EyeCare Professional Magazine April 2013 Issue

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LIGHTWEIGHT EYEWEAR / PAGE 6

DRESSING UP DISPENSING TRAYS / PAGE 14 April 2013 • Volume 7, Issue 64 • www.ECPmag.com

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EYECAREPROFESSIONAL

APRIL 2013 Vol. 7 Issue 64

Features 6

Courtesy of LINDBERG

Contents

Magazine

LIGHTWEIGHT EYEWEAR Keep your customers cool and comfortable with the latest in lightweight eyewear and sunwear.

by ECP Staff

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DISPENSING TRAY PERFECTION How you present a pair of finished frames can make a lasting impression on your patients.

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by Corrie Pelc

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ANTI-EYESTRAIN LENSES Hand held devices have led to an increase in Computer Vision Syndrome in young people.

by Renee Jacobs, OD, M.A.

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SPRING COLOR TRENDS The latest PANTONE report can help give your practice an edge in offering the hottest color trends.

by Lindsey Getz

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RAINY DAY READING Some great books that can help make you a more effective dispenser, manager and overall person.

by Judy Canty, LDO

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MY EXPERIENCE WITH THE REVEREND Detailing a unique experience I had with the renowned Reverend Leon H. Sullivan.

by Elmer Friedman, OD

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On The Cover:

Departments

US OPTICAL

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

800-445-2773 www.USOPTICAL.com

MOVERS AND SHAKERS ..................................................................................16 MANAGING OPTICIAN.....................................................................................18 EQUIPMENT FOCUS .........................................................................................32 OD PERSPECTIVE..............................................................................................38 ADVERTISER INDEX .........................................................................................42 INDUSTRY QUICK ACCESS..............................................................................44 LAST LOOK .........................................................................................................46 EYECARE PROFESSIONAL 3

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EDITOR VIEW Jeff Smith

EYECAREPROFESSIONAL

Magazine

Keeping it Simple he optical industry has been experiencing an explosion of new technology.

Of course, that’s nothing new ... remember when all glasses had glass lenses?

Or when letters were typed on a typewriter? For many people, trying to understand how a computer works can be just slightly easier than transcribing Sanskrit. Remember how frustrating it was long ago when you tried to make sense of what the computer salesman was telling you: Byte? ROM? OS? Well, it has come full circle.

T

Technological advances in lens design, coatings, or frame design and materials can be exciting to us, but just as frustrating to the patient if presented incorrectly.

Remember, what patients really want is simply the best vision possible. While it has become easier to accept the technical jargon associated with computers, the average optical patient hears about PAL, AR, and poly maybe once every two years.

The guiding principle when presenting the latest in optical technology is KIS (Keep It Simple).

The first step in presenting technology is to know as much about it as you can.

The more you know, the easier it is to explain in simple terms. While it may not be important to know all the physics involved in, say, free-form technology, you should know the benefits to the patient of a free-form lens and why. Know when new technology is beneficial to the patient, and when it may not be appropriate, and what the limitations might be. Many of the newer lens designs are engineered to help patients with relatively high corrections, high cylinders, high add powers, or other special needs. Know your products, and when appropriate, never hesitate to recommend advanced designs.

When explaining new designs or materials, emphasize the benefits to the patient.

Think of it as starting at the bottom of a pyramid, beginning with broad, general terms and only advancing to more restrictive, technical language when necessary.

Of course, there will always be those patients who want a more detailed explanation, either out of curiosity or to test you. In that case, go ahead and get more technical, but beware of your limits. If you’re not sure, admit it, don’t try to bluff your way through. If your not sure (or even if you are), grab a brochure and quickly go over it with the patient. This will not only guide you through, but gives credence to what you’re saying.

Publisher/Editor . . . . . . . . . . . . . . . . . . . . . . . Jeff Smith Production/Graphics Manager. . . . . . . . . . . Bruce S. Drob Director, Advertising Sales . . . . . . . . . . . . Lynnette Grande Contributing Writers . . . . . . . . . . . . . . . . . . . Judy Canty, John Dick, Paul DiGiovanni, Gary Fore, Elmer Friedman, Lindsey Getz, Renee Jacobs, Ginny Johnson, Jim Magay, Warren McDonald, Corrie Pelc, Anthony Record, John Seegers, 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 7 Number 64 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 © 2013 by OptiCourier Ltd. All Rights Reserved For Subscription Changes, email: admin@ecpmag.com Scan this barcode with your smartphone to go to our website.

If the new technology provides real benefits, and is presented in an understandable fashion, then the benefits will out-weigh the costs, and the patient will make a financial decision based on value. Get excited by the new technology, and get your patient excited with the amazing benefits made possible by it; after all, you’re offering the best solutions for their vision needs. ■

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LIGHTWEIGHT Eyewear & Sunwear The different materials that make up this segment have one thing in common: comfort and simplicity.

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1. Charmant

2. Scheyden

3. REM Eyewear

XL2040 and XL204: The newly developed temple is made of seven delicate lines laser micro-welded, offering a supple structure, with a simple and delicate look. Created with Excellence Titan, LineArt offers amazing lightness, a gentle touch with hardly any pressure, while at the same time making an ultramodern fashion statement. www.charmant.com/us

The Scheyden Fixed Gear Mustang is hand crafted with the finest materials in the world; offering hand ground crystal clear mineral glass lenses, ultra-light titanium frames, and silicone nose pieces.

A distinguished sporty look designed to fit a range of facial shapes. www.scheyden.com

Visualites reading glasses are renowned for their timeless 3-piece mount style and lightweight TR-90 material. The easy-towear and easier-to-love readers are now available in 21 vibrant colors. These ultraflexible and comfortable readers have developed a dedicated fan base due in part to the seemingly endless variety. www.remeyewear.com

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4. Jee Vice

5. Gold & Wood

6. Kaenon

Timeless is a light little frame, made for the woman with timeless sophistication.

Going back to the classic cat eye and rich color choices, these frames are truly beautiful and forever timeless. Available in Grey, Red and Tortoise. www.jeevice.com

The Alpha model was born from contemporary design mixing natural wood and high tech aluminum, and features the patented Wood Lock System for mounting lenses. The lightness of wooden eyepieces is four times lighter than a frame in aluminum and seven times lighter than a frame in titanium. www.gold-and-wood.com

Kaenon Maya: Maya’s gentle, feminine design draws just enough attention to itself without overwhelming. Subtle surfaces with an upswept, curvy brow, Maya’s classic styling makes for a perfect addition to any trip outside. This frame features Kaenon’s proprietary SR-91 polarized lens material. www.kaenon.com

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J.F. Rey

Each shape of the Lace concept has its own exclusive pattern, the incredible precision of which demonstrates the highly precise engraving work performed in our factories in the Jura. Now everybody’s talking about this extremely lightweight, real lace work. It features a supple and expanding silicon endpiece to make assembly easier whilst discretely ensuring extra efficient hold. www.jfreyusa.com

McGee Group

MOREL

Lightec is now excited to roll out Carbon 4, which features newer, slimmer, carbon temples and is fitted with the screwless Alpha spring-hinge. Two of the Carbon 4 models feature fronts with a stainless steel structure overmolded with polyurethane rubber. Polyurethane rubber is also used inside the temples to provide exceptional comfort, while carbon is visible on the outside. www.morel-france.com

ic! berlin

The style and sophistication of the art deco movement are brought to a fashionable climax in the most recent eyewear styles from Boutique by Totally Rimless. TR 195 features a modern eyeshape with uplift for added interest. The twisted metal temples give a rope effect with a jeweled embellishment and marble acetate temple tips to finish the look. TR 195 is available in Satin and Soft Brown. www.mcgreegroup.com

XX2i Optics Designed with top athletes in mind, France1 Pro Racing Sunglasses offer unparalleled performance while going easy on your wallet. Fully adjustable temple tips and nose pads ensure an accurate, individual face fit that hold strong while remaining feather light. Their semi-rimless design allows for rapid changing of lenses and superior peripheral vision. Fully Rx-able in multiple style and lens configurations including Polarized and Sport Reader. www.xx2i.com

What makes a great idea even better? The answer is: Never stop innovating! Even with simple yet ingenious technologies like the ic! berlin screwless hinge system, there is always room for adjustments that revolutionize the concept. ic! berlin have just raised the bar with its new inclination hinge, which allows the wearer to change the angle of the frame up to 3 degrees up or down to ensure that temples perfectly fit to each person’s ear. www.ic-berlin.de

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Pro Design

Marcolin

Olivia in color 072 (shiny pink): This elegant style offers a feminine shape with a semi rimless construction. The profile is thin, providing a delicate temple design with four small crystals decorating the temple and end piece. Featuring snap-in adjustable nose pads and spring hinges for additional comfort. www.marcolinusa.com 4th Dimension 4681-83: A highly feminine collection for the woman who wants a retro acetate frame – but still with very unique look. The designer have used the amazing 3D temple design and combined with brand new layered acetate color combinations, for fronts and end tips, the end result is really striking. www.prodesigndenmark.com

Match Eyewear

Clariti Eyewear There is no need to sacrifice style or quality when choosing a lightweight frame. Style 1108 from Adrienne Vittadini features a stainless semi-rimless front with intricately laser etched filigree temples subtly embellished with Swarovski crystals.

