EyeCare Professional Magazine April 2014 Issue

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SPRING AND SUMMER SUNS / PAGE 6

•

TIPS ON BUYING GROUPS / PAGE 12 April 2014 • Volume 8, Issue 75 • www.ECPmag.com

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TS CONTENTS

APR 2014

Vol. 8 – Issue 75

4 Selling Sunwear Increase your sunglass sales by offering functionality and staying on top of the latest in shapes and styles.

by Lindsey Getz

12 Buying Groups Some tips of how to evaluate if a buying group or business alliance is right for your practice.

by Cliff Capriola, President, Focal Point Consulting

14

6

Purchasing Patterns

Spring and Summer Suns

Study your lens invoice sales data to spot trends that could help determine potential areas of growth.

Leave the winter behind and brighten up your practice with the latest in colorful sunwear. by ECP Staff

by Renee Jacobs, OD, MA

18 Optical Apps See the latest in fitting, dispensing, education, and lens design apps for smartphones and tablets.

by Judy Canty, LDO

26 All About Edgers

18

30

Having an edger with drilling capabilities gives your practice a clear advantage over your competitors.

by John Seegers, M.Ed.,LDO

30

On The Cover

Contact Lens Graffiti ECPs still face challenges dealing with the various films and deposits commonly found on contact lenses.

US Optical 800.445.2773 www.USOPTICAL.com

by Sam Winnegrad, MBA, LDO

38 Homebound Eye Care Nursing Home and Homebound eye care is a challenging but ultimately rewarding service.

by Jason Smith, OD, MS

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OPTICAL MARKETING Lindsey Getz

Here Comes the Sun! SPRING IS HERE! And with spring comes the possibility for making an increased number of sunwear sales.

T

THE MARKET for selling sunwear is unlimited. Unlike prescription eyewear, everyone should be wearing sunglasses.

If you think of your sunwear in terms of it being an add-on buy for patients who are already purchasing Rx eyewear, you’re limiting your sales potential. The truth is that sunwear can be positioned as a main purchase and you can aim to sell it to anyone that walks in your door.

Aim for a Variety

Sunwear consumers fall into every demographic. Everyone from kids to seniors should be protecting their eyes from the sun’s harmful rays. If you’re serious about boosting your sunwear sales, the first step is to make sure you have a wide variety of merchandise that will suit patients of all ages and style preferences.

Style preference relates to the fact that sunwear can be considered within two key categories: sports and fashion. Additional categories (crossover, prescription, etc.) could be considered but for simplicity sake, we’ll look at sunwear falling into those two main subsections. The goal is to aim to have a variety of frames that suit both.

The objective is to find out what your patients might need sunwear for—is it sports or fashion? You can find out this key information by asking questions while the patient is in the waiting room or the chair. Don’t wait until they’re in the dispensary as it may be too late. After all, not all patients plan to stop in the dispensary on a routine visit.

Surveys can also be an excellent tool for obtaining information. In addition to standard paperwork, some practices have

4 EYECARE PROFESSIONAL

patients fill out lifestyle-type of surveys while they’re waiting to be seen. This can be done the “old-fashioned” way with pen and paper. Or if you’re moving paperless, you could direct patients to a computer or iPad that is already set up with your survey. A few simple questions about their activities should help you pitch the perfect frames.

highest standards and 100 percent UV protectant are also necessities.

Photochromic lenses can also be helpful in reading greens and may help golfers perform better by allowing them to notice subtle differences in the course.

Tennis player

Sports Sunwear Those who are seeking out sports eyewear have a specific purpose for their eyewear in mind and if you can find out what it is, you can help make the sale—and also make your patient happy. If you find out that your patient is in the market for sports sunwear, the next step is to find out what sport they play. Are they a weekend warrior or do they avidly participate in a sport or recreational activity? Their level of seriousness with the sport may help you determine how serious they are about getting the right eyewear to enhance their performance. However, even the weekend warrior might be willing to invest in a nice pair of frames if you can tell them how it will not only make their activity more enjoyable but will enhance their performance as well. Once you know what your patients’ needs are, you can craft your sales pitch to meet them. For instance, consider these three sports players and the eyewear pitch that would complement their needs...

Golfer Golfers spend a lot of time with the sun beating on their face, so a wrap style is ideal since it protects not only the eyes, but the skin around the eyes as well.

Lenses that are impact resistant to the

If you find out your patient is a tennis player, recommending a polarized sunglass can help them to cut the glare from reflection and therefore help them to better spot the ball. In addition, tinted lenses can also help them to see the ball more clearly and allow them to make better contact with their racquet.

Continued on page 11

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™

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Spring and Summer Suns

1

2

3

1. VELVET EYEWEAR

2. LINDBERG

3. ADLENS

Rock the Velvet “Ava”. The perfect feminine Aviator inspired by Amelia.

The frame is rich handmade Italian acetate offered in our newest Turquoise Lava. The lenses offer 100% UV protection and optical quality for clear, distortion free vision. Beautiful metal inlays add a touch of “Velvet.” www.velveteyewear.com

LINDBERG Sun frames combine the style, fashion and comfort benefits of our award-winning eyewear with prescription lenses, and effective protection against both glare and ultraviolet rays.

These statement designs are based on the Strip and Acetanium collections, with high-quality sunglass lenses from Zeiss. www.lindberg.com

With all of the benefits of UVA and UVB protection, Adlens Sundials™ are instantly adjustable for any distance at the turn of a dial. They are suitable for over 90% of eyeglass and contact lens wearers who do not have astigmatism.

Perfect for reading in the sun, gardening or sightseeing. www.adlens.com

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6 5

4

4. EVATIK

5. ULTRA PALM

6. ic! berlin

Evatik Sun uptrend’s the classical aviator style with model E-1039; a modified flat metal aviator shape with a double bridge. This model is a combination sunglass model made with a stainless steel front and camo-inspired acetate temples. Available in khaki camo and black camo, in size: 59-17-145. www.evatik.com www.classique-eyewear.com

By Caviar: Pink w/Clear/Silver Night Crystal Stones w/Grey Lens (Model 3008). The frames feature clear crystal embellishments with silver butterfly adornments. Pink is the new pretty and a great accessory for Spring and Summer fashions. www.caviarframes.com

Worlds collide. Day meets night meets day. Berlin is a hybrid city where anything goes and everything is possible. ic! berlin, makers of screwless sheetmetal glasses presents its first collection of hybrid sunglasses: superfine acetate rims inside a stainless steel frame.

Available in three models in obsidian, white and blue. www.ic-berlin.de

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LAFONT

NIGHT is the sunglass crown jewel of the new 2014 Spring and Summer collection and has 56 hand-placed Swarovski Crystals adorning the frame front and temples. Available in three exclusively LAFONT colors, the style is produced in limited quantities and is already a highly sought after special edition piece. www.lafontusa.com

theo

REVOLUTION EYEWEAR

Robert Graham eyewear offers high quality craftsmanship and sophisticated silhouettes, along with infusing iconic fabric and trim designs to reflect the essential characteristics of the brand’s American eclectic spirit. Robert Graham and Revolution have created a collection of eyewear that will resonate globally. Featured is the Princeton in Tortoise with mahogany temples that are equipped with adjustable temple tips. Other colors include: Black Tokyo Tort, Cola, and Clear Beige. www.revolutioneyewear.com

EYEBOBS

For this collection, Tim Van Steenbergen took inspiration from the sublime Fenders played by his musical heroes like Kurt Cobain and together with theo designer Serge Bracké, came up with six intense models. theo big boss Wim Somers chose a palette of ‘shadow colors’, such as white, grey, black and dark blue, and dubbed them the ‘Shadows’, after his personal guitar heroes. Worldwide, there are 75 sets of 6 models available. www.theo.be

MARCOLIN

123P The Graduate Polarized Sunglasses: These glasses say, “Mrs. Robinson, you’re trying to seduce me.” You’ll be utterly irresistible in this saucy sun style. High quality polarized lenses offer a glare-free view of the world with 100% UV protection. www.eyebobs.com

The Just Cavalli Spring/Summer 2014 Eyewear Collection features contemporary design and modern appeal combined with a youthful approach and iconic detailing.

