EyeCare Professional Magazine March 2010 Issue

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NEW FRAMES FOR SPRING / PAGE 6 LOW VISION DISPENSING / PAGE 20 March 2010 • Volume 4, Issue 27 • www.ECPmag.com

Francesca Gabbiani Artist

PRODUCED AND DISTRIBUTED BY LUXOTTICA GROUP - MOD. PO 2934V

Los Angeles, USA

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Something big is happening to frame screws

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MARCH 2010

EYECAREPROFESSIONAL

Vol. 4 Issue 27

Contents

Magazine

Features 6

SPRING FRAME RELEASES Usher in the new season with the latest and greatest in eyewear and sunwear.

by Amy Endo, ABOM, CPOT

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STRATEGIC DISPENSARY MANAGEMENT In today’s optical environment, in-depth strategic management is more important than ever.

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by Warren McDonald, PhD

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LOW VISION CARE Low vision aids provide an excellent niche to help your patients and improve your bottom line.

by Carrie Wilson, BS, LDO, ABOAC, NCLEC

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DISPENSING IS SELLING Sell may be a four letter word, but you must find a way to fit it into your practice.

by Ginny Johnson, LDO, ABOC

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TRADE SHOW PREPARATION Having a successful trade show takes a lot of planning, research, and discipline.

by Judy Canty, ABO/NCLE

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FIT YOUR PATIENTS FOR SUCCESS Style your patients with the eyewear that suits them – and gain satisfied and loyal customers.

by Timothy Coronis, ABOC-NCLE

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On The Cover: PERSOL® www.persol.com

Departments EDITOR/VIEW .....................................................................................................4 MANAGING OPTICIAN...................................................................................24 MOVERS AND SHAKERS.................................................................................28 OD PERSPECTIVE ............................................................................................36 SECOND GLANCE ............................................................................................40 ADVERTISER INDEX .......................................................................................54 INDUSTRY QUICK ACCESS............................................................................55 LAST LOOK .......................................................................................................58

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EYECAREPROFESSIONAL

Editor / view

Magazine

by Jeff Smith

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

ADVERTISING & SALES (215) 355-6444 • (800) 914-4322 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 4 Number 27 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.

Purpose: EyeCare Professional Magazine, ECP™ is a publication dedicated to providing information and resources affecting the financial well-being of the Optical Professional both professionally and personally. It is committed to introducing a wide array of product and service vendors, national and regional, and the myriad cost savings and benefits they offer.

For Back Issues and Reprints contact Jeff Smith, Publisher at 800-914-4322 or by Email: jeff@ECPmag.com Copyright © 2010 by OptiCourier Ltd. All Rights Reserved

4 | EYECAREPROFESSIONAL | MARCH 2010

The Future of Publishing OR MOST AVID MAGAZINE READERS (myself included), the traditional print format is a ubiquitous part of our lives. The impending demise of the printed word has been well documented, and while it may be true for local and regional newspapers, I still believe there is a strong future for trade publications. That being said, a growing number of people are recognizing the convenience and immediacy of being able to access their media in a digital format for online reading or downloading.

F

At EyeCare Professional, we don’t just consider ourselves a print magazine, but a brand of information. While we continue to publish our regular, physical magazine, we want to provide that information in whatever medium is most convenient. Digital issues will allow us to present our content in a magazine format, which can enhance the content and the advertiser’s message with rich media (you can click on an Ad and link to a company’s website, for example), in a format that is more environmentally friendly.

Many readers rely on a digital edition when they’re traveling or on-the-go, and those with an iPhone, iPad, Kindle or other handheld devices would be able to access the digital issue before their physical copy arrives in the mail. Our downloadable edition will be available in the coming months on our website, but in the meantime, please go to www.ecpmag.com and click on the front cover to see how the digital issue looks on your computer screen (Our entire archive of articles is also online).

Back to the present, as this month’s issue includes the usual mix of editorial, education, and entertainment: Amy Endo introduces us to the latest in eyewear and sunwear for the spring.

Dr. Warren McDonald stresses the importance of detailed, future focused strategic management in today’s optical world.

Low vision aids are a great way to help your patients and increase your bottom line, as Carrie Wilson explains. Ginny Johnson uses her experience as a Mobile Optician to illustrate how important it is for dispensers to acknowledge that they are in the selling business. Anthony Record shares some insight into what has made his practice successful over the years.

Judy Canty reminds us how important is it to come to trade shows prepared.

Jason Smith gives us a fresh take on refraction from an OD perspective. Near Death Visions are a fascinating phenomenon that haven’t been given their proper due, as Elmer Friedman reveals. And Timothy Coronis gives his expert advice on the best way to fit your patients stylishly and effectively.

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Spring

Anything goes with current

New Releases

eyewear trends, and here are some styles and colors that are seen more frequently these days. Vintage inspired shapes such as the aviator and modified cat eyes are fun and very cool to wear. Cut out shapes on the frame front and temples are unusual and draw attention.

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1. Revolution Eyewear The Ed Hardy Street Collection features state-of-the-art specialized treatments on the temples to give off a stained glass effect. The sophisticated detailing of these sunglasses incorporate unique color palettes and crystals accents that stand out like no other frame. Revolution Eyewear comes through with more beautiful, new, innovative styles from the most well known fashion brands. www.revolutioneyewear.com 2. Tura Ted Baker model Dahlia II B173 is stainless steel style with a modified rectangular front and a simple Ted Baker logo screened on the temples. The temples feature an unexpecTED tricolor gradient in bright colors that can be found throughout the Ted Baker spring & summer apparel collection.

Available in eyesize 50/16-130 and in the color array of Ebony, Brown Town and Red Sunset. www.tura.com

3. REM Eyewear The Converse brand is always a step ahead, but never too far from the familiar. The Heritage Collection features progressive takes on iconic shapes, retro styles, like aviator silhouettes and oversized frames are infused with artisan details, such as handmade acetate and customized rivet hinges. www.remeyewear.com

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4. Kenmark Taking inspirations from her Spring 2010 Ready-to-Wear collection, Vera Wang combines modern, vintage inspired shapes with a bold, yet feminine color palette to create a signature accessory in fashion. The sun collection showcases Vera Wang’s artistry through the use of color, temple decor and laying textures. www.kenmarkoptical.com 5. Jee Vice Jazzy is a classic and is available in brown, white and black.

The simple curves and solid colors will complement any outfit and still make a statement. The frames can also be changed into prescription glasses. They are made with the ultra-lightweight and super durable TR90 frame material. www.jeevice.com

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6. Safilo “The Lolita” from Juicy Couture is a new metal sunglass which is both flirty and fun and makes a unique gift for the women on your shopping list. It will be offered in frame colors of light gold, pink and white. Made of flat metal, the custom shaped frame features Juicy details including the signature heart cut-out on the right temple tip and a hidden saying, “Eat Cake Wear Juicy”, on the temple’s interior. www.safilo.com

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McGee Group

The Smitten Collection from XOXO will leave you lovestruck with smoldering colors and sassy styles that will keep you stylish from day to night. Spicy is a plastic frame with a modified oval eyeshape and spring hinges. This style features a dual color theme and metal XOXO logo plaques accent the temples. Spicy is available in two colors; black/red and demi purple. www.mcgeegroup.com

Fysh UK

Viva International Group

The new SKECHERS Eyewear Collection features styles for men including classic aviator and pilot shapes, croc laser etchings, sun-weathered colors, metal hardware and dragon graphic elements. The women’s collection includes features such as organic metal cutouts, animal prints, graphic tattoo designs and vintage cat-eye shapes, also infused with logo treatments. www.vivagroup.com

Baumvision

Fysh UK’s spring collection’s funky styling and whimsical patterns will appeal to frame wearers who wish to unleash their creativity and let their personalities shine. This inspiring urban kool collection features F-3414, a fun and flirty frame with a floral-inspired print and delicate pastel colors available in brown ivory, brown plum, black mint and red coral. www.fyshuk.com

Marchon FENDI – Precise cut-outs emulate a refined lace pattern on rich zyl temples and frame fronts. Depth and definition is created through pressed logo patterns at the end pieces. True to form, the attention to detail is what makes the house of FENDI the ultimate luxury, synonymous with superior quality and craftsmanship. www.marchon.com

Paul Frank Blue Ice Collection is a limited edition collection, whose translucent blue acetate is a first for the seven year-old collection known for its orange and seafoam layered frames. www.baumvision.com

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

Featuring: Women’s CC #194, Men’s CC #211

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Morel Koali takes us to the watery depths of the Atlantic Ocean. In creating these new optical models, the designer was inspired by the axinella: a very colorful sea sponge. Available in 5 eye-shapes, 4 rimmed frames and one semi-rimless front, Axinelle draws on contrasts, offering a range of unique colors. www.morel-france.com LBI

Luxottica

Tory Burch TY 7002Q updates the oversize shield with an acetate front and aged leather temples. Small metal studs embellish both temples and recreate the signature Tory Burch logo. This chic design is done in deep brown leather, merged with the double laminate of chocolate brown on the exterior and horn on the interior. www.luxandme.com

Enni Marco

The St. Moritz model Cyber MZ 12 is an elegant addition to St. Moritz’s well established collection of metal-plastic rimless frames. The fashion forward design brings an x-shaped accent that joins the front to temples in unison; where metal and plastic unite in harmony. Silicone adjustable nose pads give comfort wear ability. Available in eye size 51-18-135, in colors Burgundy, Coffee, and Ebony. www.lbieyewear.com

Live Eyewear Cocoons®, designed to be worn over prescription eyewear, has been expanded to include a new soft touch slate frame finish.

Slate is available in all six shapes with gray, amber, copper or yellow Polaré® polarized lenses. New improvements include the fusion of the adjustable Flex2Fit® temples to the main body of the temple to improve durability, and an increase in the dimensions of the side lenses to greatly improve the peripheral line of sight. www.liveeyewear.com

The latest additions to the Enni Marco 2010 spring collection are finely crafted with each detail playing a key role. New styles feature captivating combination of different materials and finishes, delicate filigree-like and dazzling crystals embellishments, and modern architecture-inspired designs. www.ennimarco.com New Releases are always the hottest inventory to carry.

People prefer to be the first to show their eyewear, and go over the features and benefits to their friends. Be sure to show “New Releases” to everyone!

Amy Endo, ABOM, CPOT amy@ecpmag.com

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OLA and The Vision Council Announce Plans to Merge The Executive Committees of Optical Laboratories Association (OLA) and The Vision Council met during The Vision Council’s annual Executive Summit in January, to conclude discussions ongoing since May 2009 and to confirm their intention to merge the two organizations.

Mike Daley, chairman of The Vision Council, announced that the OLA and The Vision Council had signed a letter of intent to merge the two organizations. “We’re excited about moving these two great industry organizations closer together and will update the industry as the merger agreement is finalized and more details emerge,” said Daley.

The announcement follows months of discussions and deliberation. OLA members were surveyed last Fall, and an open forum was held during the OLA’s 2009 Annual Meeting to discuss the potential benefits of bringing together the OLA and The Vision Council.

An important feature of the agreement is the plan to co-locate the OLA Annual Meeting with International Vision Expo West in Las Vegas.

“Everyone agrees in principal that ‘the sooner the better’ is the answer,” said Bob Dziuban, executive director of OLA, “but OLA has existing contracts for the 2010 and 2011 meetings that have to be resolved.

OLA and The Vision Council staff are already working together to resolve these contract issues, and we hope to have a conclusion very soon.”