Vibrant semi matte colors include Purple (shown here), Red, Brown, and Black. www.matcheyewear.com

Konishi Lite KL3684: The Konishi Lite Collection offers an array of weightless, sleek frames made for everyday leisure. You’re going to love the look of freedom. www.claritieyewear.com

LINDBERG The LINDBERG Strip range has been extended with completely new designs in the upper rim 7000 range and modified versions of the existing full frame strip. A new vibrant orange stands out and will be an eye catcher in this collection. www.lindberg.com

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mlindberg 2164 路 PATENTED

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Trevi Coliseum Eyewear

Cotton Club Carbon Fiber Line is constructed of the newest space age materials and defines the concept of style, quality and luxury. Made of carbon fiber with rubberized temples for lightweight comfort, extreme strength and adjustability, Model CC 280 is available in Black Gun, Black and White Black (shown) with a striking contrast. Made in Italy and backed by a two year warranty. Sold exclusively in North America by National Lens. www.national-lens.com

Hilco

Hilco’s FrameWorks™ Premier Rimless Collection ... “Fashion Forward” styling with end piece and temple embellishments and treatments. Available in Gunmetal/Black and Gold/Brown, in sizes: 53-17-140 and 51-17-140. www.hilco.com

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Kodak and the Kodak trade dress are trademarks of Kodak, used under license by Signet Armorlite, Inc. CleAR is a trademark of Signet Armorlite, Inc. Š2013 Signet Armorlite, Inc.

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MARKETING ECP Corrie Pelc

Presentation Perfection

dispensing tray is a plastic tray that is the same tray they used back in the lab.

Case in point – eyewear. How an optical or optometrist’s office presents a pair of finished frames to their patient can make a lasting impression, either good or bad.

Patricia Bobilin, managing director of the southern region for Eye Designs, has found that a number of opticals and offices use a dispensing tray like this, that many times still has material on it from cutting lenses or other lab work, making them not very attractive looking. This, she says, can be a poor reflection on a practice in the eyes of the patient.

“Presentation is such an important part of the optical experience – you want your patient to perceive their eyewear as something unique,” says Susan D. Weeks, ABOC, dispensing optician/office manager at The Vision Center at Seaside Farms in Mt. Pleasant, SC. And George Karber, general manager and board certified master optician at North Cypress DEY Optical in Cypress, TX, says cleanliness in presentation is top priority. “Patients will be more open to products, especially upper end products, if it looks pristine and brand new,” he explains. “It can’t have dots on it from marking ... fingerprints need to be removed. You just need to keep your product very fresh looking like you just took it out of a package from the manufacturer.”

FROM DISPENSING TRAY ...

Many times when an optician is delivering finished eyewear to a customer, they are doing so using what is commonly referred to as a dispensing tray. For many opticals or optometrist offices, the 14 E Y E C A R E P R O F E S S I O N A L

“If somebody is spending $200-$500 plus on a frame, you don’t want to give them a dirty tray when presenting back their finished product,” she adds. “In any medical setting, it should be as clean as possible. You really need to have something that’s more upscale, is clean, and gives a nice presentation.”

For Craig Chasnov, optician and owner with his wife of Eyetopian Optical in Fort Myers, FL, the plastic work tray “never, ever” goes out to a dispensing table or comes out of the back room. He says every pair of eyewear presented to a customer should be handled like a piece of jewelry. “If you go to a jeweler, they would never bring it out in a plastic container – they always bring it out on a nice jeweler’s pad,” he explains. “If it isn’t something you would find in a jewelry store, I wouldn’t do it in my store.”

Ey eD

In the world of selling, presentation is key. And that doesn’t include just how an item is presented to the customer when they first come in – presentation is just as important when a customer has already purchased an item and is coming to pick it up.

esi gn sP res en tat ion Tr ay

Turning Your Dispensing Tray into a “Presentation Tray.”

TO PRESENTATION TRAY ...

To help make a better presentation when dispensing eyewear, some opticals and offices are elevating the dispensing tray to a “presentation tray.”

For example, Weeks uses a black colored wooden tray, about 8 inches by 7 inches in size, lined with velvet to bring completed eyewear out to customers. When dispensing, eyewear is placed in the front of the tray and in the back of the tray is a bag with the practice’s logo on it. In the bag, Weeks says the customer will find the appropriate branded case for their new eyewear, his business card, lens authenticity card, cleaning cloth, bottle of spray cleaner, notepad, pen and a piece of gourmet chocolate.

“A large part of my reputation rests on the patient’s overall dispensing experience,” Weeks explains. “The finished product carried in a tray to the table, along with the proper fit and instruction of wear, is what sets us apart from others.

No matter the cost of the eyewear, it needs to be presented to the patient as if it’s the

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most expensive item they have ever owned.”

Gary Fore, lab manager at Texas State Optical, says having a well-designed and appointed “presentation tray” could offer an opportunity for an optician to present the finished product with a “bit of flair” and enhance the eyewear so patients can

frames, plus a space for a cleaning cloth and case. “Especially for higher end products, a tray with a velvet cloth, cleaning products and cloth help the patient see the special nature of what they chose and purchased,” he says.

To meet the needs of their clients, Eye Designs has developed its own

CNS Fram e

Displays

– Tray w

ith overla y

for 6 glas ses.

11.75 inches long, and has three slots for placing frames, plus a larger slot at the end for holding a case or cleaning cloth.

Bobilin says they picked materials that were easy to clean, and decided on the black color as it helped hide smudges or dirt from lotion or dirt someone may have on their hands. “There’s a reason why we did everything to that tray, even the size of it — the depth of the last compartment holds most optical cases, especially sunglass cases because they’re pretty big,” she adds. “There was a lot of thought that went into it.”

TO “FIRST IMPRESSION” TRAY ...

Although the higher level “presentation tray” can help make a good final impression on a customer, it can also help make a good first impression.

see the value. He envisions this type of dispensing tray being made of hardwood with several divided areas for different

presentation tray. The tray has a black leather-type material with a satin finish interior, measures 7.75 inches wide by

For example, some opticals even use a higher-end looking tray to help customers shop. Chasnov uses a black tray, measuring about 12 inches by 24 inches, lined with black felt for not only dispensing finished eyewear, but also to carry multiple frames when a customer is Continued on page 16

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“Some opticals and offices are elevating the dispensing tray to a “presentation tray.” selecting different options to try on.

“Instead of holding a handful of glasses, I’ll go grab a tray and use that,” he explains. “It makes it just like a shopping cart.” Chasnov feels having a more professional tray such as this has helped him with not just regular sales, but second pair sales as well.

For its presentation tray, Bobilin says they recommend optometrist offices to use the tray as a way to start a patient’s appointment by handing the patient the tray and inviting them to visit the optical

and start selecting frames. Being that the tray has three slots, that normally encourages patients to select three frames. And after the eye exam, “it also helps with the capture ratio because the patient feels very obligated to go back in there to buy frames because they’ve already picked out frames,” she explains. “If I can take a capture ratio and increase it by one percent, that could be worth tens of thousands of dollars to somebody.”

displaying and bringing out “finer merchandise,” such as jeweled frame lines, to customers. “It distinguishes the products from everything else that is on the board because being separated and isolated like that, it gives more attention to its own detail,” he explains. “The presentation is definitely a big deal and presentation trays can go a long way on just differentiating yourself from the average optical that is out there.” I

And at North Cypress DEY Optical, Karber says they use a higher-end tray for

MOVERS & SHAKERS Luxottica Retail Optical North America

Eyeglass.com

Mark Weikel has been named president and CEO of Luxottica Retail Optical North America, a major division of Luxottica Group.

He had formerly been president and general manager of LensCrafters, and joined Luxottica Mark Weikel in 2010 as general manager of Sunglass Hut North America. Previously, Weikel served as chief operating officer of Lord & Taylor department stores and chief operating officer of Victoria’s Secret stores.

Eyeglass.com, one of the first online eyewear retail websites, announced that public relations and marketing authority Richard Laermer will become its new CEO. Eyeglass.com’s founding CEO, Jim Morrison, Richard Laermer will become chairman of the company and remain active in the site’s day to day business. Laermer is an author, blogger and founder of the dot-com marketing firm RLMpr, which has helped raise the profile of a range of e-commerce and digital media companies.

Viva International Group Viva International Group has named Antonio Bortuzzo as its new president. He is succeeding Sherry Lay who served as interim president following the departure of Frank Rescigna several months ago. Most recently, Bortuzzo Antonio Bortuzzo was chief executive officer of Alain Mikli International Group. He was also the CEO of fashion optical eyewear wholesaler Allison S.p.A, and, from 2002-2007 he was the CEO and general manager of Marcolin Group.

