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ECO-FRIENDLY EYEWEAR / PAGE 6 THE LOWDOWN ON HIGH INDEX / PAGE 30 February 2012 • Volume 6, Issue 50 • www.ECPmag.com
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Visit Us at Booth #1603 at Vision Expo East
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FEBRUARY 2012
EYECAREPROFESSIONAL
Vol. 6 Issue 50
Features 6
Courtesy of Blue Planet Eyewear
Contents
Magazine
ECO-FRIENDLY EYEWEAR Do your part for the environment and offer your patients the latest in Eco-Friendly Eyewear and Sunwear. by ECP Staff
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FUTURE OF OPTICIANRY Only through an increase in education and licensure can Opticianry reach its full potential
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by Warren G. McDonald, PhD
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EYEWEAR ICONS There has been a huge range of eyeglass and sunglass wearing icons over the years. by Laura Miller
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GLASS HALF EMPTY OR HALF FULL? Maintain a positive outlook about things you can directly control and become a better ECP. by Anthony Record, RDO
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HIGH INDEX 101 High Index lenses have become the lens of choice for high power prescriptions and rimless mountings. by Dee Carew, ABO/NCLE, LDO, MLS
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GENDER IN OPTICS Women have come a long way from the days when female ODs were sometimes referred to as “nurse.” by Elmer Friedman, OD
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On The Cover: US OPTICAL LLC 800-445-2773 www.USOPTICAL.com
Departments EDITOR/VIEW .....................................................................................................4 INDUSTRY PROFILE........................................................................................22 MOBILE OPTICIAN .........................................................................................26 MOVERS AND SHAKERS.................................................................................28 PATIENT CARE..................................................................................................34 OD PERSPECTIVE ............................................................................................40 ADVERTISER INDEX .......................................................................................42 INDUSTRY QUICK ACCESS............................................................................43 LAST LOOK .......................................................................................................46
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EYECAREPROFESSIONAL
Editor / view
Magazine
by Jeff Smith
Eyewear Enthusiasm! HE ATTITUDE you bring to the dispensary and your process of dealing with patients profoundly affects your ability to provide the best in care and service. You can use all the techniques ever written about sales & dealing with patients, but not bringing some excitement and fun into the process is completely missing the point. Eyewear and lenses have changed from being drab prosthetics to eye-catching accessories, so the sales approach must be altered to reflect these changes.
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Publisher/Editor . . . . . . . . . . . . . . . . . . . . . . . Jeff Smith Production/Graphics Manager. . . . . . . . . . . Bruce S. Drob Director, Advertising Sales . . . . . . . . . . . . Lynnette Grande Contributing Writers . . . . . . . . . . . . . . . . . . . Judy Canty, Dee Carew, Paul DiGiovanni, Gary Fore, Elmer Friedman, Lindsey Getz, Ginny Johnson, Jim Magay, Warren McDonald, Laura Miller, Anthony Record, Jason Smith Technical Editor . . . . . . . . Brian A. Thomas, P.h.D, ABOM Internet Coordinator . . . . . . . . . . . . . . . . . . . . Terry Adler Opinions expressed in editorial submissions contributed to EyeCare Professional Magazine, ECP™ are those of the individual writers exclusively and do not necessarily reflect the opinions of EyeCare Professional Magazine, ECP™ its staff, its advertisers, or its readership. EyeCare Professional Magazine, ECP™ assume no responsibility toward independently contributed editorial submissions or any typographical errors, mistakes, misprints, or missing information within advertising copy.
ADVERTISING & SALES
Can you imagine a sales clerk at an upscale clothing boutique handing a customer one of the latest fashions and saying, “Here, this is the latest fashion; try it on if you think it looks nice.” More likely they will say, “Look, here’s the latest fashion... isn’t it stunning! It would look so good on you, why don’t you try it on and see.” The same type of approach, or at least a modified form of it, should be used in the fashion business of eyewear. You are providing the benefit of making sure the frame the patient chooses is appropriate for the prescription and their lifestyle, while at the same time reducing the cost of having to wear glasses by guiding them to fashionable frames they will enjoy wearing. If the cost of wearing glasses exceeds the benefits of better vision and fashion, some patients won’t perceive the value of wearing glasses and may not wear them when they need to. You are not “selling” anything, but rather offering guidance so they will choose stylish and functional frames that provide real value. When showing frames, be aware of the personality of the patient. Try matching the frame style, and your approach, with the patient’s personality. If they seem more conservative minded, then you might have to calm your approach and present more conventional styles, while still maintaining an undercurrent of enthusiasm. With a more extroverted patient, you can really have some fun. Don’t be afraid to have them try on some of the more outlandish frames ... you never know. At the very least it will often get them thinking in a different fashion direction and is a good way to move the patient off the same style they’ve had for the past 10 years! You might even find that a frame style you thought no one would look good in really does work for them. If you are excited, your infectious enthusiasm will most certainly rub off on the patient, hopefully creating a satisfied and “chic” customer for life.
4 | EYECAREPROFESSIONAL | FEBRUARY 2012
(215) 355-6444 • (800) 914-4322 lgrande@ECPmag.com
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 6 Number 50 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 © 2012 by OptiCourier Ltd. All Rights Reserved For Subscription Changes, email: admin@ecpmag.com Scan this barcode with your smartphone to go to our website.
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SEIKO Optical Products of America
Diamond Clear
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New Tintable Hardcoat! sæSpherical Design s Absorption to 90% s Extended Range to -4.00 Cyl.
“Fashion tints in as little as 15 minutes; sunglass dark in about half an hour.” Frame: Minima 3 Plus, Distributed by SEIKO Optical Products
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Try Tinting Diamond Clear Yourself Request a FREE sample lens (untinted) while supply lasts, at www.seikoeyewear.com We think you will agree that when the prescription calls for the highest optical performance in a tintable polycarbonate lens, the choice is Diamond Clear.
SEIKO Optical Products of America www.seikoeyewear.com
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Closer to Nature In today’s tough times, people are becoming more in touch with nature. Consumers are looking for natural colors and designs that are comforting and environmentally friendly.
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1. Crocs™ Eyewear All styles in the Crocs™ Eyewear adult collection include eco-friendly polarized lenses. Crocs™ Eyewear’s polarized lenses are made using cellulose, the most common, organic compound on earth. Cellulose is a natural resource and is extremely renewable. www.eyeking.com
Eco-Friendly EYEWEAR & SUNWEAR
2. Eco by Modo These design-forward frames are made from 95% recycled plastic and hypoallergenic/non toxic stainless steel. The collection is certified recycled by UL Environment (ULE), case is made from recycled PET, and for every pair sold, a tree is planted with a community through Trees for the Future and Mezimbite Forest Centre. Unwanted frames can also be mailed back in the recycled packaging to the OneSight Charity. www.modobiz.com
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Going-Green 3. Rolf Spectacles 3
The model “Primus” is available in four different wood combinations – bog oak, bog oak/maple/bog oak, oak and robinie steamed. The unique wood design combined with ROLF innovation, means that each frame is a one-ofa-kind piece of eyewear. www.rolf-spectacles.com
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Natural Look In simpler times, frames can have a sleek, nature inspired look. In an effort to help the environment, some companies may also be planting a tree for frames purchased.
