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NEW FRAME RELEASES FOR SPRING / PAGE 6 OPTICAL APPS GUIDE / PAGE 16 March 2012 • Volume 6, Issue 51 • www.ECPmag.com
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MARCH 2012
EYECAREPROFESSIONAL
Vol. 6 Issue 51
Features 6
Courtesy of Acuity Optical
Contents
Magazine
NEW FRAME RELEASES FOR SPRING Usher in the new season with the latest and greatest in eyewear and sunwear. by ECP Staff
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LOOKING AT THE LIGHT SIDE With light products of all types being fashionable right now, offering light frames is a must.
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by Laura Miller
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ECP APPROPRIATE Even those less technically inclined should be aware of all latest optical apps for smartphones and tablets. by Anthony Record, RDO
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UN-BUNDLING Un-bundling is a way for ECPs to clarify the ancillary services that they provide to the consumer. by Judy Canty
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SPRING COLOR TRENDS Give your practice an edge this season by offering the hottest in spring color trends. by Lindsey Getz
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BLIND MINSTRELS The great tradition of blind musicians and singers stretches from the Ukraine to the rest of the world. by Elmer Friedman, OD
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On The Cover: RUDY PROJECT USA www.rudyprojectusa.com info@rudyprojectusa.com
Departments EDITOR/VIEW .....................................................................................................4 INDUSTRY PROFILE........................................................................................22 MOBILE OPTICIAN .........................................................................................24 MOVERS AND SHAKERS.................................................................................28 PRACTICE MANAGEMENT.............................................................................38 OD PERSPECTIVE ............................................................................................42 ADVERTISER INDEX .......................................................................................46 INDUSTRY QUICK ACCESS............................................................................47 LAST LOOK .......................................................................................................50
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EDITOR VIEW Jeff Smith
EYECAREPROFESSIONAL
Magazine
Eyes of the Tiger MILLIONS OF DOLLARS are spent every year by athletes and their organizations, who seek to improve athletic performance and gain a competitive edge. Recently, the scope of this training has gone beyond the traditional focus on the muscles that enhance running, throwing, jumping, etc. One area that is especially concentrated on is vision training. If the seven muscles in the eye don’t work well together, it makes the tasks faced by athletes more difficult. The eyes of athletes must measure depth perception— locating items in space—see targets in motion, possess peripheral awareness, aid in quickening reaction time, and manage contrast perception—that is, separate objects from their background. Much of the time in sports, more than one of these processes are occurring at once. The vision training equipment most commonly used ranges from a block letter chart pasted on a simple Popsicle stick to an elaborate digital rotation trainer costing thousands of dollars. These techniques can alter how an athlete processes or interprets visual information. Gaining a split-second in recognition and response time can mean the difference between success and failure in the hyper competitive sports world. An interesting area of visual training is the use of the tachistoscope, which measures inspection time or visual recognition time. Its main purpose is to train the eyes to work together. Numbers, letters or images are flashed on a screen 10 feet away from the athlete for 0.1 to 0.01 seconds. The athlete must then say what he or she saw. A football quarterback, for example, might be given 0.01 seconds to recognize different defensive formations. Tachistoscopic test scores are also correlated positively with batting averages for baseball players, especially in batting performance. Implications may also be drawn in other non-sports related areas such as law enforcement and military work. Simpler variations of these training techniques originated after World War II, when fighter pilots were shown brief images of aircraft silhouettes, and had to quickly determine from the shape whether the plane was an enemy or friendly. Another training exercise involves Saccadic movement, which involves fast, jerky movements aimed at fixating an object on to the eye’s most acute area of seeing, the fovea. A pair of vertical columns and a pair of horizontal columns, each with a series of letters, are mounted on a wall. The athletes have to read off the letters by darting their eyes back and forth between the columns. On the vertical set up, they read from the first row on the left, then the first row on the right, move to the second row on the left, and so on. The hard part is trying to relocate where they left off as their eyes move, and processing what they see. I’m sure these techniques would be valuable to anyone wanting to improve skills like hand-eye coordination, and not just athletes. But in the cutthroat, post-steroids sports world of today, any little competitive edge can mean more wins and more dollar signs. 4 | EYECAREPROFESSIONAL | MARCH 2012
Publisher/Editor . . . . . . . . . . . . . . . . . . . . . . . Jeff Smith Production/Graphics Manager. . . . . . . . . . . Bruce S. Drob Director, Advertising Sales . . . . . . . . . . . . Lynnette Grande Contributing Writers . . . . . . . . . . . . . . . . . . . Judy Canty, Dee Carew, Paul DiGiovanni, Gary Fore, Elmer Friedman, Lindsey Getz, Ginny Johnson, Jim Magay, Warren McDonald, Laura Miller, Anthony Record, Jason Smith Technical Editor . . . . . . . . Brian A. Thomas, P.h.D, ABOM Internet Coordinator . . . . . . . . . . . . . . . . . . . . Terry Adler Opinions expressed in editorial submissions contributed to EyeCare Professional Magazine, ECP™ are those of the individual writers exclusively and do not necessarily reflect the opinions of EyeCare Professional Magazine, ECP™ its staff, its advertisers, or its readership. EyeCare Professional Magazine, ECP™ assume no responsibility toward independently contributed editorial submissions or any typographical errors, mistakes, misprints, or missing information within advertising copy.
ADVERTISING & SALES (215) 355-6444 • (800) 914-4322 lgrande@ECPmag.com
EDITORIAL OFFICES 111 E. Pennsylvania Blvd. Feasterville, PA 19053 (215) 355-6444 • Fax (215) 355-7618 www.ECPmag.com editor@ECPmag.com EyeCare Professional Magazine, ECP™ is published monthly by OptiCourier, Ltd. Delivered by Third Class Mail Volume 6 Number 51 TrademarkSM 1994 by OptiCourier, Ltd. All Rights Reserved. No part of this magazine may be used or reproduced in any form or by any means without prior written permission of the publisher.
OptiCourier, Ltd. makes no warranty of any kind, either expressed, or implied, with regard to the material contained herein. OptiCourier, Ltd. is not responsible for any errors and omissions, typographical, clerical and otherwise. The possibility of errors does exist with respect to anything printed herein. It shall not be construed that OptiCourier, Ltd. endorses, promotes, subsidizes, advocates or is an agent or representative for any of the products, services or individuals in this publication.
For Back Issues and Reprints contact Jeff Smith, Publisher at 800-914-4322 or by Email: jeff@ECPmag.com Copyright © 2012 by OptiCourier Ltd. All Rights Reserved For Subscription Changes, email: admin@ecpmag.com Scan this barcode with your smartphone to go to our website.
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See Us At Vision Expo! Booth LP7303 (Downstairs)
SEIKO Patented 100% Back Surface Free-Form Design sæ2EVERSEæPOWERæACCOMMODATIONæTECHNOLOGYæOFFERSæTHEæHIGHESTæLEVELæOFæOPTICALæPERFORMANCE sæ3UPERIORæTOæSINGLE VISIONæANDæNO LINEæBIFOCALæLENSESæFORæCOMPUTERæANDæDESKTOPæUSE sæ!VAILABLEæINæALLæMATERIALSæINCLUDINGæ æHIGHæINDEXæANDææ4RANSITIONS®æLENSES sæ3OFTWAREæTOOLæAVAILABLEæTOæSELECTæOPTIONALæCONlGURATIOns
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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 offer your patients the latest trends and fashions.