“There will be an OLA Annual Meeting in 2010!” said Mike Francesconi, OLA vice president, “and it will include the same education and networking opportunities always provided by our annual gathering of labs. The location and dates will be confirmed as soon as negotiations are completed, but we know that we will create the traditional OLA Annual Meeting experience no matter where and when it is held.”

The two possible locations and dates are the first week of October in Las Vegas with International Vision Expo West, and the first week of December in the Dallas-Fort Worth area.

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National Lens to Distribute TreviColiseum Eyewear Use one website to order all of your stock lenses electronically with no usage or ordering fees!

If you are currently ordering lenses from any of the following participating vendors, you can create and submit your order using the Opticom website at no cost!

Arch Vision (Tejin Lenses) Augen Optics Avada Eyewear Bristol C&D Carl Zeiss/AO Sola Conant USA Cunnigham Lens Dagas Optical USA Essilor (Silor, Varilux & Gentex, Prio) Eyenovate Eyewear by ROI Eyewear Designs Fantom Optics Gator Lens Hilco (Supplies) Hoya Lens I-Coat ILENCO J G Lens Kaenon Polarized KBco L.B.I. Lenses Lensco

Melibrad Nassau Lens NXT Sun Lens Optima Oracle Lens Pixel Optics Polycore Polylens Rodenstock RSE Optics (Tokai Lenses) Seiko / Pentax Shamir Insight Shore Lens Signet-Armorlite SOMO Optical Specialty Lens/iRX Polaroid Titmus (Frames) United Vision Vision-Ease X-Cel Optical Younger Optics Zyloware (Frames)

TreviColiseum of Italy has announced a North American distribution agreement with National Lens for the distribution of TreviColiseum eyewear. The agreement covers the collections of Cotton Club, Clark and Coliseum. The line will debut at Vision Expo East in March – all products are made in Italy and are exquisitely designed with the finest available materials of Acetate, Titanium and Wood trimmed.

“We are very proud to be entering into this new partnership with the National Lens,” said Stefano Vanin Export Manager.

The collection responds to what the consumer is looking for in eyewear today. With such an incredible creative force behind the brand, the possibilities are endless.

“We are very excited to work with TreviColiseum as our eyewear partner,” added David Roberts, Director of Operations of National Lens, “After meeting with the TreviColiseum management and design teams, we believe that their ability to create high-quality and stylish eyewear for both men and women resonate positively with our customers in North America.”

For more information please go to www.national-lens.com or call 1-866-923-5601.

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

STRATEGIC MANAGEMENT

For The Eye Care Professional, Part III WE CONTINUE our series on Strategic Management this month, and I trust you are finding the information useful.

Value The key issue we should concern ourselves with from an internal perspective is how we can create value. We want those who come to us for care to feel as though they received a real value for their hard earned dollars. I think that is what all of us expect, and we need to consider our own office operations from that perspective. Taking a long, hard look at ourselves will often pay dividends. That can be difficult, because we are often looking through a cloudy lens.

We must be completely objective so seeking opinions of the patients we serve can really be beneficial. We need input from the stakeholders with which we interact, and also the advice of a professional consultant may be a benefit. These folks are trained to assist you in improving your organization’s performance, and if you can, seek their advice.

Strategy is a key component of our success, and must be considered, particularly in the economic conditions of today. In the first article, we introduced Strategic Management as a concept, followed by last month’s look at the external environment and its effect on our organizations. We must know what is going on around us if we are to remain competitive, so the environment in which we live and operate is important for us to understand.

This month we will evaluate the internal environment, but from a slightly different point of view. We will evaluate the concept of value and how we can provide that perception in the eyes of those we seek to serve. I think you will find this of great benefit to your office.

The Organizational Value Chain What is value? According to most “experts”, value has two primary factors, cost and performance. Does it perform at the level it is supposed to, and is it fairly priced? Low-cost and cheap are not related to value in this context. To evaluate how our organizations can provide real value, Swayne, et.al. (2008) provide us with a descriptor they call the Organizational Value Chain.

Porter and others have used the term in previous publications, but this one is especially good for our purposes.

This chain consists of several points along a service continuum where we have opportunities to provide value to patients. Preservice, point-of-service, and after-service activities are a part of the chain that are opportunities for us to provide value. All of these are supported by three support activities: organizational culture, organizational structure, and strategic resources.

Pre-service activities – these activities are undertaken before patients ever choose to come into our office. These activities include marketing activities that define and attract our target patients/customers to the office. Important is our pricing and distribution models as well as promotional activities.

Continued on page 18

16 | EYECAREPROFESSIONAL | MARCH 2010

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Come See Us At: Vision Expo East Booth # 1251

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Point-of-service activities – These include our clinical operations, processes, and point-of-purchase marketing activities.

In essence, these are activities that relate immediately to patient satisfaction. How are patients treated across the office? Was the receptionist friendly and helpful? Was the clinical staff able to handle the patient’s wants and needs efficiently and effectively?

These and many other activities are important to our success in this step in the chain.

After-service activities – This is an often neglected factor in the chain. Correct billing, follow-up on services and product performance, and follow-up marketing are among the very important steps in after-service activities. Correct billing is especially significant in third-party billing, to assure all parties are accurately compensated and paid. Anyone who has had to deal with today’s third-party payment system realizes that it can often be inefficient. Billing in a reasonable time frame is important to assure greater efficiencies.

Often we can also assure repeat visits and a long term patient if we do not forget them after they are gone from immediate service. Using patients newsletters, and direct mail to current patients/customers is always an excellent tool to drive them back in for additional services and products.

Support Activities I don’t know about you, but nothing irritates me like poor service. I do some consulting across the country and I must say that I have seen both ends of that spectrum. There are several factors that can define a patient’s perception of the service we provide. The first of which is organizational climate. In one office I was in recently, I was in the place for approximately 10 minutes, and not one person spoke to me in any fashion. In fact, it was a large chain organization that featured an Optometric office in the front of the establishment with the dispensary to the left. As I entered the facility the doctor’s receptionist saw me come in, and actually looked away without so much as a welcome, and I was left with a very poor first impression.

Often that is all you get in today’s ultra-competitive environment. I went into the dispensing area, which was very attractive and inviting, but again, not one person spoke to me at all. I left without meeting or speaking to a soul, and they were not busy.

In my travels, I often go into Opticians and Optometrists offices to say hello, and encourage them to read our publication. I am always amazed at the responses I get. Some are pleased to see you and speak immediately, some never speak.

While I will never know the bottom lines of these organizations, which would you perceive as having the higher level of customer service? This is what we mean by organizational climate, and it can be taught.

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Make sure your staff greets people, even when busy. It takes only a moment to say, “sorry to keep you waiting; we’ll be with you in a short while.” Remember, and this is very important, that this idea of a positive organizational climate begins at the top of the food chain...meaning you if you are the boss! You must be a model for the staff to emulate, especially when it involves ethics and customer service.

The second is the organizational physical structure. Is the office laid out to maximize patient/customer processes and efficiency? Do patients have to travel excessively to get to their destination? For example is the dispensary convenient to the refraction area? In other words is the office efficiency at the level it needs to be for staff and patients in order to facilitate ease of utilization? In larger organizations, the actual design of the organization is more important. Is it departmentalized, functionally designed, or is a matrix organizational design employed? We will leave that for another article, since most of those in eyecare are smaller organizations. These specific office issues are much more important for us.

Our final topic is strategic resources. Do we provide sufficient funds to support our initiatives? Technological and human resource needs are examples of initiatives that require adequate funding. One office I visited had patients backed up three deep and had a sole receptionist on duty to meet the demand, which made for unhappy patients and inefficient office flow. Having the right number of staff available is an example of strategic resources. Technology today is important, and probably more than ever before. Patients expect to see the bells and whistles and they can provide us with a significant competitive advantage. If we are not up-to-date, we often are seen as “less than” the competition.

Conclusion As we conclude this month’s article, let me encourage each of you to consider this concept of an Organizational Value Chain.

Making certain we can remain competitive requires that we consider the value we provide in our service area. Our target market has specific needs and wants, and those who meet them will be successful long into the future. But keep in mind, the process is on-going. We must always remain cognizant of changes within the marketplace and adjust accordingly. In previous articles, I have addressed SWOT, reviewing our strengths, weaknesses, opportunities and threats. This month, we have described a second way we should evaluate ourselves...the value we offer our patients.

Next month we continue with this concept of Strategic Management. I hope this topic has been useful and has provided some insight into methods we can use to be more competitive in our individual markets. ■

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Through the Lens Carrie Wilson, BS, LDO, ABOAC, NCLEC

Raising the Bar in Low Vision WITH THE ARRIVAL OF SPRING, the eye care professional’s mind turns to new ways to improve the bottom line of the practice. Although the usual thoughts revolve around frames and accessories, one should look at an ever improving product line: low vision aids. This is not only a non-traditional source of revenue, but it is also an area where you can provide much needed and much appreciated specialized care to your patients.

What is Low Vision?

Low vision occurs when there is a visual impairment that does not allow a patient to achieve a visual acuity of 20/60 or better with correction, when the degree of peripheral vision is less than 20, or when there is a loss or contrast – or so the textbooks state. In reality, low vision occurs whenever your patient cannot see what they need or want to see due to decreased acuity. What is low vision to one patient is only a minor inconvenience for another. The classifications of low vision are as follows:

which reduces the testing distance and makes the letters easier for the patient to see. Alternately, the practitioner can have the patient walk slowly toward the Snellen chart until they can see the 20/200 letter. The distance would then be recorded. When the refractionist reduces the distance, he or she must convert the results to a 20 foot notation.

• Profound low vision – 20/500 to 20/1000 VA

To convert to a 20 foot notation, the refractionist must first document the testing distance and optotype. The reduced distance becomes the top number and the bottom number is the size of the optotype recognized; for example, 4/100. Next, the top number is multiplied by the integer needed to produce the answer of 20. In this case, the number is 5. The bottom is then multiplied by the same number. Therefore, the 20 foot notation for a 4/100 would be 20/500 VA.

• Near total blindness

Low Vision is on the Rise

• No Light Perception (NLP) – This is usually less than 25% of the legally blind population

The most common causes of severe vision loss are injury, macular degeneration, glaucoma and diabetes.

To better understand exactly what 20/200 means, the largest letter or optotype on the standard Snellen chart (E), is 20/200.

Since there is no optotype between 20/100 and 20/200 on a standard chart, or an optotype over 20/200, the refractionist usually has to utilize a special hand held visual acuity chart

Macular degeneration is the leading cause of blindness in individuals over the age of 60. It is a disease that affects the central portion of the retina, called the macula. The macula is the area where we have excellent central vision. Age related macular

• Moderate low vision – 20/70 to 20/160 VA • Severe low vision – 20/200 to 20/400 VA. In the United States, this is considered legally blind

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degeneration, or AMD, causes a loss in the patient’s central vision and it occurs in dry and wet forms.

• Dry AMD – Characterized by yellow deposits on the macula called drusen. Although a majority of these patients will never lead to central vision loss, it does need to be monitored carefully. If the drusen increase in size or amount it can cause a distortion in the patient’s vision or a loss of contrast. In advanced cases, the drusen can cause an atrophy of the macula tissues which will lead to loss of vision. Dry AMD can also lead to Wet AMD in about 10% of Dry AMD sufferers.