4. DRIFT Eyewear DRIFT Eyewear turned heads last year with their Timber Collection and the introduction of reclaimed wood to eyewear. This Chicago-made brand will continue to push the eco-envelope this spring by incorporating Mazzucchelli M49 bioplastic, groundbreaking designs, and an evolution of their classic meets modern appeal. www.drifteyewear.com
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5. Blue Planet Eyewear Blue Planet Eyewear is a line of sunglasses and reading glasses for today’s eco-conscious consumer featuring recycled or reclaimed materials and first quality lenses. The manufacturing process includes non-toxic finishes that are lead free and nickel free. All products are shipped with eco-friendly recycled hangtags and packaging, and reclaimed wood display units complete the package. www.blueplaneteyewear.com
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Environmentally Responsible
6. Anni Shades Committed to create from what nature has made, Anni Shades was founded on the belief that one can contribute to the well being of the environment in a fashionable manner. Continuously inspired by both the urban and rural world, we are passionate about building one of a kind wooden frames in Ohio, USA. www.annishades.com
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A-Look Optics
Tony Morgan Eco-Sheek A3208 is perfect for men and women who seek eco-friendly eyewear in a trendy, retro design. The frame features an acetate front with wood temples and spring hinges. Available in size: 53-17-145. www.alookoptics.com
ICU Eyewear
Gold & Wood
The new B20 sunglasses for women from Gold & Wood are made from a mixture of refined materials and influences: made of precious, contemporary ideas of Gold &Wood, and sophisticated glamour from the elegant and feminine 50’s. Based on handcrafted marquetry decors, the temples are made of mixed precious woods from sophisticated patterns. www.gold-and-wood.com
Kenmark
Featured is the eco-friendly metal hinged oval bamboo reader in Lime Green. Also comes in Dark Brown if you prefer something a little more subdued. They are handcrafted and a perfect shape for any face. www.icueyewear.com
Wooden Specs Wooden Specs stop an artistic, style-conscious clientele in its tracks. Design elements (earth-toned paints, wood-burned designs, mother-of-pearl inlay) and handmade details (remarkable steam-bent curves, handmade brass hinges) impart value well beyond the frames’ unique, natural material. Styles in the collection cover a range of sizes and are designed for reasonable durability, repairability, adjustability and glazing. www.woodenspecs.com
The Timex – T261 is made from a biodegradable acetate, which is created from renewable natural resources: cotton lintels, wood pulp and a non petroleum based plasticizer – the latter being the “eco-friendly ingredient” that differentiates this material / frame from others. The plastic will also fully decompose in the same amount of time it takes a leaf to biodegrade in soil. www.kenmarkoptical.com
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Luxottica
iwood ecodesign
The Stella McCartney’s eco-friendly eyewear collection features injected bio-plastic made from 54% castor-oil seeds, a renewable resource that helps limit the exploitation of petroleum. SM3009 is a round oversized shape that features a steel frame and an ultra-feminine profile with thin temples on a step design. The recognizable yet subtle Stella logo is applied on the temples. www.luxottica.com
All frames are made from luxurious veneers reclaimed from business jet interior jobs. The veneers are “micro laminated” to 9 layers for strength using formaldehyde-free glues. A handapplied protective coating emitting no VOC’s is added for durability. Temples are stainless steel imported from Italy. All frames can be Rx and all species of woods are FSC certified. www.iwoodecodesign.com
Sires Eyewear Sire’s Crown – Using innovative technology to create one of a kind functional wearable art. We are taking part in a growing demand that requires less cookie cutter manufacturing and more handcrafted individualism. Our frames are comprised of reclaimed, sustainable, and FSC woods. www.sireseyewear.com
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Viva International Group hosts annual North American Sales Summit
Viva International Group sales associates gathered recently for the company’s annual North American Sales Summit at the Westin La Cantera Resort in San Antonio, Texas. The four-day meeting included 176 members of Viva’s North American sales force, a support team from Viva corporate and executives from parent company HVHC, Inc. The agenda included professional development training sessions,
brand and product presentations, achievement awards and a charity team-building event. A themed “Glam Night” showcased a host of achievement awards, including the new inductees for Viva’s prestigious “President Club,” which honors the top 10 achieving sales consultants in North America.
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The 21st Century Optician Warren G. McDonald, PhD Professor of Health Administration Reeves School of Business / Methodist University
2012: Reflections on the Future of Opticians Over the last number of months, my articles have been focused on management topics. I have written about marketing, strategy, and a number of other important topics, but felt that I needed to go off in a new direction this month. I am a frequent reader, and former active participant in an online forum called Optiboard (www.optiboard.com), and it prompted me to think about where opticians may be in the future. It is a marvelous forum filled with very dedicated people from the eye care community who talk about anything under the sun that is related to the optical industry and related professions and sometimes things not related at all. In my reading of these threads, it is clear that the term optician can have a completely different a meaning even within the field. So this month, I felt that we should see if we could get some folks thinking about somehow developing a national definition of what an optician really is and does in their professional life. The Changing Face of the Profession Opticians today have seemingly been relegated to the role of “spectacle peddler” in a retail or chain store environment, far removed from the professional optician of the past that fitted contact lenses, and other devices used in the correction of visual anomalies. The changing landscape of the eye care industry presents a quandary for the optician. Where do they fit into this new environment? Should they expand practice roles
through additional education and training, or serve as technicians and assistants working for chains and eye doctor’s offices? What are the personnel needs for the future and how will those needs be met? Licensure/Certification Requirements Twenty-two states require a specific state license to practice opticianry. One other state (Texas) recognizes a national board certification they refer to as voluntary licensure, but it is not required to practice (hats off to those who undertake this professional designation!). The remaining states have little or no restrictions placed on the sale of prescription eyeglasses. In other words, the primary requirement to practice as an optician in those jurisdictions is a pulse! Pass rates on state and national boards vary according to training and education of the student. Additionally, as the core knowledge and skills required for opticians to pass their licensing board examination increases, it may necessitate an increase in the qualifying level of education and/or experience for licensure. Should an increase in educational and experience requirements for opticians be considered unacceptable by the profession, can opticians continue to work under the supervision and direction of an ophthalmologist or an optometrist? Furthermore, if opticians only work under the supervision and direction of other professionals, should additional education be required prior to sitting for state board or national certification examinations, or are those examinations even necessary to serve the public as an optician? Obviously, these questions can only be answered by the opticians involved and other eye care professionals in the states where it is an issue. Just what is an optician? There are some differences within the opticianry community as to the definition of “optician” in the United States. Some Continued on page 14
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within the profession view it as a retail business that demands limited education, while others see the role of the optician as becoming far more advanced, with an increase in the scope of practice to include refraction and more involvement in contact lenses and other specialties. Several questions must be answered to gain a clear understanding of what the optician will be doing professionally in the future. These questions also underlie the problems facing opticians today as a profession. For instance, what level of education and training should be required to safely and effectively utilize new and emerging technology in practice? An acceptable answer to this question has not been adequately resolved by opticians throughout the United States. This is important because some of the new technology available for opticians – and should within their scope of practice such as advanced refraction systems – require additional training to safely operate them. These systems allow the technician in the eye care professional’s office to accurately perform refractions to develop a prescription for spectacles or contact lenses, so should opticians consider using them as well? Some opticians are currently using advanced refraction systems in their practice; however, it is not known how their education and training differs from that of other opticians that are not using these systems. Another key problem which has not been studied or addressed by opticians is to define the role they will play in the eye care delivery system of the future. Opticians seem to have only two choices – become an assistant or a technician in an ophthalmologist’s or optometrist’s office or expand their current scope of practice, because today the independent is seemingly a dying breed. If we are to regain some independence, we must advance. However, ophthalmologists and optometrists view the optician’s potential advancement as encroaching on their territory. Optometry regularly fights the ability of opticians in legislative arenas across the country. Opticians of today are seemingly at a crossroads. They will either advance into new areas of activity or be reduced to a paraprofessional under the supervision of an ophthalmologist or an optometrist. Regulatory problems also impact the optician. The issue which has a significant effect on the profession is the question of licensure. States have the power to regulate and impose licensure for opticians under the state’s police power. The state’s
power to regulate opticians is an attribute of a sovereign government. In the United States’ Constitution, sovereignty is found in state governments. However, licensing of opticians can only be justified to protect the public’s health. This is an important concept to understand because the issue of licensure is resolved by state government and not the opticians themselves. The issue of licensure is further complicated by the fact that some members of the profession, particularly those from unlicensed states, as well as other eye care professionals do not see the need for licensure or certification of opticians. So with all this confusion, where do we go from here? Redefining the Profession To adequately understand the role that opticians may fill in the future, a clear picture of the profession as it currently exists must be presented. The profession is currently ill defined due to the varied role optician’s play in different regions of the country. In many states, opticians are licensed health care providers with the right to fit contact lenses and other visual appliances. Those states require an examination, state licensure and varied levels of education and training. On the other hand, many states require no training at all. For example, Nebraska has no licensing requirements, but the author’s home state of North Carolina has an extensive 2-day examination. This disparity causes obvious problems in defining a future role, but the emergence of new technology could provide a measurement for what the profession feels will be the level of education and training needed to safely and efficiently practice in the future. This new technology may expand the need for better-trained practitioners or eliminate the need for them completely. The technology may be good enough that technicians trained at a very basic level could do the tasks that opticians do today. Conclusion As opticians, we all must look to the future. If we are nearing the end of our careers, we want to leave the field better than when we came. If we are just starting, we certainly want to maximize our potential. We need to be cognizant of who is leading our professional organizations, and take an active role in seeing that we select strategic-minded leaders that can make a positive difference. We must assure that the future will be bright, and it is up to us. ■
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The Fashionable ECP Laura Miller
Icons in Eyewear Fashion provides a wonderful form of self-expression. It defines what one likes and who they are. It represents periods, cultures, religions and ethnicities. HO SETS STYLE BETTER than celebrities who have large followings? Here is a list of some of the most influential eyeglasses wearers who glamorized their signature frames and popularized eyewear in pop culture. Can you predict who will influence frame styles in 2012? Sometimes, the best way to look at the future is to study the past.
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Benjamin Franklin – In 1784, Ben Franklin developed bifocal glasses. He was getting old and was having trouble seeing both up-close and at a distance. Getting tired of switching between two types of glasses, he devised a way to have both types of lenses fit into the frame. The distance lens was placed at the top and the upclose lens was placed at the bottom, creating early bifocals. Bifocals are still popular and the oval frame he wore is still in fashion today. Search for Benjamin Franklin glasses on the internet and you will be bound to find many. Jacqueline Kennedy – Jackie O brought style and sophistication to every American home. Her signature oversized, round sunglasses represent the impeccable taste of the former First Lady. She was always seen wearing her sunglasses and helped to create the luxury sunglasses market. Each year, many manufacturers come out with a Jackie O look in their summer line. There is always a demand for them.
Sara Palin – Some called her the “Jackie Kennedy” of eyewear. The Alaskan governor came into national limelight when she chose to run for vice president in 2008. She was always seen
sporting her rectangular rimless frames by Kazua Kowasaki and people still ask for the Sara Palin look today. She caused a rimless crave that inspired numerous frame companies to add rectangular drills to their collections, creating an affordable and attainable look for all of her fans. Though her political views may have been polarizing, her glasses were a firm hit on all sides of the political spectrum. Websites by the thousands offer John Lennon glasses. The rock legend’s most recognizable trait was his perfectly round, metal frames. When the singer broke out from the Beatles and started his solo career, he was hardly seen without Windsor eyeglasses. The frames symbolized Lennon’s ideas of peace, love and freedom, which is one reason why they are still popular today.
