s). The enamel on the double ring and the Montblanc emblem complete a piece of eyewear designed for the person who enjoys iconic designs made from the finest materials. Available in shiny dark grey metal with striped black horn and rose gold metal with honey-colored striped horn. www.marcolinusa.com
PLAN B EYEWEAR The Glacée 6696 takes smooth sophistication to the next level. Beautiful swooping temples create artful movement leading up to the beautiful rounded front. The 6696 (shown in Red & Ivory) is made from high quality metal, and features a smooth matte finish. www.planbeyewear.com Plan B Eyewear – The Glacée 6696
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Robert Graham Signs License with Revolution Eyewear ROBERT GRAHAM has announced a new partnership with REVOLUTION EYEWEAR. This deal marks the entrance of eyewear to round out the men’s product range of Robert Graham, including sportswear, premium denim, furnishings, accessories, and outerwear.
Godfather Crystal Orange
Polk Brushed Pewter
“We are thrilled to partner with Revolution Eyewear and further extend our product offering within the world of Robert Graham,” said Michael Buckley, Chief Executive Officer of Robert Graham. “Their attention to detail is unparalleled, and together we will create product that is distinctively unique in the marketplace.”
“The American Eclectic vibe and the majesty of the Robert Graham Brand, leads me to believe that we are setting out on a mission to create a classic collection that will become a staple in every optical retailer operating today,” continued Martin. “We are celebrating our 20th Anniversary in 2013, and couldn’t be more proud to add Robert Graham to our brand portfolio.”
“I couldn’t be more excited.” said Gary Martin, President/CEO of Revolution Eyewear Inc. “I believe Robert Graham and Revolution will create a collection of eyewear that will resonate globally. We love bringing different, incredibly creative ideas into the optical marketplace as we have done time after time. Our history of creating high quality products with creative flair is what I am most proud of.”
Robert Graham eyewear will offer high quality craftsmanship and sophisticated silhouettes, along with integrating iconic fabric and trim designs to reflect the essential characteristics of the brand’s American Eclectic spirit.
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MODERN OPTICAL
A&A OPTICAL
The A350 from the Modern Art Collection: Retro meets glam in this handmade zyl frame that will whisk her from office to evening. Multifaceted baguettes, delicately placed in the front corners and temples, accentuate her feminine, elegant style. Available in Black, Brown and Burgundy, in size 5316-140. www.modernoptical.com
Jimmy Crystal Impulse shimmers with elegant design and two tone color scheme. The semi-rimless frame is accented by four sparkling crystal spheres which gradate from dark to light in color. Impulse is available in two colors. The black frame, accented by white acetate, features a gradation of quartz and jet stones. The brown frame, accented by orange acetate flickers with light and smoked topaz Swarovski Crystals. www.aaopticalco.com
CLASSIQUE EYEWEAR
MATCH EYEWEAR
William Morris Black Label is a luxury eyewear collection inspired by the iconic looks of famous personalities from the 60’s and 70’s. The collection is designed for sophisticated men and women who seek that distinguished, iconic look coupled with superior quality, fine detailing, and excellence in design. Styles are classic, refined, and stylish, and are reflective of the latest trends on the London scene fashion runways. www.classique-eyewear.com
EASTERN STATES EYEWEAR The 5399 is one of the standout pieces of Eastern States Eyewear’s latest Diva release. A modern shape with a classic twist, this style is graced with lovely Austrian Swarovski Crystal adornments. It is available in four rich color combinations ranging from translucent grey-rose to Forest Green-Cognac. www.eseeyewear.com
Adrianne Vittadini model AV1132 is a semi rimless Italian made design with a metal front that has an end-piece that is adorned with Swarovski crystals for a touch of luxury. A tasteful AV logo is inset within the richly colored acetate temples. AV1132 is offered in three colors such as Violet, Gunmetal with Burgundy temples, and Brown in eyesize 51/18/135. www.matcheyewear.com
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OPTICAL MARKETING Lindsey Getz
Tips for Luxury Success There is great opportunity for optical dispensers in the luxury market.
A
A report from Bain & Company (a management consulting firm) shows that there is definite growth in the luxury segment. While it holds a lot of opportunity, the key to success is not only attracting the right buyer and having the right product but also fulfilling a sales experience that helps seal the deal. We take a closer look at the Who, What, and How of selling luxury frames to help give you the best chance at success. WHO
Success in the luxury market means attracting the right customer. In order to do this, you should know who the luxury customer is. It appears that a new luxury customer has emerged in the market and is the one you want to target. While the financial news is reporting rebounds in consumer spending, Pam Danziger, a luxury expert and president of Unity Marketing says that the post-recession growth is not occurring uniformly across all economic segments. Instead it is the affluent consumer who is spending more. More specifically, it is those falling into the segment of the economic structure known as HENRYs (High Earnings, Not Rich Yet) that have increased their spending the most. This group makes between $100,000 and $249,999 per year. “I think the most important shift in the economy at large is the growing importance of the affluent in driving the recovery,” says Danziger, who recently authored the Luxury Report 2013 with research and data covering the luxury market over the last five years. “The middle-class and lower-income folks have greatly reduced 12 E Y E C A R E P R O F E S S I O N A L
spending power, due to tax changes, unemployment, etc., so the affluent are the heavy-lifters behind the good news about retail and consumer spending growth.” But Danziger says that the “ultra-affluent” segment (those earning over $250,000 per year) have actually cut back on luxury accessories like jewelry and watches. So it’s truly the HENRY group that is ideal to target for eyewear. This group aspires to have “nice things.” They are often young professionals and they care about how they look and what brands they choose to wear. WHAT So what is it that luxury consumers want to buy? There is no doubt that they value accessories. The recent report on luxury from Bain & Company also found
that the luxury clothing and accessories market is set to reach almost $300 billion this year. Luxury consumers want top-ofthe-line watches, perfumes, cosmetics, and of course eyewear. A HENRY is not going to wear a designer suit, top-of-the-line dress shoes, and a brand-name cologne, and then select a cheap pair of frames. Think of the eyewear as a piece of their overall look—and pitch it that way. Traditionally luxury buyers have been interested in brand recognition. They also tend to be brand-loyal. If they love their Coach purse, for instance, they might desire a pair of Coach sunglasses to match. But luxury consumers also care greatly about quality. Handcrafted frames using exotic wood or beautifully placed precious stones or diamonds are likely to attract the eye of your luxury buyer. Talk about the materials used to entice your buyer. And
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when you’re handling frames, handle them like they’re a piece of fine jewelry. Hold them delicately and encourage the buyer to do the same. It’s all about setting the tone of making a luxury sale. You have to show the buyer that the frames are worth their expensive price tag. HOW Now that you know who the luxury customer is and what it is that he or she is looking for, the big question is how will you make the sale? Attracting the buyer and having the right product are important parts of the puzzle but actually making the sale is going to depend on how well you present the frames and handle the sales pitch. It’s important to recognize that the luxury consumer is also buying into the “experience� during their frame selection process. Keep in mind that these consumers are used to shopping at stores where they get one-on-one attention and top-notch customer service. If you’re going to successfully sell to your affluent patients it’s important to recognize that their shopping experience in your dispensary will be a major factor in what they buy—and whether they return. Keep these points in mind to improve their experience:
Don’t Rush. Never rush the selection process. The luxury consumer enjoys looking at all of the options and carefully making their decision. Give them time to look around and never make them feel under pressure. The luxury consumer often wants to feel like they’re your top priority and that they’re not competing for your attention. Try to find a way to meet their needs without completely ignoring your other patients. A Flawless Presentation. If you have a $500 pair of frames sitting on the same tray or frame stand as frames in low price points, you’re doing a great disservice to the positioning of your luxury brands. Make these frames look extra-special. Make them look like they should cost more than the other frames around them. Your display should look flawless—well-cleaned (nothing devalues the frames more than putting them on a dirty display tray), showcased with proper lighting, and arranged thoughtfully. Use nice fabrics like velvet or satin on the display trays of your top frames to add to the high-end presentation. And be sure to pay attention to the frames or lenses as well. Smudged lenses can certainly detract from the presentation.