FGX International FGX International has named César Melo as chief executive officer. Melo arrives at FGX International after a 23-year career at ColgatePalmolive, one of the world’s leading consumer products companies. Melo has lived and César Melo worked in the U.S., Central and South America, Asia, Europe and Russia in roles of increasing responsibility in general management and marketing with Colgate-Palmolive.

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EYECARE PROFESSIONAL

VSP Global VSP Global has named Darryl Lemecha chief technology officer. Lemecha, who most recently served as chief operating officer of Eyefinity, a VSP Global division, succeeds Jim McGrann in the role. McGrann will now focus Darryl Lemecha solely on his role as president of VSP Vision Care. Before entering the optical industry with Eyefinity in May 2011, Lemecha was an award-winning senior technology leader in a range of industries.

Reichert Technologies Reichert Technologies, a unit of Ametek Ultra Precision Technologies, has named Christopher A. Thatcher as division vice president and business unit manager. He has over 19 years of experience in developing new Christopher Thatcher products, and also has an extensive background in ophthalmology, having previously held executive positions at Bausch + Lomb and Allergan.

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MANAGING OPTICIAN Anthony Record, ABO/NCLE, RDO

As Easy as A-B-C THERE’S ALWAYS ROOM FOR IMPROVEMENT. If you’re not a part of the solution, you’re part of the problem.

f you’re not learning something new you’re falling behind. Those are three of the most famous if not annoying quotes regarding the need for continuous improvement. I think we’d all agree that there are some aspects of ophthalmic dispensing we need to improve.

I

For some eye care professionals (ECPs), that area of improvement might be technical in nature. Others may feel the need to improve communication skills, including persuasion techniques and the ability to overcome objections. Organizational skills, time management, sales...the list goes on and on. Regardless of the skill area you wish to improve, always remember two things. First, there is no guarantee that the steps you choose to overcome your challenges will be effective – success is never a guarantee.

However, the second thing to remember is probably the most important: If you always do what you’ve always done, you’ll always get what you’ve always got. That’s IS a guarantee. We have to do things different than we do now. For some ECPs that means starting to do things that aren’t being done now; for others it means they have to STOP doing some things that are being done now.

Here are three ABCs that I believe are critical to making what could be significant improvements in your abilities as a dispenser. As you read them, ask yourself what things could you start doing that you’re not doing now;

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

what things should you stop doing that you are doing now; and what things could you be integrating into your optical habits that have never even crossed your mind.

Advocacy. That’s right – advocacy.

Perhaps one of the single most impactful things I started to do was to consciously decide to be an advocate for my patients.

Act on their behalf. Keep their best interests at heart. The mutual benefits of that approach are infinite for you and your clients.

For example, if the driving force for you trying to sell polycarbonate or Trivex® lenses is that your district manager is on the phone every morning hassling you for having the lowest percentages in the entire district, chances are no improvements will be made. If on the other hand your driving force for providing the most-impact resistant lenses on the face of the earth to each and every one of your patients is because you take seriously their safety and well-being...then that approach would

probably have a significant impact on your poly and Trivex sales. Of course you probably have to start doing some things differently too. Perhaps that means not even asking which lens material a patient wants, simply entering your lens choice for the patient on the order form. Why even discuss it? I can think of only one reason: A patient asks, “Why is the fee for my lenses so high?” Maybe you could stop answering that question (and similar questions) the way you do now.

Perhaps you could start answering it in a spirit of advocacy. “I give all my patients this type of lens because it’s hands down the best. It provides the most physical safety for your eyes because it is the most impact resistant...the cheaper lenses are far more likely to shatter should you ever be in an accident or get hit with something...and they have built in protection from harmful ultraviolet rays from the sun that cause cataracts and macular degeneration...you know, the same thing that causes skin cancer and sunburn.

They’re also way thinner and lighter [or in the case of Trivex, the lightest, most comfortable], and they have a really tough, guaranteed scratch-resistant surface. Look, if you were my mother/sister/father/brother this is the kind of lens I’d give you.” (By the way if working with a woman and you can’t decide whether to say mother or sister...always go with sister.)

Be Up Front. What does that mean? Stop waiting for the patient to come back to your dispensary a

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few weeks after picking up her Transitions lenses to complain that they don’t get very dark in the car. Start having that discussion on the front end – whether the patient has already decided on his own that he wants Transitions, or if you suggested them.

Have the discussion up front. If he already wears Transitions, simply reiterate what he probably already knows: “I see you’ve been wearing them for a few years now, so you know that Transitions don’t get as dark in your car as they do in direct sunlight outdoors, right?” If you start using that question, perhaps that will open the door for discussions involving Transitions XTRActive or a separate pair of polarized sunglasses. The same holds true with a new Transitions wearer. You won’t lose many sales by explaining their performance up front. But you will gain many loyal clients.

Another example of being up front might be an honest discussion of the efficacy of standard progressive lenses. Yeah they’re great, but are they adequate for

intense ten-hours-a-day computer users?

Not in my experience. Being up front means that at the initial fitting you talk about that in addition to her everyday progressives, the patient might find a pair of Near Vision Focus (aka office progressives) lenses beneficial. If you start having those kinds of conversations, maybe you’ll begin to discover what I have learned over the years: When I make up-front suggestions, eyewear-related diagnoses, and efforts to overcome initial objections I feel like a professional, a teacher, an advisor, an advocate. When I failed to do that I was then forced to sell, defend, explain, and back pedal. That made me feel like a weasel. The choice is yours.

Consistency. The final letter in the ABC acronym, being consistent, is a function of the other too. Consistency means that many of us need to stop picking and choosing the people for who we will be advocates. Rather, we start advocating for the eyes and vision of every potential patient who crosses our threshold.

Every one.

It also means that we be up front with every frame, lens, and accessory we sell - the good, the bad, and the ugly. Let honesty be your guide.

Years ago, in a continuing education seminar, the instructor used a metaphor that I think really explains what consistency means in this context. He said it was like fishing. He said imagine you plan to go fishing with your buddy, and the gods of fishing have ordained that you will catch a fish 10% of the time you cast your bait in the water. Now...if you start goofing around, telling jokes, sipping Margaritas and you each end up casting your bait ten times each, you will go home with two fish. But if you get serious, goof around a little less, tell fewer jokes, put off the Margaritas until you get home, and cast your bait a hundred times each, how many fish will you go home with? Twenty.

Go fishing every day. Be consistent. Reap the benefits. (In case you’re interested, that instructor was me.) I

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THROUGH THE LENS Renee Jacobs, O.D., M.A.

Anti-Eyestrain Lenses: Improve Focus and Energy to Boost Productivity

G

REAT TECHNOLOGIES can bring information literally to our fingertips. Integrating that information, combining what we know with what we want to know, requires sustained focus and attention at near. Continuous accommodative demand can have side effects. Many suffer from symptoms of eye strain, occurring at younger and younger ages. Because school age children, college students, and young professionals use digital devices during study and daily work, they increasingly suffer from dry eyes, tired eyes, and blurry vision. It is no surprise that motivation suffers too.

To state it bluntly, the bad news is that eyeballs cannot adapt as fast as hand held technologies gain market share. Now, even young people are suffering from symptoms of Computer Vision Syndrome which is also known as Visual Fatigue Syndrome. The good news is that optical solutions exist. Now is the time to evolve your lens mix, differentiate your business, and increase revenue per patient. We can achieve business success by offering comfortable alternatives to traditional single vision lenses in order to assist these patients. Help your patients improve focus plus productivity during school, work, and digital recreation.

Identify Your Anti-Eyestrain Products of Choice Before selecting your products of choice, investigate technology options, wholesale price points, as well as vision plan reimbursements.

Vendors employ a variety of methods to reduce eye-strain. Some position low addpower in down gaze or straight ahead gaze. See Figure 1.

Computer Vision Syndrome does not have any age prejudice – it strikes across all demographics. Potential consumers are young individuals who enjoy digital

Figure 1: Anti-Eyestrain Lens Products Providing some plus power in order to relax the ciliary muscles is one method to reduce eye-strain. Other methods include a tint to improve contrast, prism to aid convergence, hues to adjust color spectrum from back lit devices, filters to decrease HEV (High Energy Visible) light, wrap to reduce tear evaporation, and antireflective layers to cut glare.

Understand Market Forces When you investigate wholesale price points and vision plan reimbursements, it helps to understand dynamic market forces. These market forces include the consumer, eye care providers, online retailers, and vision plans.

devices for work, study, and play-the people who suffer from digital eyestrain such as the asthenopia described earlier. These patients don’t want the stigma of bifocals, and they don’t want the expense either.