Unisex acetate JC559S sunglass style has polarized lenses and a square profile with modern, textural studs on the temples.

In addition to classic black, this style is offered in a number of color-blocked combinations such as: bright green/ice, vivid blue/violet (shown) and magenta/white. www.marcolinusa.com

Marcolin, Unisex acetate JC559S sunglass style

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EYECAREPROFESSIONAL

Magazine

Publisher/Editor. . . . . . . . . . . . . . . . . . . . . . . . . Jeff Smith Production/Graphics Manager . . . . . . . . . . . Bruce S. Drob

ADVERTISING & SALES VP, Advertising Sales . . . . . . . . . . . . . . . . Lynnette Blanton (215) 355-6444 • (800) 914-4322 Contributing Writers Mary Armstrong, Judy Canty, Cliff Capriola, Elmer Friedman, Lindsey Getz, Renee Jacobs, Ginny Johnson, Jim Magay, Corrie Pelc, Anthony Record, John Seegers, Jason Smith 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.

EDITORIAL OFFICES 111 E. Pennsylvania Blvd.

Feasterville, PA 19053 (215) 355-6444 • Fax (215) 355-7618 www.ECPmag.com editor@ECPmag.com EyeCare Professional Magazine, ECP™ is published monthly

by OptiCourier, Ltd. Delivered by Third Class Mail Volume 8 Number 75 TrademarkSM 1994 by OptiCourier, Ltd. All Rights Reserved.

No part of this magazine may be used or reproduced in any form or by any means without prior written permission of the publisher.

OptiCourier, Ltd. makes no warranty of any kind, either expressed, or implied, with regard to the material contained herein.

OptiCourier, Ltd. is not responsible for any errors and omissions, typographical, clerical and otherwise. The possibility of errors does exist with respect to anything printed herein.

It shall not be construed that OptiCourier, Ltd. endorses, promotes, subsidizes, advocates or is an agent or representative for any of the products, services or individuals in this publication.

For Back Issues and Reprints contact Jeff Smith, Publisher at 800-914-4322 or by Email: jeff@ECPmag.com Copyright © 2014 by OptiCourier Ltd. All Rights Reserved For Subscription Changes, email: admin@ecpmag.com Scan this barcode with your smartphone to go to our website.

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TIFOSI

COTTON CLUB

The Lore from Tifosi keeps you cool all summer long with open lens construction and vented lenses. The lightweight frame features hydrophilic rubber on arms and nose pieces for a no-slip fit, even under sweaty conditions. www.tifosioptics.com

RUDY PROJECT

Cotton Club Polarized sunglass collection is constructed of the newest materials and defines the concept of style, quality and luxury at affordable prices. This new line of 30 sunwear frames consists of men’s, women’s, unisex and sport models. (models pictured CC 1047 and CC 1059) Sold exclusively in North America by National Lens. www.national-lens.com The Nebula is a casual sunglass designed via the combination of timeless and unique Rudy Project design elements and ergonomic features. Durable and lightweight, this full-rim sunglass ensures maximum protection from the sun while upholding supreme style. www.rudyprojectusa.com

ZYLOWARE EYEWEAR

BCBGMAXAZRIA

From powerful statement-makers to classic, confident styles, the BCBGMAXAZRIA Sunwear collection reflects the lifestyle of the BCBG woman. These suns translate this premier fashion brand’s DNA into a chic, sleek, wearable collection that lets today’s modern woman feel beautiful and effortlessly cool. www.cvoptical.com

The Randy Jackson RU S911P is a full rim zyl frame in a rectangular shape offered in two popular colors Black and Brown. With the wide-fit feature, this frame meets the needs of a variety of men and attracts attention with a stylish metal plaque design on the zyl temple. Available in size: 57-17-140. www.zyloware.com

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The Mathematical Look

Boater or Fisher (or other water sport enthusiast)

This trend is all about “angular cuts and neutral colors.” Frames with a combination of geometric shapes and bold contrast (such as black and white patterns) round out this sophisticated look.

Anyone who spends a lot of time on the water knows that the reflected light can be incredibly rough on the eyes. Polarized lenses can help cut that glare factor and allow your patient to enjoy their water sport more thoroughly.

The Aquatic Look This trend is all about color and texture.

Inspired by the ocean, the runway was packed with blue, turquoise and teal hues—both in clothing and accessories.

Fashion Sunwear If protection from the sun and looking good are the two key reasons your patient is looking at frames, you may want to direct them to some of your more fashionfriendly eyewear. Brand name frames tend to be popular among the fashion-conscious. But often people just want a frame that looks good on their face. It does also help to keep up with the latest fashion trends. Although it’s not easy since fashion changes so quickly, it would help to at least have an idea of some of the key trends so that you can ensure your dispensary is offering the latest styles.

Fashion forecasters Stylesight and Eyecessorize recently collaborated on the “Eyewear Product & Trend Review” for spring/summer 2014 and reported four major trends in eyewear this season. These

The Garden Look

included what they dubbed the “Instagram Look,” the “Mathematical Look,” the “Aquatic Look,” and the “Garden Look.”

We summed up each...

The Instagram Look This look is all about “throwback style” with frames that have a 1970s appeal including gold-tinted lenses, tortoise print, and wooden frames. These retro designs are trending on the runway and making their way to everyday wear.

This look is all about earthy greens and vibrant pinks “evocative of spring foliage.”

Some designers are even using floral embellishments to really drive this look home.

With just a little bit of forethought, you can be ready to tackle the sun season with your patients. Remember that regardless of what style preference they’re looking for, all patients will benefit from education on the importance of protecting the eyes from the sun. After all, it’s not just a sales tactic, it’s your professional duty to educate the patient and make sure they are doing their best at maintaining good eye health. I

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PRACTICE MANAGEMENT Cliff Capriola, President, Focal Point Consulting

Buying Groups Buying groups were originally started in the 1980’s as a way for independent eye care professionals to attain the discounts formerly offered only to larger optical chains. At the time, they seemed like the best bet to level the playing field as local, regional, and national chain stores proliferated.

D

ISCOUNTS WERE all the rage back then as they seemed the only method to increase ECP’s profitability, especially in optical and contact lenses. Of course, the options available to consumers were very limited back then. You basically had your choice of glass or CR-39 lenses, with or without scratch coating, or the new hi-index lenses.

Anti-reflective lenses were in their infancy, great in theory but not in practice. In sunwear you had your choice of polarized grey or brown. In rural areas it was not unusual to find practices selling 50% of their eyewear in glass lenses. Needless to say, the buying experience was heavily focused on frame selection.

Fast forward to 2014 and the options for consumers and eye care professionals have grown exponentially. Buying groups still exist although many have expanded their focus to include staff training and practice management. For independent ECPs, the choices have grown from whether or not to join a buying group to which kind to join, the traditional discount-focused group or the newer business alliance groups.

When making a decision of whether and what kind of group to join, it’s important to take into consideration only those potential benefits and vendor discounts which apply to your practice. In fact, I would go as far as to change the focus from discounts to growth. There are countless

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

buying groups which can offer deep discounts; I would say to a buying group or business alliance, “How can you help me increase both profits and efficiency?”

It’s certainly a fair question. I remember the days when ODs would switch labs to save ninety cents on a pair of FT-28’s. Now, most ECPs have realized that they can increase their profit on that flat-top patient by at least eighty dollars by guiding the patient into a progressive. You would have to sell a heck of a lot of flat-tops to equal that. Now, most ECPs have realized that they can increase their profit on that flattop patient at least eighty dollars by guiding the patient into a progressive. You would have to sell a heck of a lot of flattops to come out even. And we haven’t even talked about sunwear yet...

Now let’s take a look at some of the steps to take in evaluating a buying group or business alliance:

1. Maximize your present discounts. Talk to your frame reps and lab rep about your consideration of buying groups.

Traditionally, vendors do not like to deal with buying groups because they have to offer a deeper discount. You might discover that if you consolidate your frame buying into five or six main vendors (a smart move for a lot of reasons), you might match or come very close to the buying group discount.

2. Evaluate buying group discounts against your current discount level.

The most efficient method for doing this is to give each buying group you are considering the same three months of statements from your vendors and ask them to run the invoices at the buying group rate.