Perfect Your Pitch. If they’re planning to spend a lot of their money on your products, your luxury consumers are going to expect you to know your stuff. Know all of the key details about your luxury frame selection. Point out design elements and frame features that make the eyewear “worth� its cost. As you consider these points, recognize that sometimes it’s the small details that really do matter to your luxury customers. Things like extra customer attention or handling the frame delicately may seem minor but they all go hand-in-hand to formulate a high-end buying experience. It certainly helps to understand the who and what of the luxury market so that you can execute the how. “Understanding the complex behavior exhibited by affluents is the first step in capitalizing upon this bright spot in the U.S. economy,� says Danziger. As you understand these things and make even minor changes to your practice and your sales pitch you may just find that you can hit a home run with your luxury clientele. I
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PRACTICE MANAGEMENT Cliff Capriola, Practice Management Consultant
5 New Year’s Resolutions for 2014 1. CHART A COURSE Every business plan has to start with a realistic self-appraisal of the previous year, including financial goals met or missed, staff performance, identification of practice strengths & weaknesses, and identifying the causes of both any problem areas and strengths. Unfortunately, too many eye care practices find it all too easy to get caught up in the everyday stresses of doing business and lose sight of where they are now, where they are heading and why. Or as the street grifters in New Orleans say to the tourists, “I bet you five dollars I can tell you where you got your shoes at.” The wager accepted, the grifter replies “you got your shoes on your feet, you fool,” snatching the five dollars and disappearing into the crowd. It’s fairly easy to set goals, but over the years we have noticed that the practices which are successful in meeting their goals also have a plan to reach those goals; and they share their plan and their goals with their staff. Financial Goals – assuming you set goals for 2013; your practice management software should provide the numbers necessary to see how far over or below the practice performed in relation to your goals. There is no shortage of practice metrics published on the web and in trade magazines, but here is a list of what we feel are the core metrics important to every practice. • Gross revenue • Net income • OD hours worked
• Staff hours worked • Total patient visits • New patient visits • Medical eye care visits • Eye exam revenue • Medical revenue • Frame sales • Lens sales • Contact lens sales • 3rd party (insurance) revenue • Cash revenue From these numbers you can figure the important ratios, such as percentage of new patients to total patients, percentage of revenue coming from the optical dispensary, and many others. You can also drill down deeper into the numbers to find product percentages in the optical and other information which will tell you the overall health of your practice.
and staff, or they can be an opportunity for mutual understanding and improvement. We have developed a 2-page employee appraisal for the doctor or manager to fill out, while the employee fills out the same form as an employee self-appraisal. The two then sit down for a short period of time and discuss their findings; there are usually some surprises on both sides. These appraisal forms keep the doctor/ manager in charge while allowing the employee to have some input into the management of the practice. Just email me at cliff@ecpmag.com and I will forward copies of the form for your information and/or use. 2. GET A CREW
In projecting growth for the upcoming year, an independent OD will grow on average between 2% and 6% per year; growth of 1% or less is an indication of serious problems in the practice, and growth of 7% or more is considered excellent.
Are you happy and satisfied with your current staffing as it is now? If you have recently concluded your annual employee evaluations, it might be a good time to make any necessary changes if they will improve your practice. Like it or not, increases in managed care results in your staff having more and more influence on your patients’ perception of your practice.
Staff Performance Reviews – these can be a source of tension between management
Also, your personal perception of the practice is not necessarily the perception your Continued on page 16
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patients have. Try to see your practice through your patients’ eyes: remember that they visit your practice for only about an hour or so every one or two years. Their visit takes up a significant portion of their day, it may be stressful, and they are usually spending hundreds of dollars on glasses and/or contact lenses. Knowing this, are you happy and satisfied with the attitudes and professionalism of your staff? Hopefully, your answer would be yes... One of the misconceptions we had to deal with as consultants was that we were there to make wholesale changes in the staffing of the practice. In fact, nothing could be further from the truth. In almost twenty years of consulting we have only recommended terminating three employees, and in each case they were stealing money and/or equipment from the practice. We would go in assuming the staffing would remain the same; we concerned ourselves with raising the overall education and work habits of each individual staff member to improve patient care. That said, there were instances where doctors would put up with bad attitudes among their staff for far too long, and for reasons such as being members of the same church or being distantly related to the employee. Again, we would advise them to take a step back and look at the situation from the point of view of their patients: Is a staff member’s negative attitude obvious to patients? Is it negatively affecting other staff members? If so, then turnover would be a good thing. One last thought on the subject: have you noticed how the most successful practices tend to bring along many staff members for continuing education at the state & regional optometric shows? Have you ever considered that perhaps the continuing training of their staff is one of the reasons for their success, and not one of the results? 3. MANAGE YOUR MANAGED CARE PLANS Far too many doctors sign up for just about every plan that crosses their desk, or because the doctor down the street signed up, no matter what the reimbursements or the number of potential patients to be 16 E Y E C A R E P R O F E S S I O N A L
covered. Remember, vision insurance is a two-way street; the administrators of the plan need you as a provider when they go out and market their plan to local industries. Take the time to evaluate how much income the plan might bring in. You already should know what your average income per patient is currently; compare that with what the plan brings to the table. I can’t tell you how many times I have heard doctors tell me “I hate this plan. I only accept it because the other doctors in town do.” Have you ever thought that they might be saying the same thing? However, each practice has to evaluate vision plans independently. If your competitor down the street does not accept a plan because of low reimbursements, it might still be worth it for you if you are new to the area and need to increase patient flow quickly.
“It’s fairly easy to set goals, but over the years we have noticed that the practices which are successful in meeting their goals also have a plan to reach those goals.”
4. DON’T ASSUME ANYTHING ABOUT YOUR PATIENTS If you’ve been in practice for a while, you and your staff probably feel as though you know your patients pretty well by now. Well, I’d like to challenge you to try something new this year: forget the assumptions you have regarding your patients. That’s right. Try to view them as a blank slate so far as their visual needs are concerned. Ask them what they both like and dislike about their present eyewear; and ask what is new
in their lives: changes in their workplace routines, hobbies, and sports activities, anything which might have changed visual requirements. Try not to pre-judge them; that mild-mannered accountant may have just fulfilled a lifetime dream of buying a Harley and really needs some top-rate polarized sun wear, or the suburban soccer mom might have taken up racquetball or kickboxing at the local health club and need sports goggles right now. They’ll appreciate your taking the time to know them better, and you might find out you didn’t know them quite as well as you thought. 5. MARKET YOUR PRACTICE INTERNALLY One of the biggest surprises we had going into consulting was the interest, bordering on obsession in some cases, that doctors have about their competitors down the street or across town. “What do they do over there?” we were asked over and over again. Over and over again we stressed that knowing what they do across town was beyond their control; all you can control is what happens in your practice. It’s been proven many times that people will return to and buy from establishments which treat them fairly and respectfully. Only you can control whether or not that occurs at your practice. The advertising people at chain and big-box stores would kill for the effectiveness of word-of-mouth advertising that happens every day in your town – and it’s free! Work closely with your staff to ensure that each of your patients knows that your practice is the only place they’ll ever need for their vision care. Should the opportunity arise, there is no reason why the receptionist or the employee working up the patients can’t discuss the importance of sports goggles for children, and if she notes the discussion on the chart the doctor can reinforce the thought. To the patient, it appears the entire practice is concerned with their vision and everyone is on the same page. I
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Santinelli Introduces Spring Hinge Tool Kit Augmenting its new collection of optical tools and working aides, Santinelli International now offers a unique Spring Hinge Tool Kit which assists with the removal, repair and replacement of spring hinge temples with ease. The kit is an optician’s must-have working aide as it simplifies the reassembly of “pesky” spring hinge temples. Previously this type of work was a challenge using hard-to-handle tools that were not designed for the job at hand. The Spring Hinge Tool Kit has everything you need to extend the spring hinge from its housing, simplifying the realignment and assembly. This patented, handy tool kit includes a hemostat-type clamping plier, easy-lock tweezers, a lever tool and a set of three pins, with six varying sized tips.