1. LINDBERG The Spirit collection features more than 300 different lens shapes and more than 50 different colors and finishes, as well as more than 25 different components, so it offers countless combination possibilities. www.lindberg.com
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2. Reptile Sun Reptile’s aviator wraps with gradient polarized crystal lenses hit all the style buttons and provide the newest in lens design technology. With 99.8% polarized efficiency and Reptile’s multi layer TPC-X lens technology you get the best protection and optical performance. Terrapin (shown) is a large square wrap aviator, available in Gold Plated or Silver Chrome. www.reptilesun.com
AVAILABLE IN APRIL
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3. Hilco The Leader Rx Sunglasses collection features sporty 8-base wraparound styling with standard Rx lens mounting. The Element Rx style will now be available in a hot, white frame color option and the Element Junior Rx style is adding a brilliant, red frame color option. Each is supplied with plano polycarbonate sun lenses in standard Rx adapters, a carrying case, cleaning cloth, and sport strap. www.hilco.com
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4. Best Image Optical Best Image Optical’s 2012 Spring/Summer Collection dubbed ‘Eye Candy’ brings bright color tones to the mix from the red, yellow, green, and blue color family. Additionally, most colors are enhanced with painted designs in contrasting colors. www.bestimageoptical.com
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5. Acuity Optical The new Free Form Green collection is focused on sustainable production through an innovative design. The frame is completely free of screws and possibly the lightest sheetmetal frame in the world. The design boasts a 360 rotating self-adjusting nose pads and the colored nylon line on the half-rim frame. www.facebook.com/freeformeyewear o
Environmentally Responsible
6. Monoqool Monoqool continues its innovative designs with another new series of eyewear that combines the spiral hinge from the award winning Helix series with fronts in NXT® polymer. The Helix NXT® series also comes with photochromatic NXT®. US distribution by Studio Optyx. www.monoqool.com, www.studiooptyx.com
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Lafont
Trevi Coliseum Eyewear
Lafont’s Spring/Summer 2012 collection is the start for the new Lafont men’s product concept, the Carbon line. Lafont is launching 3 new products which combine, acetate or titanium with exclusive carbon temples. The carbon color is matched with the front color. It is a true masculine, high tech concept. www.lafont.com
Baby Banz
Clark 766 is a cutting edge frame design with a retro look. Constructed of the highest quality Mazzucchelli Zyl. It features spring temples for added comfort and durability Backed by a two year warranty. These Italian made frames are available in two distinct Color mixes, Blue/Clear (shown) Black/Clear. Sold exclusively in North America by National Lens. www.national-lens.com
Revolution Eyewear
Introducing Camo Bloom, a new Adventure Banz color choice. Adventure Banz improve on our Original Baby Banz by adding an embedded silicone nose and brow piece for added comfort. Baby Banz were originally designed in Australia for one of the world’s toughest UV environments. Clinically tested by one of the world’s leading authorities on sunglasses, Baby Banz have passed the most stringent standards on sunglasses in the world. usa.babybanz.com
RUDY PROJECT – Technically Cool Eyewear The Maya Sport Utility Frame™ is Rudy Project’s multi-use prescription eyewear, weighing just over an ounce. Designed for sport but ideal for any occasion, it features the quick change lens option, allowing you the versatility of interchangeable clear and sun prescription lenses in the same frame. The Maya also comes with a 360 adjustable Ergo IV™ nosepiece, Grilamid® frame, 360 adjustable rubber temple tips, and an easy mount optical insert “Nylor.” www.rudyprojectusa.com o
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The brand Affliction has been recognized around the world for its unique design aesthetic. It has become a household name with some of the world’s biggest celebrities, band members, and athletes wearing their many different products now available under the Affliction name. Featured is the Lizette in Tortoise Gold. www.revolutioneyewear.com
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friezeframes
Clariti Eyewear
KF8334 from Clariti Eyewear’s Konishi Flex Titanium line has a memory metal nose bridge and temples with spring hinges. These frames come in matte grey, matte brown, and matte dark blue (shown). www.claritieyewear.com
Global Optique This timeless bold look will put you among the most legendary figures of our time. Going to the office or cruising up the coast, the Little Joe by friezeframes will get you noticed. Also available with Polarized UV lens. www.friezeframes.com
Kaenon The Kishimoto Signature Model 313 has a simple yet sophisticated look that is made with the highest grade and light stainless steel with grilamid temples and spring hinges that gives the frame super comfort. www.globaloptique.com
Modern Optical
The 601, part of the new Optical Collection from Kaenon, offers unique styling inspired by Kaenon’s California lifestyle. Featuring hand-painted Italian colorways and adjustment-free frame design, you can now enjoy the benefits of Kaenon, both in and out of the sun. www.kaenon.com
Allison America Missoni Berber Jewel – Perfume of freedom, sand and sun. The Berber artwork is born where the ray of light meets the material and becomes precious natural combination. The new style MI746 (shown) feature layers of metal and handmade acetate, which match together in natural desert nuances and tribal geometries. Available in four colors and Rxable. www.allisonamerica.com
Frame A324 from our Modern Art Collection features lineal temples in hues of black, brown or burgundy present a fresh, distinctive air of sophistication. www.modernoptical.com
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Balenciaga and Marcolin Moving Towards a License Agreement Marcolin S.p.A., a leading eyewear company, and Balenciaga, which is considered one of the most influential brands in ready-to-wear luxury and men’s and women’s accessories, have announced that they have reached a general agreement paving the way to signing an exclusive license contract for the design, production and distribution worldwide of sunglasses and prescription eyewear collections with the Balenciaga brand for a period of five years, renewable for an additional ten. The first collection will be presented during 2013. Both parties are committed to continuing the negotiations underway to define all aspects of the contract that is expected to be finalized by March 31, 2012. Maurizio Marcolin, the Marcolin Group’s Style & Licensing Officer said: “We are especially proud and excited to announce this agreement and to be able to work with Maison Balenciaga and its Creative Director, Nicolas Ghesquière – one of the top fashion names in the PPR Group. This new license will reinforce our mission: to create, produce and market products with unique, unmistakable and top-quality design. We are a successful partner who knows how to interpret the values and exalt the DNA of this brand through their eyewear. Balenciaga is a perfect fit for our brand portfolio and broadens the luxury market that we target.” Isabelle Guichot, President and CEO of Balenciaga, said: “This agreement with Marcolin SpA echoes our conviction with Nicolas Ghesquière that eyewear is definitely an essential fashion accessory which must be translated and marketed as such respecting brand vocabulary and iconic codes. This remains our ambition for the coming partnership and we will be fully committed to closely collaborate with Marcolin as weíve been witnessing their ability to interpret brands in different segments always with accuracy and consistency.”
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THE FASHIONABLE ECP Laura Miller
Take a Look at the
Light Side
My new running shoes are rather unusual. They are bright pink with heavy, black zigzag lines and bright pink oversized soles. They do not match any of my running clothes. This is an unusual choice for me since I have been accustomed to my standard white running shoes with an alternating pink or navy strip and small white soles. They are very traditional and they match with everything. I needed a change for endurance and it took two months of vigorous research to decide to buy these odd running shoes. The minute I tried them on, I knew I had to have them. Each shoe weighs only 4 ounces. They were so light, and I felt like I could run faster, jump higher and kick like a rockette. Who cares if they matched any of my clothes? I am done with my heavy running shoes for good. I was so happy with my unusual, light running shoes; I decided to reflect on other heavy accessories weighing me down. Light seems to be the new trend everywhere. Handbags are getting smaller because the large, heavy ones are producing back and shoulder problems. Some women are just using their cell phone cases. Luggage companies are fighting over who has the lightest bags. I guess my old Samsonite with the heavy wheels is no longer in vogue. Hershey’s is even making light candy bars.