This way you are comparing apples to apples and not oranges.

3. Ask your peers what they think of the buying group. Call the doctors in your town and ask them what their experiences have been. Then ask the buying group for a list of participating ECPs within a 50-mile radius; call some of them randomly and ask the same questions.

4. Now the big question; “How can you help me increase both profits

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and efficiency”. One of the nice perks of buying groups is that everything comes to you on one statement; with one check to write for many vendors. Another thought on this subject: as ECPs find themselves placing more emphasis on the medical model for their practice, they are turning ever-increasing tasks to staff members. So efficiency really matters more than ever. Talk with the person(s) who will be responsible for inventory and writing the checks every month.

5. What practice management tools are available? Is there a forum for peer discussion and review? It’s not unusual in today’s market for an ECP to emerge from his or her dark exam room at the end of the day and not know much about what has transpired that day in their practice.

It’s nice to have an outlet to discuss mutual issues with their peers or industry leaders.

6. Read the fine print. Evaluate the contract for the articles such as the

length of the deal, control of your practice, web site design, hidden fees, and how hard it would be to get out of the contract if they were dissatisfied. When you think you have completely reviewed the contract, give a copy to your lawyer and ask them to do the same.

7. What is the cost of membership?

Or as Groucho Marx once said, “I’d never join any club which would have me as a member”. There are some vast differences between the cost of buying groups and business alliances. Is it a one-time yearly fee? A percentage of your gross income? Are there additional costs for accessing additional components of membership, such as national or regional meetings?

8. Are your current vendors participating in the buying group?

While not a deal-breaker, it can be important if you are trying to maintain continuity in progressive lens choices.

Let C&E Vision help you

Evaluating the business alliance model can be a little trickier, and they really should not be evaluated by discount levels alone (or even at all!). I honestly believe that these came about because ODs are terribly underserved by their optometry schools. The bottom line is that each individual practice is a self-supporting business; in fact optometry is the only medical discipline I can think of where the majority of its profits are expected to come from a retail shop. And how much business training is available in optometry schools?

Very little, if any. I have gone back and forth with a few schools on this subject; they just do not seem to understand that they can educate and graduate wonderfully skilled optometrists but is all for naught if they cannot afford to keep the lights on.

Whether it’s a buying group or businessalliance model, they all serve a purpose and they will continue to evolve as the needs of private ECPs change. It’s up to each ECP to judge for themselves what their needs are and which model serves them best. I If there is a Practice Management subject you would like to see addressed, email me at: cliff@ecpmag.com

MAXIMIZE YOUR

Ö Ijh[Wcb_d[ oekh 8WYa E¥Y[ · Increase your Monthly Savings · Tailor your Membership to Meet your Needs · And much more (800) 346-2626 www.cevision.com

SAVINGS

“C&E gives me additional discounts and terms on my stock orders that I do not get from my vendors.” … having “ access to my invoices online 24/7 allowed me to spend more time where it was needed, with my patients. ”

“ My customized membership plan saved me thousands of dollars last year through C&E… ”

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

Study Purchasing Patterns Mind The Gap To Your Business Success

Then take appropriate action. Get on track toward business success. Invoice Review is an evergreen strategy that you can use to Mind the Gap. Move safely from where you are into your successful business future.

Invoice Review is an evergreen strategy that eye care providers can use to Mind the Gap. That statement might sound confusing until we appreciate the vocabulary.

Evergreen: An evergreen tree has green leaves throughout the year, regardless of the season. Just like a tree that is green all year, invoice review is relevant all year for uncovering opportunities to increase the green in your business, specifically – Revenue per Patient, explicitly – green currency!

Mind the Gap “Mind the Gap” is a warning to train passengers to take caution while crossing the gap between the station platform and the train door. It was introduced in 1969 on the London Underground.

In eye care, the station platform represents your business status today. The train represents progress, fast-tracking your business toward destination success. If you don’t “Mind the Gap”, then competition will hit you like a passenger train. Specifically, your Capture Rate will decline. Explicitly – the green currency goes elsewhere.

Invoice Review Invoice Review is the study of customer purchasing patterns in your optical. A month of lens invoices can be viewed as a stack of raw data. You can study that data to determine if your patients understand the value of owning more than one pair of glasses. You can study that data to determine if your patients understand the value of top tier lens products.

In addition, you can determine if your business earns patient trust and loyalty over time.

With study and some comparisons, discern if your business is growing, static, or in decline.

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

Macroscopic: The Obvious Start by identifying where you stand today, your station platform. Most lens vendors will make the macroscopic overview easy for you by providing a monthly lens sales summary report.

A typical report will list units of lens products sold plus calculations of common key performance indicators like AR %, Photochromic %, Trivex %, and the proportion of top tier progressives sold. Upon request, your vendor representative can help you understand your current status, how your business compares to industry averages and regional averages, plus your best opportunities for improvement.

Summary reports are useful for another reason. You can evaluate key performance indicators over time. Notice if your business is literally standing still. Observe trends in volume. Are jobs per month increasing? Evaluate variability in the key indicators of Revenue per Patient. Are sales of top tier lens options increasing?

Are multiple pair sales increasing? Is your business stable, growing, or in decline?

If your lens vendor representative is not helpful, then do your own calculations.

Perhaps your business management Continued on page 16

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software can display monthly sales indicators. Sometimes, your last resort is the best method. Pull a month of spectacle lens invoices. Tangible documents reveal facts.

Sort and count them to measure your AR %, Progressive Free Form %, Single Vision Free Form %, Photochromic %, Sun Wear %, and more.

makers, purchasing single vision lenses, represent opportunity to improve how you “show and tell” to explain benefits.

Next, identify the indicators with greatest profit potential, and then delve deeper. An indicator has greatest profit potential when every patient can benefit, and your income for the option is greater than the wholesale cost after all discounts and vision plan savings are applied. Typically, these will include:

Today, many businesses have renamed the “Clear” pair. Now it is called “Every Day Wear” because patients can enjoy a variety of light activated tints that enhance comfort without replacing actual sunglasses.

The Every Day Wear can have Transitions Signature VII, XtrActive, or Vantage technology. Hoya has SunTech. Vision Ease has LifeRx. Carl Zeiss has PhotoFusion.

The options are continually expanding because automatically adjusting tints improve all-day comfort.

• Anti-reflective treatments to enhance clarity.

• Impact resistant materials to improve safety.

• Photochromic tints to increase comfort.

For these lens options, the target market is everyone. Another big indicator, with high profit potential, is second pair sales.

Identify Populations that DO NOT Understand Product Benefits Ultimately, for business success, you desire to identify which patient populations understand lens benefits and which patient populations do not understand lens benefits. The evidence is buried in their purchasing patterns. If you know which populations are not persuaded to purchase options like AR treatments, high index materials, and automatic tints, then you can improve how you communicate product benefits.

Consider anti-reflective treatment as an example. Calculate your AR % for progressive lenses, lined multi-focals, computer lenses, and single vision lenses. This will help you notice which patient populations understand benefits and which patient populations are not persuaded. If your AR % is respectively: 75% of Progressive lenses, 100% of Computer lenses, and only 45% of Single Vision lenses, then you know that most progressive lens wearers, and all computer lens wearers, understand the value of AR. You also know that decision 16

EYECARE PROFESSIONAL

Photochromic sales might represent another opportunity for improvement.

Years ago, doctors thought a multiple pair sale included “Clear” and “Sun” lenses.

Remember, photochromic Every Day Wear does not replace the need for sunglasses.

First, everyday photochromic lenses do not get as dark as true sunglasses. Second, the Vantage everyday polarized technology is never 100% polarized, like a great sunglass.

Finally, in general, sunglasses have larger frames for better coverage blocking extraneous light. Patients need Every Day Sun Wear, even when their Every Day Wear is photochromic.

Some offices have evolved multiple pair sales to include more than Every Day Wear and Every Day Sun Wear. Some offices are offering Media Use prescription lenses.

These might include the full variety of near variable focus lenses for presbyopes and anti-eyestrain lenses for single vision patients. As work and study behaviors evolve toward greater use of smart phones, tablets, and computers, the symptoms of computer vision syndrome increase. Newer lens solutions, with AR treatment, can offer both accommodative relief plus protection from the harmful effects of excessive blue light. When you match patients to lens products best for them, and communicate value, then Revenue per Patient will increase.