• Wet AMD – Deriving its name from the blood and fluid that accumulates in the retina, Wet AMD is the result of choroidal neovascularization. This is when there is an abnormal growth of blood vessels in the choroid, just behind the macula. When the blood vessels leak fluid, the fluid causes distorted vision, blurry lines and a loss of central vision. As the choroidal neovascularization increases, scar tissue can result and a permanent loss of vision occurs.

Glaucoma is an eye disease that usually involves an increase of intraocular pressure along with other risk factors, in which optic nerve damage occurs. Normally symptom free in the early stages, glaucoma can result in noticeable blind spots, tunnel vision and then total blindness when left untreated. Glaucoma is a major cause of blindness in America, and the leading cause of blindness in African Americans. There are two main categories of glaucoma in adults: open angle glaucoma and narrow angle glaucoma.

Open angle glaucoma is the most common type of glaucoma.

It affects 70 to 80 percent of all glaucoma sufferers. It is more prevalent in individuals over the age of 35, African Americans, and those with a sibling history of the disease. Open angle occurs when an individual gradually loses the ability to drain aqueous from the eye or when the eye over-produces the aqueous causing the pressure inside the eye to reach abnormally high levels. Since it is gradual, the patient usually doesn’t realize they have the disease until permanent damage is achieved and vision loss has occurred. Glaucoma vision loss usually occurs at the periphery of their visual field and progresses inward.

Narrow angle glaucoma is less common but is a more serious form of the disease. A medical emergency, narrow angle glaucoma occurs when there is a mechanical closing of the angle and there is an immediate increase in intraocular pressure. The result is ocular pain, nausea, vomiting and the classic halo’s around lights.

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Diabetes is a major cause of blindness in adults ages 20 to 74.

Diabetes can be a contributing factor in patients developing macular degeneration and is the cause of diabetic retinopathy.

Diabetic retinopathy is a progressive disease that affects the blood vessels on and around the retina. Diabetic retinopathy is usually diagnosed in four stages: • Mild Retinopathy – Blood vessels in the retina develop tiny aneurysms.

• Moderate Retinopathy – Blood vessels that feed the retina are blocked.

• Severe Retinopathy – Areas that are deprived of blood due to blocked blood vessels begin to atrophy and signal the development of new blood vessels. When the new blood vessels actually develop, the last stage begins.

• Proliferative Retinopathy – Weak, abnormal blood vessels are formed along the retina and vitreous surface.

When these blood vessels leak blood, vision loss results.

Treatment Options When surgery, medications and other treatment options are not viable for the patient, then he or she must turn to low vision aids. Low vision aids can range from the simple hand held magnifier, to a high tech computer, and are usually designed around the patient’s needs. Low vision aids in general fall into the categories of optical and non-optical aids.

Low Vision Aids for Near Use One of the first options is specialized near vision glasses or high add bifocals. These are an excellent way for a practice to offer low vision aids to a patient. Patients are usually already comfortable with wearing glasses, they offer hands free use, they provide a wide field of vision when compared to a magnifier, and they are easier to use for long term work. When fitting a patient with these devices, keep in mind: • If the patient has excellent binocular vision, keep the add power to a maximum of +5.00 diopters to help avoid convergence problems.

• The ECP should adjust the near PD to allow for the greater convergence needed to utilize higher powered plus lenses and bifocals. The easiest technique for this is known as the Gerstman inset. Multiply the add power by .75 to arrive at the inset per eye. Some low vision experts recommend 1.0 mm inset per diopter of add power.

• Higher binocular add powers than +5.00 can be used in patients with monocular vision. However, do not inset the segment as much because a monocular patient will turn their head to avoid their nose.

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Hand held or stand magnifiers are an excellent low vision device for an ECP to offer to their patients. They are the conventional and most recognizable low vision aid, and are relatively easy to use, when the proper power is used.

A good, diversified supply of magnifiers will include dioptric powers of 2, 4, 6, 8, 10, 12, 16, 20 and 24(or .5X, 1X, 1.5X, 2X, 2.5X, 4X, 5X, and 6X). Magnifiers are easy to carry, may allow for a greater working distance than specialized glasses, and the stand type of magnifiers are excellent for older patients with tremors and/or arthritis. Magnifiers that are lighted and can run on either batteries or electricity are also excellent for near use because they increase the amount of usable light to the eye making images easier to see. LCD lighting is becoming standard on these magnifiers.

Telemicroscopes are mounted on an eyeglass frame and can be designed to allow for any near or intermediate working distance. This can be of great benefit to those who use a computer frequently, play an instrument, crochet and other tasks that are more comfortable at a longer working distance.

Low Vision Aids for Distance Use Telescopes are the primary low vision aid for distance use.

When a patient cannot see sporting events, signs, or the black board a telescope can be of great use to them. A telescope can be hand held, placed on a lanyard or mounted on a pair of glasses.

The prices can range from inexpensive premade designs as well as custom ordered designs. A standard set of telescope powers to have on hand are 2x, 4x, 6x, and 10x. The strongest telescope, 10x, should only be used for patients with a visual acuity up to 20/600. If a patient has a visual acuity worse than 20/600, special mobility training may be required. Remember, as plus power increases, the patients’ field of view decreases.

Non-Optical Aids Non-optical aids can include everything from large print media to lighting to high contrast overlays. Most low vision patients can benefit from the large print versions of routine consumer magazines that are readily available. Lighting can also be beneficial. With increased illumination, the patients’ pupil constricts which allows for an improvement on their depth of focus. Using a yellow bulb, or a yellow plastic overlay can also add a high contrast improvement for reading tasks.

Low vision aids are an excellent way to provide additional care to patients. Not only is the ECP filling a niche within the marketplace, but he or she is helping to improve the quality of life of a patient. It is not often that the ECP can enable a patient to resume an activity or task that most of us take for granted, but with low vision aids this can become a frequent occurrence and a most satisfying endeavor. â–

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Managing Optician Anthony Record, ABO/NCLE, RDO

Whatever Works Released in 2009 and starring Larry David and Evan Rachel Wood, Whatever Works is Woody Allen’s latest film that tries to make sense of the sometimes seemingly senseless world in which we live.

With that in mind, I thought I would share with you some of the specific things I have done to build what I believe is a modestly successful optical practice; one that boasts a fiercely loyal clientele. There are no doctors on the premises, and I accept no insurance, not even Medicare or Medicaid. We have been in the same location for nearly 14 years and are only open three days a week: Friday, Saturday, and Sunday from 9:00 – 4:00. I have never spent one dollar on advertising. We have enjoyed good times and endured recessions.

Recently, while some of my colleagues are cutting hours and wages, and offering discounts and sales in a struggle to keep afloat, we are doing okay. Last weekend we sold 63 pairs of eyeglasses. Not too shabby. I believe this modicum of success did not happen by chance, but because of some specific things that I wish to share with you here. Take them with a grain of salt or take them to heart, but I believe if you can incorporate some of these things into your practice, good things will happen.

AS THE TITLE IMPLIES, he suggests that no matter what it takes, whatever we have to do to “filch” some small bit of happiness, whatever works is okay. With some modification, I have held a similar belief in building an optical practice.

Basically, my philosophy in building a business is if it isn’t illegal, and it isn’t immoral, and it works...you ought to do it.

24 | EYECAREPROFESSIONAL |MARCH 2010

We concentrate on doing one thing good. Don’t get me wrong, we sell accessories: Solar Shields, readers, chains, cords, clip-on sunglasses, holders, you name it – if it’s optically related we probably sell it. We sell contact lenses too, and will even arrange eye examinations with local optometrists or ophthalmologists, but what we decided to concentrate on is selling eyeglasses.

That’s what we do best. Therefore eyeglasses make up 98% of our revenue.

We set fair, reasonable prices. We don’t match prices. We never offer sales. Buy one get one free? Not from me. Some practices will take the cost of a frame and mark it three or four hundred

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percent. I know of a local ophthalmologist’s dispensary selling a metal frame with a retail price of $129. I buy the same exact frame wholesale for $6.95. I wonder if that practice owner would think it reasonable if some of the places he pays for goods and services started charging him more than 17 times their cost of goods. With some exceptions, we double our cost of goods on lenses, and make a judgment call on the frame prices. But all our prices are fair and reasonable and we extend the same lab and manufacturing warranties we enjoy to our patients – generally one year.

We are professionals. Only licensed opticians service our clientele – no unlicensed, support staff. We take the hands-on fitting of frames very seriously. All frames are comprehensively adjusted on the front-end of the transaction – to the point that upon delivery almost nothing needs to be done. We touch our patients – behind the ears, along the temples, to ensure a proper fit. Many times this means that temples need to be shortened, which is again, done on the front end. I wish I had a dollar for every customer who has informed me – sadly – that I was the first optician who ever took such care in adjusting the frame.

We fish. Huh? Think about it: If you decide to go fishing today, and the gods have decided that you will catch a fish 10% of the time you cast your bait – and you cast ten times, how many fish will you catch? One. But if you get serious about it, and cast your bait a hundred times, how may fish will you catch?

Ten! So, I and my staff members are constantly fishing. When placing an order, every patient is asked when he plans to update his current prescription in his sunglasses. If the patient answers the question “incorrectly” he will be asked the same question again upon dispensing. Every customer who has been given a free adjustment, screw, repair, etc. is asked to watch a 30-second demonstration of polarized lenses. Figure out ways you and your staff can go fishing and be amazed at the results.

We are honest. By the way, honesty and integrity do not have degrees. You either are honest or you are not. Your practice is characterized by integrity or it is not. For example, because we are only open three days a week, it is imperative that all glasses sold on those three days are ready by the following Friday morning. This is such a huge goal (and we meet it more than 96% of the tine) that patients are told they may pick up their glasses any time next weekend – we’ll call if they won’t be ready. It sure is a heck of a lot more efficient to have to call one or two patients and explain that their glasses didn’t pass final inspection than to have to call fifty patients to tell them they’re ready. (By the way, in 14 years only ONE patient requested – and was given – a refund due to not meeting the delivery goal.)

But, as you can imagine, sometimes “stuff ” happens.

Continued on page 26

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Last month our usually reliable lab was experiencing massive delays due to the installation of new equipment. Twenty-three jobs failed to make delivery, meaning the patients would have to wait another full week to pick up their orders. Of course they were all called Thursday evening so they wouldn’t waste a trip. I also sent out a letter to all of them explaining exactly why their order was delayed and how unusual it was. I also wrote that “talk is cheap, so the next time you or a family member needs glasses, just bring in this letter and I’ll extend another 10% off our already fair prices.” Call me crazy, it just seemed like the right thing to do.

“We decided to concentrate on selling eyeglasses. That’s what we do best. Therefore eyeglasses make up 98% of our revenue.”

We communicate with our clients. I know we all communicate with our clients, but we really do. The apology letter explained above is a good example. Every first-time patient receives a personalized, signed thank you letter from me, thanking them for their patronage, asking them to tell others about our practice, and encouraging them to call me or come in if they are not 100% satisfied with their purchase. I even include my cell phone on all correspondences and business card to ensure that a patient can communicate with me any time. In 14 years, guess how many times a client has taken advantage of that by being a pest or by calling at an unreasonable hour?

That’s right...never...not once. Repeat patients get a personally signed thank you card for their “continuing patronage,” as do all of customers who refer other people to our practice.

Occasionally I find the need to send what I call an Oops Card– a short note to apologize for any inconvenience that was caused by our actions. Not surprisingly, our customers appreciate and respond to that kind of communication. I’ve also been known to phone a customer if I think I’ve got a frame that might interest him or her. It’s called communication.