I can go on and on, but you get the gist. As many accessories are getting lighter, eyewear trends seem to be moving in a heavier direction. We all know that the biggest trend in eyewear is the funky, geeky, oversized plastics. Plastic is usually a light material, but volume adds more weight. Metals are still popular, but are also getting heavier with funky stones, wide temples and rigid, oversized, design. I know this is fashion. As I am one who is usually found in high heels, I am fully aware of the sacrifices in comfort I make for fashion, but at the end of the day, it feels so nice to fall into my warm, comfy slippers. In this industry we are lucky. We have choices. We actually have stylish frames that are lightweight and comfortable. On that note, styles in eyewear don’t change gradually; they usually go 180 degrees in the opposite direction. Don’t be surprised if your fashion-forward patients with heavy, geeky frames start filling their new prescriptions with lighter and smaller frames. Make sure you offer a selection of frames made of these materials. Titanium and beta titanium frames are ultra lightweight and durable. They usually come in metallic colors but can be made stylish and modern for both men and women. Titanium is usually more expensive, but you can’t put a price on comfort. Many companies will have some titanium pieces in their collection. You don’t have to invest in an entire new line. Continued on page 14
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Rimless frames are fantastic in giving a light feel and look. Rimless eyeglasses provide a minimal look in eyewear, making the glasses nearly invisible on the face. They are very simple, light and delicate looking. The lenses attach directly to the temples. Exclusive temples, with a detail on the flexible nose bridge, make eyeglasses reliable and as lightweight as you can imagine. The rimless eyewear features smooth, polished and luxuriant looks. Lenses are joined together by the nose bridge only, attached directly to the inside of each lens with tiny screws. In rimless eyeglasses, mainly plastic lenses are used, which are also available as sunglasses. For an even lighter option, find a rimless with titanium temples and nosepieces. Even with the lightest of frames, your lenses are going to add some weight, no matter what. Using the right material for these light frames is pivotal. The following are among the most popular. Hi-Index lenses are thinner and lighter than glass and plastic. These lenses will have thinner edges and will require less material, reducing the weight. The weight of the edges will ultimately depend on the refractive index. As the index gets higher the lenses get thinner. The cost of the lenses will increase as the thickness decreases in most cases. Trivex lenses are best for drill mounts. They create excellent optical clarity and have the lightest available specific gravity (1.11). Lenses made with Trivex material are ultra-light for ultimate comfort. Trivex material is one of the lightest materials on the planet and unlike other lens materials, it combines the benefits of lightness and thinness, often resembling the thinness of a high index lens, but weighing even less than polycarbonate. Remember to upsell lenses by adding anti-reflective coatings. Most coatings won’t add any noticeable weight to the lenses. You also want to keep comfort and fit in mind when styling these light frames. If a frame is uncomfortable, its weight does not really matter. Lightweight frames can also be more difficult for you to adjust. Give your patients a chat on the care of their rimless frames and make sure they listen. It will save you both a lot of headaches when they keep coming in for adjustments. Try to pass your light ideas down to your sunglass patients. I am a sunglass guru, owning 15 pairs for every occasion. Though I have an admirable collection of designer shades, I only seem to wear one pair most; my light, rimless, brown-polarized frame that does not leave imprints on my nose or give me a headache. I don’t care how they look when I am driving in the car. Since oversized heavy plastic and metal frames are in fashion right now, are you also stocked with lightweight suns? For many of your patients, a couple less ounces on their eyes will reduce headaches. How is that for a sales pitch? â–
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MANAGING OPTICIAN Anthony Record, ABO/NCLE, RDO
ECP APPropriate I’VE ALWAYS BEEN A TECHNOLOGY BUFF and some of my favorite new devices include The Kindle, which allows me to catch up with my “fun” reading on my iPhone, iPad, or my Kindle itself; Bookworm – an addictive word game my daughter, Allison, hooked me on (I’m up to 560,000 Ali!); and IMDb – which keeps me updated on the latest films and lets me check movie times wherever I travel. Those are just three of the more than one hundred apps I have downloaded over the last few years. For the few ECPs (eye care professionals) out there who are blissfully ignorant of the App, here’s a Cliffs Notes version of what exactly it is. “Apps” is short for “applications.” More specifically, they generally refer to software applications designed for use on mobile devices such as smart phones, iPads, and other tablet computers. Some are free, but some are for sale – usually for a nominal fee – as low as ninety-nine cents. There are currently more than 500,000 apps available, and if you don’t get involved with them (even if that means simply familiarizing yourself with all that’s out there for your clients), you are missing the proverbial (optical) boat. There are basically two types of optical apps: those that are designed for ECPs and those that meant for lay people – people who wear contacts or eyeglass wearers. In an effort to pique your curiosity here are just a few: I might as well get it out of the way: If you do a search in the App Store with the word “optical” in it, you will be directed to dozens of apps that feature optical illusions – most of them free. Some are very basic, some more intense, but all are guaranteed to entertain. Additionally, while not technically apps, you can create an icon on your smart phone that leads you to the page of your favorite optical website. You might notice an icon on my phone for CEDO (Continuing Education for Dispensing Opticians), which is a premier CE organization offering seminars in Florida, Georgia, North Carolina, and more.
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Having this on my phone allows me to quickly check CEDO’s schedule of events and more. Much to the dismay of optometrists and ophthalmologists, and despite their many disclaimers to the contrary, there are many apps that purport to provide different types of eye exams. The one I downloaded is simply called Eye Exam. It features five different types of “exams.” Among those tests offered are Visual Acuity (for farsightedness and presbyopia), Color (for color blindness and color vision deficiency), Astigmatism, Duochrome (for the ability to focus on an object correctly), and Macular (for macular degeneration). Not bad for only ninety-nine cents. Vision Test does the same things, but has two additional features: Eye Advice (all of which I agree with) and an Optician Finder, which searches for ECPs by ZIP code. Despite its name, Eye Exam Pro starts its exam with the participant’s interpretation of some optical illusions. There are many apps that are geared for optical professionals. Offered for just under a dollar, Ophthalmology is filled with information and photos. From Arteritic Anterior Ischemic Optic Neuropathy (an inflammatory disease) to Xerophthalmia ( a type of dry eye), there are hundreds of entries and photos in between. There are more than a dozen other ophthalmology apps, ranging HD Ophthalmology from Free to $84.99 (Clinical Ophthalmology: A Synopsis). If ophthalmology interests you, check out HD Ophthalmology, Atlas of Ophthalmology, or Ophthalmology: The Official Journal of the AAO.
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There are plenty of apps that should appeal to frontline ophthalmic techs and especially opticians. OptiBoard is a website I have encouraged ECPs to get involved with for many years. The app version is user friendly to say the least. Check out its Forums, Blogs, and Articles. Post inquiries and wait for all the replies. At a fairly pricey $84.99, check out Optical Dispensing Assistant by Optical Directions Optical Dispensing Assistant by Optical Directions Consulting. It touts itself as being two Consulting apps in one. It claims to be “...an accurate progressive lens markup tool, plus a four-view-atonce optical mirror to aid customers in spectacle selection.” While it’s not as universally applicable, if you sell Silhouette frames, you should consider downloading the Silhouette iMirror app. It works very well. iGlasses is an app that allows you to virtually position over a hundred different types of generic glasses on saved photos. Some are useful just to give a person an idea of how they would look in a particular style frame, others are just plain fun. Once you have saved the new image, you can easily email it or text it to family and friends – they’ll let you know what they think.
dollars. Imagine how many people must have downloaded this app and used the information generated by it to order glasses online. There are many apps meant for contact lens wearers. Magic Eye Color (there’s a free version and one for $1.99) allows CL wearers to see themselves in all different colored lenses. In the category of a very useful utility, there are dozens of apps that help CL wearers keep track of their contact lens wear. Once the information is entered, most of them Scan by QR Code City send reminders when it’s time to dispose of lenses, clean lenses, and change them. Lens Tracker and Lens Gauge are both free, while My Contact Lens (a humorously animated app), Contact Lens Tracker, and Contact Lens Usage Tracker will set you back ninety-nine cents each.
There are many different apps designed to assist in the practice of opticianry. One of the best is Optical Tool. Among its many tools are back vertex, determining compensated power, determining the power of a lens in any meridian, Prentice’s Rule, determining horizontal and vertical prism amounts, and tools for determining thickness and magnification. Patients and prospective paying customers could spend all day exploring all of the different apps designed to help them with their eye care choices. Some actually are a help, others tend to be a bit confusing, and one tries to make it unnecessary for an ECP to take a PD. It is called Pupil Meter. When I first purchased it, I spent $4.99. Currently, it costs ninety-nine cents. I’m not surprised that the users of the app rated it only 1 out of 5 stars. From my point of view, and apparently theirs, it’s very poor. I took my own PD (which is 62) four times before I gave up. It never got it within 6mm. Oh well, that was a waste of five
Silhouette iMirror
LensGauge by 1-800-CONTACTS
As of this writing, I don’t know for sure, but what I want to tell you about is so cool, I want to take a chance. If you are attending Vision Expo in New York, check and see if an app is available to download on your device. At the last couple of Expos an app has been available. It lists special events, maps, schedules of classes, and much, much more. Go for it! ■
MARCH 2012 | EYECAREPROFESSIONAL | 17
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DISPENSING OPTICIAN Judy Canty, LDO
The Case for Un-Bundling
advise their customers to visit their local eyecare provider to request PD and seg height measurements and to visit again for the “free adjustments.” These services are not free. Both time and money was spent to acquire the skills and those expenses have traditionally been built in to the cost of the eyewear, just like all of the fixed costs of running a business. It’s time, actually past time, to place a monetary value on the various services that are provided in the dispensary. The question now becomes how to place a value on these services. • How much time is spent on the frame and lens selection process? • How much time is spent pre-adjusting frames and taking the proper measurements? • How much time is spent on minor repairs, i.e. replacing screws and nosepads, restringing semi-rimless frames, etc?
There is a small yet growing trend in the industry that may provide brick-and-mortar eye care professionals a way to promote the unique services they provide. It’s called Un-Bundling.
• How much time is spent on frame adjustments including initial dispensing and service after the sale? • How much time is spent troubleshooting eyewear problems? • How much time is spent advising patients who do not purchase? • How much time is spent ordering and verifying lab work?
From the very beginning, patients have seen two prices on every invoice; one for lenses and one for a frame. As a result, the ancillary services provided, like minor repairs and adjustments have no specific value in the eyes of the consumer. While prescribers are very aware of the value of their “chair time,” too often little regard is given to the value of the time spent in the selection, fitting and dispensing of prescription eyewear, especially if the eyewear is not purchased in the same office. What began as a courtesy to patients, free adjustments and minor repairs are now assumed by consumers and online retailers to be a free service. It is the reason that online retailers
These are the skills and services that patients and online retailers consider “free” for the asking. Someone smarter than I can probably devise a formula to calculate the value of these free services, but in the mean time let’s try this: • Divide your daily wage by the number of patients you see in the dispensary in a day to determine your wage per patient.