Microscopic: MINE the Gap It is one thing to Mind the Gap, identifying opportunities to better communicate lens

benefits with specific patient populations.

It is something else again to MINE the Gap. Take invoice review to the microscopic level. Review a single day. Study every individual, who had a comprehensive eye examination. Evaluate two things: First, evaluate Capture Rate. For that day, calculate the number of patients who received a spectacle prescription that can be filled in any optical. Of those patients, what percentage then purchased eyewear in your optical? This is a one-day Capture Rate.

Second, evaluate optical treatment plans compared to invoices. For each patient, review the treatment plan of multiple lens solutions that the doctor prescribed.

Compare the doctor’s optical treatment plan to actual products purchased.

With this knowledge, you can mine for missed opportunities. Discuss each patient’s experience. Determine if conversation about product benefits started during pre-test or sooner. Learn how the doctor communicates product knowledge during the exam. Review all product messages that occurred before, during, and after the point of sale. Figure out strategies for improvement. When you implement your strategies, monitor success with additional Invoice Review. Success is defined as increasing Revenue per Patient, plus increasing Capture Rate as more patients decide to purchase from your optical instead of purchasing from your competition. The gap, between what the doctor prescribes and what the patient buys, identifies your treasure trove of opportunity.

When you improve messaging, until most patients experience top tier lens products from your optical, then your business will thrive.

Invoice Review is an evergreen strategy that you can use to Mind the Gap. Use it at the macroscopic level to identify your status quo plus obvious opportunities. Mine deeper to maximize Revenue per Patient and Capture Rate. Move safely from your current platform, across the gap, into your success. I

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U.S. CONGRESS AUTHORIZES FIRST OPTOMETRIST FOR ADVISORY PANEL ON IMPROVING HEALTHCARE SYSTEMS For the first time, the Patient-Centered Outcomes Research Institute (PCORI) has appointed an optometrist to its advisory panel on Improving Healthcare Systems.

On Tuesday, Feb. 25, the board of governors of PCORI approved the American Optometric Association’s (AOA) chief public health officer, Michael R. Duenas, OD, for a three-year term on its advisory panel on Improving Healthcare Systems.

The panel, authorized by the U.S. Congress, guides national priorities for research and improving health care delivery. It is one of four PCORI panels established April 1, 2013 in accordance with federal law to prioritize clinical research that helps develop the best evidencebased information for patients and caregivers to reference and make informed decisions that lead to an overall improvement in health care outcomes.

While PCORI’s advisory panels do not make policy, their guidance helps the institute refine its research and other activities to improve health care delivery and outcomes nationwide.

Nearly 300 systemic diseases have ties to vision and eye health, but without the evidence base, those ties are not as tight as they may need to be to protect and preserve the public health, according to Duenas. His research includes public health and epidemiology, linkages between chronic disease and visual impairment, environmental health, risk assessment, disease prevention and measuring access to care to improve quality of life at all life stages.

“This is a well-deserved recognition for one of our own, Dr. Duenas, for the AOA, and for our entire profession,” said Mitchell T. Munson, OD, AOA president.

“Dr. Duenas will be at the table as an equal partner with a wide range of other health care stakeholders as this new panel takes on its national role in improving health care delivery and outcomes.”

This handheld device delivers accurate IOP measurement “I was thrilled when I saw this instrument at the 2008 AOA meeting because individuals hate to be shot in the eye with a puff of air and I have been looking for 30 years for something not so barbaric. This instrument removes the need to place a puff of air in the eye, while meeting both the quality and ease-of-use requirements of larger tonometers.”

Randall Thomas, O.D., M.P.H., F.A.A.O

FAST, EASY, PAINLESS. GOOD COMPLIANCE AND RELIABLE RESULTS.

Dr. Duenas was selected from among 331 applicants to fill an open seat on one of two panels and will be recognized as a “clinician” with AOA being his “primary affiliation.” He brings more than 30 years of experience in private clinical and hospital-based optometry practice, in addition to his service with the Centers for Disease Control and Prevention and the National Commission on Vision and Health.

www.icare-usa.com

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TECHNOLOGICAL ECP Judy Canty, LDO

APP HAPPY and technology behind polarized lenses. This is a great tool for new hires or as a refresher for everyone in the office. The basic information is generic, but it does recommend NuPolar lenses with links to their website. This one has been on my iPad for a while and it has been very handy when explaining the value and effectiveness of polarization.

NOT LONG AGO, a group of tech and marketing gurus announced the development of an online refractive exam.

The app expects to become available in the summer of 2014 and advertises a valid prescription, signed by an Ophthalmologist in 10 minutes.

A number of ECPs lost their minds.

Why are we freaking out about apps? Before there were apps, there were software programs and before that there were catalogues and pricelists that were guarded like the crown jewels.

Are we afraid that apps, easily available to the general public will displace us or take some of the mystery out of what we do?

Probably.

So, what are we going to do about it?

How about we embrace the technology rather than run from it or talk smack about it?

I decided to search my iPad for apps that are currently available to ECPs and our patients. Sadly, there are lots of them. Many are free; most cost less than $5.00. Some of them are in the hundreds of dollars and require access through professional portals. A few are slightly disturbing “eye surgery games”.

Here are some of the free apps that I found along with my non-scientific impressions. These are apps that can be useful tools during the fitting process and for training a new hire.

NuPolar—from Younger Optics, is a nice app that explains pretty much everything you need to know about the history

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

Know Your Eyes—is an app based on activity sheets from the American Optometric Association circa 2006-2011. At least, that’s what the introduction said. This is another tool that could be used to provide some basic knowledge for new hires or to provide information for patients while waiting for an appointment.

There are enough questions in the 4 sections to spark meaningful discussions between patients and ECPs. My New Frames—is a simple photo app that can be customized with practice information. It will take up to 6 different photos to compare and allow the pictures to be shared with friends for those all-important second opinions. The pictures are watermarked with practice information.

Essilor—has a very jazzy interactive app designed to provide basic information to patients about Varilux, Crizal and Xperio products. There are a couple of games and a practice locator feature. I’m not sure where to go with this one. If you want patients to access it for information on specific products, fine, but the locator function could send them to another practice.

Silhouette—offers a virtual try-on app that is interesting, but not the easiest thing to use, especially for presbyopic me. If I took my glasses off, I had trouble seeing the outline to use for the picture.

Once I figured it out, it was fun to try shapes and colors. I did have trouble visualizing the temples on most of the mountings. i.Demo—is a consultative app from Zeiss. It is free, but available only to selected Zeiss Opticians. According to the app description, it interactively assesses the patient’s visual needs and recommends available options using Zeiss spectacle lenses.

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OTTO—is VSP’s virtual assistant app. The download is free, but requires a username and password to enter. That’s probably not free. It does look like a powerful app, including patient check-in, vision screening and measurement functions.

In fact, most vendor sponsored apps contain a practice locator, so recommend them judiciously. Better yet, have them available on your office tablet to use as an assistant or a handy catalogue/reference.

I found this little gem after reading the wails and moans of ECPs who need to learn the next new system: ICD-10 Search—is for all of you coders out there who are struggling to learn a whole new generation of insurance codes. This is another limited free app. You get 5 free searches and then you need to subscribe to a monthly or annual app. The beauty of this one is that it will cross link ICD-9 and ICD-10 codes in an attempt to un-muddy the waters a bit.

Now to the real nitty-gritty, perhaps the one app that really grinds our lenses: Glasses.com for iPad—this is the app with the try-on technology that one major player just paid a lot of money to get. To tell the truth, it’s pretty cool. If you’re used to taking selfies in the bathroom mirror, this app’s for you! Having played around with it for about an hour, I can see the attraction. It’s easy, once you get the selfie you want. The try on features, especially the side-to-side views are impressive. However, and this is where you brick-andmortar types can really shine, the lens options are almost nonexistent. You must choose between SV and Progressive/Bifocal; CR-39 or two levels of polycarbonate; free No Glare or Elite No Glare and Transitions Grey (not available in SV CR-39).