See the Spring Hinge Tool Kit in action by viewing the video at: www.santinelli.com/products/suppliesandtools To place an order or request the company’s all-new catalog, call 800.644.3343 (option 6).
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MANAGING OPTICIAN Anthony Record, ABO/NCLE, RDO
P
EC I RECENTLY learned a new acronym. It’s ACRONYM. It stands for Abbreviated Code Rarely Or Never Yielding Meaning. You have to admit that we ECPs love us our acronyms: ECP, PD, AR, BC, UVA, UVB, OD, LDO, CVS, ARMD...OMG. We all know what those acronyms stand for, especially ECP – Eye Care Professional. If asked to define those three words, most ECPs would have no trouble with “Eye,” a bit of a struggle with “Care,” and their definitions of “Professional” would be all over the map. Trust me. I’ve experimented. In a room filled with 50 opticians, there would literally be 50 different definitions of what it means to be professional. It is a very subjective word. As the New Year begins, it is my hope that you take just a few minutes to think about yourself, your career, and your effectiveness. If you haven’t made any resolutions yet, may I suggest that you resolve to become more professional in 2014. Now that’s a pretty vague resolution. We have learned in the past that if we are to truly reach our goals (which is just another word for resolutions) they should be SMART – another acronym! That is: Specific, Measureable, Actionable, Realistic, and Time-Driven. Therefore, “I resolve to become more professional in 2014,” is not a very “SMART” goal. However, “I resolve to land a job at a more progressive practice, earning at least a $10,000 salary increase, by January 1, 2015. I will do this by going on at least one interview every month, registering with an optical employment agency, participating in the on-line blogs, and by increasing my technical and sales abilities by attending classes and seminars.” Now that’s a “SMART” goal. For another ECP, becoming more professional might just mean earning the respect of your employer, getting a modest raise, or being promoted to practice manager. Whatever becoming more professional means for you, I have turned the word itself into a 12letter acronym: P-R-O-F-E-S-S-I-O-N-A-L, I would like to share with you 12 things that I think would go a long way in making us all (myself included) more professional, effective, and successful. P – Paradigm Shift. At the risk of replacing the use of acronyms with overused business jargon, to be more professional – to make any changes – we have to shift (change) our paradigm (the way we do things). Basically, if you always do what you’ve always done, you’ll always get what you’ve always got. We have to change the way we do things. This can be very uncomfortable at first, but eventually it will become your habit. My biggest paradigm shift was changing from a “why” dispensing mode to a “why not.” For example, I stopped looking for reasons to suggest polycarbonate or AR lenses. I realized I always gave them to my family members because I thought they were beneficial. Then why shouldn’t I automatically give them to all my clients? 18 E Y E C A R E P R O F E S S I O N A L
R – Ready. In his best-selling book, The 7 Habits of Highly Effective People, the late Dr. Stephen R. Covey said that the first habit of highly effective people is to be proactive, as opposed to reactive. Most ineffective ECPs conduct themselves in their practice reactively. They simply react to what the patient says or does. The way they react is usually random. They will react one way on a Monday, but quite differently on a Thursday. Why? They haven’t consciously experimented with what works best – they practice by the seat of their pants. They have no habits. I suggest you write out at least 10 challenges/objections you encounter in your practice.
O – Optics. What a novel thought! We are opticians, so maybe we ought to be experts when it comes to optics. That doesn’t mean you have every optical equation on the tip of your tongue, or know the biographical details of Ernst Abbe (think Abbe Number). But if you can’t explain the difference between 20/20 and 20/60, or think and neutralize in plus-cylinder form as proficiently as minus-cylinder form, or explain to a kid why his image in a convex mirror is normal, yet upside down in a concave one, or be able to inform an emerging presbyope why he can’t see up close anymore...well...get thee to an optical book...or seminar...or school. Be an expert in your field. F – Fun. What’s the point if you can’t have some fun? There is no contradiction in being a serious-minded professional and having a sense of humor. Lighten up. Smile. Have a few appropriate jokes or stories you can share with your clients. Remember that boring teacher you had in school and how you dreaded going to that class? Don’t be that person. Have some fun! E – E + R = O. Always remember: Event + Response = Outcome. You didn’t know that irate jerk was going to be waiting at your front door this morning demanding a refund (event). Eventually that event will have an outcome. In between – and the only thing you are 100% in control of – is your response. How you respond to that event will be the biggest determining factor in the outcome. How will you respond? See “R” above. Ineffective practitioners react; professionals respond. S – Serious. Again, no contradiction here with “F.” You can be serious about your professionalism and still have fun. Being serious simply means truly embracing some of the things you’re reading about right now. S – Subscriber. Actually that should read “Subscriber and Reader.” Subscribe to every optical journal and publication you can – print and digital. Most of them are free for goodness sake. I – Integrity. You don’t have to be an angel or a saint, but basic honesty and integrity is non-negotiable. Without it, you will never
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be seen as a true professional in the eyes of your clients. For me that means three things: always acting with empathy – with the patient’s best interest at heart; never lying to a patient – about anything; and always admitting responsibility when a mistake has been made and acting quickly to make it right. O – On-Line Expert. As you read this, someone is opening up a package from eyeglasses.com, coastal.com, or 1800contacts.com. Are you aware of what’s available for your clients on-line? Spend at least 15-minutes a month poking around the Internet, thinking like a lay person. Educate yourself about the pricing and policies of the on-line vendors. Conduct yourself in such a way that your clients get real value from you and the personal, professional interaction at your bricks-and-mortar dispensary. Decide ahead of time how you will deal with requests to verify or repair Internet-purchased prescription eyewear. N – No-Line Expert. No negotiation here. Truly professional ECPs can quickly, and in plain language explain to their patients the differences among basic progressives, higher-end progressives, High-Definition progressives, Individualized progressives, and Near-Vision Focus progressives. The less-than-professionals mumble vague generalities about less distortion (which by the way, is the same rap patients have heard since the 1970s). Professionals have they themselves worn all the different types, and have memorized an effective 60-second spiel to quickly educate and persuade their clients. A – Appearance. We’ve all been taught from an early age not to judge a book by its cover. But guess what? We do it all the time – and so do your patients. From the minute they walk in to your office, your clients begin to form unconscious (and sometimes conscious) opinions about the practice, company, doctor, and optical staff, all before they have any interaction with any of them. Experts say that people begin to form their first impressions within four seconds. Walk through your front door with the empathetic view of a first-time client. What do they see? Is the environment clean, organized, and welcoming? Are staff members well-dressed, well-groomed, polite and friendly? Professionals know that a good appearance will make everything else they try to accomplish with a client infinitely easier. Make five specific, positive changes to upgrade your office’s appearance, and five specific, positive changes in your personal appearance upgrade yourself. Whatever changes you make will pay off in dividends far beyond the cost or effort to make them. L – Listen. We started by learning a few acronyms and jargon. How about a few clichés? Good listeners are perceived as more professional than good talkers. Good listeners make better salespeople than good talkers. We were born with two ears and one mouth... that ought to tell us something. Learn to listen...listen to learn. Of all the ways we communicate – reading, writing, speaking, and listening – listening is the only one we are never formally taught. True professionals take the time to learn a few specific listening techniques – and use them to their advantage every day. There is no shortage of information on listening, both in books and on-line. One of my favorite books on listening is Learn to Listen, published by National Press Publications. Research and learn the Reflective Listening Technique – you’ll be glad you did. I
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EDUCATION: WEDNESDAY, MARCH 26– SUNDAY, MARCH 30, 2014 EXHIBITION: FRIDAY, MARCH 28– SUNDAY, MARCH 30, 2014 Javits Center | New York, NY
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MOVERS & SHAKERS Luxottica
Vision-Ease Lens
Luxottica has announced the appointment of Holly Rush to the position of president Wholesale North America. In her new role, Holly will oversee Luxottica’s wholesale distribution network in both the U.S. and Canada. She will report to Paolo Alberti, executive vice president Holly Rush of Wholesale. Rush succeeds Andrea Dorigo, who has decided to pursue new professional opportunities. Rush joined Luxottica as senior vice president sales in March 2011 after having spent nearly two decades in a variety of sales leadership roles with major blue chip companies, most recently with L’Oreal.