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While John Lennon wore the small round wire frames, Harry Potter is best known for his large, round frames. They are also a huge web phenomenon with thousands of sites offering the Harry Potter look for costume and for vision. The question remains….Why does Harry Potter have to wear glasses if he has magical powers? Why doesn’t he just correct his vision? Author
Bono’s Bulgari sunglasses
J.K. Rowling never addresses these questions but without his trademarked glasses, he simply would not be Harry Potter. Bono has made sunglasses acceptable for night. His sunglasses give him a distinct “rock star” look that is often imitated. The shades, usually Bulgari, helped to create his signature style but he wears them out of necessity rather than for fashion. Bono is known to have very sensitive eyes that get red and irritated from the constant flashing of cameras. He started the trend for newer music stars such as P Diddy and Kanye West, who are both known to sport their shades indoors. Fans usually follow the fashion of their favorite stars and now indoor sunglass wear is more acceptable. Elton John is not only known for his vast quantity of glasses, but also for the outrageous styles that he has been known to wear for his stage shows and public outings. His crazy spectacles were what actually started his reputation for wild, off-the-wall fashion. His most famous were the ostrich feather festooned glasses that accompanied his feather boa outfit on the Captain
Fantastic Tour. Another pair of glasses made famous on very same tour was comprised of 57 individual lights that when ignited, spelled his name and were bright enough to be seen from the end of the concert hall. Any outrageous trend in eyewear today can be credited to Elton John’s crazy and individual style. Fans may not have the money to replicate an entire outfit, but can easily find a pair of affordable Elton-like pair of eyeglasses if they want to imitate his style. Sally Jessy Raphael is known for her signature red, oversized plastic frames. The 80’s talk show queen confessed to Oprah that she needed large glasses to read the teleprompter and she wanted a pair of $19.95 frames she saw advertised, though they tried to show here something fancier. Her talk show that had a 19 year-run, inspired millions of women to imitate her look with red frames. People still think of Sally Jessy when they see a red frame. Malcolm X has famed browline glasses that became popular in 1950’s. The human rights activist was always seen in these glasses that are a combination of colors, with the dark color on the top of the frame fading to a clear color towards the bottom. Companies still make combination frames in their collections, imitating Malcolm X’s bold and strong style. Celebrities such as Kanye West, Jay-Z and Justin Beiber have followed this unique trend. These are just a few of the biggest trendsetters of fashion in the eyeglass world. Fashion is relative and nobody knows what the next big trend is going to be. Younger celebrities such as Justin Beiber, are creating the Geek-Chic craze. Smart, sexy actresses such as Anne Hathaway dispel the old saying that “boys don’t make passes at girls who wear glasses”. Will she be the next big trend setter? What about Justin Timberlake? These days he is rarely seen without eyeglasses, though he has not decided on his look yet. It is about time for another big icon in eyewear. History shows it happens every decade or so. It is always fun to try to predict what is coming next. Your guess is as good as mine. ■
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Managing Optician Anthony Record, ABO/NCLE, RDO
Is Your Glass Half Empty or Half Full? All of us must eventually decide. At least that’s the opinion of the late Randy Pausch. ANDY WAS A PROFESSOR of computer science and human-computer interaction at Carnegie Mellon University in Pittsburgh, Pennsylvania. In September 2006, at the age of 46, he was diagnosed with pancreatic cancer, and less than a year later, he was given a terminal diagnosis. He was told by his medical team that he had “3 to 6 months of good health left.”
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On September 18, 2007 Randy did something that many professors have done. He gave a lecture imagining that it was the last lecture he would ever give. Traditionally during these lectures, professors are asked to think about their demise and to ruminate about what they have learned and what matters most to them. It is usually the intent of these lectures and the professors to impart whatever insight and wisdom they can if after the lecture, that’s it, they’d be gone. The only difference here was that, given his diagnosis, Randy didn’t have to do much imagining. In a few short months he knew he would be dead. In fact, less than a year later, on July 25, 2008, Randy passed away. But during his lecture he did what he had done most of his life – focus on the positive. He shared all of his tips and insights on how to stay focused on the bright side. Here’s the thing: No matter how bad a day you’re having...no matter how challenging your last patient was...the perfect antidote for it all is simply reading Randy’s book: The Last Lecture. I won’t give it all away, only to say that Randy doesn’t use the glass half full or half empty metaphor. Instead, he defers to A.A. Milne, the creator of Winnie the Pooh and the Hundred Acre Wood. Pausch says we all need to decide which Pooh character we’re going to be. He poignantly asks the question: Are you an Eeyore or a Tigger? As eye care professionals (ECPs) that is a
fundamental decision we all have to make. In case you forget it from your childhood, Eeyore is an old, grey donkey who lives in the southeast corner of the Hundred Acre Wood, in “Eeyore’s Gloomy Place, rather boggy and sad.” He has a poor opinion of all the other animals, describing them as having no brain at all. His favorite food is thistles. He seems constantly depressed and has an uncanny ability to see the grey cloud within any silver lining. Tigger on the other hand, is a tiger-like character who is always smiling. With his distinctive black and orange stripes, he bounces from one adventure to the other, bringing out the best in those around him. There is no grey cloud big enough or dark enough that Tigger can’t wrap in a silver lining. He sees the best in every opportunity. In more than thirty years in the optical profession, I have never met a truly and wholly successful person who is rotten and miserable – never. That says a lot. Continued on page 20
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Essilor Acquires CSC Laboratories, Second Largest Independent U.S. Wholesaler Essilor International has acquired CSC Laboratories, the second largest independent laboratory company in the U.S. The purchase price was not announced. Based in Watsonville, Calif., CSC Laboratories was owned by the Kim family which retains a minority share. The company is headed by D.K. Kim, who founded the company in 1967. CSC Laboratories, which also operates a lab in San Jose, Calif., generated net sales of $34.5 million in 2011, with Rx sales of $32.8 million, produces about 1,860 jobs a day and has 170 employees. In addition to being a major producer of ophthalmic lenses and coating, CSC distributes an extensive line of private label ophthalmic frames. CSC serves the U.S. market, Central and South America and the Caribbean. Kim will remain with CSC for the next three years, according to sources close to the company.
Clariti Eyewear Announces ECP Magazine Cover Winner
The cover of the December 2011 issue of EyeCare Professional Magazine had a little something extra special on it. No, not the model in the cool retro Clariti Konishi frames, but a small and well hidden Clariti logo that could win a lucky reader a pair of those frames plus a $50 Macy’s gift card! Readers were asked to find the logo and submit its location to be entered to win. And the winner is... Stephanie Yee of Guber Optical in Winter Park, FL! Congratulations Stephanie!
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So imagine the following scenario – one that plays out hundreds of times in optical dispensaries day in and day out – all across our country: A patient walks into your dispensary, complaining that her lenses have become so scratched that she cannot see out of them at all. As you examine the glasses, you quickly determine that in fact it is the AR coating. The moment that client walked through your door, it could be said that she initiated an EVENT (E). Although most of us usually don’t think in these terms, we all experience dozens, perhaps hundreds, of Events every single day. From this point on, let’s consider how this optician handles this particular Event. For the sake of reflection (no pun intended) let’s assume that this client had purchased her glasses out-ofstate, and that any warranty on the lenses has long since expired. One possible response from the ECP is this: “Well...you know...it’s really not your lenses that are scratched. What you have are lenses that have been treated with what’s called an Anti-Reflective, or AR coating. That’s what’s really scratched. You have to be really careful with what you clean them with. They’ll scratch if you look at them the wrong way. Really all you can do is purchase new lenses.” Once the ECP informs her that new lenses would cost $275, the client recoils. “I can’t afford nearly $300. My insurance doesn’t kick in for another three months. I’ll have to struggle with them until then.” To which the ECP (and in this case the E in ECP might just stand for Eeyore) replies, “Sorry I couldn’t help you...have a nice day.” What you have just read is this particular eye care professional’s RESPONSE to the Event. What if the ECP had been more of a Tigger and instead had responded like this: “Wow! You’re really lucky. You have what are called AR lenses – that stands for anti-reflective. You probably remember when you first got them how crystal clear everything was, especially at night. It’s probably what was used to clean them that scratched them. Anyway, like I said you’re lucky. First of all, they’re usually warranted for a year or two. If the warranty has expired, I can strip the AR layer off and then the lenses should be good as new. Now of course, lights at night will bother you a bit, but you should be able to function a lot better without all the scratches. And remember, whether you
get your next pair from me or somebody else, make sure you always insist on AR or anti-reflective lenses. They’re the only lenses that we can remove scratches from...they’re just the best! Come on back in 20 minutes and I’ll have all those scratches stripped off for you.”