For this reason, vendors and online retailers are differentiating anti-eyestrain lenses from single vision options with creative tactics to avoid progressive lens status. Visit YouTube to experience campaigns directed at consumers. View www.youtube.com/watch?v=fQCTA26NiJo (retrieved 17 March 2013) to understand how Gunnar’s patented “i-AMP lens technology platform”, with “fRACTYL lens geometry”, “pre-focuses light” specifically tuned for mid-range viewing distances.

Continued on page 22

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View www.youtube.com/watch?v= 0cL6OxRdVZQ (retrieved 17 March 2013) to learn how Hoya customizes “Radial Aspherization” to add an “Activated Area” to the bottom of the lens creating a “whole new class of modern single-vision lenses”. Notice the imagery, word choice, and testimonials targeting young people.

the optical center. When sophisticated software calculates free form topography, the lens shape nasal to optical center might be different than the lens shape temporal to optical center. Then, apply this reasoning to progressive lens design.

Progressives can be defined as a kind of atoric, such that lens topography becomes increasingly asymmetric in down gaze.

It is one thing to differentiate anti-eyestrain lens products from single vision lenses, and position them as an affordable alternative for consumers. It is more difficult to differentiate the same lens products for eye care providers and vision plans. These market forces have an existing paradigm for understanding low add progressives and near-variable focus lenses. In each case, plus power provides accommodative relief, each brand has unique fitting parameters, and each wholesale price point is justified by the technical difficulty inherent in ordering or manufacturing.

Furthermore, inside robotics enabled labs, the real difference boils down to complexity of proprietary software that computes the topography for each branded lens design. Digital manufacturing is similar for all the lenses. Realize that individuals - who understand optics - might object to differentiating anti-eyestrain lenses from near variable focus lenses and progressives.

In order to address these challenges, some vendors are attempting to re-define a lens technology continuum, expanding the category of atoric lenses. See Figure 2

Because differentiation is complicated, and dynamic market forces are at work, you are likely to discover inconsistencies between the brands when you evaluate wholesale price point and vision plan reimbursements. With this understanding, research diligently when you select antieye strain products best for your patients and your business.

strain lenses. Thomas Gosling O.D. is an independent optometrist who practices in Centennial, Colorado.

Thomas Gosling, O.D.

Dr. Gosling shared advice that any optometrist can follow. He reports that his success hinges on two things. First, he correctly identifies patients who will benefit from anti-eyestrain lenses.

Second, he helps each patient experience improved visual comfort during the eye examination. And whenever possible, he uses the patient’s own digital device during his demonstrations.

Correctly identifying patients is as easy as adding media use questions to your current medical history questionnaire.

Ask patients about their typical day. How many hours are they viewing their smart phone, tablet, lap top computer, and ereader. Ask if they alternate focus between devices. Some people use multiple tools while also watching TV. Ask about digital hobbies like gaming or online scrapbooking. Notice patient behaviors like rubbing eyes or squinting.

Figure 2: Expanded Lens Technology Continuum

Think through the logic while envisioning shapes. /Spherical/ means round shaped. /Aspheric/ means not round shaped. In practical terms, we know that aspheric lenses will flatten or steepen symmetrically on either side of the optical center. Next, atoric lenses are another kind of aspheric shape. In practical terms, atoric lenses are not symmetric around 22 E Y E C A R E P R O F E S S I O N A L

Follow a Leader Once you know your products, understand market forces, and set your own fees, then look for a role model.

Sometimes it is easier to follow a leader rather than trail blaze.

Recently, I met someone who has achieved business success with anti-eye-

Finally, ask about symptoms and severity. Inquire about dry eyes, tired eyes, fluctuating clarity, decreased concentration, light sensitivity, poor night vision, and overall body fatigue. Remember to ask about neck, back, and head pain too. Do not exclude school age children. They often use computers for school work, smart phones for email and social media, and they play video games too. Even those with 20/20 distance acuity can suffer ocular side effects plus attention deficit secondary to sustained near focus.

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smart phone or tablet. He asks, “What do you notice? How does it feel? What do you see?” Many patients immediately experience sharper vision and greater comfort. After about 15 seconds, Dr. Gosling lifts the flipper. If the patient reacts by pushing their hand-held device further from their eyes and squinting, then Dr. Gosling knows he has identified a candidate for anti-eyestrain lenses.

Low Add Flipper, Best Rx and Digital Device

When a patient reports symptoms, then “show and tell” the benefit of prescription help toward relaxing their eye muscles at near. Let patients experience this comfort during the eye examination, well before the point of sale.

Follow this video link, to see how Dr. Gosling tests and demonstrates accommodative relief with low plus power. www.practicemanagementdepot.com/Free /ECPMagTGoslingODdemo.php If you are feeling uncertain that your patients will love anti-eyestrain lenses, watch the video. Dr. Gosling uses a +1.00 flipper, over the patient’s best corrected distance Rx, while the patient views their

When the patient’s responses indicate visual benefits from low add power, Dr. Gosling does one additional test. He repeats the use of the flipper while instructing his patient to shift their eyes from their hand-held digital device to the distance eye chart, the instant the flipper is raised. If his patient reports comfort at near and clarity at far, again, that individual is a good candidate for anti-eyestrain lenses.

Troubleshoot Any Failures Dr. Gosling reports a 95% success rate identifying patients who will enjoy anti-eyestrain lenses. He also studies every single non-adapt. For each case, he reviews documented history questions regarding behaviors and symptoms of eyestrain. He re-confirms acceptance of add power during “show and tell” with the plus lens flipper. Finally, he interviews

each patient, and listens to their reasons for non-adapt. He asks if the patient experienced any improved visual comfort or mental focus.

Dr. Gosling reports that the most common reason, for non-adapt, is what you might predict. Even subtle amounts of plus power, or asphericity, positioned in down gaze, alters peripheral vision.

Some patients, especially athletes, prefer the edge to edge clarity of single vision free form lenses. These patients might prefer separate reading glasses or occupational progressive lenses during sustained near work.

Like Dr. Gosling, you can use both science and art to help most of your patients most of the time.

Succeed in Business Notice each patient who complains of intermittent blur, tired eyes, headache, eye strain, fatigue, and lack of mental focus.

Realize that digital devices can cause ocular side effects and attention may suffer as well. To date, there is no App to prevent eye fatigue!

You can make a difference. Embrace new technology lenses. Evolve your lens product mix. Achieve success prescribing anti-eyestrain lens solutions. I

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THE FASHIONABLE ECP Lindsey Getz

E

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 2013 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-to-date on the color trends of an approaching season so that you can guide your patients in the dispensary. Your knowledge of 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 colors are bright and cheery. According to PANTONE, the designers are addressing consumers’ “desire for self-expression, balance, and the need to re-energize.” The fashion savvy are pairing dynamic brights with some go-to neutrals to create fashion combinations that demand attention, yet still offer some practicality.

“The expression ‘balancing act’ is something we all relate to as we strive to find harmony in the frantic pace of our everyday lives,” said Leatrice Eiseman, executive director of the Pantone Color Institute®.

“The same can be said for fashion as we look for a balance between light and bright, classic and new. This season’s color

Spring Color Trends Bold and Bright Colors are the Latest Hit for Spring Accessories palette emphasizes this need for balance, while at the same time allowing for individuality, self-expression, and excitement.”

Green with Envy There is no denying that green was a big hit on the runway this season. And with several different shades of green making PANTONE’s list, it’s obvious that green is going to be a hot color in spring and summer accessories.

According to PANTONE, this season’s shades of green offer a “stunning foreground or the perfect backdrop for all other hues.” “Tender Shots” is one of those shades and is a vibrant yellow-green that falls somewhere in the middle on the brightness scale.

“Grayed Jade” on the other hand is much more subtle with a gray undertone that the experts at PANTONE say “brings about a mood of quiet reflection and repose.” The sophisticated “Emerald” green that has made PANTONE’S top 10 list is a much more lively and radiant green and definitely one of the most popular hues seen in spring fashion previews.

Red, Orange, Yellow For the fashion-savvy who want to go very bold, the exuberant “Poppy Red” that made PANTONE’S top 10 list is a bright choice. PANTONE says this shade of red is “seductive, sensual, and celebratory and whether it’s used for a knockout dress or a kiss on the lips, every woman’s wardrobe Continued on page 26

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You could WIN a cruise certificate & earn gift card rewards Purchase KODAK Progressive Lenses from a participating lab during April 1 - August 31, 2013.

Register now and redeem lenses at:

www.KODAKLensPromo.com

ABBREVIATED PROMOTION RULES Promotion includes a sales incentive program and sweepstakes. No purchase necessary to enter sweepstakes. Open to individual eye care professionals or eye care practice employees who are 19 years of age or older and a legal resident of one of the fifty United States or District of Columbia, and who have approval from an owner, officer or director of the professional eye care practice at which such individual is employed or working. Void where prohibited.

Runs 4/1/13 - 8/31/13. Subject to official rules (which include details on free method of sweepstakes entry) available at www.KODAKLensPromo.com.