Vision-Ease Lens (VEL) has named William Krueger as its new executive vice president of sales and marketing. With an eye on global trends and providing value to customers, Krueger brings nearly 30 years of business experience to the ophthalmic lens manufacturer. As executive vice William Krueger president of sales and marketing, Krueger will lead the company’s worldwide sales, marketing and business development efforts. Before joining the company, Krueger was vice president and general manager-global group at GOJO Industries, a skin health and hygiene solutions company.
Revolution Eyewear has named Paul Tollefson national sales manager. Tollefson brings more than 30 years of experience to the role, with roles at Match Eyewear and REM Eyewear. Revolution Eyewear’s portfolio includes the Robert Graham, Ed Hardy, True Religion, and Affliction Eyewear Paul Tollefson Collections, along with the company’s magnetic frame and clip-on collections.
Vision-Ease Lens also welcomes Kristina Engelking as its new marketing communications specialist. Engelking brings more than a dozen years of marketing experience to the company. In her new role, she will enhance Vision-Ease Lens’ events, trade show presence and customer Kristina Engelking education initiatives. Prior to joining, Engelking served as sales and marketing associate at Lemna Technologies Inc., where she coordinated advertising, led trade show logistics and developed technical sales and marketing materials.
American Board of Optometry
Kering
The American Board of Optometry (ABO) elected new officers during its 2013 annual meeting. The slate of new officers is as follows: Chairman James M. Vaught, OD; Vice-Chairman David A. Heath, OD, Ed.M.; Secretary Chelsea L. Miller, OD, and Treasurer John P. McGuire. In addition, James M. Vaught, OD Jackson Lau, OD, of Beverly Hills, Calif., was elected the new director representing the American Optometric Association (AOA), and Michael D. Gerstner, OD, of Memphis, Tenn., was elected as a new member-at-large. David A. Cockrell, OD, a founding member of the board and its founding chairman, stepped down as a board member.
Kering, formally PPR and owner of luxury brands Gucci, Saint Laurent Paris and Bottega Veneta, among others, has hired Roberto Vedovotto, formerly CEO of Safilo Group, to review the French group’s eyewear strategy, Roberto Vedovotto effective immediately. Vedovotto will be responsible for the eyewear strategy across all brands in order to optimize and further develop the business, the company said. He will coordinate Kering’s efforts across its luxury and sport-lifestyle brands, which include Balenciaga, Stella McCartney, Boucheron, Puma and Volcom, a company spokesperson confirmed.
Revolution Eyewear
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NEW LENS RELEASES! SEE MORE Occupational Solutions
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WORKPLACE SOLUTIONS
SEE MORE SCREEN
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Clear continuous vision up to 4.5 feet. Near and intermediate only. • Great for people who use their computer and have near vision needs for extended periods of time.
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Clear continuous vision up to 13.5 feet. From near vision to room distance.
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SEE MORE DESKTOP Clear continuous vision up to 6.5 feet. Near and intermediate vision only. • Ideal for a “cubicle” person or someone who has extended desk work/task needs •
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DISPENSING OPTICIAN Judy Canty, LDO
The Year of Being BOLD
overweight and I’m not going to beat myself up about it anymore. My metabolism tanked years ago and that’s that. Perhaps if I quit stressing about it, something will change or perhaps it won’t. In any event, I’ll be happier and that’s what’s really important.
The past 12 months have been fraught with change. We ended one political season and entered another. Our access to healthcare is changing and no one yet knows exactly how it will impact the eyecare industry. Big corporations swallowed up smaller ones and new players have emerged. Some onliners discovered the necessity of bricks and mortar. Vision care plans are creating and consolidating their markets and networks and, again no one knows exactly how it will affect independent practices.
Making one bold decision for your professional life could be a bit more challenging. Is the decision for you professionally, as in an additional degree or professional certification? Or will it be for your professional practice?
We’ve lost industry giants, including Dr. Irvin Borish a world-renowned and respected author and educator. At the same time, others have emerged to pioneer new educational venues, including Dr. Alan Glazier (ODs on Facebook/Seeing is Believing) and Dr. Gary Gerber (The Power Practice/The Power Hour). The only thing that has remained consistent is change; therefore I am declaring 2014 as the Year of Being Bold. “A foolish consistency is the hobgoblin of little minds, adored by little statesmen and philosophers and divines.” — RALPH WALDO EMERSON
This is the year to step up and make one bold change. Stop worrying about what resolutions you kept or broke. Quit checking off your bucket list. A bucket list is a list of things to do before you “kick the bucket”; before you die. What happens if you run out of things on the list? Do you close the curtains, turn off the lights and wait for the end? Do you spend the month of December kicking yourself for not keeping every resolution? This year, make one bold decision for your personal life, one bold decision for your professional life and one bold decision for your community presence. 24 E Y E C A R E P R O F E S S I O N A L
Remember those motivational talks involving big rocks and little pebbles in a jar? Making one bold decision makes the other thousand little everyday decisions easier. It places all those little decisions in their proper perspective. According to PolicyMic, the top 10 New Year’s Resolutions are: 1. Eat healthy and exercise regularly 2. Drink less 3. Learn something new 4. Quit smoking 5. Better work/life balance 6. Volunteer 7. Save money 8. Get organized 9. Read more 10. Finish those around the house “to-do” lists According to Time magazine, the top 10 most broken New Year’s Resolutions are: 1. Lose weight and get fit 2. Quit smoking 3. Learn something new 4. Eat healthier and diet 5. Get out of debt and save money 6. Spend more time with family 7. Travel to new places 8. Be less stressed 9. Volunteer 10. Drink less It just makes more sense to make one bold decision about something in your personal life than to make multiple promises you just can’t keep. My personal bold decision? Well, I’m
Small businesses often face an uphill battle. According to Six Disciplines, a coaching/consulting firm, 80% of all new business start-ups are out of business within 5 years. 80% of the surviving 20% won’t survive the next 5. “Proof,” they say, “that you’re in an elite group if you’ve just survived, let alone thrived.” The folks at Six Disciplines identify the top 6 challenges for small businesses as follows: 1. Financial Issues. Includes finding adequate funding, getting billings out on time, collections, and credit management. In a word, a top problem is CASH. 2. Customer Issues. Includes understanding what the customer really wants, finding enough of the right kind of customers and keeping them happy, so they don’t turn to competitors. 3. Production Issues. Varies by type of business. In general, businesses of all types struggle with being able to give customers what they want, when they want it, at the price they want it, and at the highest quality levels. Doing this predictably and repeatedly is a tremendous challenge. 4. People Issues. Includes finding the right people, keeping them happy, compensating them, motivating them, training them, and getting them to deliver quality work.