It all seems so simple, and really, it is. But as I grow older and hopefully a bit wiser, I have come to realize that some of the most beautiful, effective things in life are indeed, the most simple. It’s amazing to me how often a new patient arrives at my doorstep simply because the last place they bought their glasses didn’t bother to adjust their glasses, didn’t thank them for their business, didn’t communicate sufficiently...like I said earlier, take it with a grain of salt or take it to heart, but in this multi-tasking, crazy, high-tech world in which we live, getting back to the basics usually pays huge dividends. ■

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AND

Shakers

VSP Global

PPG Industries

VSP Global has named Donald J. Ball Jr. as its chief financial officer. Ball will replace former vice president and CFO Patricia Cochran who recently retired after 31 years, and report to chief executive officer, Rob Lynch. Most Donald J. Ball Jr. recently, Ball was senior vice president and CFO of Raley’s, a major grocery chain, and previously spent 19 years at global home furnishings giant, IKEA.

PPG Industries has appointed Brett Craig vice president, PPG. He remains president of Transitions Optical and will report directly to Richard C. Elias, PPG senior vice president, optical and specialty materials. Craig joined Brett Craig Transitions Optical in July 1999 as general manager/managing director, Asia/Pacific. In 2002, he was named general manager/managing director for Europe, Middle East and Africa. In mid-2006, Craig assumed the role of chief operating officer and provided day-to-day leadership for the global business.

VSP Global has also named Jim McGrann – most recently Eyefinity/OfficeMate president – as chief technology officer. Steve Baker, Eyefinity/OfficeMate’s current chief technology officer, has been named president of Jim McGrann Eyefinity/OfficeMate, succeeding McGrann.

Baker will report to McGrann in his new role.

McGrann has served as Eyefinity/OfficeMate’s president since Eyefinity and OfficeMate merged following VSP’s acquisition of Marchon Eyewear in August of 2008. Prior to that, McGrann served as both senior vice presiSteve Baker dent and chief information officer at Marchon Eyewear, and CEO of OfficeMate Software Solutions since 1999. Prior to the merger of Eyefinity and OfficeMate, Baker served as Eyefinity’s president from 2007 to 2008 and was then named chief technology officer.

SECO International

Ron Bannister

Ron Bannister, OD, of Thomasville, Ga., was elected president of the SECO International organization at last month’s annual meeting in Atlanta. Bannister succeeded Jonathan Shrewsbury, OD, of Beaver Dam, Ky., who became SECO’s immediate past president.

Also elected to offices within SECO International were Neil Draisin, OD, of Charleston, S.C., president-elect; Ronald Foreman, OD, of Lake City, Fla., vice president; Darby Chiasson, OD, of Cut Off, La., treasurer; and James Herman, OD, of Hurricane, W. Va., secretary.

CIBA Vision

Jan Wagner

CIBA Vision has named Jan Wagner its vice president, North American marketing. Wagner succeeded George Pastrana, who is now CIBA’s VP of customer satisfaction. Wagner was previously category marketing director for pain products at Novartis.

The Vision Council Election of officers and new directors by the membership of the Vision Council took place during the organization’s annual Executive Summit last January in Florida. Re-elected for the second of two possible one-year terms Mike Daley were: chairman, Mike Daley, Essilor; vice-chairman, Jamie Shyer, Zyloware; secretary-treasurer, Doug Hepper, Vision-Ease, and immediate-past chairman, Larry Clarke, Satisloh.

Elected for a three-year term as directors joining the board are: Gerard Santinelli, Santinelli International, Inc. and Marty Bassett, Walman Optical. Also re-elected were directors: Pierre Fay, Luxottica; Don Howard, Kenmark; Dick Larry Clarke Russo, Safilo; Dave Cole Transitions; Fred Howard, Carl Zeiss Vision; Steve Rappoport, L’Amy America; and Mike Hundert, REM Eyewear.

SoloHealth SoloHealth has announced that Tony I. Sommer, Jr., will be joining the management team as vice president, sales and marketing.

Sommer comes to SoloHealth with almost six years of eyecare industry experience in marTony I. Sommer, Jr. keting and sales as an executive with CIBA Vision, where he and his teams won awards for innovation, marketing breakthroughs, and distinguished performance, including the company’s Country of the Year award for his team’s performance in North America.

Hoya Vision Care Europe Hoya has appointed Hans Werquin as CEO of Hoya Vision Care Europe, effective April 1. He will report to Gerald W. Bottero, who has been leading the European branch in the past five years. Bottero will remain CEO of Hoya Vision Care Movers & Shakers continued on page 32

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Dispensing Optician Ginny Johnson, LDO, ABOC

“The Future’s So Bright, I Gotta Sell Something” If a patient is in the office for an eye health exam we don’t always think of it as selling. Guess what? It is.

We did sell the patient something: a service. If they are sitting in the exam chair, someone sold them on being there.

Does the doctor sell to the patient during the eye health exam?

Maybe so. Maybe not. Not sure. Should they?

I believe the doctor should prescribe to the patient. Sell?

Prescribe? What’s the difference?

Prescribe means to lay down in writing or otherwise, as a rule or a course of action to be followed; to specify with authority; to designate or order the use of as a remedy.

Therefore, sell means to offer and prescribe means to order.

I study optometric practices I teach optician classes I know a crazy doctor, she wears dark glasses Things are going great and they’re only getting better I’m doing all right, when someone calls I’m jumping The future’s so bright, I gotta sell something SELL IS A FOUR-LETTER WORD whose meaning can be hard to grasp for ECPs in a medical setting.

Some common dictionary definitions of sell are: to transfer goods to or render services for another in exchange for money; to persuade or convince someone to buy something being offered.

The question is, how does the word sell fit into your practice?

Are you one of those ECPs that cringes every time you think about having to sell something to a patient?

30 | EYECAREPROFESSIONAL | MARCH 2010

The doctor gathers information from the patient’s exam results and prescribes the remedy. The patient follows the doctor’s orders, if that’s not happening, the future might not look so bright. Calling all doctors (if applicable): Relax, you can stop worrying that patients are thinking of you as their doctor who is also a pushy salesperson. You say the last thing that you want is for patients to think of you as a shady character. Being a shady character is a good thing! All of our patients should be wearing sunglasses.

Sunglasses aren’t just to make a fashion statement or to wear as a clothing accessory. Sunglasses should be the other first pair of everyday eyewear. Unprotected sun exposure begins early in life and can cause long term damage. Children need to be taught the importance of wearing sunglasses, just as we teach them to brush their teeth, use sunscreen and wear a seatbelt. For safety reasons, children should have impact resistant sunglass lenses.

The lens of a child allows 70% more UV rays to reach the delicate retina than in an adult. Some studies say that up to 80% of a person’s lifetime exposure to harmful UV rays occurs by age 18.

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If it is bright enough outdoors for an adult to be wearing sunglasses, then it’s way bright enough for children to be wearing sunglasses. We are doing our patients a disservice by not prescribing, specifying with authority or selling the importance of sunglasses to every patient. The sun may be 93 million miles away from the earth, but no one is exempt from its potential damage.

Moving right along to the famous ‘either or’ sell. You know, the contact lens patient that doesn’t own a pair of eyeglasses. They have gotten away without having any eyeglasses for years at their previous doctor’s office. They love to try and pull rank on ECPs and tell us they don’t need eyeglasses. They have decided that their eyes are just fine without them. If a patient owns up to the responsibility of wearing contact lenses for vision correction, then they need to own a reliable pair of RX eyeglasses.

The doctor’s authority should trump any excuses that the patient can come up with to avoid this. It should not be a negotiating process. It should not be based on insurance coverage.

Why do contact lens patients need back up eyeglasses? The doctor said so. It’s impossible to predict the exact timing of eye emergencies, eye infections, loss or abuse to contact lenses, or other issues related to contact lens wear. Not having a pair of back up eyeglasses when emergency situations arise is too late.

Reverse your thinking and prescribe contact lenses as a back up for eyeglasses. Make sure you are practicing within the guidelines of the law.

Due to the multitude of vision products available today, it is impossible to keep up with every single one. Combining the expertise of your practice’s doctors, opticians, managers, techs,

etc to determine the patient’s optimal vision solution can be quite challenging. The key is to overcome the interoffice sell which takes place daily in practices everywhere. Decisions, decisions, what should we do? Is this progressive lens better than that one? I think so, but you don’t.

Oh yeah, you don’t even wear eyeglasses, how would you know if the patient is going to love them or not? Can this anti-reflective treatment be ordered on that lens? Is this lens supposed to be this thick? Why did we order this lens material? Hey, what about the patient? They may not be happy with this. I think they will, you say they won’t. And on and on. We won’t always agree, however, there has to be final decision maker that is sold on the vision products that we are dispensing.

When serving patients practice speaking in terms of we instead of he or she. If human error is involved, avoid singling out the ECP by name. Pointing out co-worker’s errors in front of patients is uncalled for. Tattle tales are for day care, not eye care.

ECPs can’t possibly be selling patients on outstanding service while nana nana boo boo-ing another team member. If you want to prove people wrong in front of others, switch careers and become a judge. Outstanding service is an easy sell if we always strive to do our very best work and promptly correct any errors that we make as a team.

Remember that our patients are most likely going to be selling our practice to their family, friends and co-workers, whether we want them to or not. And, the future is going to come whether we want it to or not. So with a bright bunch of law abiding shady characters, prescribing remedies, it will be hard for us ECPs not to grasp the sell. I

MARCH 2010 | EYECAREPROFESSIONAL | 31

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Shakers

globally. Werquin has 20 years experience in the optical industry and is currently president of Hoya Lens Belgium and Hoya Lens France.

Optelec US Optelec US has announced that Andre Hardy has been appointed president. Hardy is responsible for spearheading and expanding corporate and product strategy, business development, and overseeing all finance, Andre Hardy operations, sales and marketing initiatives.

Since joining Optelec US in 2007 as vice president of sales and marketing, Hardy has expanded the company’s product sales, distribution channels, and industry relationships.

VISTAKON VISTAKON® has named Arthur Shedden, MD, MBA, Medical Safety Officer, Professional Development, responsible for pre- and post-marketing product assessment from a medical safety perspective. He will continue overseeing Medical Affairs for Pharmaceutical Products reporting to Colleen Riley, OD, MS, FAAO, Dipl CL, Vice President of Professional Development.

Will be Missed...

Clarence L. “Chauncey” Wheaton of Palm Harbor Florida, formerly Geneva NY, passed away peacefully on February 12th. Clarence served in the Army and the Korean War, achieving rank of Corporal. He was employed Clarence L. with Shuron Textron in New York from 1963Wheaton 1970 and Precision Optical from 1970-1977 before relocating to Florida. Clarence then briefly worked for Shuron Textron again at the Tampa location in 1977 and 1978 before starting his own business Wheaton Optical Service in 1978.

Wheaton Optical Services operated until 1995 when Jeff Wheaton took over and formed Star Optical Service.

Clarence continued with Star Optical Service until 2001 when Vision Systems Inc was founded. He is survived by his son Jeff Wheaton, President of Vision Systems Inc. His daughter in law Tracy Wheaton Accounts Manager of Vision Systems Inc. His son Stephen Wheaton Northeast Sales Manager of Santinelli International, his son Gregory Wheaton Senior Ophthalmic Technician of Vision Systems Inc. And his Grandsons Christopher and Dylan Wheaton Ophthalmic Technicians at Vision Systems Inc.