Continued on page 20 18 | EYECAREPROFESSIONAL | MARCH 2012
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Crizal Sunshield™ Crizal Avance UV™ Crizal Alize UV™ Crizal Easy UV™ Crizal Avance™ Crizal® Alize® Crizal Easy™ Zeiss Super ET Carat Advantage House Ez
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• Track how much time is needed to complete each of the tasks listed above. This list assumes that your lab is supplying complete pairs. If you do your own edging, you need to add this to the list and account for the time it takes. • Track how often the same tasks are performed in a day. • Track the cost of the consumables you use, i.e. nosepads, screws, nylon string, edging supplies, etc. All of this may sound a little odd, but remember, this is the optical business, not the optical not-for-profit. The dispensary makes money by selling glasses and anything that takes you away from that task costs money and time. This isn’t meant to be the typical Cost of Goods Sold (COGS) formula that includes utilities, cost per square foot of space and the other factors that accounting professionals use to value a business. Once you have an idea of what it costs to do your job in the dispensary, you can un-bundle those costs and decide how you can begin to educate your patients about the value of hands-on, face-to-face professional services. To be clear, I wouldn’t suggest invoicing every patient with every little cost associated with their eyewear, but some tasks simply beg to be highlighted. Certainly minor repairs, screw and nosepad replacements, re-stringing and re-inserting lenses should be among them. There should be a value placed on the time spent providing advice on frames and lenses to the patient who then picks up his or her prescription and leaves. Some of you may argue that this is what we’re paid to do, but don’t kid yourself. You’re paid to run a profitable dispensary. With these thoughts in mind, my suggestion is to create discreet signage in the dispensary identifying specific tasks and their costs. Please note that I have not included any fees for providing facial measurements. This is a personal or practice choice. I can only speak for my home state of Virginia, where the State Board for Opticians has decided that by providing such measurements, PD and seg height, the licensed Optician has inserted him or herself into the fabrication process and could be held liable for
any errors or omissions in the final eyewear product. My advice in these matters is to check with your own regulatory agencies for clarification. The beauty of having these costs displayed publicly is that you are now free to charge or not charge for any of them. The point is that the buying public now knows that the services provided in your dispensary have value. You have un-bundled them, and with the last statement, re-bundled them for your patients. REMAKES AND REFUNDS The two words that make our optical blood boil. Nonetheless, they are a fact of dispensing life. I’ve written in the past about having a clear policy regarding how your dispensary handles remakes and refunds. The question now centers around the costs involved with those two issues. Every statement should clearly indicate any time limits imposed on remakes and refunds. If your lab says 90 days, your patients should understand what that means. We have all heard excuses, some of them quite incredible, as to why we should make exceptions to the rules. The fact remains that someone is going to pay for that remake or refund, usually in higher costs somewhere in the supply chain. Make sure your patient understands the “what” and the “why” of your policies. If you are filling a prescription from an outside prescriber, make sure that the outside office understands you policies as well. Refunds are another can of worms. At this point, something has gone terribly wrong with the entire dispensary experience and no one is happy. However, eyeglasses are a custom crafted product. You may be able to return the frame, if it is a current style and in salable condition. The lenses are generally not returnable. This is why many practices charge a “restocking fee” for returned eyewear. This policy should also be clearly noted on every statement. Every service provided in your dispensary has value. If we don’t publicly address this issue, the buying public will continue to drop in for those “free” services. ■
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C ORNING 21st Century Lens Technology EyeCare Professional’s Paul DiGiovanni, LDO, speaking with Lyle Rubin, North American Sales Manager/Ophthalmic, Corning.
Briefly describe the history of SunSensors® Lenses. In late 1999 Corning introduced SunSensors, its first plastic photochromic lens material. The 1.56 mid-index material was developed with a density of 1.17 grams/cc making the lens lighter weight than polycarbonate with the photochromics in-mass. The lens material was, and still is, manufactured at the company’s Lyle Rubin Sullivan Park facility, located in Corning, NY. What styles are SunSensors® currently available in? Today you can get SunSensors thin and lightweight mid-index material in a wide variety of styles including: Single Vision, Aspheric Single Vision, Flattop 28 & 35 Bifocals, Kryptoc Bifocals, 7X28 Trifocals, Progressive Lenses, and Digital Progressive Lenses. Who are the key lens manufacturers marketing SunSensors®? We work with many lens manufacturers, labs and distributors around the world, two key lens manufacturers promoting SunSensors® domestically are: •
Polycore USA who has been in business since 1976, and a major player in the ophthalmic lens industry.
•
Techtran lenses who have been serving the US market for more than a decade.
Both will be exhibiting at Vision Expo East and I encourage eye care professionals to meet with them and discover the labs and stock houses they work with to supply the full range of SunSensors. How is business overall at Corning? The Corning business had record sales in 2011, the strongest in our 161 year history. With that said, innovation is at the heart of our success and last year we made a video about a family in the future that highlights the innovative technology we see in the future. The video is called “A Day Made of Glass.” The video was among the most seen corporate videos on YouTube, and if you have 22 | EYECAREPROFESSIONAL | MARCH 2012
not viewed it yet, I encourage you to do so today: www.youtube.com/watch?v=9qmwdbhsbVs&feature=related Are you planning any further videos in 2012? Yes, this year we continued our vision of the future with “A Day Made of Glass 2,” Corning’s expanded vision for the future. This video continues the story of our family in the future and how highly engineered glass, with companion technologies, will help shape our world in a futuristic home environment, as well as in educational and medical settings. Again, it is worth taking the time to view: www.youtube.com/watch?v=jZkHpNnXLB0&feature=youtu.be What technology will you promote within the ophthalmic industry in 2012? Photochromic technology is still evolving and we will continue to work with industry leaders to promote and expand this technology and its use. What tools does Corning provide to help the eye care professional promote photochromic lenses? Corning provides Continuing Education Courses to educate the eye care professional on the technology as well as point of purchase displays and consumer brochures. The POP material is available through both Corning direct or our lens manufacturers and distributors. Does Corning have any other new technologies we can expect to see? Yes, PolarCoat™: A breakthrough technology in the polarized field – the first polarized coating. Polarcoat is a patented technology, the culmination of several years of research and through testing, lens manufacturers licensed by Corning can now apply a surface treatment with 99% of polarization efficiency (PE). What is the availability of Polarcoat™? This new coating, launched in early 2010, is applied on the backside of plano sunglass lenses. In the near future, it will be available for the front-side treatment of semifinished prescription lenses and of bi-refringent materials such as polycarbonate and nylon. ■
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Corning and SunSensors are registered trademark of Corning Inc, Corning, NY - Copyright© 2011 Corning Incorporated.All rights reserved
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THE MOBIILE OPTICIAN Ginny Johnson, LDO, ABOC
Walk the Line(s) I keep a close watch on this industry all the time I keep my eyes wide open on and offline I keep my ears out for any news that binds Because of their mind, I walk the line(s) While working with a patient as she played over and over in her head what her new eyewear should look like, I knew there was an EyeCare Professional article reason why our paths crossed. No lifestyle scripts, just talking about real life. She told me she was a computer software analyst, which I was able to gain a laugh with when I told her I might need her help getting the eyewear order put through our system. Admiring her necklace I found out that she owns a small business designing fine jewelry which she sells online. I asked her for a business card and we glanced at her website featuring stunning one-of-a-kind jewelry (of course that’s considered work related). Her prices matched the fact that the jewelry quality and her time were both valuable. The eyewear conversation continued as she told me that a rectangular frame shape with cheap lenses would be just fine. I listened to her say one thing yet mean another while keeping constant eye contact. She began trying to justify why she settled for her current pair of mediocre eyewear that she purchased online. The following message was paid for and approved by me: Pt: I hate wasting money on eyewear. They stay on my face all day and it’s not like I’m rough with them. I definitely don’t think I need all those bells and whistles, especially that expensive no glare stuff that doesn’t work anyway. Me: Actually there’s no doubt in my mind that you absolutely need that whistle (pause). Since I’ve been sitting here talking to you I’ve noticed that the no glare treatment you have now is inferior to what your new lenses will be like. Pt: What do you mean?