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5. Limited Resources. Small businesses usually don’t have large cash reserves, dedicated research departments, fully-staffed IT functions, strategic planning functions, etc., to address challenges or opportunities. 6. Growth. Growth brings the challenge of change. It’s one thing to get good at something when you can hone your skills through repetition; it’s a completely different challenge to get good and stay good when the rules of the game keep changing with regard to competition, customer expectations, globalization, people issues, finance, technology, etc. What one bold decision can you make this year to address at least one of these challenges? Improved financial management? What generates the most income for your practice? What does it cost you to produce that income; the return on the investment of your time and talent? Where are your patients coming from? Are they the patients you want or the patients you must settle for to keep the chairs warm? Do you have the best staff or the least expensive one? Are you in a position, financially and psychologically, to grow? I allowed the unexpected death of my Mother at Thanksgiving last year to paralyze me. Traveling to visit my accounts and friends lost its excitement and joy. My first venture out was incredibly disastrous, making it easier to find other ways to do my job. My bold professional decision is to run the wheels off my poor car; to rekindle the joy I feel when a call goes well and the challenge of one that doesn’t. The third bold decision should be about you and your place in the community. It could be volunteer work or simply being a good neighbor or a mentor or a good listener. The potential benefits of becoming involved in your community are enormous. This is excerpted from a special health report published by Harvard Health Publications: “Helping others kindles happiness, as many studies have demonstrated. When researchers at the London School of Economics examined the relationship between volunteering and measures of happiness in a large group of American adults, they found the more people volunteered, the happier they were, according to a study in Social Science and Medicine. Compared with people who never volunteered, the odds of being “very happy” rose 7% among those who volunteer monthly and 12% for people who volunteer every two to four weeks. Among weekly volunteers, 16% felt very happy—a hike in happiness comparable to having an income of $75,000–$100,000 versus $20,000, say the researchers.” I love to sew and any sewist will tell you that we can never have too much fabric. There aren’t any kids at home to sew for and only 2 grandchildren, so the contents of my fabric stash aren’t really changing enough. My bold decision for my community is to sew for the same battered women’s shelter that my Mom did. I can honor my Mother, indulge my love of creating something pretty and useful and contribute to my community all at the same time. By this time next year, I probably won’t be any thinner but I might get a new car and I’ll be able to replenish my fabric stash. Where will your bold decisions take you? I
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THE MOBILE OPTICIAN Ginny Johnson, LDO, ABOC
Scents of Vision Recently I attended a birthday party and ran into a friend I haven’t seen in a couple of years. We hugged each other briefly and took turns giving each other our cliff notes version of life since we last saw each other. After I walked away I was so disappointed to find out that I would be wearing her cologne for the rest of the evening.
smelling analogy to pass on to other ECPs.
• Your office manager interviews several candidates for the lab position.
Regardless of your ECP position everyone’s job requires selling. From the front desk to the doctor to the sales reps to the lab artists in the back, selling surfaces everywhere.
• A few of the above sales examples are probably pretty obvious to most. The rest are just proof that every ECP plays a part in the selling process. Whether you are selling products or an idea to the boss, you are involved in sales.
Here’s how I know:
I’M NOT SURE WHAT BRAND IT WAS AND IN HER MIND I’M SURE IT SMELLED GREAT, IN MY MIND, IT REEKED. Actually it was borderline repulsive. Everywhere I turned I smelled like stinky cologne. I sure didn’t want people to think that I wore cologne that reeked. I thought about apologizing for the way I smelled to everyone I came into contact with. But then I might end up saying something sarcastic and running the situation into the ground. I seriously considered leaving the party and going home to change clothes. That would be ridiculous though because I would have to explain my absence and outfit change when I returned. It turns out I’m thankful for the reeky situation because it gave me a sweet
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• Every time you request a day off you sell that idea to the boss (oh come on, I know you’ve earned it, done your due time, deserve it and are entitled to it). • You receive that job promotion you’ve wanted because of outstanding work performance. • A golfer who was just looking last week returns to buy those same sunglasses that the doctor wears. • You bring in a new line of designer frames. • A patient purchases contact lenses from you. • Your peers are curious and ask questions about your multifocal lenses as opposed to their dollar store readers. • A potential patient calls to ask questions regarding your office hours, doctors and fees.
There is a purpose for every patient’s visit. Practice remembering that the entire time the patient is in your office. Stay focused on helping them to achieve what they came in wanting or needing. Help them discover what they need. Refer often to the reason(s) for their visit. Keep in mind that their purpose, chief complaint and reasoning may stink so you may have to hold your breath. I received a phone call the other day from a friend who shared some information with me. She said her brother went to have his eye examined because he was having problems with night driving. The doctor told him he didn’t need a prescription so he left the appointment still concerned about his night time vision. That stinks. He dreads driving at night and it’s not like he’s an old man. That’s just one example of a patient leaving an appointment without having their wants or needs met. Continued on page 28
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When the patient’s purpose is determined, a sweet smelling plan should be implemented.
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• to verify identity • to provide optometric services • to provide opticianry services
We never want a patient to leave feeling like their purpose was not fully addressed or their vision opinions, feelings, wants or needs don’t matter.
• to meet regulatory requirements • to collect medical and vision service plan payments
Routine eye exams are often underrated. Same patient, different year, no changes, keep everything the same. That stinks. There’s nothing that sounds special or feels important about a routine eye exam. If it’s important for patients to return every year then their hour long visit should be special. Pre-appoint them to return next year because it’s important to take special care of their eyes, not that it’s just a routine procedure. ECPs understand the importance but sometimes the words we choose to convey that to the patient becomes too routine.
Helping patients requires ECPs to practice their work within the comfort guidelines of each patient’s personal space. Wikipedia defines personal space as the region surrounding a person in which they regard as psychologically theirs.
To find out the purpose of a patient’s visit, ECPs have to professionally address personal information of which the patient needs to be willing to divulge. If a patient starts out by withholding or refusing to provide you with the information needed to complete their appointment process, you simply can’t help them. Don’t refer to the requested information as just being routine, remember routine is not special or important. Refer to the information as being essential. Essential is absolutely necessary and an extremely important part of their patient care.
When technicians or doctors administer eye drops they explain the procedure before touching the patient. Opticians can determine by sense of touch how well a frame fits on a patient. Most patients allow their optician to properly place the frame on them and check behind the ears to make sure it fits properly. When a patient’s personal space is being invaded they may lean back away from the optician or reach for the frame and put it on themselves. Communication beforehand in a professional manner will avoid personal space invading. The more calm you are in those close personal space situations the more relaxed your patients will probably be.
Why do ECPs request personal information from patients? • to ensure a high standard of service to our patients
The eyecare industry happens to be one of those in your face and personal space type of businesses. Technicians, optometrists, ophthalmologists and opticians all work within inches of the patient’s face and at times their jobs require hands on treatment.
We’ve all doused ourselves with too much sales cologne at one time or another. Learning about a new lens or product that
we’re sold on is all it takes sometimes. We unload our new found information on a patient and go on and on about how amazing, convenient or advanced technology is. Information can stink if you use too much of it at one time. Patients are not always looking for what you are sold on. They want what will work best for them in all of their personal spaces. Recommendations are more valuable when you stay patient focused first followed by technology and convenience. I had good reasons for going to a birthday party that night. Celebrating with friends, meeting new people and delivering a birthday gift were just a few of the reasons. At the time I didn’t realize I needed to have a reeky cologne experience. Now I know why it happened. It was meant for me to reek that night so I could use a stinking article of clothing to write a stinking article with good intention and purpose. So I will leave you with this... Patients are gifts to eyecare practices and their wants and needs should be unwrapped before selling anything. Handle patients with care so they won’t go to your stinking competitors. Overdoing your part is not necessary for them to have a special experience. Just a dab of compassion, empathy, integrity and a rare sales cologne that has subtle appeal is all that’s required. That way you’ll never have to worry about patients giving you any stinking bad reviews. I
EyeSocialEyes.com “Focusing The World’s Eyes on Your Business”
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SeeJaneSee.org
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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THROUGH THE LENS John Seegers, M.Ed., LDO, owner – OpticianWorks.com
Year End Lens Wrap-Up ISN’T IT FUNNY, how things just come together sometimes? I have been spending most of my time lately working on a Consumer’s Guide to Buying Eyeglasses on my website, OpticianWorks.com. he guide includes a glossary of common terms and a FAQ. When I began working on entries for free-form and digital lenses, I realized that even though these lenses have been on the market for several years, we still do not have any agreement on what these terms really mean.