Here’s the thing: No matter how bad a day you’re having...no matter how challenging your last patient was...the perfect antidote for it all is simply reading Randy’s book: The Last Lecture.” I think we can all agree that each of these two separate Responses would result in dramatically different OUTCOMES. The Outcome of the first scenario is a frustrated, disillusioned client who will never – and I mean never – want to have anything to do with AR lenses. On the other hand, after the second Response, that client will benefit in that she will be able to see clearly until her “insurance kicks in,” making herself and all the people around her safer. Additionally, even if it means shelling out more money, you can bet that she will always insist on AR lenses. What a radically different result! The thing that most affected the outcome of each scenario was what? Of course...the Response of the ECP to the Event! With all that in mind, I (and I think Randy Pausch) would encourage you to always keep the following algebraic-looking formula in mind – consciously in mind: E + R = O. That’s right, always remember that Event + Response = Outcome. And of all those three things, the only one that you are completely, 100% in control of is your Response to each and every Event that occurs each and every day. Choose wisely. ■
Progressivelenses.com 20 | EYECAREPROFESSIONAL | FEBRUARY 2012
4/1/11
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©2011 Intercast Europe S.r.l. All rights reserved. NXT is a registered trademark of Intercast Europe S.r.l. Trivex is a registered trademark of PPG Industries Ohio, Inc.
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Unrivalled technology. Unrivalled performance vision. A prescription shouldn’t stand between your patients and an incredible visual experience of the world around them. And it won’t with NXT® Rx lenses featuring: ÊÊÊUÊ `Û> Vi`Ê } ÌÊ/À> à >Ì Ê/iV }Þ ÊÊÊUÊ1 Ì >ÌiÊ ÌÀ>ÃÌ]Ê >ÀiÊ> `Ê Þ > VÊ À } Ì iÃÃÊ ÌÀ ÃÊ ÊÊÊUÊ >`iÊÜ Ì ÊÕ ÌÀ> ÊV i>À]Ê`ÕÀ>L i]Ê } ÌÜi } ÌÊTrivex® material Now you can offer the premium performance of NXT lenses in many customized lens `ià } ÃÊvÀ Ê >À Ê<i ÃÃÊ6 à °Ê Available in the complete range of NXT lens treatments to meet every sun lens need: ÊÊUÊ* >À âi`ÊÊÊÊÊUÊ* Ì V À VÊÊÊÊÊUÊ* >À âi`Ê« Ì V À VÊÊÊÊÊUÊ Ýi`ÊÌ ÌÃÊÊÊÊÊUÊ ÀÀ ÀÃ
Ì>VÌÊÞ ÕÀÊ >À Ê<i ÃÃÊ6 Ã ÊÃ> iÃÊÀi«ÀiÃi Ì>Ì ÛiÊ ÀÊÛ Ã ÌÊÜÜÜ° ÝÌ Û Ã °V Éâi ÃÃÊv ÀÊ ÀiÊ v À >Ì °Ê 1- ÊÊ£ nää Îxn nÓxn
www.nxt-vision.com/zeiss
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MARCO Greater Efficiencies In the 21st Century EyeCare Professional’s Paul DiGiovanni, LDO, speaking with Michael Crocetta, Excecutive Director of Marketing, Marco. Marco has been in business 40 years. What are the biggest changes you see facing the industry? The biggest changes we’re seeing today are not some evolutionary series of changes, but revolutionary, wholesale changes in the way practice’s function. Product and process changes are now colliding. For a long time, the goal of Optometry has been to achieve the true status of ‘gatekeepers’ of eyecare – not simply dispensers of corrective hardware. To do so, the profession needs to institute a clinical, medical model in practice – becoming diagnostic screeners of glaucoma and retinal disease, and more sophisticated in combined wavefront assessments in refractive examinations. None of us know all that the future holds, but we all know a few simple truths about the future of health care. Doctors will be seeing more patients, many more...but how, when the hours of each day are already consumed? This is an unavoidable truth that requires a solution. GREATER EFFICIENCIES is the only answer. ROI becomes a combined formula of seeing more patients daily, providing ‘appreciably’ higher levels of eyecare, and finding greater total efficiencies. Every product purchased needs to fulfill this mission— both as the technology itself, and in the services that support every purchase. At Marco, that’s what we deliver every day. Do doctors understand what changes will be coming...and will be necessary to make? Most do not fully grasp the magnitude of the issue, and many still are not feeling the pain needed to move out of harm’s way. For some, life just goes on, as is...but the ‘head in the sand’ approach needs to be replaced with searching for available data ‘in the cloud.’
22 | EYECAREPROFESSIONAL | FEBRUARY 2012
Many don’t recognize that control is slipping away from them, with potential patients lost to competition. But the ground is moving beneath our feet, quickly. Doctors need to become more efficient, and find more consultative time with their patients— who are demanding it. Internet educated patients demand more...and Angie’s List tells them what practice to entrust their families eyecare to. Doctors need to learn how to market their services to patients...and elevate the patient experience... this cannot be underscored enough. What are the hurdles for practices to address the needed changes? • The belief is that delegation of refraction is impossible without compromise. While it may have been true in the past— not so today with existing automated technology. So there is a need to TRUST automation to accurately standardize refractive results...consistently— among many staff members. The subjective patient decisions between time-lapsed ‘1&2’ presentations... that are then further subjectively interpreted by Doctors or staff create far greater errors than necessary, given what technology offers today. With the ability to present old and new Rx, #1 and #2 options together, and differences in patient’s day/night vision, any variability in testing BETWEEN staff is negligible compared to the benefits gained by reducing subjective patient responses. • Knowing
what questions to ask to purchase the correct automated equipment.
• The
fear of EMR implementation and technology integration. Disruption is daunting...especially for larger practices.
What are companies like Marco able to provide doctors to succeed? First, there honestly are not many companies like Marco— that provide the services we do...and that have done so for more than 40 years. Continued on page 24
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you KNOW how to thrive amidst change Healthcare is demanding that you change the way you practice. Sure, change, at some level, always involves adjustment, but it need not involve wholesale disruptions to your practice. The TRS-5100 refractive system integrates smoothly into your daily routine and EMR program. You’ll only be challenged to figure out what to do with all that extra time in the day. We’ve got a few ideas on that also. Contact Marco for your free practice assessment, and learn how we can make a measurable difference in the life of your practice at www.whosincontrol.info.
TRS-5100 Total Refraction System
Manufactured by Nidek
®
www.marco.com 800.874.5274
VEE ● 6703
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Of course you need to deliver the best technologies to customers...and robust technologies that meet the rigors of real-practice use...but the key is in the support services, knowledge base of clinical and technical support, and a lifelong partnership commitment for a practice.
Marco offers free practice assessments...and so many automated instruments and workstations, that we don’t force square pegs into round holes, we don’t need to. We deliver the custom solution for your practice today...and again for tomorrow...however the practice changes.
What does Marco do differently for practices? We do a lot of listening to what you want to accomplish. We provide education, assessment, and metrics of patient flow and worksite efficiencies. We transcend the ‘consulting of the 80s and 90s’...to roll-up the sleeves ‘reengineering’ needs of this millennia. We don’t just tell you what we think you need to do...we work with you to actually implement what YOU want to achieve. It’s about YOUR specific objectives...and one size just doesn’t fit all. We provide a 3-step solution: • We
help you develop a solid plan
• We
show you specific, prioritized ways to regain greater control of your practice, patients, and profitability
• We
forge a strong and lasting partnership with the practice
Within this process, we offer a full staff of product managers and specialists, 24/7 on-line training, and GoTo meetings to resolve issues and to utilize 100% of instrument capabilities (that few practices utilize in the first year). Marco Area Managers are trained practice flow experts and our Technical support services are unrivaled.
TRS-5100 Total Refraction System. One of numerous, fully automated, refraction solutions.
How critical do you think it is that practices embrace necessary changes— NOW? It is an essential realization— but only the first step. Accepting a plan and hitting the ‘NOW’ button is critical...but in fairness, many doctors have never been presented with an achievable roadmap that doesn’t require tearing down walls...and major overhauls to the practice. You can believe that efficiency and quality can coexist...and they do so in thousands of Marco practices today. Sure— practices are businesses— and success first requires survival...but the reality is that, while so many practices are flailing while being buffeted by new magnitudes of change...Marco practices learn how to THRIVE amidst change.
Bottom line: • Practices
need to make an honest assessment about what’s working and what isn’t
• Create
a needs wish list
• Contact • Let
us record and document activity, and provide realistic metrics concerning your unrealized potential
• Prioritize
24 | EYECAREPROFESSIONAL | FEBRUARY 2012
what changes you need to tackle first
• Equip
the practice with the necessary technologies
• Begin
to elevate best patient care and satisfaction
• Control
The practice of the future is NOW. The combination of Nidek technology and Marco ‘Tech-Knowledge-y’ provide the needed tools to find measured success.
us to observe flow and process in the practice
the realization of your vision and experience your ‘WOW’— NOW ■
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EXPAND YOUR FIELD OF
THE COMPLETE EYECARE EVENT
EDUCATION: MARCH 22–25, 2012 | EXHIBITION: MARCH 23–25, 2012 New York, NY | Javits Convention Center | www.visionexpoeast.com
EYEWEAR & ACCESSORIES
CONTINUING EDUCATION
LENSES & PROCESSING TECHNOLOGY
MEDICAL & SCIENTIFIC
BUSINESS SOLUTIONS
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The Mobile Optician Ginny Johnson, LDO, ABOC
“I Believe We Can Fly” While standing in line at the airport recently waiting for my flight to board, I was noticing the different ways that passengers handle the ground rules.