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Optical Education Judy Canty, ABO/NCLE

Planning for Success Going to a trade show without a plan, is like going to the grocery store hungry and without a list. Everything is going to look very tasty, and you’ll probably forget the milk.

I’m a “list maker”. I have to be because I’m an impulse buyer.

Until we moved back to Virginia Beach, I was on a first name basis with the ladies in my local fabric store. I have two dressers full of fabric that was just beautiful and on sale—the perfect storm.

Planning for a successful trade show trip should start weeks, if not months ahead of time. Rather than looking at your practice as one single entity, break it down by categories: Equipment • Do you need to upgrade to improve or expand the quality of services you can offer?

• Have you maxed out the depreciation on your current equipment?

• If you operate an in-house finishing lab, does the equipment help or hinder its efficiency and your profitability?

Fixtures • How long has it been since your last remodel?

• Has the appearance or “feel” of your neighborhood changed?

• Have your demographics changed?

• Has your competition changed?

• Has your “message” changed?

GOING TO A TRADE SHOW, whether for 1 day or 3, takes lots of planning, research and most of all discipline. Remember what happened the last time you wandered aimlessly through Macy’s or Home Depot? It was expensive and you came home with stuff that looked good at the time, or seemed like a great bargain only to discover that the stuff was on sale for a reason.

34 | EYECAREPROFESSIONAL | MARCH 2010

Hardware/Software • How old is your computer system, including peripherals like printers and monitors?

• Does your software allow you and your staff to move seamlessly through the day, integrating electronic

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medical records, insurance coding and billing, dispensary records, etc.?

• If you are using an internet based system, how protected are you from attacks by viruses or hackers?

• Is your system vulnerable to power surges or outages?

• Do you have a back up system?

Laboratory Services

• Are you satisfied with your current laboratory?

• Do they offer you enough choices in products and services?

• Are they competitively priced?

• Are they responsive to your needs?

practice from your competitors?

• Do you and/or your staff need more training on new products/technologies and is it easily available?

• Do you have enough “patient friendly” literature?

• Do you need generic patient information or do you prefer manufacturer specific information?

Frame Inventory

• How many frames do you currently display in your dispensary?

• How many vendors are you using?

• What is your “mix” of frame styles? ❍

i.e. men’s, women’s, unisex(classics), designer, teens, kids, sunwear, sport-specific, safety

❍

price points

• How does your lab address breakages/delays/ backorders/warranties?

Ophthalmic Lens Products

• Do you prefer to work with a single family of lens products?

• Do you use your lens offerings to differentiate your

❍

packages

• What are your dispensary demographics? ❍

Gender, age, income level, purchasing history Continued on page 50

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OD Perspective Jason Smith, OD, MS

REFRACTION REVISITED In an article by Warren G. McDonald, PhD on Refraction/Refractometry that was published in the December 2009 edition of this magazine, I was impressed with the details that Dr. McDonald offered in his article.

I wanted to add my perspective on refraction as an optometrist that will hopefully compliment Dr. McDonald’s excellent article on the same subject.

In the textbook that first-year optometry students used at the New England College of Optometry, “Clinical Procedures for Ocular Examination”, Dr. Carlson, Dr. Kurtz, Dr. Heath, and Dr. Hines state, “we refract for people, not eyeballs and therefore prefer to state the goal in functional terms: to identify the lenses that will allow the patient to achieve clear and comfortable vision; that is, to see everything he or she needs and wants to see and to use his or her eyes for as long as desired without strain or discomfort” (1990. P.43). What held true in 1990 still holds true in 2010.

One of the leading educators and greatest minds in optometry, Dr. Irvin Borish wrote a 1500 page book on “Clinical Refraction” which he regularly updates. Dr. Borish first wrote this scholarly textbook in 1949, and it became the Bible for thousands of optometry students. This book emphasizes the fact that there are many aspects to vision analysis and that refraction is one component of a very complex process.

In respect to an optometrist’s eye and vision examination and refraction, there are many pieces of information that are evaluated subjectively and objectively in order to provide a medically and legally approved prescription for a patient. This holds true whether this is a prescription for eyeglasses or for contact lenses. The refraction is a big part of this analysis but there are other pieces of information that need to be evaluated in order to be a good “detective” and to solve the patient’s vision problem. Refractions are a complex, many-step process that involves problem solving skills, education, practice, and experience.

It is often said that refraction is simultaneously both a science and an art.

There are always clues during an examination that will help to determine the best refractive outcome. Every patient who completes a history or questionnaire is asked: What is the chief complaint? What brings you in for this examination? If their vision is blurry in the distance, this may be a myopia or astigmatism problem. If it is blurry only up close, this may be a hyperopia or presbyopia problem. Is it blurry in the distance and close, also?

There may be combination of refractive problems and they may be different in each eye. Is it blurry to the same degree out of each eye? One eye may be nearsighted and one eye may be farsighted. Is there a significant anisometropia or antimetropia between the two eyes? Are there some unknown, underlying medical conditions that have not been diagnosed that any refraction may not improve such as advanced cataracts, macuContinued on page 38

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lar degeneration, corneal dystrophies, diabetic retinopathy, hypertensive retinopathy, or glaucoma?

A patient’s visual acuities and their age will provide the clinician with further insight as to what the vision problem may be.

An auto-refractor-keratometer can be used on every patient in order to provide some idea as to what the prescription may be.

With statistical analysis included with every measurement, the measurements provide statistical validity. With corneal problems, cataracts, or non-cooperative patients the auto-refractorkeratometer measurements are sometimes not accurate. In lieu of an auto-refractor-keratometer, retinoscopy can be used as an objective source of information on the patient’s refractive status. A simple spectacle neutralization can also provide valuable clues.

A keratometer should be used on every patient in order to confirm the auto-refractor-keratometer measurements. It provides another source of information and will indicate if any astigmatism found during the refraction is confirmed again.

Does the patient have a pair of glasses that they were wearing?

Lensometry will provide more clues as to what a correct prescription should be.

Retinoscopy is something that is done with every patient and is a skill that definitely takes a great deal of practice. Using a retinoscope allows the clinician to determine a patient’s refractive error and prescription. It is extremely important for children, un-cooperative patients, or non-communicative patients.

Every clinician must be a good observer of their patients. Look at the patient’s eyes even before they sit in the exam chair. If a patient has a turned eye or a head tilt, there may be a need as a component of a refraction to incorporate prismatic lenses to improve a patient’s vision. The head tilt or turn is often indicative of a muscle imbalance associated with strabismus. Prisms can be used after other tests confirm the diagnosis that it will help the visual problem. These other vision tests include phoria testing, vergence testing, NRA/PRA testing, Maddox Rod testing, and Hirschberg testing.

Refractions can be done using a phoropter or a trial frame. A trial frame refraction may simulate wearing a pair of glasses more closely than a phoropter. Both methods are accurate and reliable. Some practitioners will utilize both methods. The phoropter to do the clinical refraction and the trial frame to show the patient what the final prescription will look and feel like. The patient must be given an opportunity to determine which spherical and/or astigmatic lenses will best correct their refractive error. This requires patience and gives the patient time to make decisions about their own eyes. One eye is occluded while the other eye is tested and then the first eye is occluded while the second eye is tested. When the clinician is satisfied 38 | EYECAREPROFESSIONAL |MARCH 2010

that the proper prescription is found, the refraction in the distance is continued by doing a “binocular balance.” This involves being sure that the patient determines that each eye has the same comfortable and balanced visual acuity. A near refraction will then be done to be sure that the patient’s visual acuity at near, at a comfortable reading distance, or at a computer terminal, is also clear.

For those presbyopic patients, an add prescription will be necessary. The clinician should always check each patient’s visual acuity monocularly, right eye and left eye for near vision. Some patients require unequal adds or “split adds.” Age-related adds are useful as a guide but it is always necessary to check the patient’s reading distance, posture, and near demands to be sure that they will be comfortable with what is prescribed.

Cycloplegic refractions using eyedrops may be necessary in order for the clinician to determine the amount of total, absolute, facultative or latent hyperopia present. Other factors that may affect a patient’s refraction, their prescription, or to achieve an accurate visual outcome is the health of the eye.

Trying to have a patient see 20/20 or 20/15 may be predetermined by medical complications of the eye. A few of these complications may include the following: Are there preexisting eye muscle problems or the presence of a strabismus? Are the eyelids in a normal position or is there the presence of a ptosis?

Are there corneal irregularities such as keratoconus or high or irregular astigmatism? Are there iris anomalies or pupillary problems such as anisocoria? Are there cataracts present? Are there floaters in the vitreous or a problem such as asteroid hyalosis? Are there retinal problems such as hypertensive or diabetic retinopathy, macular degeneration, or glaucoma?

The vision of an elderly, aging eye may not permit 20/20 vision.

The practitioner can utilize a pinhole occluder to determine if the patient’s vision can be improved further with lenses. Every health aspect of the visual system must be evaluated in order to appropriately evaluate the proper visual outcome. This should include other testing such as visual field analysis and dilation.

It is very important to discuss all findings with every patient.

The extra time that is spent with a patient is time worth educating and informing a patient or the parent/guardian. Every clinician may have some unique technique or skill that will help them with their refractions. Every patient presents with differing vision problems that may require further vision testing that cannot be covered in this brief analysis. In order to provide an accurate evaluation of this complex topic, only the genius of Dr. Borish’s textbooks and articles or the many authors who have written on this subject would provide greater details. This would also provide the reader with the understanding of the complex neurological connection between vision, seeing, psychology, the eyes, and the brain. I

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Second Glance Elmer Friedman, OD

Near Death

Vision In the lexicon of eye care providers there has been very little reference to “Near Death Visions.” The abbreviation is NDV and the term was coined by an American physician, Dr. Raymond Moody. It is also known in the field of paranormal studies as “Near Death Experiences.” A vacuum exists within the eyecare community regarding this extraordinary phenomenon.

We will attempt to break the barrier. Simply stated, death bed visions are apparitions. These appearances are usually from deceased family members or friends of the one who is dying.

Nevertheless, seeing living people or well known religious figures has also been reported. Some remarkable cases record that caretakers attending the dying have also witnessed the apparitions. The latter assume the role of escorts as they presumably help the dying to pass from this life to the next.

But first, consider some history. The interest in paranormal vision goes back to antiquity. Accounts of reincarnation and the journey through this life, then death and on to another form of existence are commonly found in many cultures and religions from time immemorial. Views of afterlife exist for Christians, New Age, Jewish, Hindu, Atheist, Buddhist and Muslim peoples.

In 1961, physician Karles Osis analyzed over 35,000 deaths reported by nurses and physicians. He claimed that death bed visions are hallucinations since they were not verifiable.

40 | EYECAREPROFESSIONAL |MARCH 2010

(Even UFO sightings require at least two witnesses.) Near death experiences frequently provided details of color, size, shape, distances and movement visualized in a particular episode.

It included not only people but landscape scenes, as well. About 97% of those surveyed by investigators said that it was a positive and affirming experience. Most lose their fear of death and come to a belief in survival after death. Many become religious or develop a stronger belief in God. Scientists say that NDV are but delusions due to lack of oxygen to the brain, along with psychological, pharmaceutical or neurological reasons. Science has proved that there is no aspect of personality within a human being that could travel anywhere without a physical body to propel it. Dr. Susan Blackmore, of Bristol University, U.K., declares that a NDV is a manifestation of a “winding down” of brain functioning as a person nears death. She explains that the oft time mentioned “Tunnel of Light” seen by the dying is a result of the turmoil occurring in the vision center of the brain.