Sweepstakes Prizes (cruise certificate or cash alternative) will be awarded to the professional eye care practice at which the registered participant is employed or works, NOT to the entering participant. Gift card incentives will be awarded to the individual participant.

Kodak and the Kodak trade dress are trademarks of Kodak, used under license by Signet Armorlite, Inc. All other brands mentioned are the property of their respective owners. Š2013 Signet Armorlite, Inc.

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and beauty essentials should include this spirited true red.”

Also on this season’s list was “Nectarine,” a bright and effervescent citrus orange with coral undertones that PANTONE says “provides a tangy burst of flavor.” On the other hand the cheerful “Lemon Zest” on the list brings out a “piquant taste while remaining very refreshing with its spritely greenish cast.”

True Blue, and Purple Too! Of the blues and purples that made this year’s top 10 color list, the exotic “African Violet” was a designer favorite, bringing a touch of “intrigue” to the color palette.

The experts at PANTONE say that fashion savvy individuals will try incorporating it into a number of different combinations—perhaps matching it with a neutral or even going bolder and pairing it with this season’s “Poppy Red.” In terms of blue, two different shades made the recent list including “Dusk

THE TOP COLORS

Blue” which is a much more subtle hue that offers a sense of tranquility and is quite similar to its green counterpart “Grayed Jade.” According to PANTONE, Dusk Blue and Grayed Jade are this season’s two “newest neutrals.” For a deeper shade, designers went with “Monaco Blue,” a fairly classic blue that is reminiscent of navy but a bit bolder and brighter.

The fashion experts at PANTONE suggest pairing it with Poppy Red or even Emerald for a “fresh collegiate look.”

Preppy styles are always popular in the spring!

Fallback Neutrals Neutral tones like white, beige, and gray are always go-to colors for the springtime.

They are the canvas on which many fashionistas build their look—using a neutral base for their clothing and then punching it up with colorful accessories like scarfs, handbags, and of course eyewear. In addition to the new neutrals Dusk Blue and Grayed Jade, a warm “Linen” color also

DESIGNERS’ TAKE Every year Pantone interviews some of the hottest designers from New York Fashion Week to find out how they’re using color in their fashion designs. Here’s a sampling of what some of the designers had to say about color in Spring 2013 fashion.

BCBG BY MAX AND LUBOV AZRIA This season’s inspiration? The graphic nature of Black and White photography as well as the dusty muted hues of vintage color photography and garments—the sophistication of the mysterious hues and shadows create a curious mood.

Signature Color? Frosty Blue and Cool Dusty Pink—these colors are fresh, yet muted, and invite a feminine mood to the strength of the season.

NICOLE MILLER Inspiration? Flowers, books, and art

Signature Color? Slate Blue as a neutral—it’s much more interesting than traditional neutrals and complements the other colors prominent in the collection.

made this season’s list. This light and airy tone provides a “nude-like basic that is a ‘must-have’ for spring,” say the color experts at PANTONE.

Catering to the Fashion Savvy— and those who aren’t as well While not all of your clients care much about fashion, it never hurts to try and stay on top of the latest trends.

Oftentimes, some of the most unsuspecting patients turn out to be interested in fashion and recommending shades or ophthalmic eyewear that is on par with the latest fashion trends may be an appreciated gesture.

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.” I TOMMY HILFIGER Inspiration? Classic Tommy Hilfiger heritage colors and patterns.

Signature Color? The brand’s classic Reds and Blues are present in Haute Red, Port Royale, Rust, True Blue, Bright Cobalt, and Sky Captain.

ELIE TAHARI Inspiration? The outdoors, ocean, and beach inspired a lot of the colors such as Rainstorm, Mushroom, Cotton Seed, Sea Bed, Meteor Blue, and Scuba.

Signature Color? Hibiscus Red—it’s vibrant, stands out and transforms a basic piece into a fashion forward statement.

TRACY REESE Inspiration? The Greens at Premiere Vision in Paris; back in New York my book of David Hockney landscapes with several paintings of forests with so much greenery—the vast palette of Greens he used really struck me.

Signature Color? Mentholescence, and White would be a close second—the freshness of these colors paired together is really extraordinary.

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DISPENSING OPTICIAN Judy Canty, LDO

What to do when it’s Raining As I’m writing this, it’s raining…again. The temperature isn’t climbing out of the 40’s in Virginia Beach and a weather-predicting rodent in Pennsylvania has been indicted for fraud.

What to do?

READ A BOOK, OR TWO. First up, The Experience Economy, Updated Edition, by Joseph Pine II and James H. Gilmore. Originally published in 1999 and updated in 2011, Pine and Gilmore examine new ways to connect customers to the goods and services they want by creating the level of loyalty necessary to compete and prosper in almost any market. Using such diverse companies as Disney, the U.S. Army, Heineken, Starbucks and Wal-Mart as examples, the authors examine how to build customer loyalty in a marketplace filled to the brim with commodities.

For example, coffee beans are a commodity, sold in bulk in a commodities exchange. So what are the differences between a cup from your kitchen, a cup from your local diner, a trip to Starbucks and a cup of coffee at the Caffé Florian in St. Mark’s Square in Venice? About $15.00 (plus airfare). Worth it? Could be. I don’t even like coffee, but the idea of meeting a friend at the local Starbucks seems more exciting than meeting at the local fast food place. It’s not about the coffee; it’s about the Starbucks experience.

“When a person buys a service, he purchases a set of tangible activities carried out on his behalf. But when he buys an experience, he pays to spend time enjoying series of memorable events that

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

a company stages—as in a theatrical play—to engage him in an inherently personal way.”

This book, which has become a business classic, sparked my interest in creating the Dispensing Experience or “Dispensing Theater” as I covered in a previous Eye Care Professional article as well as the idea of creating the perfect patient experience from scheduling the appointment to the final dispense.

While the business of eye care is serious, the patient experience need not be. Why else would Dean Butler bring the manufacturing process into each LensCrafters location and put it in full view of customers? He accomplished several things with this approach.

• The actual processing of eyeglasses was de-mystified.

• The lab technicians were seen doing serious work in lab coats.

• The “experience” of choosing eyewear as an accessory was heightened with a wide variety of frames to choose from.

• The immediate gratification of wearing a customized product home the same day it was ordered.

This is eye care as “edutainment” or “infotainment”. However it is viewed by patients, it is an experience, not just an appointment. “ …medical providers should rethink the educational element of treatment, lest the ever-increasing availability of information online further frustrate doctors and patients as they communicate past each other. And what hospital or doctor’s office wouldn’t benefit from fundamentally rethinking the ‘waiting room’ paradigm in order to increase the esthetic value of the welcoming

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The second book I recommend is The Drama-Free Office by Kaley Klemp and Jim Warner, published in 2012. Truth be told, if you are a manager, want to be a manager or need to manage your manager, this is a great book.

Fair warning, the first step is a doozy.

Klemp and Warner demand that you first learn to manage yourself, so be prepared for some serious soul-searching to find your own hot-buttons and how to keep them turned off.

The authors help you identify the 4 dramatic personalities: • The Complainer—“Nobody knows the trouble I’ve seen.”

• The Cynic—“That will never work.” experience?...Take a cue from refractive eye surgeon Roy Rubinfeld of Washington Eye Physicians & Surgeons in Chevy Chase, MD, who joins staff and patient in a shot-glass toast of carrot juice before entering the surgery room!”

The Experience Economy should be on your nightstand or on your e-reader, if for no other reason than to ignite the single idea that could change the eye care experience in your practice from routine to memorable.

• The Controller—“Nobody does it better than me.”

• The Caretaker—“No, no…let me do that for you. I’ll take care of it.”

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Once you are able to identify these 4 personality behaviors, you’ll also recognize that they rarely surface one at a time. Most often they arrive in combinations: • The Complainer-Caretaker becomes The Martyr, or • The Cynic-Controller becomes The Cunning Dictator.

Using case studies and scenarios based on several thousand encounters, Klemp and Warner coach you through the process of redirecting unproductive behaviors toward what they describe as authentic behavior, that combination of effectiveness (productivity) and awareness (the ability to see situations from differing viewpoints) that desire to learn from every encounter and not fall into your own disruptive behaviors.

You can read the introduction to The Drama-Free Office at their website, www.dramafreeoffice.com.

At a time when everyone, from the very newest new-hire to the seasoned practice owner is sweating a slowly recovering economy, this book will help you create a positive environment focused on stability and growth. I only wish that I had found The Drama-Free Office several decades ago.

The third and final book on my Kindle is Quiet: The Power of Introverts in a World That Can’t Stop Talking by Susan Cain. A full one-third of us are introverts. Because society has placed a high value on extroverts, we are missing some of the skills that introverts possess. Introverts are inherently good listeners.

They ask lots of questions and benefit from a quiet space to reflect on answers and seek solutions. Introverts thrive on cooperative rather than competitive environments. Unfortunately, we encourage extroversion almost from birth, somehow believing that constant

stimulation will produce the perfect child, teenager and finally our concept of the successful adult.