This is the final boarding call for Flight 20/20, ECPs please take your seats in first class as we prepare for takeoff. First class treatment and going the extra mile takes place throughout the duration of the flight (appointment). First and foremost the entire crew needs to treat each other and the passengers (patients) with respect. You can’t have first class anything if half of your crew is on standby. Getting everyone on board with being and doing their best requires having fun final destinations every single day. Make up your mind to get rid of those jet lag thoughts and that terminal seriousness. Start at your arrival time and decide to have fun throughout the day with every passenger.
The stress of traveling is apparent on many faces while some show little concern. There are a few aggravated travelers working to remain calm while complying with the requests of the security staff. Some passengers are holding back tears as they get closer and closer to the gate. As we board the plane it hits me that my safety for the next 3 hours is being placed in the hands of commercial pilots that are total strangers to me. I’m tempted to ask them how well they get along and if they feel they are a good match for making quick joint decisions. I could have bought a limited edition pair of designer prescription sunglasses for what I paid for this flight. Seems like it would have been less expensive since the plane is not new and actually looks vintage. The person behind me taps me on the shoulder and asks where my final destination is going to be today. I tell him either Charleston or heaven, I’m just not quite sure yet. He laughs.
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Our special agents (front line staff) assist the passengers before, during and after their flight. They are in charge of traffic control and can tell us what’s working fine and what’s not. This can be extremely valuable information for improving first class performance. Pilots need to know things like the check in process is too taking too long, when scheduling issues come up or that the system keeps crashing. Prompt attention to these types of matters is needed to keep the special agents from exploding or being blown up. Make sure that they have all of the tools necessary to do their job in an upright position with confidence. Passengers should not feel uneasy or skeptical about the way your airline does business. To soar above those low lying optical shops or fly by night DIY eyesight websites, ECPs have to be prepared to hear about nose dive offers that some passengers fall for. As much as you might want to fly off the handle, remember that’s not the best way to steer the passengers back to your airline. One pilot (doctor) that I work with tells his passengers that he wants to help them take good care of their eyes for life. He can’t do that for them if they decide to go elsewhere.
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ECPs should constantly be working on different approaches towards going the extra mile to insure that every passenger has a rewarding experience. Offer fun frequent flier incentives or maybe showing up on time passenger programs. Remind passengers to stop in every 5,000 miles for an eyewear check up/adjustment. If your airline makes adjustments on eyewear purchased elsewhere be sure to tell the passenger about any concerns you may have regarding their frame before you begin working on it. There may also be a base fare that you charge for that service. Passengers don’t like fee surprises so if your time zone is not complimentary then make sure you let them know that upfront. Handling the bumpy parts of the ECP flight is not always the most comfortable seat to be in. Rising above the negative carry-ons and ascending in a more positive direction is mandatory. Some days you will need a higher altitude to reach for if your attitude has turbulence. There may be days when you need an oxygen mask or feel like another crew member needs one so go ahead and offer to help them out. Take a hit for the whole crew. Deal with that obnoxious passenger. Put the brakes on letting him/her ruin the flight for everyone. For some passengers first class isn’t even good enough. They expect non stop free flights. If every time these passengers stop over they have an air rage tone then you might have to take the final approach. Have the captain thank them for the times that they flew with your airline. It has gotten to the point of no return now so it is probably best for everyone if they get into their cargo and drive off into the sunset. From time to time passengers will get lost when it comes to insurance. Insurance can certainly turn out to be a trip you’d rather not take. The sooner you can help the passengers better understand the difference between vision insurance and medical insurance the easier the flight will be. Our crew tells the passengers that vision insurance is used for routine eye care only (nearsightedness, farsightedness, astigmatism). Medical insurance is typically used for emergency visits, eye injuries or eye infections. Medical insurance may also cover a comprehensive eye exam if there is no separate vision insurance or if the eye exam is due to diabetes, glaucoma, cataracts, macular degeneration, among others. For safety regulations remind the passenger that proof of their identity and insurance information is required at time of check in. You can’t discount first class treatment. Passengers have the choice of flying with any airline they choose to. There are no shortcuts you can take if you plan on having passengers for life. I believe ECPs can fly every single day. Heaven only knows where we could end up. ■
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Shakers
PixelOptics
Zeal Optics
PixelOptics has appointed Brett H. Craig as president and chief executive officer. Craig brings nearly 14 years of experience in the optical industry. He joined Transitions Optical in 1999 as general manager/managing director Brett H. Craig for Transition’s Asia/Pacific operations. He became the company’s chief operating officer in mid-2006, taking over day-to-day leadership for Transitions’ global business at that time. Craig was named president of Transitions in 2008 and resigned from the position in June, 2010.
Zeal Optics has appointed David Borbon as Director of Sales. He joins the company after holding the Key Accounts Representative/ Accessories Manager position at O’Neill Clothing. He also spent years as an optical, David Borbon apparel, footwear and accessories representative for Oakley, and helped the company launch numerous products and stage innovative marketing events that propelled the brand’s success.
Optical Women’s Association Modo Eyewear Modo Eyewear has announced the appointment of Pierre Fay as CEO for North America. Fay brings over 25 years of experience in the optical industry to Modo Eyewear. He held top management positions at leading companies Pierre Fay such as the Luxottica Group where he headed the North America wholesale division from 2005 to 2010 with direct responsibility for strategies in the sale, marketing and distribution of the group’s extensive brand portfolio.
The Optical Women’s Association (OWA) has selected Shirley Platzer-Stocks as the 2012 Pleiades award recipient to be honored at the OWA’s annual event in New York in March. Shirley is the owner/partner and owner/conShirley sultant of two companies, The Optical Vision Platzer-Stocks Site LLC and SPS Associates. She joined the OWA in year one of the organization and became a board member soon after. She created the mentoring program for the OWA and launched the first Professional Optical Women’s Workshop.
Transitions Optical Transitions Optical has appointed Sherianne James director of North America marketing. James is responsible for the development and implementation of organizational marketing plans in the U.S. and Canada. James has been Sherianne James with Transitions Optical since February 2011, when she began her tenure as the director of global consumer and professional insights and was responsible for leading global research for ECPs and consumers.
Essilor Vision Foundation The Essilor Vision Foundation has appointed two longtime Essilor executives to leadership positions. Bob Colucci has replaced Jacques Stoerr as chairman of the Foundation, and Stephen Shawler replaced Ed Fjordbak as Bob Colucci president. Colucci has spent the last 22 years with Essilor serving in several senior sales and management roles, and will assume this position in addition to his current role as president of Essilor’s Independent Distributor Division. Shawler has 30 years of vision industry experience; the last 11 years have been with Essilor serving in a number of executive positions.
28 | EYECAREPROFESSIONAL | FEBRUARY 2012
Zyloware Zyloware Eyewear has announced the promotion of Jennifer Derryberry to the position of senior vice president of corporate accounts. Derryberry has more than 18 years of experience in the optical industry and had most Jennifer recently been the company’s vice president of Derryberry corporate accounts. Derryberry joined Zyloware in 2002 and has directed and managed the implementation of corporate marketing initiatives, created brand awareness and brought new brands to market.
Welch Allyn Welch Allyn has announced that Julie Shimer, president and CEO of the company for the past five years, will retire at the end of 2012. The company said its board of directors has appointed a search committee and hired an Julie Shimer outside executive search firm to assist in securing a new CEO. Shimer’s career at Welch Allyn began in 2002 when she joined the Welch Allyn board of directors. In 2007, the board asked her to become president and CEO.
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Alain Mikli international Guiseppe La Boria joins the Alain Mikli International Group as sales and marketing director. For 8 years, Guiseppe worked for Safilo as sales manager for Italy, he worked for 9 years for Luxotica as International Sales Guiseppe La Boria Manager and about 2 years for the Allison group as product marketing and sales assistant Director. In the Alain Mikli International group, his responsibilities will notably include the development of field marketing and sales for the company’s brands.
The Charmant Group The Charmant Group announced that Gayle Bennett has joined Charmant as Regional Sales Manager in the Southeast Region. Ms. Bennett’s initial focus will be supporting existing business while identifying growth Gayle Bennett opportunities for the representatives in her region. Having started in the optical industry with Optyl in the early 80s, she was most recently a Regional Manager at L’Amy.
sibility, including vice president of strategic partnerships, vice president of marketing for LensCrafters and vice president of strategy-internet/phone sales and service. Lechner holds a BS in accounting and finance and an MBA in marketing.
Live Eyewear Live Eyewear expands its sales force with the recent hire of Bob Zappia. He comes to the company with 30+ years of sales and customer service experience derived from the intensely competitive wholesale Food and Bob Zappia Beverage sector. Mr. Zappia will focus on developing and supporting Live Eyewear’s accounts in the optical and specialty channels to ensure they are reaching their full potential in the OveRx® category. President of Live Eyewear, Kieran Hardy says, “We are very pleased to welcome Bob to the sales team. Over the past 10 years, our OveRx® eyewear collections have helped us build an incredibly loyal customer base.”