T
At the exact moment of that realization, I received the HOYA HiDefinition Technology Update from HOYA CEO Barney Dougher, which focuses on their mission in 2014 and beyond: To increase the use of free-form design, and, most importantly, to increase educating eye care professionals about the importance of free-form design. The report states, “Looking at the trends, we see that by 2015 60% of all lenses sold in the US market are going to be free form lenses.” The report goes on to clearly state HOYA’s position on the differences between free form and digital. “The reason we are not producing more free form lenses is because there is a lot of confusion in the market place around the definition of ‘free-form.’ Some people think it is a material. It is not. Others think it is digital. It is not digital. Free-form is a combination of three things: the science behind the design, the measurements the optician takes from the patient, and the software to complete the process.”
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The report goes on to further explain those three inputs. “First we need to be mindful that every patient is different. Eighty percent of peoples’ faces are not symmetrical. Therefore, the skills of the optician when they measure the angle, tilt and wrap are critical.” How does the optician or ECP get these measurements? Barney states, “We are very supportive of quality measurement devices, like Optikam, and apps such as our own Spectangle that help ECPs gather the data they need to prescribe personalized lenses.” “Second, we are able to take those measurements and use them as inputs to our software. Each patient adds another dimension to the database, further refining the lens designs. And third, our manufacturing process is amazing! You need to know that no other manufacturer can do what we do with our integrated double surfacing designs.” In 2013, Seiko brought us several new products, including the PolarThin 1.67. With a proprietary process, which places the polarization film just 0.4 mm below
the surface, PolarThin lenses can be surfaced to a 1.3 mm CT. Combine the thinner CT with a 1.67 material, and you can offer even your high Rx patients a thin, lightweight and attractive polarized alternative to thick or heavy lenses. PolarThin lenses are available in traditional grey and brown. Seiko also released the new Trivex-based single-vision Ultra 1.53 aspheric with new, improved Surpass AR. Seiko states, “Ultra 1.53 lenses combine the benefits of Trivex® with Seiko Optical’s advanced aspheric design, improving cosmetic appearance while enhancing optical performance. They are available in a non-tintable superior scratch-resistant hardcoat, or with multi-layer Surpass® AR with super hydrophobic and anti-static topcoat. Surpass® AR has the toughest scratch resistance available, and the super hydro topcoat is extremely easy to keep clean. They are available from +4.00 to -7.00 out to a -2.00 cylinder.” Seiko’s Supernal progressive series takes center stage in Seiko’s good-better-best lineup of individualized progressive lenses. The Supernal series utilizes Seiko’s patented “Internal progressive + Internal aspheric design,” resulting in a lens with less distortion and much wider fields of vision. The Supernal series incorporates a non-linear progressive power change, which starts with wide, clear vision at the fitting Continued on page 32
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point, “increased by approximately 50% compared to previous lenses,” and builds power through a unique corridor design that best matches the eye’s natural movement. What lens is complete without a coating? Opticote, which has been coating prescription lenses since 1971, and continues to fill a need for labs all across the country who need to outsource optical coatings. Opticote offers two levels of AR coatings: the Illusion, and the Illusion HP, each with mirror coatings. Opticote AR coatings are available in six colorations with matching backside AR, all processed and shipped out the same day they are received. It is believed to be the only coating house in the country offering this service on mirror coatings. OptiCote says, “This determination resulted in averaging a same-day service percentage in the mid 90% range year to date.” Michael Bellomo, Director of Sales and Marketing for Opticote, says, “For 2014, Opticote believes that mirror coatings today are no longer considered a cosmetic enhancement to sunwear. With all the studies being done about reducing glare, UVA, UVB, eye fatigue and bright light sensitivity, adding a mirror coating aids in combating the stress these conditions place on our eyes. Pair a mirror with a polarized polycarbonate lens and backside AR, and you have the ultimate in sunwear protection. Of course, you can add a mirror coating to any plano or Rx lens material.”
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In addition, Opticote continues to experienced strong growth in its Fog Free coating for all applications. ECPs should always talk to patients about the importance of fog reduction in safety eyewear, where it can actually mean the difference between life and death. Consider Fog Free in sport eyewear as well. Athletes will gladly upgrade to lenses that will reduce fogging when they most need clear vision! Headquartered in Ramsey, MN, VisionEase Lens is a leading manufacturer of high quality ophthalmic lenses. The company provides many different styles of lenses in polycarbonate, plastic, 1.70 high index and glass materials. In spring 2013, Vision-Ease Lens introduced two new progressive lenses to its Anthology Series: the general purpose Novel® and short-corridor Novella®. The advanced technology behind the Novel and Novella conventional frontside progressives make these polycarbonates as good as or better than many backside digital progressives across a large percentage of the Rx range. Vision-Ease Lens also expanded its ChangeRx® plastic photochromics line to include ChangeRx FSV. The versatile Advanta™ spherical FSV polycarbonate lens was introduced in October. Heading into 2014, Vision-Ease Lens will release its new Novel and Novella progressives in clear plastic and plastic ChangeRx photochromics.
And in the “When is a lens more than a lens?” category: Adlens™ shook up the industry in the fall of 2013 when they introduced the Adlens Focuss™, and they appear to be poised to keep on rocking the boat. The company says, “Adlens® has developed several lines of variable focus eyewear technology, and Adlens Focuss™ is poised to change the landscape of progressive lenses by taking full advantage of the latest advances in Adlens® technology. Currently, progressive lenses incorporate distance and reading into one shared lens, causing adaptation and wearing issues for many people. Adlens Focuss™ delivers a full field of vision to progressive lens wearers by allowing them to turn a small dial on the inside of the temple arm to adjust their prescription to a range of customized powers. Advances in Adlens’® current technology have also led to key design enhancements, making Adlens Focuss™ the company’s most fashion-forward to date. Adlens Focuss™ will be available in three styles, each with a choice of six rich finishes and colors.” Look for Adlens Focuss™ to be distributed through LensCrafters stores in the US. Did you know that the expression, “May you live in interesting times” actually has its roots in a curse? Anyway, I think the next few years will have the ECP living in interesting optical times. Happy 2014, everyone. May you have a peaceful and profitable new year. I
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SECOND GLANCE Elmer Friedman, OD
The Eyes Have It
THE PREDICTION THAT HUMAN CLONING WILL BE AVAILABLE IN 50 YEARS RAISES ISSUES, GOOD, BAD AND DOWNRIGHT UGLY. Whether it is ethical will depend on whether the “good” is sufficient to outweigh the potential “bad” and “ugly.” Good and bad in this context are not easy to define or measure. Even if there were good reasons for human cloning, and that is a big if, it would need to be a pressing need to outweigh the potential for harm. The risk for abnormalities is high. It has been suggested that cloning might be used to replace a lost child with a copy. It is here that a myth takes hold. The idea that