Continued on page 42

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“The oft time mentioned “Tunnel of Light” seen by the dying is a result of the turmoil occurring in the vision center of the brain.”

Dr. Sam Parnia, a research fellow at Southampton Hospital in London, explains, “Our studies must hold an answer to the question of whether mind or consciousness is actually produced by the brain or whether the brain is a kind of intermediary which exists independently.” It proves that vision is part of a mysterious process that involves the field of paranormal investigations.

Insofar as visual manifestations are concerned, there are reports of stunning visual sightings by users of the hallucinatory drugs back in the ‘60s. Some artists depended on drugs for inspiration. The images resulting from this type of stimulation were clear and reproducible. Of course now we know the harm that continued use of such drugs could cause. Many who have experienced an NDV share the same sights such as white lights and the ubiquitous long tunnel with a bright light at its end.

Scenes of life flashing before them is another NDV view commonly reported. Our main problem is that none have returned from the dead to verify these episodes. It is still an unsolvable mystery.

Numerous instances have been recorded in which those seated beside the death bed report seeing spectral entities, as well.

Some bizarre reports exist wherein the dying “see” people who have died prior to their knowledge of the incident. Scientists continue to try to detect, measure and communicate with the dead. Until this very moment, they have been unsuccessful.

Here is living proof of the NDV in living color. Dr. Elisabeth Kubler-Ross worked in a Chicago hospital in 1968. She reports that a turning point in her career occurred when a deceased patient appeared before her in fully materialized form. Dr. Kubler-Ross had been discouraged about her research with the dying because of cynics and opposition which she encountered there. But the apparition of this particular patient, Mary Schwartz, appeared to tell her not to abandon her work because life after death was a reality.

Dr. Carl Jung describes his NDV after he suffered a broken foot and a heart attack. “It seemed that I was high in space. Far below I saw the globe of the earth bathed in a gloriously blue light. Below my feet lay Ceylon and the subcontinent of India,

42 | EYECAREPROFESSIONAL |MARCH 2010

My field of vision did not include the entire earth but its global shape was plainly distinguishable.” He added that he felt that his visions were real and not the products of imagination or a fevered brain.

Famous author Ernest Hemingway has written of his NDV while serving in the trenches near Fossatta, Italy. It was about midnight on July 9, 1918, when a mortar shell exploded near him, badly wounding his legs. He later stated that he experienced death at that moment and his soul departed from his body. He wrote about this in his famous book, A Farewell to Arms. “A blast furnace door is swung open and a roar that started white and went red, in a rushing wind.” The hero later feels himself sliding back to life and breathing once again.

Dr. Melvin Morse of the University of Washington reports on a patient who suffered a heart stoppage and was rushed to the hospital for emergency treatment. Her name was Kathy and she stated that she experienced an NVD vision. “I was high on top of a beautiful ridge overlooking a beautiful valley. The colors were extremely vivid and I was filled with joy. I felt that my entire essence was filled with light.”

The newest research reported in the New England Journal of Medicine suggests that standard tests may overlook patients who have some kind of consciousness with the possibility of communication. A 29 year old patient was considered to be in a vegetable state but was able to answer yes or no questions by visualizing specific scenes the doctors asked him to imagine.

The imaginations sparked different brain activity viewed through a scanning machine. Researchers were stunned and found this to be amazing. Other experts said this research tool needs more study before the specialized scans could be used routinely.

This article is meant for your amazement and curiosity. It is, in no way, meant to trivialize the seriousness of near death experiences. I do not deny or support any particular concept put forward by any of the researchers mentioned heretofore.

I will be glad to receive any communication expressing the reader’s outlook on these matters. I

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Frame Fitting Timothy Coronis, ABOC-NCLE

Do THESE GLASSES Make My Nose Look Big? Comfort Level Why not be direct? It’s important to understand that some patients will love talking about themselves and their appearance. It’s only natural for them to be interested in how they look. Others will be less comfortable carrying on about themselves. With this type of patient, the idea is to speak a little more about value, optics, and appropriateness of frame size, shape, and color.

Same or Different As you get started, it’s a good idea to determine if a given patient is looking to maintain or change their look. Is the patient wearing a subtle design and looking to continue that? Or are they sporting a conservative frame and now wanting something more expressive?

WHEN POSED with the question of which frame he would recommend over another, one dispensing Optician declined to answer, thinking it was a matter of subjective opinion. That was a shame, because the patient wasn’t asking for an opinion, they were really looking to someone for their expertise.

When making cosmetic recommendations to patients, you may find yourself in a similar situation. Here are a few suggestions about how to deal with it.

Types Consider your patient’s type of look. You may want to come out and ask them or you may want to probe more gently, but the idea is to refine the look the patient is trying to achieve.

Whether subtle, traditional, contemporary or bold, chances are that you have something to help them achieve that particular look.

Previous Pair The patient’s last pair of glasses can often be an easily overlooked way of determining how to satisfy them this time around. Remember that patient who was reticent to talk about himself? Chances are they will have no trouble telling you exactly what they liked about their last eyeglasses. Be prepared to hear what they didn’t like too, and be sure you have your lens toolbox ready mentally. Taking points from the previous pair will often put you on the path to recommending. It also puts you in the role of the expert, someone to listen to previous problems and offer solutions for improvements.

Cosmetic or Technical There’s something else valuable about discussing the previous pair. It gives you an opportunity to consider the intersection of cosmetic and technical factors. Examples of this are limitless.

Continued on page 46

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Examples of Cosmetic Meeting Technical Were the patient’s last glasses thick or thin? Did a high index material adequately reduce lens thickness? Were aspheric lenses noticeably slim? How about lens decentration in the last pair? Is this something of concern for the new pair? How much did frame size contribute to thick lenses at the edge? Which shape might work better this time? Were the temporal edges of those long rectangular lenses of concern?

Several Factors Take a look at the lens thickness of a rectangular frame with prescription lenses, and you can easily judge the level of success with the use of high index, aspheric lenses, and minimal decentration (the amount to which a lens needs to have its optical center moved to coincide with the patient’s inter-pupillary distance). With the lenses in the frame, it’s possible to see how these factors work together to determine the thickness of the finished lenses. You may see opportunities for improvement.

Frame Shapes With so much material already available about matching frame shape to the shape of the patient’s face, I’ll leave that to others.

Still, there are a few points about particular frame shapes you may find valuable. Long, narrow rectangular lens shapes— popular in many frames right now—may leave you with thick edges for minus lenses at the patient’s temples (or thick edges of plus lenses at the nasal).

Round frames are your best choice to combine with the thinnest available lens material, when aggressively taking steps to reduce thickness of high power prescriptions where lens thickness is a significant issue. Round shapes may be a little severe, so in some instances an oval may be your second choice.

A better solution with the high power Rx might be to retain the round shape and use a very light color to keep the frames nondescript.

Aviator shape frames are another illustration of the fact that cosmetic and technical recommending can go hand in hand.

While some might assume that frame shape is a cosmetic matter, experienced dispensers are aware that aviators may be troublesome for progressive addition lenses (PALs), because this shape frame may interfere with natural vision in the near zone.

Building Attractive Eyeglasses Remain the expert, and start with lenses first. Once you have an idea of lenses to go into the frame, it is time for you to consider how the patient’s prescription will look. As an eye care professional, the patient needs you to interpret the fact that decentered minus lenses become thicker at the temple, and decentered plus lenses become thicker at the nasal. Don’t blow 46 | EYECAREPROFESSIONAL |MARCH 2010

it. This is the time for recommendations, not technical dialogue between you and the patient.

Easy Does It Patients don’t look at thousands of eyeglass frames like ECPs do. So the best thing you can do is use your experience and knowledge to help them come up with the best lenses and frames, something you can do for them much more quickly than they can do for themselves. In general, the choices you can make are simply more refined than those of the patient, which means they will respond enthusiastically when you show them something extraordinary.

So help the patient refine those fuzzy ideas into something tangible – and wearable. When it comes to color, easy does it.

Too much color is usually overpowering. For example, suppose a patient has an inkling for a demi-amber or tortoise metal or zyl frame. The patient may respond to the fact that these frames have a depth of colors. They may find the frames have a “natural” color palette. Your role is to demonstrate some good examples. The patient may have thought all tortoise was alike, for example, and walked out of the office with much too dark of a frame.

Types of Lines The shape of an Ophthalmic frame may be thought of as a line (as opposed to color or texture), lending the frame character.

Types of character might be soft, subtle, uncluttered, refined, busy, or bold.

Round or square frames may be too severe for some tastes.

The idea is to think not so much about frames as things, but to consider the qualities of the frames.

The author once updated a patient’s eyeglasses by suggesting she change from a large zyl rounded oval frame to a smaller, bright red, angular design. The smaller frame thinned out and lightened the patient’s modest prescription. The brighter color was more appropriate to the patient’s age (the previous glasses made her look older), and the busy angles of the frame contrasted nicely with curve of the patient’s face.

Play Up Colors A technique to get you well on your way to making informed cosmetic recommendations is to take a good look at a patient’s hair color and see if you can notice any highlights or variation in color, then recommend Ophthalmic frames to them one shade lighter than the lightest color of their hair.

Picking frames this way allows you to quickly identify a frame that will “disappear” on the patient’s face. Combine this with a premium anti-reflective lens, and you will have done that Continued on page 48

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patient a favor. You will have found a frame they will not tire of wearing.

Lighter is usually better than darker, when it comes to frames.

There are a few reasons for this. Too-dark of a frame means you see too much of the frame before observing the person, also most people lighten their hair color because it softens their appearance, and finally, hair color usually darkens over time (look at pictures of yourself as a child), so a lighter appearance may register as more youthful.

Silver For the grey, white, or silver haired patient, you need not fret.

Offer them similarly colored fames, or else something to harmonize with their skin tone or eye color.

If you do recommend silver frames for grey haired patients, be sure to favor muted tones over a harsh chrome.

Blonde patients may instinctively gravitate toward silver frames as more interesting than their own hair color. It would be well worth the patient’s while for you to show a blonde patient a yellow, green, or gold frame in a muted tone, lighter than their hair color.

Types of Looks While each pair of eyeglasses is in fact a custom made item, presenting you with an opportunity to best interpret that patient’s needs and tastes in a cosmetic and technical manner, looks come in a few distinct categories. It is not necessary for you to verbalize the categories described here, just keep them in mind as you interact with the patient.

As you go about combining lenses and frames, features and functions, you will be most successful proceeding by reading the patient’s tastes and furnishing eyeglasses fitting that image.

Often, you will be better able to do this than the patient himself. Through active listening and observation, you will help your customers find a look that appeals to them, and just feels right.

A patient may respond to a more traditional look. Such a look may convey a sense of permanence, an established look saying “I am not frivolous.” In light of the present economic climate, it would not be surprising for more patients to find value with a more timeless look.

On the other hand, a patient’s tastes may lean in a more contemporary direction, less rooted in the past. This look is up to date without being overly modern or traditional.

For tastes running in other directions, you have frames at your disposal. When providing your patients more trendy or bold 48 | EYECAREPROFESSIONAL |MARCH 2010

options, pay close attention to how these options look. Often, vivid color and bold designs look more appropriate than conventional wisdom would suggest.