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Me: I mean you spend countless hours on a computer battling glare from what you’ve told me. Those lenses must drive you crazy having to clean them constantly. Pt: They do but I told you I was cheap. Me: You’re right, you did (she broke the silence after about 10 seconds). Pt: How much is the no glare stuff? Me: Less than the beaded bracelet on your website that I love. I’m glad I was able to save her from another vision care nightmare. Her wishful, cheap thinking just didn’t match up with other areas of her life so I had to help her figure that out. Online prescription eyewear sales continue to be a hot topic. ECPs are learning how to deal with the fact that some eyewear patients, young and old, are choosing to take their prescription and fend for themselves online. Speaking harmfully against a specific business where a patient chooses to have their prescription filled is prohibited. Some practices have signs hanging in their reception area regarding PD requests and their fees for services performed on eyewear purchased elsewhere. Patients that are waiting to be seen by the doctor can now choose between reading a magazine featuring movie stars or reading about fees. Hmmm, which will it be? I hope neither one. My hope is that there is little reception time and more time to focus offline on how we can we keep our patients from having vision care nightmares. People love to talk about things that are important, convenient, and beneficial to them. Although ECPs know that vision meets all three criteria some patients don’t see it that way. They take their vision for granted until something happens and they are forced to seek vision care from an OD/MD.
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What about offline eyewear that gets dispensed that does not meet prescription specifications? ECPs should do everything possible to prevent this from ever happening. The eyewear inspection process needs to be performed by licensed ECPs. Make sure professional liability insurance policies are up to date. When I’m driving to work I often wonder how many people I am sharing the road with are wearing incorrect Rxs or fending for themselves. Add that to exceeding the speed limit or someone driving 35mph backwards on the interstate and I’m reminded how ECPs need to help as many people with their vision needs as possible. I am always interested in reading the employment ads that OD/MD practices post online. Here are four random job requirements from practices in their employment search for optician applicants: “Optician experience preferred but not necessary.” (no mention of training program) “Optical experience a plus but not required for optician.” (no mention of training program) “Minimum 5 yrs in-depth experience as an optician.” (I like the in-depth wording)
“Optician wanted FT/PT. Experience helpful.” (Helpful? How about mandatory?) Think about what these requirements say about each of these practices. It’s not surprising that patients are going to research every avenue of eyecare if practices are hiring overnight opticians that have no clue what they are doing. Wake up before your practice ends up being an offline vision care nightmare. Making smart hiring decisions is a must. On the other end of hiring, ECPs should always have an updated resume. Some ECPs might believe they are above needing a resume so I challenge you to prove on paper how good you are at what you do. I have a couple of friends right now that are walking the line of unemployment. They have been in this industry for many years and are excellent at what they do. I got a phone call from one of them the other day asking me for resume help. She knows how to screen applicant’s resumes and handle the interviewing and hiring process. She’s stuck when it comes to making a brag sheet about herself. Update your resume, it will make you feel better and you will be taking a step in the right direction. When you feel good to great about yourself you can walk any line(s) you put your mind to. ■
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If We Don’t Understand Sports Eyewear Standards, How Can We Advise Our Patients? by THE VISION PROTECTION COMMITTEE OF THE VISION COUNCIL
It seems like a new line of sports eyewear or sunglasses is introduced to the American market weekly; complete with fashion photos of athletes engaged in a variety of sports activities. While pictures and words may imply that products are acceptable to wear during sports activities, it is important to check labels to ensure the level of protection matches the correct activity. The ANSI Z87 is the industrial safety standard, while the American Society for Testing Materials (ASTM) provides standards for a variety of sports-related activities. It should be noted that section 2.1 of the most recently published ANSI Z87.1-2010 standard specifically excludes “sports and recreation.” ANSI Z87 impact testing involves either a small (1/4”) projectile moving at high speed (high speed testing) or a pointed projectile moving at slow speed (high mass testing). Hazards encountered during sports activities typically involve large, blunt masses like balls and elbows. Projectiles such as squash balls, lacrosse balls and baseballs exert massive forces sufficient to fracture all but the most robust, well-designed frames. Even when lenses are retained in a frame, the force can be severe enough to cause eye damage from frame and lens flexure (oil canning). For this reason, detailed eye protection standards for many ball sports activities are published by the ASTM. ASTM F803 standards are specific to individual ball sports, or groups of sports, and products that claim to meet the standards must be labeled accordingly (i.e. “meets ASTM F803 for squash”).
It is important to understand how the products we dispense will be used in order to avoid unnecessary accidents and/or liability. Use the guideline below when discussing sports and/or protective eyewear with your patients: What you need to know about protective sports eyewear: •
ASTM* F803 is the recognized standard for Rx and plano protective ball sports eyewear.
•
ANSI Z87 is the industrial eyewear standard, which excludes sports eyewear. ASTM F803 is sports specific. Testing protocols simulate the hazards of particular sports activities. Product labeling must define the sport(s) for which the protector was designed and tested.
•
Select eyewear that meets the standard for the appropriate sport, or a sport with similar risks.
•
ASTM F803 testing protocols are not available for all sports activities. Not every standard can be met with available Rx eye protectors (i.e: 55mph baseball).
•
For maximum eye protection 3mm polycarbonate lenses are recommended.
*ASTM – American Society for Testing and Materials
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INQUIRE. INFORM. INTRODUCE.
Protect Their Vision. Diversify Your Revenue. It is estimated that more than 2.5 million eye injuries occur each year. By using the “Inquire. Inform. Introduce.” strategy you can help protect your patients’ vision while at the same time expanding your patient base and diversifying your revenue stream. Ask: What are you doing to protect your vision? Consider: Job-specific tasks and hobbies Discover: Your patients’ daily activities Providing accurate information and solutions begins with asking your patients the right questions. Learn how to ask the right questions at thevisioncouncil.org/ecp.
helping you to grow your practice
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MOVERS AND SHAKERS VOSH International C. Ellis Potter, OD, has been installed as president of the VOSH/International Board of Directors. A graduate of the University of Kansas and Southern College of Optometry, Potter practiced in Iola, Kan. As a member of C. Ellis Potter the Kansas Optometric Association (KOA), he served as editor of the Kansas Optometric Journal and on numerous committees. He was named KOA Optometrist of the Year in 2006.
Live Eyewear
Quint Stevens
Live Eyewear, Inc. announces the appointment of Quint Stevens to the position of Creative Director. In his new role, Stevens will be responsible for the creative direction related to further strengthening the identities of the company’s core OveRx® brands, while developing the look and feel of new collections.
The Kenmark Group The Kenmark Group is pleased to announce the hire of Lauryn Morris as Product Designer for the kensie eyewear collection. Morris will be responsible for overseeing concept, design and development of product and merchandisLauryn Morris ing materials for kensie. She previously designed the “Michael” Michael Kors sun collection as well as the Michael Kors ophthalmic collection.
Boston Foundation for Sight Boston Foundation for Sight (BFS) has announced the newest additions to its board of directors, Michael B. Raizman, M.D. and Clifford Scott, O.D., M.P.H. Dr. Raizman is an internationally recognized cornea, refractive Michael Raizman surgery, cataract, and lens implant specialist. He has been with Ophthalmic Consultants of Boston since 1991, and has served on the full time faculties of Harvard Medical School and Tufts University School of Medicine. Dr. Clifford Scott was named the New England College of Optometry’s 12th President in December of 2009. Prior to his appointment, Dr. Scott was the Dean of Academic Affairs and also held the position of Chair of the Clifford Scott Department of Community Health at the college for eight years. He has been a faculty member at the college since 1970 and has been a Professor of Optometry since 1990.
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FRAME BOARD MANAGEMENT Lindsey Getz
Spring Color Trends Spring is upon us. Take some time to learn about this season’s color trends and you just may give yourself an edge in the dispensary.
the latest fashion trends will be appreciated by patients who are looking to stay ahead of the curve—and even those that just want to find the right frames for their wardrobe. This season’s Color Report showed a variety of influences among designers. Their styles range from free and playful to contemporary classics and the colors that will be trending this season reflect those attitudes. There’s a mix of vivid brights, soft muted tones, and of course the go-to spring pastels that will always be popular. “Consumers look to spring for renewed energy, optimism and the promise of a brighter day,” says Leatrice Eiseman, executive director of the Pantone Color Institute®. “They have learned how color can help them alter a mood, while providing the vitality and enthusiasm that enables them to experiment with new looks and color combinations.” Bold Brights Oftentimes, people like to use their accessories to punch up a neutral wardrobe and stay on top of the color trends so consumers might be looking for eyewear that comes in some of these trending colors. Eiseman says she feels eyewear is the “perfect way to introduce vibrant colors into the wardrobe.” In other words, your patients might not be ready to commit to an entire color palette for their spring wardrobe, but they might want to have a little bit of fun with some colorful shades by purchasing eyewear and other accessories.