Coastal Contacts Coastal Contacts Inc. has named Greg Lechner vice president of business development for the U.S. Lechner brings more than 18 years of senior marketing, brand and business development experience from Luxottica Group, where he held positions of increasing respon-
FEBRUARY 2012 | EYECAREPROFESSIONAL| 29
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Through the Lens Dee Carew, ABO/NCLE, LDO, MLS
HIGH INDEX 101 HIGH INDEX LENSES are often the lens of choice for high power prescriptions and rimless mountings. The higher the index the more efficiently the light is refracted, requiring less lens material to provide the same amount of correction as standard plastic or glass lenses. However, that does not mean that high index is a panacea. Good fundamental opticianry still needs to be maintained in order to arrive at the best looking spectacles for your patient. That means watching sizing and frame shape. Keep the frame shape symmetrical with the A dimension within 2 mm of the ED and try to match their pupillary distance whenever possible.
each pair of spectacles. Following are general guidelines for materials and Rx powers:
High index Glass
Abbe Value
High index glass lenses come in 1.60, 1.70, 1.80 and 1.90 indices. High index glass has excellent optics and scratch resistance and it is thinner as the index increases. However, because of the high specific gravity of these lenses, the weight increases as the index gets higher (See “Specific Gravity” below). The 1.60 index lenses can be hardened and will pass the drop ball test for impact resistance, but the 1.70, 1.80 and 1.90 index lenses generally require chemical tempering. In some cases they may not meet ANSI standards and may require a waiver from the patient stating that he understands that the lenses will probably not be impact resistant. The 1.90 index lenses are not available in the United States any longer.
The Abbe Value of a lens is a measurement of the dispersion of color in the lens as light passes through it. Lenses are basically constructed of two prisms, base to base in plus lenses and apex to apex in minus lenses. As white light passes through these prisms, it is separated into the components of the visible spectrum made up of wavelengths which correspond to the various colors of the spectrum. This separation of the colors after refraction is called chromatic aberration. The higher the Abbe Value the less chromatic aberration. High index lenses tend to have lower Abbe Values, thus producing more color dispersion.
High index Plastic High index plastic offers the biggest benefit to minus prescriptions, where the edge of the lens is thicker than the center and therefore, easy for the patient to notice. Plus lenses can also benefit from high index materials but the benefit is not as obvious to the patient. However, many high index materials have an aspheric design, which gives them a thinner and flatter profile and reduces the magnification that conventional plus lenses are known to produce. Minus prescriptions and astigmatism also benefit from the high index and aspheric combination because of the lighter weight and thinner profile characteristics, but here again, the aspheric benefits are not as obvious to the patient. Prescriptions above +/- 3.00 sphere benefit most from high index lenses. However, this rule will vary depending on the individual characteristics (amount of decentration, ED, etc) of 30 | EYECAREPROFESSIONAL | FEBRUARY 2012
1.67 index Sphere below +/- 6.00 and Cylinder below +/-4.00 1.70 index Sphere below +/- 7.00 and Cylinder below +/-5.00 1.74 index Sphere +/- 8.00 or above and Cylinder below +/-6.00
Specific gravity Specific gravity is the ratio of density of a lens material to the density of water. The higher the specific gravity of the lens material, the greater its weight. The lower the specific gravity, the less the lens weighs. Specific gravity is measured in grams per cubic centimeter. There is a large variety of indices, Abbe Values and specific gravity in lenses. The following table shows the components of some of those lens materials. (See “Table” bottom of 32) While there are many advantages to high index lenses, including better ultraviolet protection than with standard plastic and glass lenses, there are some drawbacks as well. High index lenses tend to have increased chromatic aberration. The flatter profile and poorer light transmission can cause increased internal surface and backside reflections. Where Continued on page 32
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Marchon Introduces Eco-Friendly Folding Case Marchon is proud to introduce a new eco-friendly folding case for all house brand collections, helping to reduce the global carbon footprint worldwide. The simple, effective and innovative design of each case
will reduce carbon emission caused by transportation, production and storage. “The design of our new house brands’ case will result in significantly reduced carbon emissions,” said Claudio Gottardi, President and CEO. “Marchon ships millions of frames and sunglasses every year and with this new case design, we can expect to save significant energy, directly benefitting the environment.” The foldable case, which is approximately one-tenth the volume of the average eyewear case when shipping, offers wearers a sleek silhouette when closed. This functional, eco-friendly eyewear case is part of Marchon’s ongoing commitment to environmental protection and worldwide social campaigns. Marchon plans to selectively extend the new case program to the designer brand portfolio. House brand case deliveries will begin in the Spring of 2012.
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CR-39 lenses reflect about 7% of light, high index lenses can reflect substantially more. Distortion can be caused by the low Abbe values and off-axis viewing through a high index lens. The farther the gaze gets from the optical center, the more distortion is created. Base curve selection can also cause issues for myopes. This is especially true with stock high index lenses. Manufacturers tend to make their stock lenses on flatter base curves than corrective curve theory dictates to make them appear thinner. These flatter base curves can lead to distortion for the patient. Recommending high index lenses When recommending high index lenses: • always recommend anti-reflective treatment. This will cut down on the distracting reflections caused by the material and increase light transmission up to 99.5%. • suggest the smallest frames possible to decrease the amount of lens material required. This will maximize the benefits of the lighter, thinner properties of the high index lenses. • choose a frame where there will be minimal decentration. This will keep the eyes centered in the frame and reduce the center and edge thickness. Finding the refractive index The refractive index of a lens material refers to how much the material refracts or bends light as it enters the lens from air. The index is determined by dividing the speed of light in a vacuum by the speed of light going through the material. For instance, the speed of light in a vacuum divided by the speed of light in water gives the index of refraction of water. n = index of refraction speed of light in air = 186,000 miles per second (mps) speed of light in a material = varies
n (water) = speed of light in air (186,000 mps) / speed of light in water n (water) = 186,000/139,849 n (water) = 1.33 Finding the edge/center thickness Now that you know the index of refraction of a material, you can calculate the center or edge thickness of the lenses. The formula is: t = ((d/2)2 X D) / 2000(n-1) where t is thickness d is diameter in mm D is power n is index Using the formula for a -4.00 diopter lens and a 65 mm lens blank of 1.60 index: t = (65/2) 2 x 4.00)/2000 (n-1) t = 32.52 x4/(2000 (1.60-1) t = 1056.25 x 4/2000 x .60 t = 4225/1200 t = 3.52 mm plus center thickness = edge thickness High index lenses are considered a specialty lens because their properties are more complex and customized than standard plastic and glass lenses. They are an excellent choice for higher prescriptions in order to make cosmetically appealing eyewear. With anti-reflective and other lens treatments, such as roll and polish, high prescription lenses can be as light, thin and attractive as their low power counterparts. Now that you can determine index of refraction and lens thickness, you can provide to your patients the finest the eyewear industry has to offer. ■ With contributions from: Brian A. Thomas, P.h.D, ABOM
Lens Reference Chart Lens material CR-39 Trivex* Polycarbonate High Index 1.60 High Index 1.67 High Index 1.70 High Index 1.74 Crown Glass Glass 1.70
Index 1.498 1.53 1.586 1.60 1.67 1.70 1.74 1.523 1.70
*Utilizes the green wavelength instead of yellow
32 | EYECAREPROFESSIONAL | FEBRUARY 2012
Abbe 56.8 44 30 36 32 39 33 59 31
Specific Gravity 1.32 1.11 1.20 1.22 1.35 1.41 1.46 2.54 2.99
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Meet Our Hard Coat “Twins”! FEA has DOUBLED our Hard Coat Capacity
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Remember • 1 year unconditional scratch warranty (excludes processing and intentional damage) • Non-tintable (the hardest coating available) applied to both sides of the lens • Only $10.00 per pair
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Patient Care Lindsey Getz
Working with Older Adults Older patients may bring special challenges so make sure you’re up to the task Working with older patients in your practice can bring special challenges. There are many normal changes that take place with aging which can affect the way patients act and react to their eye exam or even their time in the dispensary. It’s important when working with the older population to pay special attention to their needs. These patients are also more likely to have eye health problems so properly educating them on diagnoses and eye care is of critical importance. Cognitive Changes According to the US Department of Health & Human Services (HHS), aging results in normal changes in cognition—specifically reduced processing speed, greater tendency to be distracted, and reduced capacity to process and remember new information at the same time (called “working memory”). While HHS reports that these normal changes can sometimes lead to false stereotypes or beliefs that older adults are cognitively impaired, they are in fact just a normal part of the aging process. Still, these changes may mean modifying the way you educate the patient on their diagnosis or even on what you’re doing as you go along with the exam.