“The patient needs you to interpret

the fact that decentered minus lenses become thicker at the temple, and decentered plus lenses become thicker at the nasal.

Don’t blow it. This is the time for recommendations, not technical dialogue between you and the patient.”

Harmony and Contrast Spend some time looking at a color wheel and you may make a few observations that will be a big help when recommending to patients. Complimentary colors are colors opposite one another on the color wheel. Blue and orange come to mind, explaining why a gentleman with red hair might look good in a blue plaid shirt. This principle can also be applied to his eyeglasses, and might help you decide how to obtain a look that stands out or one that fades away.

Red and green and yellow and purple are other examples of complimentary colors, but you can also find harmonizing or complimentary colors for any color on the wheel. Red hair and green or turquoise clothing are another classic example, applying these same principles to other colors will allow you to hone your skills.

Putting It Together At first blush, technical and cosmetic recommending may seem mutually exclusive, but once you determine the patient’s needs, a process begins, involving technical and cosmetic factors.

Don’t be intimidated by the intersection of technical and cosmetic recommending. The result is a pair of eyeglasses to improve vision, to be enjoyed, and to be seen. Sometimes you’ll want to make the eyeglasses “disappear,” other times, you’ll make them stand out.

The lens materials and frames you recommend should be thought of as elements of a finished product. Each choice that gets made, each property (like high index and aspheric lenses) contributes to an outcome. Be sure to combine these factors with one another, and present the best cosmetic and technical choices to the patient. It’s a sophisticated process, but when done well, it is rewarding for dispenser and patient alike. ■

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“I’m a “list maker”. I have to be because I’m an impulse buyer.”

• Do you utilize “board management” services from manufacturers’ reps?

• Do you use vendor-specific point-of-sale materials?

• How do your frame vendors handle purchase returns, warranties, etc?

• Are you comfortable with “buy-in” or minimum yearly

your practice inside and out and you need to know how your staff functions and what they need to perform at their peak every day. The temptation is to find something, some system, some frame or lens product that appeals to you as the practice owner and then try to “make it fit”. While the economy may be loosening up a bit, it still doesn’t make sense to commit working capital to something that may or may not work in the real world of your practice regardless of bells, whistles or pricing.

purchase requirements?

• Do you use your frame inventory to differentiate your practice from your competitors?

Accessories

• Do you carry resale eyeglass/contact lens cases?

• Do you have a “dispensing kit” (sample lens cleaner, cleaning cloth)?

• Do you carry eyeglass holders, sports bands, etc.?

• Do you carry low vision aids/magnifiers?

Sales Aids/Patient Information

• Do you have a website? ❍

What information does it include/how often is it updated?

• Location(s)/directions • Hours • Patient Education • Frame/Lens/Contact Lens Availability

Back to that shopping analogy, if you don’t plan your trade show visit, it becomes like that trip to the mega-wholesale club without a list—big bucks gone and a cart full of stuff you don’t need.

Now it’s time to address the other half of the big show— EDUCATION. I just received the 2010 Progressive Identifier from the OLA. It boasts 585 lenses—54 more than in the 2009 edition. Do we need 54 more progressive lenses than last year? It doesn’t matter. They’re here and they represent the need for more and better training for your staff. The scary part? That’s just the number of new progressive lenses, what about the other new technologies like free form and digitally produced single vision lenses. Or newly developed anti-fatigue lens designs. Or new lens treatments.

Like it or not, your dispensary is the cornerstone of your practice. It’s where the real money is and your opticians and ancillary staff need all the training and in-depth education you can provide for them. The education available at the big shows is top notch and in a perfect world, every staff member should be enrolled.

• Staff Bios • Insurance Information • On-line Scheduling • On-line Contact Lens Ordering • Do you produce a practice newsletter?

• Do you utilize social networking, i.e. Facebook, Twitter?

• Do you use personalized shopping bags?

• Do you use a lens information center/counter top demonstrator?

• Do you use a recall system?

That’s a lot of information to sift through before you hit the show! In the long run, it will be worth it. You need to know 50 | EYECAREPROFESSIONAL | MARCH 2010

In the real world, that may not be possible, but it could be a reward for a job well done or a privilege that rotates through the staff. If you can’t afford the “big show”, find the smaller ones held in almost every state, or spend some time on the floor of the show scheduling training visits from your reps.

The education/trade show season kicked off with SECO in early February and will continue through the Fall. There are ample opportunities to educate your staff and there’s still plenty of time to plan for the next “big show” in early October.

Along the way are numerous state and regional conferences for all three “O’s”. Not every one of them has a trade show, but all of them provide ample opportunity for education. The smart practice owner places as much value on an educated staff as is placed on the latest and greatest technologies. ■

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Why Global Optique?

Global Optique (affectionately known by its first name- Global) was founded more than a decade ago by industry’s veterans in Queens, New York.

Our credo has always been rather straightforward – delivering fashionable product at a great value with exceptional follow-up service. These three principles have become the main driving force behind many success stories of our customers and ultimately our company as well.

Our firm is recognized in the optical industry to utilize the highest grade of materials and extensive selection of fashionable frames. We have over 350 models among three distinct collections and we feel proud to tell you that our operations are virtually backorder-free!

Why Global?

1. Mature well-established and financially sound business for over 10 years.

2. A team of sales representatives and managers whom are bona-fide full-time employees of the company (vs.independent contractors).

3. 95% fulfillment order ratio. More than 85% of orders are shipped the same day.

4. Industry-leading Preferred Buyer initiative with up to 10% cash rebate, free shipping, tailored pricing structure.

Why our frames?

1. Extremely extensive collections with over 350 models that are constantly in stock. (Made from titanium, monel, grilamid and acetate).

2. Most balanced collections (according to leading industry consultancy groups) from classic timeless designs to contemporary colors and shapes.

3. Best VALUE for dollar spent (average discount 65% off Frame Book Prices).

10

ten years of dedication!

Come Celebrate with GLOBAL OPTIQUE at VEE 2010!

WORLD CLASS VALUE. WORLD CLASS FASHION. WORLD CLASS SERVICE.

Booth # 3208 SEE OUR AD IN THE ECP SHOW GUIDE FOR MORE DEALS!

BUY any 50 FRAMES Get another 50 at HALF OFF and FREE SHIPPING

BUY any 100 FRAMES Get another 100 at HALF OFF and FREE SHIPPING Inquire about Best-In-Class VIP Rebate Program

“A Milestone of Dedication, Service & Value!”

10

ten years of dedication!

GLOBAL OPTIQUE, INC.

t.

800.297.2830

www.globaloptique.com

f.

718.937.2825

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National Lens America’s Leading Discount Lens Distributor Phone 1.866.923.5600 • Fax 1.866.923.5601 • www.national-lens.com SPRING ‘10 Color

LOW 1 to 5

LOWEST 11 & Over

LOWER 6 to 10

19.95

19.75

18.95

Johnson & Johnson

1 to 5

6 to 10

11 & Over

1 DAY ACUVUE ACUVUE OASYS ACUVUE 2 ACUVUE ADVANCE ACUVUE 1 DAY MOIST

19.50 22.50 13.90 17.95 19.95

19.25 21.75 13.75 17.75 19.75

18.75 21.25 13.50 17.50 19.50

Bausch & Lomb

1 to 5

6 to 10

11 & Over

PUREVISION SOFLENS 38 SOFLENS 66 TORIC SOFLENS MULTIFOCAL SOFLENS 59

26.00 11.95 19.25 28.95 9.25

25.25 11.75 19.00 28.75 8.95

24.50 11.25 18.95 27.95 8.75

CooperVision

1 to 5

6 to 10

11 & Over

19.95 26.00 15.95 21.95 12.45 24.00 37.95

19.50 25.75 13.95 20.95 12.35 23.50 37.50

18.95 24.75 12.25 19.95 12.25 22.00 36.50

1 to 5

6 to 10

11 & Over

25.75 40.95 39.95 13.95 12.95 33.95 15.95 14.45 24.50 15.75

24.95 39.50 39.75 12.00 12.75 32.95 14.25 14.25 23.75 15.25

23.75 38.75 37.95 10.95 12.50 31.95 13.25 12.95 22.95 14.75

IMPRESSIONS COLORS Available in Rx!

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FINISHED OPHTHALMIC LENSES LENS TYPE PRICE PER PAIR 1.20 3.20 Please Call $ 7.00 for Volume $ Discounts 4.40 $ 7.00 $ 18.00 We’ll Meet or Beat Any Competitors Price on Any in Stock Lens

CR-39, 70 MM – 1.49 Uncoated Polycarbonate, 65/70 MM – Tintable Polycarbonate, 65/70 MM – AR Coated Mid Index, 70/75 MM – 1.56 AR Coated High Index, 70/75 MM – 1.61 AR Coated Super Hi Index Aspheric, 70/75 MM – 1.67 AR Coated

$ $

Business Hours 8:30 AM - 5:30 PM EST • Prices Subject to Chang e Without Notice Free 1st Class Deliver y (when available) • Same Day Shipping • We Do Not Backorder Lenses

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Advertiser Index ADVERTISER

PAGE #

PHONE #

WEB SITE

ADVERTISER

PAGE #

PHONE #

WEB SITE

21st Century Optics

39

800-221-4170

www.21stcenturyoptics.com

Luzerne Optical

21, 33, 47

800-233-9637

www.luzerneoptical.com

ABS Smart Mirror

17

888-989-4227

www.smart-mirror.com/us

Marlin Industries

57

805-473-2743

—

BACK COVER

800-526-8353

www.ArchCrown.com

Midland Optical

INSIDE BACK

800-325-3176

www.midlandoptical.com

54

800-291-8528

www.astucci.com

My Vision Express

55

877-882-7456

www.myvisionexpress.com

National Lens

25, 53

866-923-5600

www.national-lens.com

57

607-748-2166

—

Arch Crown Astucci Balester Optical

19

800-233-8373

www.balester.com

CNS Frame Displays

31

877-274-9300

www.framesdisplays.com

Cotton Club

11

866-923-5600

—

Nupolar

15

800-366-5367

www.nupolar.com

Ed Hardy Eyewear

7

800-986-0010

www.edhardyeyewear.com

Opticom

14

800-678-4266

www.opticom-inc.com

Enni Marco

9

866-648-2661

www.newlineoptics.us

OptiSource

INSIDE FRONT

800-678-4768

www.1-800-optisource.com

Eyevertise

32

847-202-1411

www.EyeVertise.com

Optogenics

26

800-678-4225

www.optogenics.com

FreeForm Optical Lab

23

212-431-2919

www.freeformopticallab.com

OptoWest 2010

13

800-877-5738

www.optowest.com

FEA Industries

29, 51

800-327-2002

www.feaind.com

Galaxy Optics

45

800-542-5596

—

Global Optique

52

800-297-2332

www.globaloptique.com

Grimes Optical

55

800-749-8427

www.grimesoptical.com

Index 53

41

800-328-7035

—

K-Mars Optical

37

800-296-1551

www.kmarsoptical.com

LBI

43

800-423-5175

www.lbieyewear.com

Nellerk Contact Lens Cases

Persol

FRONT COVER

800-500-LENS

www.persol.com

27

800-235-LENS

www.seikoeyewear.com

Signet Armourlite

5

800-759-4630

www.signetarmorlite.com

Tech-Optics

55

800-678-4277 www.techopticsinternational.com

SEIKO Eyewear

Three Rivers Optical

49

800-756-2020

US Optical

35

800-445-2773

www.3riversoptical.com www.usoptical.com

Vision Systems Inc.