Every season, the fashion savvy turn to Pantone, LLC, an X-Rite company, for their bi-annual Color Report. The PANTONE® Fashion Color Report Spring 2012 includes a comprehensive survey of designers’ use of color in their upcoming collections and gives a helpful snapshot of the hues that will be popular in the coming spring season. The Report includes a top 10 color list. For eyewear retailers, it’s particularly helpful to be up-todate on the color trends of an approaching season so that you can guide your patients in the dispensary. Your knowledge of
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Some of these vibrant colors that are trending this season include Tangerine Tango, an “enticing juicy orange that is a vivacious and appealing refresher to enliven anyone’s outlook this spring,” along with Solar Power, a deep yellow that “radiates warmth and cheer.” Both hues have a cheerful feeling that is certainly appropriate for the spring season. Also quite bright are Bellflower, a “distinct ornamental purple” and Cabaret, a “sensual and intense rosy red” that some may even say borders a deep hot pink hue. These colors are whimsical springtime hues that would certainly add a burst of Continued on page 32
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bright color to any wardrobe whether worn as an accessory or a piece of clothing. Also on the top ten list this year is Sodalite Blue, a “classic maritime hue” which is deep and calming—a bit more muted than some of the bolder brights. Sodalite is also a shade that mixes well with the other hues in the palette so it’s a safe pick and could even serve as a base color. Cockatoo, on the other hand, is a bit more daring and definitely classified as a “bright.” This tactile blue-green is said to add a “whimsical touch to the palette and will help make a statement this spring.” Margarita, a “piquant yellow-green” is not quite as bright as Cockatoo, but still a nice refreshing springtime green. Rounding out the pastels is Sweet Lilac, a purple/pink that “evokes the fresh scents of summer.” Pantone calls this soft hue a “pinkish lilac that adds a touch of romance to any wardrobe.” Necessary Neutrals Eiseman says there’s no question that “brights are still big.” Consumers are making bold and daring choices with their wardrobes but balancing it out with some staple neutrals. And two key neutrals made this year’s top 10 list. These natural, versatile neutrals “add practicality” to the season’s list of daring brights. Driftwood, an “adaptable blend of beige and gray with a slightly weathered feel” is one of these popular neutrals, as is Starfish, a lighter beige that has been called the “perfect warm summer neutral” and one that will “complement all colors featured in this season’s top 10.”
But for an ultra-bold look this spring, Eiseman says that fashionistas shouldn’t be afraid to mix brights—even if they don’t have a staple neutral as their base. Tangerine Tango combined with Bellflower is daring but beautiful and makes a sure statement. But for those that don’t want to go so bright, it’s always a good mix to punch up a neutral with a bright. A neutral like Starfish is always a safe bet. Make it a bit more exciting with a pair of sunglasses in bright Cockatoo or a scarf in sexy Cabaret. Still, Eiseman says that finding fun combinations is what fashion is all about. “Tangerine Tango goes well with many colors that make for unexpected combinations,” she says. “For example, pair it with an elegant wine color. It’s also great with a slightly greenish blue or hot pink Cabaret for a retro look. Of course it will always work with warm taupey tans and a special favorite of mine, a deep yellow green called Winter Moss. And there is the summertime staple of pairing white with Tangerine Tango.” While bright color isn’t for everyone, it seems that more and more consumers are embracing the trends. Eiseman says she’d like to see more accessories retailers, including eyewear dispensaries, represent some of these trends. “It would be smart to feature more color since eyewear are important accessories and consumers are open to more color in their accessories.” ■
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SECOND GLANCE Elmer Friedman, OD
Stranger than Fiction I WAS RECENTLY STUNNED by the content of an email I received from my friend and colleague, Dr. Natty Bumpo of Finster, N.J. He arrived home a few days ago after an exciting two week tour of Eastern Europe on a roots searching adventure. Part of his journey took him to the Ukraine and the museum associated with the Kiev Music Conservatory. He chatted up the lecturer, Luba Kurylak, who happily revealed that she had relatives in Camden, N.J., just a stone’s throw from Finster. Among the many historic artifacts was a section which displayed musical instruments, attire and costumes. Special attention was given to the history of blind Ukrainian musicians and singers. Need I describe how Natty’s eyes and ears popped open? Natty said that he had seen a blurb about blind musicians in the AOA Historical Society Newsletter and now he was face to face with the real thing. I would like to share this unique, mysterious information with you that so ignited Natty’s imagination and led to his exhilarated interest in the subject of blind Ukrainian musicians. Luba explained that there is a very strong tradition of blind minstrels in Ukraine. From 1800 (and probably well before this date) to 1930 the unbelievable fact existed that the majority of traveling musicians in Ukraine were blind. Amazing as it sounds, music was part of the social-welfare system. Those who were blind and could not work at other occupations would be apprenticed to become professional bards known as “kobzars.” They were an important part of the oral tradition in Ukraine. It seems that all blind children, girls and boys, would begin their apprenticeship as early as five or six years of age. Those who could not complete their apprenticeship became guild affiliated beggars rather than professional minstrels. They specialized in
begging songs and songs of thanks. Only full fledged minstrels could play a musical instrument and perform the full repertory. World renowned ethnographer, Natalie Kononenko, states that “lirnyky,” on the other hand, were blind church singers who sang epics, historical and satirical songs. The most important in this group of songs were the religious songs about saints, martyrs and God. There were also songs about the Last Judgment, The Passion of Christ and similar related material. A popular song told the story of an orphan girl and her troubles and travail. The village audiences loved these types of songs and felt uplifted enough to offer alms to the blind performers. Kobzars performed in a variety of venues. They would travel from village to village led by a guide. The guide was usually an orphaned, poor child who worked for food, clothing and a small wage. A kobzar would go from house to house singing a begging song. If he was invited inside the house he would perform whatever his hosts requested. Upon receiving payment as he left the house he would sing a song of thanks. They also sang outside of churches and monasteries, particularly during religious seasons when many people gathered together. They also went to the cities where they would perform at fairs. The kobzars often owned small plots of land, were married and had families. Their children did not become minstrels, unless they too, were blind. Most minstrel children became farmers, the same as the usual occupation of their neighbors. The kobzars have a special place in the heart of Ukrainian folklore. Some folklorists say that the first Cossack bandurists arose from actual witnesses of the great battles about which they sang. The thought of these warrior bards singing epics was popular and well received. Thus was created the tradition that Continued on page 36
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these valorous veterans who were blinded in battle now conveyed their interesting experiences into song. But the tradition was greatly weakened in the 19th century since those singers were more like beggars than warriors. Because the art of the kobzars was language that spoke of Ukrainian past history, they were often persecuted by the ruling powers. This persecution reached a crescendo under Joseph Stalin in the 1930s. He crushed many forms of Ukrainian cultural expression. In the late 1930s many bandurists were arrested and some were shot. Many sources report that there was a large scale massacre of Ukrainian blind musicians at that time. However, this is not confirmed by documentation and details of the events are disputed. And so, traditional blind minstrelsy had largely vanished by the late 1930s. Today the traditional repertoire of the kobzars is sung by sighted, educated performers. While researching this subject in the Ukraine, author Kononenko discovered only one blind folk performer of the old, traditional songs. He was Pavlo Suprun, who had studied bandura playing and voice at the Kiev State Conservatory. I discovered the fact that many blind musicians have performed without formal instruction, since it would be necessary for them to appreciate written musical notations. However, today many sources are available for blind musicians to learn and utilize music theory and notation. There is such a fund of information in the Braille music system. Invented by none other than Louis Braille himself, it permits the blind to read and write music just as the sighted do. The most important collection of Braille musical scores is located at the National Library of Congress in Washington, D.C. There is also a large storage in the National Library for the Blind in England. Computerization and the internet allow the blind musician to be more independent in his work. Occasionally one hears complaints that most programs are not blind friendly and difficult for them to navigate successfully. There are several organizations dedicated to helping blind musicians. The National Resource Center for Blind Musicians and The Music Education Network for The Visually Impaired are outstanding examples of support.