I would be tempted to have this app at my dispensing table. It was easy for me to drop a virtual $500 on a pair of unknown design, ultra lightweight polycarbonate PALs with Elite No Glare in a zyl frame that I have to assume fits properly and looks good.

Here are the assumptions: 1. The color on my iPad is the same as the actual color of the frame.

2. The frame really fits my bridge and the temple length is good.

3. The eye size actually works with the unknown PAL. 4. The measurements, which you cannot take until the eyewear is actually purchased, are accurate.

Why not use this app in conjunction with the conversation you have with your patients? They know what’s out there, but they still came into your office for a reason. Why not offer to help them with their online purchase? At the very least, you have the opportunity to demonstrate the limitations of these online marketers and at the same time offer them a wider selection of frames, lenses and options. Help them understand that you can keep them within their budget and still walk out with more value to show for it.

Brick-and-mortar businesses are still ahead in this game, but we’ve got to be calmer, smarter and more adaptable to remain there.

I’m hesitant to talk about fitting apps, since almost every major lab has their own and I do have my personal preferences. I will go so far as to say that my recommendation, as an optician, is to use one that does not limit you to a single brand of lenses. It may be easier to choose just one, but as I have said more than once, there is no such animal as a one-brand-fits-all lens. Our patients expect us to be smarter than that.

By the way, the app that started this brouhaha won’t be available until Summer 2014 and I’m waiting to see how that Ophthalmologist’s malpractice insurer feels about the concept. I

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MANAGING OPTICIAN Anthony Record, ABO/NCLE, RDO

Filters

ing to shower before he went to order his new eyeglasses. He was about 75 pounds overweight, the extra girth located in one of the biggest beer bellies I’ve ever seen.

That belly was held in place by a filthy, threadbare T-shirt and a grimy pair of rainbow-striped suspenders, which struggled to barely suspend a pair of faded, holey Dungarees. His eyeglass frame was taped together at the bridge, and I was bracing myself for a $49 sale to start my day.

Long story short: Mr. Hoover ended up ordering not one, but two pairs of Flexon® frames, with Transitions®, Varilux® lenses, with anti-reflective treatments of course. He ended up paying for them in full, up front, in cash! It’s also worth telling you that despite his appearance, he was well-spoken and intelligent. Now don’t get me wrong: I know we’ve all been taught from the time we were in Optical Kindergarten not to prejudge our patients, clients, or customers (whichever you choose to call them).

T’S FUNNY HOW the mind works.

I was working on the front lines of my optical shop the other day, and a client I hadn’t seen in a very long time walked through the door. In the interest of not offending any HIPAA sticklers out there, we’ll call him Mr. Hoover. My mind immediately drifted back to the first time I met him – about 20 years ago.

I

I vividly remember that day, and the lesson Mr. Hoover eventually taught me, like it was yesterday. I first spied him early that first morning as he shuffled down the aisle toward our shop. His hair was disheveled and it appeared as though he had just rolled out of bed, not bother-

Still, the overwhelmingly negative (cheap/poor) image he presented caused even me to prejudge Mr. Hoover in an unforgivable and incorrect way. But even though we’re perpetually told not to prejudge in training and sales classes, rarely do the instructors give us any insight as to why we have a predisposition to prejudge, and even more importantly, they don’t bother to tell us exactly how to avoid doing it. In the next few paragraphs allow me to do just that.

If you paid even passing attention to the title of this article you already know the reason why most salespeople – especially inexperienced salespeople – tend to prejudge the financial capabilities of their clients. It’s filters.

There are several different mental filters which subconsciously frame our perspective. Being aware of them is the first step to keeping them at bay, and keeping them at bay is a surefire way to never prejudge again.

One type of filter that stymies our approach could best be described as a Classification Filter. This filter is all about recognition. It causes us to compare what we are experiencing to similar things we have experienced before. So in the real-life example of the first time I met Mr. Hoover, I automatically “recognized” that he was just like most (but of course as I soon discovered, not all) of the people I had met in the past who dressed the way he did; he probably didn’t have a lot of discretionary cash on hand. Boy was I wrong.

Whenever you find yourself reacting to that Classification Filter of recognition, and assuming something about someone’s finances, fashion sense, or anything else, remind yourself that that’s all it is – an assumption. Try to develop the habit of consciously assuming the opposite of your initial assumption. It takes a little effort, but I can assure you it’s possible.

Another type of Classification Filter is one that could best be described as one of context. This filter causes us to assume things based on the time and situation we experience it. In other words, because I was seeing Mr. Hoover in the environment of my optical shop...and since he looked out of place...I assumed the worst.

Had I seen him in his element – in the highly successful blue-collar business he owned – I would have seen him for what he is: a successful businessman of means who only wants the best.

Continued on page 22

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

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A second example is an Interests Filter.

This one is a filter our unconscious mind uses to assess the thousands of bits of information we encounter every day, and helps us choose which to pay attention to and which to disregard. There are two types of Interests Filters. One is what I like to call a Criteria-for-Success filter, which causes us to disregard most of the information around us until we actually need it.

For example: Did you notice all the Corvettes you passed on the road as you drove to work this morning? Probably not. Why? Because you don’t own a Corvette and you’re not thinking of buying one. Regardless of that, trust me, you passed several Corvettes on your way to work today. If you do own one or are thinking of buying one, you would have noticed them all.

How did that filter affect my encounter with Mr. Hoover? It caused me to not notice his bulging wallet, his Rolex watch, and the fact that the taped frame was also a Flexon®. The other type of Interests Filter is a filter of relevance.

This one causes us to evaluate the degree of relevance of what we encounter based on how that information can best serve our needs.

The third type of filter is commonly referred to as a Future Filter. This one affects our ability and desire to anticipate what might happen next. And you guessed it – there are two types of Future Filters: one is called a filter of forecast; the other a filter of expectation.

The “forecast” Future Filter inspires hope or alerts us to danger. For example, when you arrive at the party and first lay eyes on that special someone...you approach... engage in conversation...hit it off...and exchange phone numbers. As you drive home alone you think, “I hope he calls!” That is your forecast filter inspiring hope. When you get home and look him up on Facebook and find his status listed as “married,” hopefully your forecast filter causes you to switch gears and alerts you to possible (probable) danger. Obviously, the latter was in play with Mr. H.

The fourth and final filter is a Judgment Filter, which is ever-evolving based on our past experiences with a specific, individual person or organization. As I had never met him before the encounter I described, this one didn’t apply to my first exchange with him. But it could in subsequent visits. Since he has always made expensive purchases in my office, my Judgment Filter kicks in every time I have seen him since we first met.

It causes me to assume that he always will drop significant coin with every visit.

And sadly that’s not true with Mr. Hoover. After all, sometimes even he simply needs an adjustment.

Recognizing these filters when they come in play with your patience and consciously working to keep them at bay should make you more effective as an ECP, both technically and as a communicator. It will also help you be more profitable as a business. And as Martha Stewart would surely say, “That’s a good thing.” I

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

The Hole Truth: Edgers That Drill

Santinelli’s recent “Think Outside the Box Edge” Rimless Eyewear Contest winners.

If you have been around awhile – You know that rimless was all the rage for a few years.

However, like every fashion-driven industry, eyewear has to change in order to keep up and keep selling. Rimless, at least in the store where I work, has dropped off significantly, but we still sell rimless eyewear, and we have some loyal customers who simply will not wear anything else.

Bright colors, hand-painted designs and funky shapes stand out, but for truly individual self-expression, nothing makes a statement like a rimless pair of glasses that was designed just for you. Let’s face it, when you buy off the board, you are buying something that hundreds, thousands, maybe even tens of thousands of others are wearing as well. Like tailored clothing, your eyewear only becomes truly unique when it is made just for you. Rimless eyewear allows for customization on so many levels.

Tailoring can be as simple as tweaking the “A” of a stock shape by a millimeter or two, or as outrageous as the wild results you can create by mixing colors, frame parts and asymmetrical lens shapes.