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cloning produces an identical human being is the stuff of science fiction, not of biology. A cloned human will not develop an identical, like for like, human being from whom this new being has been cloned. A person has a unique history and a unique development. Their hopes, fears, loves and hates
are as likely to be different as any other two people. Even biologically they will be different. They will carry different risks of health and disease. Recent work on the developmental origins of health and disease indicate that much of the health risks we carry are environmentally determined during development in the womb and in early life. It is highly unlikely that this could be replicated. There is another consideration connected with the idea of producing a replacement for a lost child. The psycho social environment in which such a child develops would include the fulfillment (or otherwise) of the parental needs. The burden of needing to be like the “lost child” will make it less likely to be successful. The motives of such parents and their needs would be crucial. It
should be noted that brain development and function are dependent on sensory input and social interaction. We each will have a different trajectory which accounts for the reason why “identical twins” are not what their name suggests. Why should we expect a clone to be any different or resemble human development in this matter? The news media have published reports regarding headless frogs being cloned in England. Soon, they predict, they will be able to produce human clones that are headless. These clones will, presumably, be utilized to supply organs and body parts for afflicted humans who may require them. They call it harvesting and it has provided great controversy in the world of science, ethics and religion. Manufacturing headless clones could open giant vistas for science, business and building. The care and maintenance of these bodies will give rise to new growth markets. Clothing, housing, construction, health care and entertainment will create new terminology related to these almost human persons. There will be novel equipment and services that defy our imaginations. We will be inundated with information from Madison Avenue telling us how to collect clones for fun and profit. The body fitness business would flourish since every clone owner would want his clone to be in perfect condition in preparation for a time when a part needs replacement. But who can deny that the only real advantage of this entire venture lies in the development of a procedure whereby the head and the brain of the owner will also be cloned, if necessary, onto a faultless body of our manufactured twin? After all, in the beginning, wasn’t a sheep called “Dolly” cloned in total? It is anyone’s guess as to how soon we’ll see “The Full Monty”, head and all for humans. Special rooms will be added to our homes to make room for the clones. Or
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would we place them on exhibit? A sort of a “my clone is better than your clone” behavior will unfold. Our clones will demonstrate the identical intelligence and talent of the owner. Moreover, morality, spirituality and ethics will be the exact replica of the original...for better or for worse. We must expect clone unions, and demonstrations as they struggle to obtain the right to vote and receive the attention of human rights groups. Our clones will clamor for change and improvement. They could also do our shopping, run our errands and even take our vacations when we can’t get away. And how about those dull society meetings we must attend? What a relief to be able to send something in our place. Dare I mention the dangerous results that could arise when sexual desires are percolating and your partner is not available? Along comes a clone called Lothario I-A or Trixie X who just may be the solution to that problem. Did I mention the office duties with patients and third party paper work? Abracadabra and all problems are solved. We are uneasy to think that one of the headless varieties of clones would be a candidate for an eye exam or eye wear for obvious reasons. Every industry in the world would have benefited except the ophthalmic divisions. However, with the advent of the “headed” clone, our future as eye care providers will be assured. A bonanza is seen on the clone horizon. Millions of spectacle prescriptions fabricated for the clone owner will be duplicated for their clone .No redos, same adjustments, no complaints or wasted time. The nightmare is realized when you are confronted with the clone who has
inherited the faults and foibles of his original. That is the patient who never seems to be satisfied and enjoys taxing your patience to its limits, leaving you exhausted and nerve wracked for the rest of the day. But not to worry. As soon as you spot these malcontents you will send your clone to the frame bar to contend with these patients whilst you can sit back in your easy chair, feet up on the desk, sipping a Mint Julep and relaxing or even dozing for a bit. It need not stop there. What is it worth to you to have a clone to deal with bill collectors, nasty relatives, obnoxious salespeople, snoopy neighbors and that rude auto mechanic? I had an interesting, whimsical email from my friend and colleague from Finster, NJ, Dr. Natty Bumpo. He writes, “While visiting Japan recently, I made the acquaintance of a famous Japanese scientist who claims to have cloned a human being. He invited me to visit him at his laboratory. I took advantage of the opportunity and I asked him if what he cloned was in the same way Doris the Sheep was cloned. He said yes and its name is Cyclops and it was six months old. He said they have been unable to determine the sex. When I recovered my composure, I asked him if the thing was still alive. He answered that as far as they could determine, yes. I couldn’t understand why they weren’t absolutely certain in this matter. He said, perhaps you should see for yourself. I followed him down a corridor to a small room marked for authorized staff only.” Natty continued his story: “As we entered, I almost expected to see the ubiquitous
bubbling liquids in test tubes and massive coils generating mysterious electrical impulses. Sort of like Frankenstein’s laboratory. Instead, I was confronted by an incubator similar to those that keep premature infants alive. It was situated in the middle of the room, attached to various tubes and monitoring equipment. I realized that I was on the verge of one of those momentous occasions that shape society. Yet, a fundamental question needed to be answered. If it became commonplace to clone perfect babies in the laboratory, it might also be possible to produce the female eggs synthetically. So, then what use would the opposite sexes have for each other?” “I took a deep breath and walked towards the incubator,” said Natty. “I looked in and for a moment I felt faint. I was not prepared for what confronted me. There on a large bed of gauze padding was an eye. Just a big blue eye and nothing more. I accused the doctor of promoting some kind of a sick joke. He gave a negative shake of his head. I argued that we appeared to have a living organism in the shape of an eye. I continued my attack and noted that it had no limbs, no trunk, no head, ears, nose or mouth. I insisted on taking some photographs of this unbelievable creature so that I may present proof of my experience. The doctor was cooperative to my request. (Prints are enclosed). Afterwards the good doctor escorted me to the main entrance. As he held the door open. I asked what I thought was a rhetorical question. I asked, ‘By the way, doctor, is there anything else wrong with it?’ Yes, the doctor answered, it’s blind.” I
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OD PERSPECTIVE Jason Smith, OD, MS
Head Injuries, CTE and Vision The recent revelations from ex football players, including Hall of Famers Tony Dorsett and Brett Favre, have placed contact sports and especially college and professional football in a bad light.
recent interview with NBC’s Matt Lauer, Favre said that he was having a conversation with his wife about his daughter’s recent soccer practice. He was shocked that he did not remember being at the soccer practice a few days before the interview. Similar conditions can also be found in boxers, professional wrestlers, professional fighters, and soccer players.