This is an eye-opener for all of us who envy the gifted speaker or a quickwitted friend, but are more comfortable reading a book or creating a work of art or a deep conversation with friends.

Susan Cain introduces her readers to the joys of being an introvert and, through careful research and the stories of real people shows us how we undervalue introverts and what we lose as a society by doing so. I even found a new way to describe myself. I am an ambivert, extrovert in some situations and introvert in others. I thought I was just “odd”.

Eventually the sun will come out, spring will stay until summer, but until then, find a cozy spot and read a book or three. I

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EQUIPMENT FOCUS John Seegers, M.Ed., LDO, owner – OpticianWorks.com

Parts – What To Stock Toaster broken?

Toss out the old one and go buy a new one.

Coffeemaker broken?

Toss out the old one and go buy a new one.

MP3 player broken?

Toss out the old one and go buy a new one.

Cellphone broken?

Toss out the old one and go buy a new one; and, of course, extend your current contract by two years.

Glasses broken?

If you have the same frame, in the same size, in the same color, you may well toss out the old one and replace it with a new pair.

However, there are many times and many scenarios where you will need to repair a pair of glasses for continued wear, or at least repair a pair until a new pair can be ordered, shipped and received.

Where I work, we are obsessive about tossing out anything dated or no longer in use. We stock around seventy to a hundred different parts. This article mentions only the minimum of parts that you could stock to provide basic customer service.

Quick Tip: If you sell high-end rimless chassis, then you need to stock a few complete back-up frames for repairs. Do an immediate repair using loaner parts, then do the complete repair using new parts when they arrive. That is the level of service a customer expects with high-end products.

To your patients, “broken” can mean their glasses are missing eyewire screws, missing nose pads, have poor alignment, have broken temples, or are missing or have chewed up temple ends. Of course,

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

“broken” can also mean, “I backed the car over them.”

The most commonly needed repair will be replacing the missing eyewire screw, so be sure to stock a good variety.

Ninety-nine percent of the time, for this problem, I default to a gold, thread-lock, coated 1.4 X 3.5. In fact, where I work, the drawer containing these screws is highlighted in red in our cabinet. Be sure to tighten all the other screws on the entire frame along with the replacement one.

Quick Tip: If a pair of glasses has just plain had it, then say so! Have the confidence and be able to explain why it is time for your patient to buy a new pair. Say, “Mr. Knickerbottom, your chart says these are six years old now. The right hinge is broken, and the plating has worn off, which is why you have those marks on the side of your head, and the non-glare coating is shot, which is why they seem like you cannot clean them anymore. It really is time for a new pair.”

After eyewire screw replacement, your most frequent repair will be replacing missing nose pads. There are hundreds of shapes, sizes and materials for nose pads, but at the very least you will want to stock screw-on and push-on, symmetrical

(interchangeable L for R) silicone pads in 15mm and 17mm size, and at least one type of non-silicone pad.

Non-silicone pads may be called plastic or vinyl or by a trade name. If you carry a frame line with proprietary pad attachments, then you need to get some replacements from the manufacturer and have them on hand. If you stock metal frames with solid bridges, you will need a replacement on hand.

Quick Tip: If you are new to the field, then get the hard copy catalogs from as many supply vendors as you can, and look through them page-by-page. You will be surprised what you will learn!

After missing nose pads, the next most common repair is probably alignment work. Although not technically a repair that requires parts, alignment does require a few tools that you need to stock. At a minimum, I would have a good quality screwdriver, long-thin nose pad pliers, Continued on page 34

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Progressivelenses.com wide jaw temple angling pliers, and soft jaw-round tip adjusting pliers. Modern frame materials are nothing short of miraculous in their ability to be bent back into proper alignment after damage.

Quick Tip: If you think a frame is likely to break, say this to the patient: “I am happy to try to bend these back in shape. However, these are badly bent, and I fear they may break. If they break, you must understand that there is nothing I am going to be able to do for you.” I highly recommend that this be said to the patient in front of another staff member. It is NOT your fault if a badly damaged frame breaks when being adjusted.

Nothing will make your life easier when doing a spring temple repair than Snap-It screws from OptiSource. With a pilot shaft that is even thinner than a tap-and-snap, these screws will make even the most difficult spring hinge alignment and remounting a breeze. With the snap off feature, you also eliminate the sharp edge created by using tap-and-snap screws for the same job.

Quick Tip: You must keep a parts bucket of cast off temples. There will be times when anything, and I mean a-n-y-t-h-i-n-g, that will allow your patient to wear their glasses for an hour, a day or a week will equal nothing but pure patient satisfaction.

Replacing temple tips is a quick and easy repair. Stock a few sizes in a few colors, and in a matter of seconds you can replace what was once destroyed. You may be surprised how many patients think they would have to buy a complete temple or frame to get them replaced. Temple ends are vulnerable: They dry out and split, get chewed on by puppies, and can be damaged by being stepped on.

Broken temples are a pretty common problem. You need to weigh your choices on how to handle the repair. A broken spring hinge cannot be repaired, so epoxy is your only choice for a short-term fix.

Sometimes, you can order and replace an individual temple. Other manufacturers require you to replace the entire frame.

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

Quick Tip: The long length of a Tap & Snap allows you to slowly close an eyewire around a lens that is difficult to seat because of damage. Take a turn and adjust – take a turn and adjust – take a turn and adjust…

Kurt Vonnegut wrote, “Everybody wants to create something great, something aweinspiring… something that’ll give them a hell of a lot of attention. But nobody wants to do maintenance.” How true. But some-

times as ECPs we need to do a little maintenance! Sometimes, a patient just plain insists that they want to reuse a frame.

Other times, you will make a sale based on making a patient’s old frame into a second pair. When that happens, you need to do a refurbishment job.

Refurbishing Checklist: • Disassemble everything you can.

• Lenses out of frame • Temple tips off • Nose pads tossed out • Eyewires open • If necessary, soak in a tray of hot water and soap, and give them a bath with a toothbrush.

• Wipe down and get into the cracks and crevices.

• Wipe inside the eyewire bezel and all around the nose pad guard arms.

• Remount lenses using new coated eyewire screws.

• Straighten guard arms • Provide proper alignment and be sure to open them back up so the frame has proper vertex distance again.

• Replace nose pads • Replace temple tips • If necessary, lubricate spring hinges with a light gun oil (Not WD-40).

• Complete full standard alignment checklist, and you are done.

All the parts and tools mentioned are available from 1-800-OptiSource. I

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Signet Armorlite Announces PhotoViews™ Photochromic Lens Promotion Use one website to order all of your stock lenses electronically with no usage or ordering fees!

Signet Armorlite is pleased to announce the PhotoViews photochromic lens promotion for lab and eye care professionals. During the period of March 1 – June 30, 2013, individuals may visit www.SignetArmorlite.com/PhotoViewsPromo, view a short presentation, take a short quiz and be entered to win a PhotoViews photochromic lens demo kit. The PhotoViews demo lens kit can be used two ways – as a photochromic lens demonstrator and a product display. The kit includes a PhotoViews display, a gray and a brown PhotoViews lens, a PhotoViews lens cleaning cloth, and instructions for usage, all packed in a PhotoViews-branded neoprene bag.

PhotoViews photochromic lenses offer priceconscious patients an incredibly fast fade time of five minutes and 100% direct UV protection.

PhotoViews photochromic lenses are available in a variety of lens designs including: KODAK Progressive Lenses, single vision (semi-finished and finished), flat-top 28 and trifocal lenses.

“PhotoViews photochromic lenses allow Signet Armorlite to introduce more patients to photochromic lenses,” states Francois Glon, Executive Vice-President, Global Marketing and U.S. Brand Sales. “With the availability of the PhotoViews photochromic lens demonstrator kit, more patients will be exposed to the versatility, UV protection and comfortable viewing that photochromic lenses provide.”

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SECOND GLANCE Elmer Friedman, OD

Did I Know Reverend Sullivan?

DON’T ASK! ach year on April 25 I think of Rev. Leon H. Sullivan. I remember how impressed I was with his imposing, solid, healthful appearance. There was palpable evidence of his spiritual strength and excellence of character. He died of leukemia in Scottsdale, Arizona on April 25, 2001.

regretted my decision as soon as soon as I saw that it was a full course menu with my all time favorite dessert: ice cream and cookies. I wandered about a bit and took note of the wonderful programs, the volunteers, staff and physical plant that was devoted to this senior day care center.

The meeting room was set with all the preparations that I expected and were both finalized and perfect.

E

People ask me if I ever met Rev. Sullivan. I met him back in 1952 after he became pastor of Zion Baptist Church in North Philadelphia. He measured 6’ 4” tall and was a giant of a man in many ways.

He assumed a strong leadership role locally, nationally and ultimately, as his fame grew, internationally. Yet, never a word of scandal was attached to his name. He became one of the most widely admired, respected and honored men in the world.