Whether or not you are into creating custom eyewear, having an edger with drilling capabilities gives your store an 26 E Y E C A R E P R O F E S S I O N A L

advantage. Having an edger gives you the potential for advantages like reduced turnaround times, tighter quality control and reduced lab costs – the things that are always mentioned – but let’s not forget the genuine pride you get from making a beautiful pair of glasses instead of just opening a box from the lab and inspecting the finished product. Drilling can be as simple or as complex as you want it to be. For basic work, where lens shapes are called up from memory, your work can be as simple as pushing the “start” button. For those who want to get a little adventurous, having an edger allows the ECP to play with the shape and size of a manufacturer’s shape settings.

For the artist in the “anything goes” category, having an edger with advanced features mans they can work a lens like a sculptor works clay.

For just a little flavor of what can be done, see the above examples from the winners of Santinelli’s recent “Think Outside the Box Edge” Rimless Eyewear Contest. The company asked their drilling lens edger clients to create a pair of highly imaginative rimless eyewear using the edger’s innovative Design Cut technology.

Regardless of your creative desires, there are a few features you will want to look for in an edger with drill capabilities. Be sure it has a user-friendly interface. Keep in mind that your best lab person may not be there

24/7, so others may need to use it, as well.

Be sure the edger has a full range of angle positioning. Drill holes must be placed in relationship to the lens base curve, the lens thickness and the position of the holes on the lens. Drilling mounting holes is not a matter of holding the lenses and keeping them straight! Last, be sure that the drill bit or router bit can be easily swapped and/or maintained.

Look at what Briot offers in their award winning AltaPulse edger, which Briot says has these features: • In the plastic version: Three 90 mm wheels: plastics roughing wheel (all plastics CR 39, polycarbonate, high index), bevel and rimless finishing + TBS wheel, bevel and rimless polishing wheel.

• Integrated drilling function: Countersunk holes, notches, blind or open oblong holes.

Drilling angle tilts depending on the program from 0 to 30 . o

o

• Visual preview of lens on request, before starting roughing cycle.

• Tracing prior to roughing with accuracy of 1/100th of a millimeter. Feeling front and rear curvature and lens thickness.

• Four different bevels: Normal, Mini-Bevel, Tilted Bevel, and Mini-Tilted Bevel. Six different programs: Front face, percentage Continued on page 28

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For over 40 years, Santinelli International has delivered the highest quality lens finishing equipment and industry-leading service.

Now you can get the same for your supplies, tools, frame parts and more!

800.644.3343 (option 6) www.santinelli.com orders@santinelli.com

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(default setting), 1⁄2-1⁄2, rear face, controlled bevel (manual), automatic bevel.

• Edging pressure controlled according to the materials selected, the treatment required, and their fragility.

• Minimum edging diameters: Rimless finish 17 mm, grooved finish 18.2 mm, bevel finish 18.6 mm, safety bevel finish 21 mm.

• Grooving: Front and rear face with adjustable depth and width.

Grooving angle adjusted automatically according to the curve and the height of the lens.

• Customized safety bevel (front face, rear face).

Coburn offers the Excelon 8000 series, of which Coburn says, “Seamlessly finishes plastic, hi-index, polycarbonate, and Trivex® and offers the widest range of bevel options available. With accelerated long-life milling technology super hydrophobic axis twisting is eliminated, and with the optional drill unit, virtually any lens shape or hole pattern is possible.”

• Integrated, accelerated long-life milling technology to eliminate axis twisting • Widest range of bevel options available including: Standard, Mini Bevel, Asymmetric, Semi U, and customizable beveling for high curved frames • User friendly touch screen and graphical user interface • Advanced 3-Dimensional digital technology

Santinelli has the Me1200, of which they say: “Enabling Finishing Labs to make the impossible – possible, Santinelli International’s Flagship Me 1200 Lens Edger, the most compact, feature-rich lens edger ever introduced. Wholesale Labs and retail ECPs alike looking for differentiation and increased profits can now deliver even the most complex and sophisticated eyewear to the highest level of quality standards with ease.”

“The Me 1200 proudly boasts the highest quality step-beveling technology, allowing Rx lenses for any high wrap frame. The unit also delivers high-curve beveling, exclusive partial beveling, partial grooving, design cut, faceting, advanced shape editing and exclusive 3-D grooving.”

“The Me 1200 industrial grade design, the unit was manufactured for highest precision and ‘whisper quiet’ drilling and notching. It processes every possible type of 3-piece mount, as well as Chemistrie Sunlenses with the unit’s exclusive Click Mode.”

I know I say this in every article I write on edgers, but there’s a reason to repeat it. Every optician or non-licensed optical professional should be able to make a pair of glasses for a patient.

Modern edgers have push-button input and auto-everything.

There is simply no excuse for us not to be able to make those glasses. With these feature-packed edgers, there is not even an excuse for being unable to run a basic 3-piece mounting!

• Detailed edging status is displayed graphically in real-time • Dual CPU system supports full multitasking, editing and loading The 8000 series is a modular system, where the edger can be upgraded by adding the external drill unit, tracer and blocker.

The drill unit is the HDM-8000 which features: • New systematic data profiling algorithm significantly reduces job processing time • Process and cut your next lens while drilling is in process with Smart Job Manager software • Sleek design allows for a smaller footprint

What we look for in edgers is what we look for in most products, these days. We want reliability, technologically advanced features, accuracy and speed. No matter which drilling edger you choose, these feature-packed units are bound to meet your needs. As always, be sure you test any machine you are considering in a real-life setting, and run a series of lenses in both plus and minus prescriptions of your choosing. Even if you are the financial decision-maker, be sure to have the person who will actually be performing the work there with you as you’re considering which edger to buy, and be open to their feedback.

You may find that you spend a little more, or perhaps a little less than you’d planned, but the person who will actually work with the edger every day will be able to do a better job if they’ve helped to make the right choice! I

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Essilor Finalizes Acquisition of Transitions Optical Essilor International announced April 1st that it has finalized the acquisition of PPG Industries’ 51 percent ownership stake in Transitions Optical, the leading provider of photochromic lenses to ophthalmic lens manufacturers, and 100 percent of the capital of Intercast, a manufacturer of premium sunlenses.

Essilor International had held a 49 percent interest in the Transitions Optical joint venture.

The value of the transaction, one of the largest in the optical industry in recent years, amounts to $1.73 billion at closing, subject to customary post-closing adjustments, plus a deferred payment of $125 million over five years, according to Essilor.

In 2013, the Transitions Optical joint venture and sunlens business had combined net sales of $874 million, PPG said in a statement released today.

The transaction, first reported on July 29, 2013, was approved without conditions by competition authorities in Australia, Brazil, Germany, New Zealand, Portugal, Spain, the U.K. and the U.S. Founded in 1990 and based in Pinellas Park, Fla., Transitions Optical reported sales of $844 million in 2013, of which $279 million with lens manufacturers other than Essilor.

“The acquisition of Transitions is a significant and highly promising transaction for Essilor,” commented Hubert Sagnieres, chairman and CEO of Essilor. “We will give Transitions the resources it needs to speed its growth and allow the Group to broaden its expansion in photochromic lenses, both worldwide and in different market segments.”

Transitions Optical and Intercast will be fully consolidated in Essilor’s financial statements as from April 1, 2014.

According to Essilor’s estimates, the integration of Transitions Optical will have a positive impact on Essilor’s financial indicators, notably with: •

An increase in the Group’s contribution margin of around 150 bps as from year two of the integration.

•

An accretive effect on earnings per share as from 2014, representing at least 5 percent a year in subsequent years.

•

A positive impact of around 50 bps on the Group’s like-for-like growth in consolidated revenue as from year three of the integration.

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CONTACT LENS CORNER Sam Winnegrad, MBA, LDO

Contact Lens GRAFFITI

OUR BODY HAS a way of formally complaining against a biologically foreign intruder â&#x20AC;&#x201C; the contact lens. Various films and deposits commonly found on contact lenses serve to remind us that the biocompatibility of these lenses, though markedly improved, still faces many challenges. Even after an incalculable amount of money has been spent researching and developing new lens technologies, we are still left to manage an imperfect product.

Y

Educating our patients on proper wear schedule, disinfection and storage habits will decrease incidence and severity of these defacing blemishes. Of the multiplicity of graffitious (just made that word up) deposits, this article will mainly focus on films evolving from protein, lipid, bacterial, mineral, and cosmetic origins.