T
ONY DORSETT is a 59 year old former University of Pittsburgh Heisman Trophy winner and Dallas Cowboy football running back. Dorsett was diagnosed with CTE (chronic traumatic encephalopathy) which has caused memory loss, dementia, and personality changes. CTE is a progressive degenerative brain disease that is found in athletes who have a history of brain trauma. Brett Favre is a 44 year old former Green Bay Packer quarterback who recently announced that he is experiencing memory lapses. He is worried that he is experiencing some early symptoms of what Dorsett has been diagnosed with and with what many NFL football players have experienced. In a
On December 2, 2013, five former Kansas City Chief professional football players filed a lawsuit claiming the team hid and even lied about the risks of head injuries. These players claim that they are suffering from post-concussion syndrome and latent brain disease because of multiple concussions that they sustained while playing professional football. Traumatic brain injuries can also occur from strokes, aneurysms, tumors, car crashes, shaken baby syndrome, and gun-shot injuries. The constant physical pounding of huge football players can cause many types of physical injuries in the short term and the long term. How many times have we watched college or professional football games and the game is stopped due to an injury? How many times have we seen players being taken off of the field in stretchers or ambulances? The financial rewards may
be enormous, but the health costs may be immeasurable. The school of thought when playing football used to be, “no pain, no gain.” In the past, football players were denied water during summer training sessions only to become disoriented and dehydrated. Players who suffered a concussion were often returned to the game to possibly suffer another more serious concussion. As has happened during every football season, in November, 2013, a Phoenix teenager, Charles Youvella died from a head injury suffered in a football game where he scored his teams’ only touchdown. These problems are now finally being recognized and the prognosis is usually not good, nor encouraging. There have been some disturbing accounts of former football players committing suicide. Those players who have died and who have had their brains autopsied have had the major revelation, unbeknownst to them, that their brains were damaged. These damaged brains and the prognosis of chronic traumatic encephalopathy have resulted in behavioral changes, early onset dementia, suicide, premature deaths, and an inability to care for oneself when in the prime of life. Continued on page 38
36 E Y E C A R E P R O F E S S I O N A L
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The Institute of Medicine and National Research Council has called for a national system to track sports-related concussions. The current report said that 250,000 people age 19 and younger were treated in emergency rooms for concussions and other sports-related brain injuries in 2009. That was an increase from 150,000 in 2001. As eye care professionals, we need to be aware that there may be some unexplained vision problems with patients who have experienced any form of head injury. Parents need to be asked during a case history if their child plays soccer, is their child involved in martial arts training, does their child box, or does their child play football? Has their child has ever experienced a concussion, and if so, how many? Has their child has ever been hospitalized for any form of minor or major traumatic brain injury? Has their child has ever been involved in any form of accident where their head or their eyes have been affected? And chronic or bad headaches may be an indication of a more serious problem. An automobile accident where someone hit the windshield at age 17 may have vision or visual field disturbances later in life. If there have been repeated or numerous head injuries or head traumas, then the expectations may be that mental, physical, and visual health may be compromised as one ages. This certainly seems to be the case of the football players who are now experiencing these negative affects later in life. For adults, similar questions need to be asked and ECPs should be more aware of members of the military who may be facing post-traumatic stress disorders, brain injuries, and other neurological problems after being in a war zone. Dr. Gregory Goodrich is the supervisory research psychologist at the Veterans Western Blind Rehabilitation Center in Palo Alto, California. On the website Brainline.org, he states, “20-40% of people with brain injuries experience vision-related disorders. In the military population, we have found that troops exposed to one or more blasts can have trouble with their eyes coordinating with one another, what we
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call oculo-motor or binocular dysfunction. In moderate to severe brain injury, about one third of the troops have some sort of visual impairment which includes visual acuity and field loss, binocular dysfunction, and spatial perceptual deficits.” For brain injured patients, especially, and for any patient, uncorrected visual acuities must be documented at distance and near. Are there any external abnormalities, muscle problems, or pupillary abnormalities? Is color vision normal? Is stereopsis testing normal? Cover testing, vergence, and phoria testing may disclose accommodative or convergence problems. When checking a prescription and doing a refraction, is the patient correctable to 20/20 in each eye? Is there any diplopia present which can result from cranial nerve palsy? Are the intraocular pressures normal? Are the optic nerve and retinal findings normal after dilating a patient? Are there any visual field abnormalities? Most eye care professionals have a screening or threshold visual field test done on every patient, especially if there is some unexplained visual disturbance, a patient with ocular hypertension or glaucoma, a patient with diabetes, and patients with traumatic brain or head injuries. Most visual field tests can be done with great accuracy and in a short period of time. Depending upon the age of the patient and the patient’s refractive problem, visual field tests can be done with or without correction. Trial lenses can be used with a trial frame in order to perform an accurate test. One eye is done at a time, and a print-out of the results are evaluated. Quite often we rely on a visual field test in order to determine if there is a problem with glaucoma or other neurological problems. Most visual field machines have the technology to monitor changes in a particular patient in order to determine if their visual field losses over time are progressing. For the new patient, it is a good baseline test which will reveal unknown or undetected visual field losses. Depending upon the area of the brain or the cranial nerves that may be affected from traumatic brain injuries,
there will be different results that will be seen on a visual field test. The following binocular defects may be seen on visual field testing. Occipital brain problems will show very congruous hemianopias. Parietal lobe or optic radiation problems will result in “pie on the floor” visual field results. Temporal lobe or optic radiation problems can result in “pie in the sky” visual field results. If the lateral geniculate body is affected, a “keyhole” visual field will occur. If the optic tract is affected, a very incongruous visual field test will occur. If there is an optic chiasmal lesion, a visual field test will show a bitemporal hemianopsia respecting the vertical midline. Treatment for every patient is unique to that patient. Sometimes a good pair of glasses in order to correct myopia, hyperopia, astigmatism, or presbyopia will be all that is necessary. If diplopia is present, the use of prismatic lenses may resolve the diplopia and provide clarity of vision. Prisms may also resolve the problems of headaches or asthenopia. Convergence insufficiency, convergence excess, or divergence excess problems may be helped with vision therapy. Divergence insufficiency problems may be helped with prescribing base out prism or prescribing a bifocal. Accommodative infacility can also be treated with vision therapy or by using plus lenses at near. Accommodative insufficiency is treated by using plus lenses but the eye care professional must rule out latent hyperopia. Accommodative excess which can also be similar to pseudomyopia can be treated with vision therapy or using plus lenses at near. ECPs are also aware of the fact that sometimes brain injured patients may need to be referred to a neurologist or a neuroophthalmologist when exam findings raise a red flag or the treatment falls outside of primary care. Brain injured patients may need more of the tender loving care that we have the privilege of providing to all of our patients. And when we are able to solve their problem, there is no greater professional reward. I
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Advertiser Index ADVERTISER
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5
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25
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31
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29
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13
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32
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15, 33, 37
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39
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i-see optical
35
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Tech-Optics
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11
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Luzerne Optical
27
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40
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US Optical
17
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21
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9, 41
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39
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40
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Fatheadz Eyewear FEA Industries
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Signet Armorlite
INSIDE BACK
800-759-4630 www.signetarmorlite.com/colors
40
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Trevi Coliseum
22, 23
800-756-2020
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19
866-923-5600
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EYECAREPROFESSIONAL
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LAST LOOK Jim Magay, RDO
Microfiber Management I once saw a gorgeous motor yacht sail through Portland Harbor and someone pointed it out and said, “That’s the Vanity Fair.” It was indeed – owned by the Kimberly Clark people of Kleenex and toilet paper fame.
I
t struck me then and comes back to me now, if I had a buck for every box of tissues I’ve used in the service of keeping people’s glasses clean while adjusting same – I could afford a boat like that, well...maybe a bit less grand. Boxes and boxes of Kleenex – not Puf ’s but good old fashioned tissues without any lubricants. Funny thing about that – every time I’d pull out a sheet a cloud of lint would rise with it. All around the box was a film of this dust. Finally it occurred to me (yup – it took years) that this dust was not just settling on the dispensing desk but I was inhaling a large part of it and it may have contributed to the wonderful bronchial condition I eventually acquired. Paper towels – yes, Bounty paper towels! For my health - and a recommendation from a Zeiss lab technician, we switched to Bounty paper towels. Bales of them from the big box store. Neat, reusable on the same person – like, you do an adjustment in one take? Now we are selling mostly high quality A/R coated products. People point to the roll of Bounty and say, “You can use that on my new lenses?” The phrase “Do as I say, not as I do” comes to mind. Assailed by feelings of cleaning guilt I re-read Barry Santini’s wonderful CE for Nanofilm cleaning products, and began to realize that I’d better start educating myself
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in order to educate my customers in the proper care and handling of their very expensive new lenses. My first day of dispensing after my conversion from Bounty (Mutiny against the Bounty?), my desk looked like a rag merchants back room with microfiber postage stamp sized cloths everywhere. A great truth was revealed – cheap microfiber is worth just what it costs ($0) – quality micro fiber, thicker and infinitely more absorbent, is definitely the way to go. I immediately sent a “Help me” out on a Facebook optical group, obviously A/R fluids and sprays are great and a small cloth works fine for an individual, but what about a busy pro dispenser working all day with many customers? Kimwipes were mentioned – but these are distant cousins of our old friends Kleenex – in fact Kimberly Clark makes them from wood
pulp and most cleaning instructions say, “Avoid wood pulp products” even though KC says they are 100% virgin wood pulp, which certainly must make all the difference even though a lot of folks decry them. The more cavalier among us simply say rinse at the faucet and wipe with a clean cotton shop towel – obviously out of sight of the customer. The most helpful tip came from none other than Dave (The Man) Metzger, lab rep for US Optical who suggests buying a bale of microfiber towels from the W store (I can’t bring myself to say its real name, Wa...w....walm...can’t do it! Anyway for $10 I bought a bunch of them and they seem to work well, reusable, launder-able, and colorful. I’ll keep you posted but it seems a good solution. I
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