Sally Halim, OD, of Village Eyecare in Woolwich, NJ
“You definitely have to take your time and make sure the patient is clear on what’s going on and what you’re telling them,” says Sally Halim, OD, of Village Eyecare in Woolwich, NJ, who has worked with a number of older patients at her practice. “Things change so quickly in our industry. The patient may
34 | EYECAREPROFESSIONAL | FEBRUARY 2012
be used to older technology. I find that it’s important to explain what you’re doing as you proceed through the exam so that the patient is not surprised or fearful in any way.” Halim says she’s also found that older patients can be strongly affected by past negative experiences in the healthcare world. They may be less likely to let a negative experience go and may harbor those bad feelings long term. If they had a poor experience with a past eye doctor, they may be even more reluctant about new technology or procedures. “You have to assure older patients that have had a bad experience that it doesn’t mean those things will happen again,” Halim says. “It’s almost like you have to win them over which can be difficult. But it’s important to be understanding of any difficult medical experience they’ve been through and recognize that it may be affecting their current experience with you. Explain everything you’re doing and help walk the patient through the exam every step of the way. Taking that extra time with them may be all it takes to make them comfortable.” Health Literacy and Comprehension Older patients also have a different level of health literacy that needs to be addressed. Not only may they not be familiar with newer technology, but they may also have factors working against them in their comprehension of medical information. According to the HHS, older patients’ comprehension of health information may be impacted by any number of issues including vision and hearing problems, stress, fatigue, depression, and the use of medication. They also typically have to manage multiple medical conditions increasing their chances of being distracted or forgetful, according to the HHS. Fortunately there are some techniques you can try to help convey the correct information to patients and ensure they comprehend it. The HHS says that repeating essential information is important. But the HHS says that frequent repetition of information that is “not true” may result in the information being remembered as “true” simply because older adults are
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more likely to interpret the increased familiarity of a message as being true. In other words if you repeat that the patient should “not take the medication with food” several times, they may remember it as “take the medication with food. Therefore, the HHS advises emphasizing the desire actions, not the actions they should avoid. When communicating, the HHS also recommends staying focused on important details and not letting too much unnecessary detail creep into the message as this only leaves room for confusion or for the patient to forget the vital details. The HHS also suggests personalizing information whenever possible to help the patient remember it and also to minimize distractions. And of course, be prepared to take your time. The HHS says that a slower pace may be needed and that means factoring extra time into your appointment depending on the patient. “Learning to communicate better and making sure the patient comprehends the most important details may mean slowing down,” agrees Halim. “Don’t insult the patient but also be careful not to rush through important information. Take the time to make sure they understood what you’ve told them.” In the Dispensary Once your patient has moved on from their eye exam and into the dispensary, they still have special needs that should continue to be addressed. Every patient is different but older adults may be more likely to be unfamiliar with new lens technology and may require more education on why you’re recommending a certain product. “You may need to take the time to explain why it’s better to go with a different material—such as one that’s lighter,” says Halim. “I have found that some older patients believe they’re getting more for their money by going with something heavier or bigger even if it’s not more comfortable. You may need to explain why lighter weight lenses cost more but also how they can make the patient more comfortable. Like any age group, you have to learn to speak their language based on their experiences and what’s important to them. Be careful not to do this in a condescending way. Just understand that older patients may not be as up to date with newer technology and may have more questions.” Of course you always have to look at the flipside. Many older adults have embraced the Internet and have read up on new technology. Some are into the latest fashion trends and will want frames that are currently “in style.” The bottom line is that you have to be willing to work with each and every patient at their own level, says Halim. That can require some customization of your message. Be prepared to meet the needs of each patient that walks through your door and you’ll likely see them back soon. ■
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Second Glance Elmer Friedman, OD
The Gender Question, Revisited I HADN’T HEARD FROM MY FRIEND and colleague, Dr. Natty Bumpo, of Finster, N.J. for quite a while. When I saw his email notice on my computer I knew he had something on his mind that was as irritating as a wound from an optical screwdriver that missed its mark and pierced a finger. My modem was smoking with flashes of fire as he took up an issue that was burning and troubling to him and had need of expression in the most vehement of terms. Namely, he was discomforted by the discovery and realization that women in professions, particularly optometry, have become the new standard bearers, having wrested the honor from males who have suffered the indignities of such nefarious activity. The subject comes up in our conversations from time to time and has always been a hot potato. The majority has felt that an easy peace now remains and ill will has been left behind. But there are some men who are diehards. Dr. Herbert Fingles (deceased), a Philadelphia optometrist, was the leader of a small group in the 1980s opposing the idea of women optometrists. He was vociferous on the subject and received a good deal of negative notoriety and angry calls for his trouble. He was stopped on the street and castigated publicly for his views. In the eighties, women were starting to realize their ambition in optometry. At that time, the concept of meeting financial demands required that both husband and wife join the work force. This is where my friend, Natty, takes issue. “At one time the male was considered the backbone of the nuclear family,” he said. “It was his income, for better or worse, that fed, housed and clothed the family. Soon, females were competing for seats in optometry schools with the usual male entries. This deformed approach to an increasing problem was also seen in law, medicine, communications, business, education media and
other venues,” continued Natty. “The strong, confident male always associated with delivering important news to our homes has been replaced by strong, confident and beautiful ladies. It also exists in our practices. The male practitioner has always been seen as knowledgeable and the experienced person of choice. That man has been replaced and his hopes for the future are now in jeopardy as a female has taken his seat in optometry school.” Natty continued on his diatribe. “To add insult to injury, the female tends to accept lower wages plus maternity leaves and time taken off since her husband can provide the monies she may have lost. On my way to my office I often gauge the number of women drivers on or near my route of travel,” said Natty.“Over 50% are women and I must conclude they are traveling to their own offices. In the meantime, the male who has been superseded has taken on a second job to maintain his role as the bone and sinew of his family. The final nail in the coffin of male dominance was the aggressive and skyrocketing push of government and private sectors as they forced the approval and acceptance of females in the domains that males once held. Elmer, I am sorry to be such a crab but I compare my attitude of yesteryear to today’s slick, sophisticated, big business methods. I have shared my feelings with some who threatened to sue me if I put my feelings in print. You wouldn’t believe the hate mail and calls I have received. What’s this world coming to?” But the gauntlet had been thrown and womanhood was surprisingly adept at expressing her views and her rights. Male opinions changed as female education and expertise rose to heights not heretofore imagined. It took a cigarette company to take note of the changes and gave birth to a slogan that said it all, “You’ve Come a Long Way, Baby.” Pressure from both Continued on page 38
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females and males removed the condescending phrase from use at that time. Schools, fraternal orders and clubs that were once the mainstay of male dominance are now peppered with female members; many of them serve on their board of directors and hold high leadership offices. May I point out to my fellow optometrists that the President of the A.O.A. is Dori M. Carlson. O.D. Jennifer Smythe, O.D. is the dean of Pacific University College of Optometry. I will add that the female speakers ready to appear at the 2012 Convention of the Academy of Optometry constitute approximately half of that group.
in the class and 26 males. In the clinic the patients referred to the females as “nurse.” By the time she graduated there were only two females left, the others having dropped out of the course. Looking for a job took a daunting effort, and after many trials and tribulations she was hired by an optometrist who was the sole practitioner in the practice. He gave her a white uniform and seated her at a desk where she could greet the patients as they came in. She never participated in the examination, but had to remain in the reception area. Of course, she came in handy when it was time to run to the lab to pick up the day’s work. This was the extent of the opportunities available to her at that time.
They are occupying important positions in optometry as professors, research specialists and clinical chiefs. Females are now in command of some of the most successful offices in the country. Have you noticed the heavy concentration of women at or near the top of school administrations, CEOs of important companies and entrepreneurs in every field? Women in sports have built enthusiastic fans to a level unheard of. At one time a career in sports for a female was short lived. Today they receive salaries that are commensurate with men players.
She decided to drop out of optometry and concentrate on raising our two daughters. Later, when she made up her mind to enter the field once more the whole landscape had changed. Employment opportunities were available, and there was no problem in obtaining work. Of course, at that time women were not paid on the same scale as men. Today she envies the female graduates who are so well educated, and working side by side with their male counterparts with equal opportunities in all realms. She sighs, “I was born 40 years too soon.”
My wife, Lillian, grew up in the era when newspaper want ads were labeled Male or Female Help Wanted. There was a definite demarcation between jobs that were only suitable for one sex. When she enrolled at optometry school, there were five females
And so, notwithstanding the attempts by the likes of a Natty Bumpo or Herb Fingles to make male chauvinism credible, the ladies have survived. They are stronger than ever and achieving their goals on the road to success. ■
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OD Perspective Jason Smith, OD, MS
Bifocal Implants, Apodized Diffraction, and a Case Study AS THE POPULATION in the United States ages, there will be an increasing need for cataract surgery amongst this senior population.
GE-RELATED CATARACTS create a clouding of the crystalline lens of the eye, causing a variety of visual disturbances. These problems can include decreased vision, blurry vision, glare, halos around lights, night driving issues, color vision changes, monocular double vision, and potential safety issues such as falling, tripping or driving concerns.