Factors affecting deposition are almost as numerable as the stars in the heavens â&#x20AC;&#x201C; exacerbating the difficulty in resolving some cases. Qualitative and quantitative nature of the tear film, blink rate, work environment, computer use, air quality, disregard for wear schedule, and, above all, poor contact lens hygiene have all been cited as instigators. Newer two-week and daily disposable modalities, though greatly reducing deposition, are no panacea. The battle continues...

As the primary molecule, it is only proper that we start our discussion with protein.

Derived from the Greek word protos,

meaning primary or first protein is the building block of life. Unfortunately, protein has an unquenchable affinity; yearning to court, betroth, and wed contact lenses. As soon as your patients insert a set of lenses into their eyes, protein will begin clinging to and interfacing with the surface.

Protein will primarily attach to the anterior surface of the contact lens creating an opaque, grayish-white film. Most of the protein that is absorbed into the lens is formed from albumin, lysozyme, lactoferrin, and immunoglobulins originating in the precorneal tear film.

As adsorption takes place, both water content and oxygen permeability decrease dramatically. Protein deposition translates to problems associated with comfort, visual acuity, and various eye health issues such as papillary conjunctivitis or corneal ulceration. Protein adsorption is accumulative and will not resolve unless a thorough surfactant cleaning and disinfection process is in place. Newer hydrophilic technologies have entered the market and dramatically reduced incidence of protein deposition.

Silicone hydrogels, which comprise the brunt of the contact lens market, perform quite well at resisting protein.

Incorporating silicone into the composition of the lens increases oxygen permeability and nutrient transmission to the corneal epithelium while minimizing the need for water to move throughout the contact. High water content hydrophilic lenses seem to accumulate much greater levels of protein. Switching patients with

high protein levels distributed within their tear film to a silicone hydrogel will aide both patient satisfaction and clinical outcome.

While silicone hydrogels might be wonderful at resisting protein deposition, they fall short when thwarting off lipids.

These films will appear both white and greasy and are generally more translucent than protein deposits. Fingerprints on contact lenses are consistent with lipid habitation, though this is not always the case. Lipid deposits originate from the sebaceous meibomian glands lining the rims of our eyelids. These glands produce the outer lipid layer of the tear film necessary to reduce evaporation rate.

Dysfunction of the meibomian glands resulting in excess or abnormal lipid production can lead to a deposition issue.

Other factors contributing to lipid deposits might include oily hands secondary to touching the face as well as diets that are high in fats or alcohol consumption.

Dietary abnormalities have a way of manifesting themselves in our bodily secretions, including the tear film.

It has also been noted that a reduction in the watery aqueous layer of the tear film makes it more likely for a lens to develop an oily, lipid-based film. Silicone hydrogels, which are praised for their ability to resist protein deposits, will usually accumulate more lipids than non-silicone based hydrophilic lenses. Cleaning these lenses can be a difficult task; though newer Continued on page 32

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Google and Luxottica Announce Partnership for Glass — Will Include Ray-Ban and Oakley Luxottica Group S.p.A. and Google Inc. announced last month that they will join forces to design, develop and distribute a new breed of eyewear for Glass, which will include the involvement of Ray-Ban and Oakley brands from within Luxottica’s portfolio. In its own statement, Google added that “Luxottica’s retail and wholesale distribution channels will serve us well when we make Glass more widely available down the road.”

Luxottica’s statement described “a far-reaching strategic partnership between Luxottica and Google to work together across multiple efforts on the creation of innovative iconic wearable devices. Through this relationship, Luxottica and Google will match up hightech developers with fashion designers and eyewear professionals. In particular, the two corporations will establish a team of experts devoted to working on the design, development, tooling and engineering of Glass products that straddle the line between high-fashion, lifestyle and innovative technology.”

Luxottica said that the two major proprietary brands of the group, Ray-Ban and Oakley, will be part of the collaboration with Glass. Luxottica cited Oakley’s “10-year heritage in wearable technology that has evolved from MP3 to HUD devices.” The company said details about these new products will be disclosed at a later stage.

“We are thrilled to announce our partnership with Google, and are proud to be once again setting the pace in the eyewear industry, as we have been, with more than 50 years of excellence,” said Andrea Guerra, CEO of Luxottica Group.

Astro Teller, Google vice president and head of Google X, of which Google Glass is a part, commented, “We are thrilled to be partnering with them as we look to push Glass and the broader industry forward into the emerging smart eyewear market.”

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multipurpose solutions are targeting this particular lens film with the rise in popularity of silicone hydrogels.

Bacterial deposition, though less ubiquitous than proteins and lipids, can be much more dangerous and requires immediate action. Many microbes can establish residence within the contact lens matrix including fungi, yeast, protozoa, and various viruses. These depositions will usually manifest in a filamentary pattern with colors ranging across the spectrum.

Hydrophilic lenses with elevated water content levels have also demonstrated a greater likelihood to deposit bacteria secondary to protein. Many times these microorganisms will first engage with a lens where it has already been compromised through sustained damage or deposition.

Transcending new anti-microbial surface technologies, patients that refuse to follow proper hygiene and disinfection protocol are likely to experience infection related to bacterial deposition.

Patients that practice unsanitary habits such as reusing or “topping off ” their multi-purpose solution, storing contacts for prolonged periods of time without disinfecting, as well as even using tap water or saliva to re-establish moistness are placing themselves at a much greater risk for serious complication. Lenses harboring any type of microorganism must be disposed of immediately. Wearing contact lenses in the shower, neighborhood pool, Pacific Ocean, or anywhere else bacteria such as the Acanthamoeba protozoa is found is a dangerous practice. Patients with bacterial deposition should be switched to a reduced wear schedule, such as a daily disposable modality with strict instruction on hygiene.

Inorganic minerals such as calcium phosphate can also bind to lens surfaces decreasing both acuity and comfort.

Segregated mineral deposits appear white and granular under slit lamp microscopy; however, rarely will there be just one particular type of deposit on a lens. One frequent cohabitation of deposits is lens calculi or jelly bumps. These are raised protein, lipid, and calcium formations

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protruding from the anterior surface of the lens. Jelly bumps are a sign of poor hygiene and lens care (this point is further exacerbated if present on disposable lenses). Once again, re-education and possible refitting apply for a patient that is wearing lenses with this type of formation. Any contacts with lens calculi deposits are not candidates for disinfection and must be discarded.

Telling someone that their eyes have a radiant sparkle is a nice thing to say, unless, of course, you are referring to misplaced glitter gel. Cosmetics and contact lenses are not friends, yet in most cases, it is not socially acceptable for practitioners to mandate discontinuation of mascara, eyeliner, and all things glittery. “Ma’am, I am going to need for you to stop using foundation because I am afraid it is going to compromise your visual acuity” probably would not be the best business builder. Education is our best bet.

Patients should be informed that contact lenses are to be inserted prior to any cosmetics and that they are able to be removed before cleansing the face. One easy way to remember this is to tell patients that they should be able to see what they are doing when they apply their make-up, but that they are expected to remove their cosmetics “blind”. Make-up, however, is not the only culprit. Almost all lotions, hair gels, and beautification products can find their way onto contact lenses and cause problems.

Though some of the films created by cosmetics can be removed through cleaning and disinfection, others can be less cooperative.

For example, oil based makeup is much more difficult to remove from a contact lens surface than water based products.

Even worse than diminished visual acuity and lens comfort is the increased incidence of infection related to cosmetics and contact lens wear such as blepharitis and bacterial conjunctivitis. The summer is just around the corner; a time when people wear over-the-counter sunglasses and contacts in lieu of prescription eyeglasses. As such, remember to tell your patients that contacts should also be inserted prior to applying suntan lotion or they just might have to end up discarding their beloved

lenses. After all, there are far better ways to achieve ultraviolet eye protection than aggravating the cornea with SPF-50!

After considering some of the more notorious contact lens deposits, it is only proper that we review some basics about proper lens cleaning, disinfection, and storage. First off, remind your patients to wash their hands before attempting to remove or insert their contact lenses. One recent study concluded that only 5% of people using a public restroom wash their hands well enough to kill bacteria (let that sink in, pun not intended). After washing their hands and removing the lenses from their eyes, your patients should spend at least twenty seconds rubbing their contacts with multipurpose solution to loosen any deposits.