The blind musician has been an important element in the fabric of different cultures. Homer was a blind poet and his existence has been a tremendous influence in Western traditions. Albert Lord authored the book, “Singer of Tales” and explains that in Yugoslavia he found many stories about blind musicians, almost all of whom have disappeared from the scene today. A similar situation exists in Turkey. The interest and popularity of the blind musician inspired artist John Singer Sargent to create a painting based on the subject in 1912. While the Ukraine blind musicians may be the most striking examples of this art, other cultures were also in evidence. During the 16th, 17th and 18th centuries, harpists, pipers and other musicians traveled around Ireland. They provided music for dances and other occasions. Just as their counterparts in Ukraine, these musicians experienced persecution by the English. Many of the musicians were blind. In the 6th Century B.C. the Chinese court musician was traditionally a profession for the blind. Groups or guilds of blind musicians and fortune tellers were still in evidence during the middle of the 20th century. They claimed to have originated as far back as 200 B.C. Today, there are still groups of blind musicians who continue to perform in Zuoquan County as well as other areas across China. In Japan, Heike Biwa is a form of musical storytelling which appeared in the years 1185-1333. Traveling musicians known as Biwa hoshi were often blind. They played the lute and recited stories. They were sometimes known as “blind priests” because they wore robes and shaved their heads. They attracted much interest and respect, but in fact, were not Buddhist priests. Month after month and year after year, optometric journalists have attempted to meet their deadlines with material that is fresh, interesting, inspiring and educational. Even a bit of humor and whimsy are added attractions to our articles. There is an inner excitement that results when uncovering something so intriguing. I hope you enjoyed this marvelous story. ■
Survey Reveals Aging Workforce Doesn’t Take Advantage of Vision Benefits Despite a strong interest in their company vision benefit, today’s aging U.S. workforce isn’t fully taking advantage of it, a new survey released by Transitions Optical reveals. Consequently, many employees are missing out on a critical preventive care opportunity and leaving themselves at higher risk for age-related vision problems, eye diseases and chronic conditions that impact eye health and compromise productivity. According to the annual Employee Perceptions of Vision Benefits survey conducted by Transitions Optical, Baby Boomers between the ages of 45 and 64 are only slightly more likely than younger employees to enroll in their vision benefit (79 percent vs. 75 percent). Similarly, 34 percent of Baby Boomers and 23 percent of those 36 | EYECAREPROFESSIONAL |MARCH 2012
ages 65 and over who enroll do not utilize their benefit to receive a comprehensive eye exam. The survey was conducted online by Synovate (Ipsos) in October 2011, among 2,011 full-time, adult U.S. employees whose employers offer vision benefits. “A quality vision benefit is important for everyone, but especially for employees ages 45 and older, who are more likely to experience vision problems that hurt job performance. This age group also has a higher risk for developing costly eye diseases and whole body conditions such as diabetes and hypertension, all of which can be detected through comprehensive eyecare, and addressed with the right eyewear to correct, enhance and protect vision,” said Pat Huot, director, managed vision care, Transitions Optical.
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PRACTICE MANAGEMENT Gary Fore, ABOC
Protecting Our Patients I WONDER HOW OUR PATIENTS would answer this question: “How do you protect your eyes?” It’s likely that many would just stare at us. Perhaps they would ask, “Huh? What do you mean?” Perhaps they don’t really think about it, preferring to focus on the fashion side of eyewear. This is where the professional needs to step in. Whether it is the eye doctor or the dispensing optician, someone needs to be asking this protection question every time the patient, new or established, comes in to the practice for an eye exam or for new frames. This question, their response and our education of the patient is all a part of being an ECP. This is where we start. The regular, annual eye exam is the basis for what we do in recommending the best lens option for them, recommending the best frame for those lenses and recommending the most comfortable contact for their usage regimen. The annual eye exam will make sure that, barring injury or some traumatic event, they will be made aware of issues with their eyes (or even some other parts of their body) with enough time to be proactive about it. There are discussions currently asking the question of the necessity of an annual eye exam, putting additional financial burdens upon the already rising healthcare system. These discussions may lead to a revision of the frequency of the eye exams. Regardless of the outcome of that discussion, whenever the exam is done becomes a vital part of protecting the patient’s vision. Online refraction has become another part of the eye health discussion. Since we know that individual doctors come to different conclusions about the refractive errors of the same patient’s eyes, refraction may migrate to an automated system or to an altogether different modality to increase the objectivity and overall accuracy of this test. Whatever becomes recommended or mandated, it should not substitute for a regular exam of the various parts of the eye. After all, the eye is the only portal that opens the internal of the body to the outside. That is significant.
Another way we can protect our eyes and thus our overall vision is by choosing quality lenses. I could put many different objects in front of my eyes to change my vision. The proverbial ‘coke bottle,’ a magnifying glass, a telescope or even plastic pieces would do something to my vision but would any of those protect my eyes, give me clear, sharp vision and reduce visual fatigue? Buying the cheapest lenses to be found, even with the correct prescription, could cause me more visual fatigue if they are not good quality lenses, fitted properly. I’ve seen many patients opt for single vision lenses instead of computer lenses believing that the only real difference is the cost. As much as we try to educate the patient about the differences between them there is usually some significant pushback due to costs. Strangely, many patients are unwilling to reduce the frequency of trips to the local gourmet coffee bar in favor of reduced visual fatigue and the associated headaches, neck strain and shoulder soreness. The perception of true cost seems to be lost because they pay the costs of gourmet coffee products on a daily basis and the costs of better vision on a single pay basis, although the coffee products may, in a year or two, be more than the cost of better and less strained vision. A third area of protection is in the wearing habits of those who prefer to use contact lenses. We have a number of patients who call for emergency appointments due to over wearing of their contacts, resulting in eye infections and a variety of other problems. Patients often go to bed or just fall asleep while still wearing contacts not approved for sleep. These patients come to the eye doctor, sometimes with severe pain because they tried to peel off the now dry contact from their eye, removing a thin layer of the epithelial. As professionals, we should educate and remind them that contacts have a wear period that should be followed to prevent these kinds of episodes and the inevitable pain that is associated with them. Many patients refuse to adhere to the wear period and use them as long as they don’t split. They seem to be willing to put up with the infections and Continued on page 40
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pain as long as they can save some money by stretching the time they have to buy some more, along with the associated expense of a new eye exam. This leads to yet another way to protect their eyes: the backup pair of glasses. Contact lens patients can better protect their eyes with a backup pair of glasses. Quite a number of contact lens wearers have chosen those lenses because their prescription is so high that they don’t like the look of glasses on their face. That is understandable, of course, but it brings up another problem if their eyes become infected or they lose or run out of contacts. At that point, they tend to call or come by the eye doctor’s office pleading for their prescription so they can go online and get contacts refilled, even with an expired exam, (if they work the refill system well). Another solution for them is to come to the eye doctor, discover they have an infection and need to wear glasses until the infection goes away. With their usually high prescription, they need glasses or they can’t see to drive, study or perform their routine jobs. They need glasses today (read: right now!). They are then fortunate of the doctor’s office that does on site edging and has their lenses in stock. If not, they have to wait. It would be better for them if they listen to the protection advice and have a backup pair. What does the patient do when they are out where the sun shines? How do they protect their eyes there? Those cheap sunglasses bought at most superstores or pharmacies make them believe they have great protection from the ultraviolet rays. Unfortunately, the reason those glasses are so cheap is that these lenses have only minimal protection from UV. Often that UV protection wears off quickly, leaving the patient in an even worse state, believing that they are protected when, in fact, they are not. A better strategy would be for them to have quality lenses with durable UV protection either built into the lenses or added. Today, there are anti-reflective treatments which have front and rear UV blocking built in. These are premium treatments which
come at a higher price but bring a greater benefit with them. This rear UV protection is often neglected but that neglect leaves the patient’s eyes vulnerable to reflected UV from the backside of the lenses directly into the eye. The latest front and rear UV blockage is the best protection for our patients but we need to educate them and then develop a strategy that delivers sunwear along with their clear lenses or contacts so they are fully protected at a reasonable price for them and for the ECP. What about your patients who participate in activities where their eyes are at greater risk of injury? How do we assist those patients? We can educate them to the risk of injury associated with their activity. There are statistical reports on the number of injuries as a percentage of participants in particular sports. Those injuries can cause the total loss of sight for some. Others will suffer injury that is less permanent but still painful or debilitating for some time though they will still have their sight. Sports, a leading cause of eye injuries, are not the sole cause. Doing wood working puts a person at greater risk of eye injury, too. According to the University of Illinois at Chicago Department of Ophthalmology and Visual Sciences, corneal abrasion, caused by fingernails, contact lenses and paper edges frequently cause these abrasions. They cite activities like working on cars, hammering or drilling as opportunities for corneal abrasions. Chemical burns, even from household cleaning can cause eye injuries. The solution is often very inexpensive, especially when compared to emergency room treatments, co-pays, hospital stays and foreign body removal surgery. Recommend protective goggles, even with prescription inserts for those who need them. Don’t allow your patients to come and go without asking these kinds of questions about their activities. They may reject your advice, many times based on nothing more than the cost, but, document the questions and advice and keep recommending it to them as they return. After all, patients may not be as proactive as they need to be so, as professionals in the eye care business, we must be their conscience and their partner in protecting their eyes. ■
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OD PERSPECTIVE Jason Smith, OD, MS
AMD and STEM CELL RESEARCH As eye care providers, our mission is to provide every professional, optical, medical, and surgical option to our patients in order for them to see their highest potential. t is always disheartening to me when a patient comes to see me and their best corrected visual acuities are reduced to 20/200 or Finger Counting. Sometimes we have very few options for them under these circumstances. Some of the medical complications that can compromise vision include eye injuries, corneal disease, keratoconus, eyelid anomalies such as ptosis, cataracts, iritis, glaucoma, retinal diseases, diabetes, and macular degeneration. Some of these problems can be controlled, others treatable but some illnesses are simply beyond therapeutic treatment. In recent medical news, there may be areas of hope for macular degeneration patients using stem cell therapy.