He is best known for his outstanding dedication to the advancement of economic opportunities for disadvantaged folks throughout the world. His voice spoke, untiringly, to motivate and teach people how to liberate themselves through aggressive self help programs.

He founded Opportunities Industrialization Centers (OIC). This network of community based skills training programs had helped more than 1.4 million people in 100 cities and 19 countries to find productive employment. He was a constantly sought after speaker and advisor who took the time and interest in even the smallest budding grass roots community group.

Which is exactly how we came to meet.

I had been deeply involved in the activity of a community oriented social group in North Philadelphia, where I had been practicing for several years. On some occasions the group held our meetings at Rev. Sullivan’s church, Zion Baptist.

He and I would usually exchange courteous niceties from time to time, but on one

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

occasion he took me aside and said, “Dr. Friedman, I know that you are a practicing optometrist in our area. We have a senior group that meets in our annex across the street and we try to provide a stimulating program for them. Would you care to speak to them about geriatric vision? It would be greatly appreciated.”

I accepted the invitation in a nanosecond.

He gave me the name and telephone number of the social worker in charge of special events and I contacted her the following day.

The idea was that I would present an appropriate talk on geriatric vision to a group of senior citizens. Plans were made for a meeting room to be reserved for me.

A chalkboard would be available and ample seating around a large executive table. I was to provide a sort of bio and curriculum vitae for the young social worker who would introduce me to the group. The special day finally arrived and in my excited state of anticipation I arrived a little early at my destination in the annex. It was lunch time for the group and I diplomatically refused an invitation to join them in their repast. I immediately

It was my intention to remind them that our population is aging in most of our developed and developing countries and that increased eye care needs will occur. While a large proportion of the older population maintains an active and healthy life there remains a percentage that requires more health care, including eye care. It has been suggested that over fifty seven percent of this population have visual impairment and near acuity is expected to be poorer than distance visual acuity. Thus, the frail elderly are a particular segment of this population who are slipping through the cracks. However, many of the conditions found in this group are treatable. There are situations connected with the elderly that have consequences on their vision. This includes poorer economic standing, poorer physical and mental health, more social isolation and less social support. Zion Baptist Church is vigorously involved in meeting the demands necessary to cure these ills.

Poor vision is an important predictor of falls. Because of poor performance of skills associated with visual acuity, contrast sensitivity and depth perception, lost balance frequently occurs. There is a degeneration of coordination that results from decreased depth perception and awareness. Falls in the elderly population are of great concern since they may result

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not only in serious damage to the body and brain, but there is the matter of increased dependence. Those who handle statistics resist the humane element in this discourse and feel obligated to mention the increased cost to the health care system.

At any rate, my moment arrived, the audience assembled and the proper introduction was delivered, exactly as I wrote it by the young, devoted social director. I was brilliant. I opened with two humorous stories. They chuckled and laughed in the right places and I was off and running. I gestured, I bounded, I projected, I modulated, I was pianissimo, I was crescendo and I was forte, all in the best spots. I boldly strode to the chalkboard writing keywords, and artfully drew diagrams that would have made Grey’s Anatomy weep with envy.

After a short time into my presentation, I wheeled about to face my audience with a salient point of fact and was silenced by the strange sight that met my eyes. Each and every one of my audience was dozing, nodding or was established at some level of slumber. I realized that this is a common occurrence for people who have just

devoured a good meal. My first reaction was one of shocking numbness that permeated my system. Then I felt disbelief.

This was followed by a sense of failure and disillusionment. Need I add humiliation and lowered self esteem that came to the fore hard on the heels of a desire to disappear between the cracks of the floor beneath my feet.

And then something saved me. The incongruity of the situation, the utter and wonderful ludicrousness of it all changed the matter into a laughable circumstance.

And so, I smiled, at first thinking of the burlesque that was unfolding in my presence. I actually found myself on the verge of hilarity and before I could control myself, I was laughing out loud, like a madman. I desperately wanted to share the moment with someone so I glanced toward the one person I felt I could count on, the young staff worker who planned and arranged this event. I looked at her and fell into a paroxysm of laughter. Her pretty, curly head was bent forward and her chin was resting easily on her chest with soft puffing sounds emitting from her lips.

I banged on the table, thereby startling

one and all out of their stupor. Once their eyes began to focus on me, I thanked them for inviting me and hoped they enjoyed the lecture. They applauded, and I ate a left over cookie and went home. The social worker called me the next day to thank me and also to apologize for falling asleep. She blamed it on the large luncheon that preceded my talk. I looked over the lecture notes again and they didn’t seem as glowing as I first thought. Each time I reread them they got less and less brilliant. The last time I read them, I fell asleep. And you ask me if I ever knew Rev. Sullivan? I sure did! I once mesmerized fifteen members of his senior special events class into a state of deep sleep in only five minutes!

Six telltale signs that you’re getting old: 1. Your ears are hairier than your head.

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OD PERSPECTIVE Jason Smith, OD, MS

Light and Color Vision – The Basics THE TOPIC of color vision is complex and complicated. It covers many areas of vision including anatomy, physiology, neuroanatomy, genetics, pyschophysics, quantum mechanics, visual perception, optics, depth perception, perspective, photoreceptors, and edge detectors. Some of the color vision problems that we can experience include color blindness, color distortion, protanopia, deuteranopia, monochromacy, dichromacy, trichromacy, congenital and acquired color vision defects, and rod-cone dystrophies.

emitted by a lantern, why then can we not see in the dark?” In 1604, Johannes Kepler thought that light is colorless but is “broken” and becomes colored when it encounters a colored object. In 1672, Isaac Newton made a small hole in a window shutter and placed a small piece of prismatic glass in front of the sunbeam coming through the window. He discovered that this prism divides white light into various colors which he called “variously refrangible” as the light was bent by the prism.

When describing topics of color vision, terms that need to be explained include the electromagnetic spectrum wavelength of visible light, nanometers, incidence, luminance, reflection, absorption, radiance, lux, resolution, saturation, photoreceptors, primary colors, eccentricity, perspective, shading, motion, pigment, juxtaposition, pastels, and spectra.

He discovered that the color of the light is a permanent feature and cannot form another color by itself. This breaking of white light into its component colors is known by various names such as chromatic aberration and dispersion. You may be familiar with the rating system used to specify the amount of dispersion in a lens – Abbe value.

It is obvious that a 1500 word article will not adequately address all of these topics. Books are written on each and every topic mentioned and optometry school curriculums devote 3-6 months on the topics of color vision and color vision problems. Many of the color vision problems are taught in ocular disease courses. What I would like to cover are a few of the basics for the eye care professional. Further understanding of these complicated areas can be researched on the internet or the vast array of books and textbooks that are included under the heading of “Color Vision.”

In 1802, Thomas Young stated that the nature of light is to have characteristics of “undulations” that must create vibrations.

Young felt that light must have a wavelength in its natural state. By the mid nineteenth century, many scientists provided strong evidence that light consisted of waves. In 1905, Albert Einstein stated that light may have some characteristics of particles and he proposed the idea that light energy is comprised of indivisible units or quanta of light energy that we now call photons.

As early as the 4th century B.C., Aristotle rejected a common idea that there was a “visual fire” emanating from the eye. As he stated, “if vision was produced by means of a fire, like the light

These photons of energy travel in a wavelike manner. In the 19th century, James Clerk Maxwell deduced that light is one part of a huge spectrum of electromagnetic radiation. All electromagnetic radiation travels through a vacuum at 186,000 miles a second. Visible light

shares many of the same characteristics as X-rays and microwave radiation. It is due to the special neuro-receptors of the human eye that we are responsive to the wavelengths of 380 nanometers through 780 nanometers that allow us to see colors.

The electromagnetic spectrum comprises all energy that moves at the speed of light. Visible light is a small region of the entire spectrum which includes cosmic rays, gamma rays, X-rays, infrared radiation, communication wavelengths of TV, phones, weather satellites, and power transmissions. Wavelengths are measured in nanometers and visible light falls between 380 to 780 nanometers. The visible colors are in the reverse order of red, orange, yellow, green, blue, indigo, and violet. Red falls at the higher wavelengths, green is in the middle wavelengths, and violet is at the shorter wavelengths. Specifically as a reference, red is located from 620 to 780 nanometers, green is located from 500 to 570 nanometers, and blue is located from 450 to 500 nanometers.

The human eye has two types of photoreceptor cells called rods and cones.

The cone cells have three types and are used in daytime vision, central vision and color vision. Rods are more sensitive and are used in dim lighting or night time viewing as well as peripheral vision and detecting movement. The three types of cones are referred to as long, middle, and short wavelength cones which are referred to more easily by the color wavelength of red, green, and blue. The response of each cone depends upon the wavelength of light and its amount or intensity. Within the range of visible light, different wavelengths appear to us as different Continued on page 40

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

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Essilor Launches Organization to Study Global Consequences of Poor Vision Calling attention to an estimated $269 billion in lost productivity due to poor vision, Essilor announced last month that it is establishing the Vision Impact Institute, an organization dedicated to studying the global socio-economic consequences of vision issues. Impaired vision affects 4.2 billion people throughout the world, of whom 2.5 billion have no access to corrective measures, according to Essilor.