A
In the earliest stages, cataracts may only cause prescription changes which can be improved with a new eyeglass or contact lens prescription. These prescription changes generally move the prescription in a negative direction and are known as the myopic shift. Eventually, the cataracts may become so cloudy and dense that prescription changes will not help and cataract surgery is the only viable alternative. Most cataracts occur in seniors generally beginning around the age of sixty or later. Diabetics and steroid users may be more prone to having cataracts that become a problem earlier in life. Occasionally, babies are born with cataracts that can be genetic in nature or may result from a traumatic delivery. Cataracts can also occur in people who have experienced trauma or head injuries. People who have been in car accidents can experience a traumatic cataract as can happen to a boxer who suffers multiple hits to the eyes or head. ECP’s can check for cataracts by doing visual acuity tests and checking the anatomy of the eye with a biomicroscope or an ophthalmoscope. Biomicroscopes with cameras can photo-document the cataract as well as show it to the patient so that they have a greater understanding of their own health. A visual field test can indicate to the patient what they are not seeing. A better view of the cataract is obtained by pupillary dilation and the use of a binocular indirect ophthalmoscope. A trial frame refraction will indicate a patient’s best corrected visual acuities. These standards must meet minimum driving 40 | EYECAREPROFESSIONAL | FEBRUARY 2012
standards, a patient’s own safety needs, and their minimum levels of acceptable vision for work and possibly, hobbies. When deciding if and when cataract surgery is appropriate or necessary, family doctors and family members will need to be consulted. Risk factors, medical conditions, ambulatory conditions, and other vision problems must be thoroughly evaluated. What may be appropriate for a 70 year old who is still working or driving may be different for an 80 year old who is in a nursing home. The surgical options for patients include single vision IOLs (intraocular lenses), toric IOLs, and multifocal IOLs. Medicare and insurance guidelines provide certain IOLs at no cost and cover the cost of post-cataract single vision or bifocal glasses. The costs of “premium” bifocal IOLs or toric IOLs are not covered under Medicare guidelines as well as some other insurance plans. These IOLs can be an out of pocket cost of $1,900-$2,500. Toric IOLs can cost from $750-$1,400. Bifocal implants include the AcrySof IQ Restor and AcrySof IQ Toric, the Crystalens, Tecnis, ReZoom, and the Array. The Restor lens is convex on both sides and made of a soft plastic. It is folded and inserted into the eye through a tiny incision smaller than the optic diameter of the lens. After insertion, the lens gently unfolds to restore vision. The supporting arms (haptics) of the lens maintain proper positioning within the eye by centering itself within the original lens sack. The AcrySof Restor IOL uses 2 terms called apodization and diffraction to achieve its optics. According to www.supersightsurgery.com, “Apodization is the gradual reduction or blending of the diffractive steps from the center to the outside of a lens to create a smooth transition of light between distance, intermediate, and near focal points. The application of apodization to intraocular lenses is a patented process by Alcon and can only be found in the AcrySof ReStor IOL. Diffraction is the spreading of light. It occurs when light
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passes through discontinuities such as steps or edges. In an optical system, light can be diffracted to form multiple focal points or images. On the AcrySof Restor IOL, the center of the lens consists of an apodized diffractive optic. This means that the series of tiny steps in the center area work together to focus light for near through distance vision.” There is still a significant debate in the literature concerning which bifocal implants provide the best vision. Some surgeons use 2 different implants. Clear distance and near vision is provided with one type of bifocal implant, and another type provides clear middle and near vision. According to the Cataract and Refractive Surgery Journal of March 2006, Dr. Kerry Solomon states, “there may be clinical indications for mixing and matching lens technologies. Patients describe blurring of their intermediate and near vision. Perhaps they will experience improvement in time, as is often the case with monovision. All of the patients say that nighttime halos are more noticeable in their ReZoom eyes, but none feels limited by daytime or nighttime visual symptoms. There may be clinical indications for mixing and matching lens technologies. Until surgeons better understand the limitations, risks, and side effects of this approach, my advice is to implant the same presbyopia correcting IOL bilaterally.” When opticians and optometrists refer cataract patients to an ophthalmologist, it is important that they provide the necessary pre-operative information that help patients with their visual and medical decisions. These patients may rely on other family members who will make decisions on their behalf. These friends or family members will also be required to go to an initial consultation, be present for the surgical dates, and take the patient to several post-operative appointments. The hope is that no post-operative complications occur such as bleeding, glaucoma, lens dislocation, or retinal detachments. It is important to educate your patients and their family members about potential risks. Be certain to include a discussion about the available bifocal implants and their costs, risks, disadvantages and benefits. I continue to be amazed that many patients who have Medicare or private insurance have no idea as to costs, benefits, deductibles, co-payments, and coverage. Handouts and websites can also provide another source of educational information. The National Eye Institute (www.nei.nih.gov) will provide the patient with valuable eye and eye health information at no cost and is available in English and Spanish. Bifocal IOLs can provide some unexpected results, as I recently found out. A 71 year old male patient recently returned to me after having bifocal implant cataract surgery in 2007.
Mr. “Jones” had the Restor bifocal implanted in both eyes. His visual acuity was OD: 20/25 and OS: 20/25+ for distance and near. He was initially pleased with his results for three years. But over the past year, he had noticed that his vision had become worse in the distance. His uncorrected distance vision in 2011 was OD: 20/70 and OS: 20/50. He was also very concerned that he was no longer able to track a golf ball when he was on the golf course. The glare outside in the bright sun was now becoming a problem. His “golfing buddies” were also laughing when he said that he needed to use orange balls on the golf course instead of white ones! This was the first time that I had a case where I was considering doing an over-refraction on a bifocal implant patient. I was under the assumption that if his vision was deteriorating, then the only options would be to either return to the ophthalmologist for removal of the bifocal IOLs (explant), or to live with it. Neither option was one that I liked. I also ruled out any possibilities of neurological problems, retinal changes, ARMD, strokes, or corneal problems. Mr. Jones’ pre-operative refraction in 2007 was: OD: +0.50-0.75X120 ADD: +1.75, OS: +1.000.75X80 ADD: +2.00. I took a few auto-refraction measurements in 2011 and decided to do a trial frame refraction, not expecting any improvements. Was I surprised! A trial frame refraction provided the following results: OD: +0.50-1.50X140 Va: 20/30 OS: +0.251.00X95 Va: 20/25. Mr. Jones was also thrilled that his close vision seemed crisper and clearer with this same single vision prescription. No ADD power was needed! I prescribed a pair of Transitions polycarbonate lenses for him to use. When he picked up the glasses, his positive response was immediate. The large smile was something that his wife said, “was missing for too long.” I also bought him a box of white golf balls because he donated the orange ones to the driving range. This experience with bifocal implants proved to me that this is an ongoing new technology that is neither applicable to every patient nor beneficial to every patient. We are prudent in our judgments of who should be wearing progressive lenses compared to flat-top bifocals. We should also be prudent in suggesting bifocal IOLs to patients. And we should be comfortable with the ophthalmologists as well as their postoperative results. For those ECPs who are doing refractions, use your auto-refractor as a guide. The actual post-operative refractions may, of course, not coincide with the auto-refractor. In my opinion, a trial frame refraction will provide the best results for these patients. And never be fearful of potential disappointment; the results just may happily surprise you and your patient. ■
FEBRUARY 2012 | EYECAREPROFESSIONAL | 41
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35
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EYECAREPROFESSIONAL Magazine
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Last Look Jim Magay, RDO
The Twinkie Phenomena By the time you read this Mitt Romney will/will not be the Republican opposing President Obama in November. By then more important things will have been decided.
o, I’m not referring to Iran and their quest for nukes, nor am I thinking about the titanic struggle between Jesus and God this Saturday night (of course that would be Tim Tebow versus Tom Brady in the playoffs). Actually I’m referring to the fact that the icon of empty calories, that unspoilable cellophane wrapped delicacy, the Hostess Twinkie, may be on its way out!
N
You’ve most likely read the news that Hostess has filed for bankruptcy (again) as the demand for healthy (or at least what appears to be healthy) snacks grow. In a country where obesity is now a major health concern, diabetes a scourge, and white bread consumption down over 20% since the Millennium, snack makers are shifting to yogurt and granola bars. We are forsaking sugary drinks for healthy (and expensive) bottled water. But Twinkies...those harmless little fluffy things, they can’t be that bad....can they? Each and every one has 150 calories, 4.5 grams of fat, and what the heck is the sugary cream filling made of? My guess is recycled industrial waste, but that’s just me. We are testing the indestructible nature of Twinkies – 11 years ago on the eve of the New Millennium we buried a time capsule containing many artifacts of the day – including several pristine packages of the sweet in question – we’ll check them out around 2025 and see how they are doing. So, switching gears slightly – how will as a country we be doing by 2025? As imperishable as a Twinkie? If you listen to the politicians, they all have THE answer (each one different) to future prosperity. It would be nice to know which one is right, I’m sure they can’t all be wrong, can they?
46 | EYECAREPROFESSIONAL | FEBRUARY 2012
Just like Twinkies, we are caught up in the global forces of our times. The middle class is being decimated as much by changing trends as by any political ideology. The middle class is dwindling because middle class jobs have disappeared. Not just shipped overseas – although that is some of it – the jobs are just gone. There’s not a big need for buggy whip makers, typists, or bank tellers anymore. These used to be jobs that a person with a high-school education could do and make a pretty good middle class living, and now those jobs are gone. Historically, we’ve seen the same thing happening in the office. In the 19th Century, a person who had readable, attractive handwriting and could do basic arithmetic could get a decent job as a clerk. Then, starting late in that century, the handwriting began to be replaced by typewriters, and later still the arithmetic started to be done by adding machines. And the same is happening in retail. Cashiers and salesclerks and stock-boys and other apparatus of retailers are going to lose their jobs, along with the folks who work at the mall Orange Julius and video arcade. And that is seriously bad, and totally predictable, and totally not affected by the yo-yo’s running for president. So we ECPs need to innovate, innovate, and innovate some more just to survive. Can we do it? Stay tuned, if Twinkies make it ‘till 2025, maybe we will also. ■
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