56

866-934-1030

www.Patternless.com

Don’t Forget to Tell Our Advertisers You Saw it in EYECARE PROFESSIONAL Magazine

MAR2010_60.qxd

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INDUSTRY QUICK ACCESS

EYECAREPROFESSIONAL

ACCESSORIES • CASES • CONTACT LENSES • DISPLAYS • DISTRIBUTORS • EDGING SERVICES • FRAMES / CLIP-ON SETS EQUIPMENT (NEW / USED) • HELP WANTED / BUSINESS SALES • INSTRUMENTS • PACKAGING • MANUFACTURERS

The powerful, fast-reactive photochromic lens. • Photochromic Coating Technology • High Index 1.67 • Exceptional fading speed • Available in Single Vision and KODAK Unique Progressive Lens TEL. 1-800-386-9196 / +45 7021 5530

/7 IND1UICK!D PDF !-

Magnification and Accessories

(GXFDWLRQ )XQ +ROH LQ 2QH

HIGH PLUS

HAND /STAND

+4.00 to +48.00

3X-20X LOUPENEAR/DISTANCE

2QOLQH 5HJLVWUDWLRQ 2SHQ 1RZ

MOUNTED SYSTEMS

8x-15x

2.5X-5.0X

www.techopticsinternational.com (800) 678-4277

•

(856) 795-8585

MARCH 2010 | EYECAREPROFESSIONAL | 55

To advertise please call 800.914.4322, or visit www.ecpmag.com

www.corning.com/ophthalmic

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INDUSTRY QUICK ACCESS

EYECAREPROFESSIONAL

ACCESSORIES • CASES • CONTACT LENSES • DISPLAYS • DISTRIBUTORS • EDGING SERVICES • FRAMES / CLIP-ON SETS EQUIPMENT (NEW / USED) • HELP WANTED / BUSINESS SALES • INSTRUMENTS • PACKAGING • MANUFACTURERS

OPTOGENICS we make eyeglasses

™

➧ $2 Credit for ALL e-orders placed on Optogenics.com ➧ $3 Credit for ALL AR e-orders placed on Optogenics.com

Screw it in, Snap it off!

➧ 24/7 extra e-order $$

The extra-long feeder tab makes handling easy and breaks off cleanly by hand – no cutting, no filing!

Go to Optogenics.com for more special offers!

OPTOGENICS = In House ARs

Eyewires • Hinges • Spring Hinges Self Aligns • Self Taps

The Premier Laboratory

Tel: 800-678-4225 Fax: 800-343-3925 VSP, VCP, VBA approved Free UPS pick-up (min. 3 Rx’s)

for

In House Digital FreeForm Lenses

To advertise please call 800.914.4322, or visit www.ecpmag.com

Snapit™ is a Trademark of Eyeego, LLC., Patent Pending

Step into Three Rivers Optical’s “O” Zone.

Our “Free” Lens Series offers one-of-a-kind bifocal designs that fill a void in the optical industry. With our unique, patented “Round Seg” technology, your patients will experience the best in bifocal lenses.

WHEN SKILLED HANDS using state of the art technology come together the result is precision bench work. We pride ourselves in producing edge work that is light years ahead of our competition.

Get in the “O” Zone Today

(800) 221-4170

800.756.2020 www.threeriversoptical.com

www.21stcenturyoptics.com

Click, click, click, your lens order is done.

Use one website to order all of your stock lenses electronically. With no usage or ordering fees!

Green Bay, WI 54308 800-678-4266/Fax 920-965-3203

email: info@opticom-inc.com www.opticom-inc.com

56 | EYECAREPROFESSIONAL | MARCH 2010

SALES REPS WANTED NATIONWIDE (Except for Southern California)

K-Mars Optical is seeking regional sales representatives for a rapidly growing product line – Our Frame and Lenses Packages.

Contact: Dan, 1-800-296-1551 x121

Balester Optical is a full service independent family-owned wholesale optical laboratory. We maintain an in-house Digital Processing center and 3 anti-reflective coating systems.

Balester Optical provides expert objective advice & consultation regarding the best lens for each Rx. We pride ourselves on using the most up-to-date technologies in the industry!

Toll Free: 1-800-233-8373 Fax: 1-800-548-3487 www.balester.com

National Lens America’s Leading Discount Contact Lens Distributor Phone 1-866-923-5600 Fax 1-866-923-5601 www.national-lens.com

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EYECAREPROFESSIONAL

INDUSTRY QUICK ACCESS

ACCESSORIES • CASES • CONTACT LENSES • DISPLAYS • DISTRIBUTORS • EDGING SERVICES • FRAMES / CLIP-ON SETS EQUIPMENT (NEW / USED) • HELP WANTED / BUSINESS SALES • INSTRUMENTS • PACKAGING • MANUFACTURERS

RECONDITIONED SPECIALS!!

INC.

LOW PRICE LEADER SINCE 1949 Factory Direct Savings on Fully Stitched Slip-in Cases

Op-Tags™, Labels & Bar Code Systems...

Clamshell Cases Lowest Prices in the Industry

Your most cost effective merchandising tools!

Arch Crown, Inc. 460 Hillside Avenue Hillside, NJ 07205 Toll Free: 1-800-526-8353 Fax: 973-731-2228 e-mail: orders@ArchCrown.com www.ArchCrown.com

Molded Plastic & Children’s Cases Huge Saving on Microfiber Cleaning Cloths and Spray Cleaner

Call: 800 249-1058

www.feaind.com • Videos • Invoice Lookup • On-line Ordering • Real time job tracking • Account Statements and balances • Technical & Processing Information And more.......

Safety bevels and Grooves!

Instruments Reichert Keratometer . . . . . . . . $595 Chart Projectors starting at . . . . . $395 Marco Radiuscope . . . . . . . . . . $695 Optical Finish Equipment and Supplies

Grimes Optical Equipment Co. 800-749-8427

Print too small?

We sell PALs.

F E A Industries, Inc. FULL SERVICE LABORATORY A/R AND MIRROR COATINGS

Tel: 800-327-2002 Fax: 800-955-7770

www.grimesoptical.com

Experienced Multi-line Sales Reps Wanted!

Framedisplays.com is the leading provider of optical frame displays for ophthalmic dispensing professionals. Products include optical eyewear and sunglass displays in addition to lockable, rotating, standing, wall mount and slatwall frame displays.

Call 877.274.9300 for info and catalog.

New Line Optics Inc. is seeking multi-line independent sales reps to carry its Enni Marco eyewear collection.

www.drivewearlens.com

Exquisite design with distinct Italian flair, wide range of styles, exceptional quality– all this with prices set to please.

Clearance and discontinued styles also available.

uniquely combine two of the most advanced technologies found in the industry today: Transitions™ Photochromic Technology and NuPolar® polarization. Drivewear is the first polarized photochromic lens to darken behind the windshield of a car.

Drivewear lenses

If you would like to distinguish yourself from all other competitors, then our product is the best for you.

Exceptional commissions, many territories available Please send resume to: jobs@newlineoptics.us or fax: 1 (866) 648-2661

FIXATION STATION / BREATH SHIELD by

CE

ABO/NCLE APPROVED CONTINUING EDUCATION Dry Eyes and Its Effects on Contact Lens Wear $ 12.99 for 1 NCLE Credit Hour

Available at: www.ecpmag.com/CE Take the course online and receive your certificate within 5 days!

SALES HELP WANTED Experienced Sales Reps • Top commissions • Many Territories Available

•

Two blinking LED’s provide excellent fixation points, assisting in various slit-lamp procedures.

•

No more pointing, touching or directing patient to look at the tip each ear.

•

Clear shield protects patient and examiner from breath odor and moisture.

•

If you are tired of working for a company who doesn’t appreciate what you do then give us a shot.

Contact your Preferred Distributor or Marlin.

Only $ 79.99

Fax a Resume to 800-756-0034 Attn. Steve Seibert

Email: marlinind@hotmail.com or 805-473-2743

A case with a double lock & your name imprinted on it!

ONLY

9¢

EACH

12¢ per unit Printed!

NELLERK CONTACT CONTACT LENS LENS CASES CASES 607-748-2166

Fax: 607-748-2273 MARCH 2010 | EYECAREPROFESSIONAL | 57

To advertise please call 800.914.4322, or visit www.ecpmag.com

See our complete case catalog at: http://www.LBI.biz

WEBSITE

Edgers Briot Accura CX RC . . . . . . . $13,950 Essilor Gamma RC . . . . . . . $12,950 Essilor Kappa RC . . . . . . . . . $17,950

TM

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Last Look Jim Magay, RDO

Epidemic! (Or can I do it ‘till I go blind?) play as it related to kids. Stickball, kick the can, hide and seek, fishing, mowing (ugh) the lawn, raking leaves, summer camp, bicycle riding, and winter snow sliding.

Anything but hanging around in the house on a beautiful day.

You’d have to be from another planet not to notice kids today have their noses stuck in one kind of electronic screen or another. From in-car DVD players, pocket games, iPhones, iPods, now iPads (Thanks Steve, just what we needed, another distraction) Zunes, Droids, etc., etc.

No not cholera, or swine flu, not bird flu, not SARS, but MYOPIA! Can you imagine?

Myopia is on the increase across the world – in Jolly Old England, 50% of undergrads are myopic, in the States 30 to 40%, (in the overall US population it is 20 to 25%). But whoa! – in China, India, and Malaysia, upwards of 40% of all adults are myopic. 66% of Japanese teenagers are, and in Hong Kong and Taiwan an amazing 80% of all young adults are myopic – compared to 25% a few decades ago.

The experts are confounded, studies attempting to link reading and close work have proven inconclusive. Genetic experts have likewise failed to make a clear connection. Methodology of studies has been called into question. Some experts stating the use of different age groups, groups of vastly differing social functions, and regional differences may make the studies less accurate.

The question still remains though – why does myopia continue to increase? My mother used to say, “Get your nose out of that (comic) book, and go out and play!” or “Stop watching the TV and go out and play!” or “It’s a beautiful day – go out and play!”

Mom was big on the benefits of fresh air and sunshine – and 58 | EYECAREPROFESSIONAL | MARCH 2010

At home they have laptops, desktops, PSP’s, Wii’s, Xbox’s and so on. My mother would have shaken her head and given up in disgust. She would have been right, out of all the prospective causative factors; the one thing that stands out most prominently is the amount of time a child spends out of doors. Yup! Mom was right.

This is a possible explanation of why myopia isn’t as common in Africa, and only about 17% in Australia. (eMedicine.com May 16, 2008) There seem to be two reasons being outdoors reduces incidence of myopia. One is exposure to brightness. Dr. David G. Williams (Alternatives Feb 2010) believes increased exposure to various beneficial wavelengths of light would be a major factor.

The second factor is the change of focus that being outdoors causes, as Dr. Williams states. “When we look out over large open spaces all objects are far enough away that the entire image on the retina is completely in focus – At all other times the image in the center of the retina might be in focus but peripheral vision is blurred.”

Dr. Williams feels that by focusing (pun intended) on reducing refined carbohydrates in our diet – and while working or studying; every 30 minutes or so, taking a break and going outside and looking at the horizon, enjoying our sunrises and sunsets – we may reduce or prevent myopia.

Mom was right! ■

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