The Vision Impact Institute will act as a “global connector of knowledge, data and solutions,” and to “foster research where needed, encouraging measures in the field of vision correction,” Essilor said. It will work to ensure that poor vision and its economic implications emerge as a global challenge. Toward that end, the Institute has created an interactive web platform, visionimpactinstitute.org, to unite a community of experts, increase data research and fight impaired vision throughout the world.

Poor vision is a public health issue that has substantial economic consequences at both an individual and collective level, Essilor said. The World Health Organization estimates that $269 billion in productivity is reportedly lost every year because of impaired vision, including $50 billion in Europe, $7 billion in Japan, and $22 billion in the U.S.—even though all the required solutions (eye exams, corrections) are available.

While one of the most widespread disabilities in the world, impaired vision and its cost are still underestimated in developed and emerging countries: 30 percent of young people in the world under the age of 18 reportedly suffer from uncorrected refractive error, which is often not diagnosed due to lack of awareness of access to care. This proportion rises to 33 percent in the labor force, 37 percent among elderly people and even 23 percent among motorists, according to the World Bank, Boston Consulting Group.

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colors. Even though most colors can be matched to a single wavelength of light, most colors that we see are comprised of a range of wavelengths.

A condition called protanopia affects people who have defective long wavelength cones which may also be missing altogether. Protanopes are sometimes referred to as red-dichromats because they have only two working cone types, the short and the medium wavelength cones, compared to someone with three different cone types. If the long wavelength cones are defective, they may develop with different intensities resulting in either a more or less significant level of color deficiency.

What is useful and most practical to the eye care professional concerning color vision? There are visual conditions that can affect color vision or color perception.

Patients may present with congenital or acquired color vision defects. It is rare for any patient to be totally color blind. Most people with color vision problems have color vision deficiencies. It is rare to see women with congenital color vision defects because most defects are carried on the X chromosome. Red-green color blindness is a common hereditary condition which means it is usually passed down from your parents. Color blindness is usually passed from mother to son on the 23rd chromosome, which is the sex chromosome. Chromosomes are structures which contain genes.

These contain the instructions for the development of cells, tissues and organs.

If you are color deficient, it means the instructions for the development of the cone cells are wrong and the cone cells might be missing. It may also mean that the eyes are less sensitive to light and the pathway from the cone cells to your brain has not developed correctly.

Some pathological conditions where blue-yellow defects may occur include glaucoma, retinal detachments, pigmentary degeneration, macular degeneration, myopic degeneration, chorioretinitis, retinal vascular diseases, diabetic retinopathy, hypertensive retinopathy, and papilledema. Other color vision problems include achromotopsia which is real color blind-

40

EYECARE PROFESSIONAL

ness. X-chromosome linked incomplete achromotopsia where very little color vision exists is sometimes referred to as blue cone monochromaticity. Some patients may have chromotopsia which is a condition where things appear to be a different color than the actual color. Even the color white may appear as a color and these people usually have an associated retinal disease.

In the eye care professional’s office, color vision testing can be done in several ways. For children, colored magic markers can easily be identified by their color. I sometimes play a game with the children if they know their alphabet and letters and have them spell the color for me. On the eye chart, there are red and green colors which you can show any patient in order to do a brief screening to determine that their red-green color vision is accurate. I do this with every patient as a screening especially for the adults to be sure that they know the red light from a green light when driving. I also include a yellow magic marker to identify yellow.

There are now many eye care applications that are available through Apple and there are 4 applications that can be downloaded for color vision testing. There are several other office based color vision tests that include the Ishihara pseudoisochromatic color plates, the American Optical Harty-Rand – Ritler, the Sloan Achromotopsia, the City University, the Farnsworth-Munsell 100 Hue, the D-15, the Lanthony New Color, the Holmgren Wool, the Farnsworth-Lantern, the Oscar, the Nagel Anomaloscope, and the Pickford-Nicholson. I use the standard Ishihara pseudoisochromatic color plates which are colored numbers on a differentcolored background.

The purpose of this test is to determine the accurate discrimination of subjects with color deficiency from those with normal color vision. The colored plates are illuminated directly from above and the plates are placed at about 20 inches from the eyes. The proper near correction should be used with contact lenses, glasses, reading glasses, or a prescription lenses placed in a trial frame. Tinted lenses or

sunglasses should never be used. The plates should be viewed for approximately 3-5 seconds.

There is a scoring sheet that the eye care professional can use in order to keep track of what is viewed either correctly or incorrectly. Color deficiencies can then be classified as normal, protanopia, deuteranopia, or something else. People affected by protanopia are less sensitive to red light and people affected by deuteranopia are less sensitive to green light.

Those people with color vision problems should be made aware of their problem, especially children and their parents.

Many adults are already aware that some color vision problem may already exist due to previous experiences with setting the controls on a colored TV or trying to match and coordinate their clothing.

There is no treatment for abnormal color vision even though the prospect of gene therapy and stem cell research may open some doors in the distant future.

Glasses with specific colored lenses may help some individuals and there may be improvement on the color vision tests.

Colored filters may be beneficial in doing certain tasks and the colored Irlen Lenses have proven to help some people in the processing of information and reading.

Other treatments that can help some patients have included the use of a redcolored gas permeable contact lens called the X-chrome lens. The use of a red lens can enhance some red shades, but with a problem that is embedded within the cones and the retina, there are no quick cures at the present time.

For those of us who can appreciate the beauty and the colors of a sunset at the beach and to be able to see all of the spectrum of colors and all of their different shades, this is something that we should not take for granted. Because there are many other people who will not or cannot see the way we do. I have a framed poster that someone gave to me that sits in front of my desk. It says, “LIFE IS ART, LIVE YOURS IN COLOR.” Consider me lucky to see the world in the full spectrum of color the way that I do. I

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LAST LOOK Jim Magay, RDO

Going to the Dogs Pets are a big – no... with well over $50 billion in spending – pets are a HUGE business in this country (compared to about $30 billion on eyewear products).

ig box stores like Petco, kiosks for pet treats in BJ’s, local mom & fido shops selling everything pet related, bakeries just for pets. We have pet friendly restaurants, hotels and resorts. There are pet expos that dwarf our Vision Expos.

B

When I read an article recently about eye surgery for dogs – I thought, “OK – this has gone a leeetle bit too far!”

I know, I know, I have friends who have spent $15,000 and more to save their dog after a major injury or disease. But eye surgery seemed different. What is that all about?

Well, it turns out that it is a fairly big business, and in some circumstances it actually improves outcomes for humans.

When a person needs an assistance dog, and said animal has an eye problem – the pup wouldn’t be much use to the person, and all the valuable training goes down the drain. Bomb and drug sniffing dogs, even sheparding and hunting dogs, are all valuable and useful creatures. And who would guess that there is an American College of Veterinary Ophthalmologists?

There is, and last year they began an initiative to provide free eye exams around the U.S. to a broad range of dogs that are in the assistance service to humans.

Comedian Brian Fischler, who has been blind for 10 years, depends on Nash, a yellow lab who has been Brian’s constant

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

companion guiding him in and around Manhattan. Brian took advantage of the free program.

In an interview with the NY Daily News, Brian (the organizer of the bi-coastal fundraiser Laugh for Sight) says, “As someone who has lost his sight over the last 10 years, I know how quick eye disease can come on, and affect a person or a dog.”

Board certified veterinary ophthalmologist Dr. John Sapienz urges all pet owners to watch for their pet’s squinting, red or cloudy eyes, or bumping into objects.

Dr. Sapienz comments further that “protecting eyesight includes a well balanced diet including Vitamin E, observing changes in behavior, and reducing sunlight exposure.”

It isn’t just in this country either; our neighbors to the north are showing just as much concern as do we.

The Canadian Veterinary Journal published a 2011 paper that said: “The results of this (phaco in dogs) study show a superior success rate for surgery when compared with other modes of cataract management, especially when performed early in the disease process. This should encourage general (veterinary) practitioners to recommend phacoemulsification more often and to refer more promptly after initial presentation. This study also underscores the grave prognosis for cataractous eyes when no treatment is instituted. This information should therefore reinforce to practitioners that when phacoemulsification is not possible, doing nothing is unacceptable and, at minimum, anti-inflammatory therapy and continued monitoring are essential for maintenance of ocular health.”

So, when I drive by the NEAD’s (National Education for Assistance Dog Services) center in my hometown – their home page describes their work as, “... the oldest continuing hearing dog program in the country and the only program of its kind in New England,” – I certainly will view it with a much greater appreciation. ■

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