I
Age-related macular degeneration (AMD) is a medical condition which usually affects older adults and results in a loss of vision in the center of the visual field. Central vision is provided by the macula. The degeneration of the macula is caused by slow sustained death of the cone cells contained within the macula. It is a major cause of blindness and visual impairment in older adults greater than 50 years of age. According to the January, 2011 L.A. Times article, “Stem cell trial sets sight on blindness,” about 10 million Americans suffer some degree of vision loss caused by AMD and that figure is expected to grow as more baby boomers become senior citizens. Macular degeneration can make it difficult or impossible to read or recognize faces. Central vision is affected, although enough peripheral vision may remain to provide some level of “acceptable vision.” Two forms of macular degeneration exist, wet and dry. The dry, non-exudative form appears as yellow cellular debris called drusen which accumulates between the retinal pigment epithelial layer and the choroid. The wet, exudative form is more serious affecting approximately 10% of patients having macular degeneration. This form of AMD is also referred to as neovascular or exudative macular degenera-
42 | EYECAREPROFESSIONAL | MARCH 2012
tion and causes vision loss due to the growth of abnormal blood vessels. These blood vessels can leak blood or protein below the macula causing irreversible damage to the photoreceptors. According to Wikipedia, “approximately 10% of patients 66 to 74 years of age will have findings of macular degeneration. The prevalence increases to 30% in patients 75 to 85 years of age. The lifetime risk of developing late-stage macular degeneration is 50% for people that have a relative with macular degeneration, versus 12% for people that do not have relatives with macular degeneration, a fourfold higher risk.” Some of the associated risk factors for AMD include hypertension, high cholesterol, obesity, high fat intake, oxidative stress, Caucasian race, exposure to sunlight especially blue light, smoking, and genetic factors. However, determining a precise cause of macular degeneration has proven illusive. Until recently, there were no effective medical treatments for wet AMD. New drugs called anti-angiogenics or anti-VEGF agents have been used to cause a regression of the growth of abnormal blood vessels. Vision improvement can be achieved
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when these drugs are injected directly into the vitreous humor of the eye. But these injections must be repeated on a monthly or bi-monthly basis. The names of these drugs include ranibizumab or Lucentis, pegaptanib or Macugen, and aflibercept or Eylea. Bevacizumab or Avastin is not approved for intraocular use but has been used for other systemic problems and is used as an “off-label” treatment for AMD. Recently, there has been an increase in the use of certain anti-oxidant vitamin therapies to slow the progression of AMD. Some evidence supports the use of 2 carotenoids, lutein and zeaxanthin, consuming omega-3 fatty acids, and consuming foods with a low glycemic index. Smokers who take high levels of beta-carotene may be at a higher risk for lung cancer and there has been new evidence indicating that vitamin E supplements can increase the risk of heart failure. Anyone who is considering taking any supplement for any reason should always discuss this with their ECP, their family doctor, their internist, their surgeon and their pharmacist. In the past several weeks, there has been some news concerning the treatment of AMD using stem cell research. Unfortunately, during the last Presidential administration from 2000-2008, stem cell research was halted or slowed down for 8 years. Research companies, medical professionals, and some of the
smartest minds in the United States took their research to Europe, Asia, and Canada. On July 19, 2006, President Bush used his veto power for the first time in his presidency to veto the Stem Cell Research Enhancement Act. This bill would have permitted federal money to be used for research where stem cells are derived from the destruction of an embryo. Two famous actors, Michael J. Fox and Christopher Reeves testified in front of Congressional committees to remove the obstacles that were imposed as well as having the grant money return to medical schools and research companies. But the process was slow at best due to political and religious issues. Michael J. Fox wanted the stem cell research to continue due to his Parkinson’s disease. And Christopher Reeves of “Superman” fame wanted the research to move forward due to his quadriplegia and spinal cord injuries caused by a fall from a horse. Unfortunately he passed away in 2004 from cardiac arrest. Parents also testified in Congressional hearings in hope of moving stem cell research forward. There was the hope that children with diabetes, strokes, brain injuries, Alzheimer’s, arthritis, Crohn’s disease, diabetes, baldness, cancer, multiple sclerosis, muscle damage, heart damage, and spinal cord injuries could be helped with this research. Perhaps it would ultimately lead to successful treatments and cures for these and other diseases. Continued on page 45
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The problems that develop from injuries to the central nervous system usually result in little if any improvement. Brain, spinal cord, and retinal problems can be treated, but improvements are usually minimal at best. This is because there are few, if any “repairing” cells that can heal damaged central nervous system tissue. This is in stark contrast to problems that can occur in the peripheral nervous system which has “repairing” or healing cells that can improve nerve injuries to your hands, as an example. That is why Christopher Reeve lobbied Congress so often. He knew that his only hope of walking again or moving his arms would be the miracle cure that may be found in stem cells. According to WebMD, “two legally blind women with macular degeneration are the first people ever to receive new retina cells grown from human embryonic stem cells.” One patient had dry macular degeneration and the other patient had Stargardt’s disease. According to Dr. Steven Schwartz, the chief of the retina division at the Los Angeles Jules Stein Eye Institute, “stem cell treatment is being developed as a way to prevent blindness in people with early stage macular degeneration. It is not a treatment for blindness.” Before treatment, one patient could only see hands moving in front of her eyes. Within one month she could read five letters on the
eye chart, she could see more colors, and was able to see her watch and to use her computer. This is a phase 1 study that is designed to test the safety, but not the effectiveness of this type of stem cell treatment. The other important aspects concerning this type of testing includes learning about stem cell biology, the possibilities of immune system rejection, and how new cells can develop in the eye. The first published reports show safety and efficacy. This is a positive first step in improving eye health. Hopefully, there may be more possibilities in the future to improve health utilizing these marvelous cells. This research is in its earliest stages so only time and additional research will unravel this potential. Maybe, just maybe, we may see a few stem cell fueled miracles develop in the coming years. ■
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LAST LOOK Jim Magay, RDO
TIME “Time keeps on slippin’, slippin’, slippin’ into the future,...” sang Steve Miller back in the day (1976). As a young person then (afro, big glasses, bell bottomed slacks – the full catastrophe) I didn’t appreciate the profound truth in the lyric.
THIS WAS ABOUT 10 YEARS before computers started to appear in homes, or for that matter – small offices. It was a year before George Lucas released Star Wars, that iconic Western movie set in outer space! Around that time we would have just been introduced to the Grolman fitting system for AO’s Ultravue progressive lenses, and we had to attend a seminar in Springfield, MA to learn the technique to become authorized vendors. “Big” was in for frames, high index lenses were glass, and CR39 was the material of choice, edges of high minus Rx’s were painted the frame color to disguise their incredible thickness. I had a pair of -7.50’s in a 60 eye Menrad for partying (boy were they thick)! Couldn’t wear contacts – mostly they were PMMA hard lenses then and the early soft lenses had lots of problems. Most folks wore flattops, round TK’s or Executive bifocals with the occasional trifocal or ultex lens. For post-op cataract patients we loved Welsh 4-drops mounted in a Silor frame (the lenses were glued to the eye tops with a rubbery shim and then fastened to the frame, thank goodness for super glue). A lot has changed in the intervening 36 years. I’m wearing a little 41 MM Superfocus frame while writing this. As I fidget around writing, I slide a little button on top of the bridge to stay in perfect focus on my screen. Yes, screen – another change in the intervening years – no more typewriters, now electronic instruments of all types dominate our lives. Smartphones, Kindles, iPads, iPods, laptops, Nooks, etc., etc. Our vehicles have touch screens, GPS’s, Bluetooth this and that. My kids would never drive anywhere without a movie playing for their kids in the back seat. 50 | EYECAREPROFESSIONAL | MARCH 2012
With emPower! electronic lenses presently being rolled out nationally, what would you bet it won’t be long before heads up displays will be incorporated into smart glasses interfacing with cloud computing, and giving us instant face recognition and navigation capabilities? Oh wait! Google is already working on this. In the near future you’ll be able to ride in your driverless Google car while wearing Google interactive eyewear – they will probably look like Oakley Thumps and reportedly will be controlled by a user’s head tilts and/or buttons. The glasses will feature an augmented reality display giving the user a unique view of their surroundings, more advanced than one through traditional glasses. A user can walk around with information popping up and displayed -Terminator-style- based on preferences, location and Google’s information. Since Google recently hired an Apple senior director of product integrity to work on an unnamed secret project one can only surmise that Google stuff is going to look and feel really nice! Interesting to think opticians of the future will probably have less to do with lenses and more to do with maintaining electronic devices. ■
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