This should be immediately followed with a rinse using the same solution.

Next, it is imperative that your patients place their contacts in their lens case and fill it with fresh solution; leaving them for at least 4-6 hours. Lastly, the old solution must be discarded after use, as it is likely contaminated and will no longer be effective. Tell your patients to replace their lens case every thirty days and to never store their lenses in pure saline; just because it’s sterile does not mean that it has disinfecting properties. Ask your patients open ended questions such as, “how do you take care of your contact lenses?” This is a much more efficacious way to uncover problems than the usual, “are you following your wear schedule and cleaning instructions?”

If your patients see more graffiti on their contact lenses than at a New York train station, there may be a problem; if your patients view more ‘films’ than a Hollywood critic, there may be a need for intervention. Practitioners that take an active role in educating their patients about lens deposit prevention are more likely to have healthier, happier clients. While we can rest assured that there will continue to be improvements in both contact lens and solution technology, we can also remain confident in the fact that there will always be a need for managing the biocompatibility of these wonderful devices. I

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OptiSource Introduces the Lens Inspection Station a Polariscope that identifies hidden stress in mounted lenses and injection molded lens blanks; and a Final Inspection lamp with a white light that allows the user to identify any abnormalities in the finished eyewear. This product is built with an ergonomic counter-height design which allows the user to comfortably view mounted or un-mounted lenses.

OptiSource International has developed a first-of-its kind 3-in-1 lens inspection station.

This compact machine includes a PAL Identifier which brings invisible PAL markings into focus;

www.optogenics.com

OptiSource’s pursuit of innovation continues to provide the optical trade with solution-oriented products. “When our customers requested a new PAL Identifier, we intuitively considered what other devices they currently use or need while dispensing”, said Daryl Squicciarini, president of OptiSource. “Based on that analysis, we developed a multi-use machine

for the same price or less than a PAL Identifier only, without requiring any additional counter space.” The Lens Inspection Station features interchangeable lenses that can be rearranged by the user, and an LED light source which eliminates the need for replacement bulbs.

OptiSource is a leading provider of lens processing consumable supplies and eyeglass accessories.

Their extensive product line includes exclusive products such as: Snapit patented frame screws, Cobalt King blocking pads, All Off progressive marking ink remover, OptiPets eyewear holders, Titanium hand tools, and The Clear View family of personalized lens cleaning products.

Shop their thousands of items at: www.1-800-optisource.com.

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Crizal® and Prevencia™ are registered trademark of Essilor International. Varilux® is a registered trademark of Essilor International.

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SECOND GLANCE Elmer Friedman, OD

FOAM PARTIES: A Danger to the Eyes MODERN TIMES have witnessed a number of fads, fetishes and addictions.

The gamut is wide as it encompasses hula hoops and glue sniffing to Facebook uses and abuses. One of our human foibles is yearning to experiment with new and exotic ideas and the strange equipment that accompanies them.

The latest intrusion on the usual and customary spare time amusements is “the foam party”. These exciting parties can be seen on a daily basis on college campuses, night clubs, school dances, church events, birthday parties and picnics across the United States. Special equipment can provide the foam at these parties. The original idea can be found in a 1936 film, “A Rhapsody in Black and Blue” in which Louis Armstrong struts about and plays his trumpet in a room filled with foam.

Recently, European followers were actively spreading the word about this new and stimulating event. American youth has now become enamored with this amusement and attached itself to this strange practice.

Have you ever been to a foam party? No, I didn’t think so. Picture this: soap bubbles pour down from the ceiling or from foam makers on the floor. The bubbles are distributed by blowers so that several feet of foam can accumulate. Foam parties can last for several hours while the foam keeps pace with the activities at the event. Some of the foam formulas are created from event to event, so that standards for chemical compositions and concentration are unknown for each particular occasion.

Depending on the solution being used, the eye risks may vary. Some may experience only mild discomfort, while others may suffer serious corneal damage exacerbated by contact lens wear.

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

To the followers of foam parties, the idea of being hosed down with a weightless spray of soap bubbles sounds like fun. But when heavy drinking, slippery surfaces and reduced visual coordination is introduced, we are confronted with a hazard that may be disastrous. Dr. Howard Mell, a spokesman for the American College of Emergency Physicians, said on MSNBC that slips and falls and damage to breakable items are only part of what makes those parties so dangerous. The bubbles themselves could be harmful if not prepared correctly; the soap could be an irritant, causing a burning sensation in the eyes and even temporary blindness. Dr. Mell said, “At the end of the day, it’s not the smartest way to spend a Saturday night.

It doesn’t take a whole lot of common sense to figure that out.”

College fraternities were the earliest users and planners of foam parties. However, the most celebrated case demonstrating foam damage to the eyes occurred on May 25, 2013 at a Naples, Florida night club. About 40 people sought emergency room treatment for eye injuries suffered after a foam party. The most outspoken victim was 22

year old, Lauren Martin. She reported, “I have never felt so much pain in my life.

I felt like I had shards of glass in my eyes.

My mom had to feed me and I couldn’t open my eyes until Monday afternoon.”

Emergency room doctors agree that as the trend is growing in popularity, foam parties are potentially dangerous. Official investigations still are not absolutely sure what went wrong at the Naples club but they feel that the concentrated soap was not diluted correctly and thus became an irritant to the skin and eyes. The Centers for Disease Control feel that better regulations and management of the chemicals and concentration could greatly reduce the accidents waiting to happen. According to the New England Journal of Medicine, it was reported that, “Six young men were presented with various degrees of keratoconjunctivitis due to alkaline chemical burns they had received during an evening of dancing on a dance floor covered with several feet of foam.”

Dr. Mell also reported that while working in two college towns within the last five years he encountered about one or two Continued on page 36

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MOVERS & SHAKERS Transitions Optical

Prevent Blindness

After 40 years of service to PPG Industries, including nearly 24 with Transitions Optical, Richard C. Elias, senior vice president, optical and specialty materials, and CEO, Transitions Optical, Inc., will be retiring, effective now.

Elias joined PPG in 1975 and became program Richard C. Elias manager for photochromic lenses in 1989. He was named vice president of sales and marketing when Transitions Optical, Inc. was established in 1990, and he became its president in 1995 and chief executive officer in 2007. Elias was named general manager of optical products for PPG in 1998 and was elected vice president, optical products, in early 2000.

He was named senior vice president for the optical and specialty materials reporting segment at PPG in 2008.

Prevent Blindness has announced the election of Kate Renwick-Espinosa, chief marketing officer of VSP Global, to the Prevent Blindness Board of Directors, as voted at the organization’s winter board meeting. Renwick-Espinosa works in development and management of marketing Kate Renwick-Espinosa strategies and programs across the VSP Global companies, which include VSP Vision Care, Eyefinity, VSP Optics Group and Marchon Eyewear. Renwick-Espinosa has served VSP for 22 years, where she has been instrumental in expanding the role of marketing within the company.

National Federation of Opticianry Schools The National Federation of Opticianry Schools (NFOS) elected new officers during its 2014 annual business meeting. New officers are president Prof. Robert J. Russo, New York City College of Technology; vice president Prof.

Kimberly Strickler, K.S., MA, LDO, ABOC, Robert J. Russo NCLC, New York City College of Technology; secretary Sheri Red Shirt, Southwestern Indian Polytechnic Institute; and treasurer Sheldon O’Guinn, Tri-Service Optician School. Prof. Randy Smith of Baker College is the executive director, and Kristi Green of J. Sargeant Reynolds Community College is past president.

Williams Group Gilan Cockrell, OD, FAAO, has joined Williams Group as executive vice president of corporate strategy. In private practice in Emporia, Kan., since 1980, Cockrell graduated from Oklahoma State University and received an optometry degree from the Southern College of Optometry.

Gilan Cockrell He was president of the Kansas Optometric Association in 1998, chairman of the State Government Relations Center for the American Optometric Association in 2007, co-founder of the Eye Care Council and “See to Learn” program, and recipient of numerous awards within his profession. He currently serves on the Kansas State Board of Examiners in Optometry.

CooperVision CooperVision, Inc., a unit of The Cooper Companies, has appointed Bob Ferrigno as president, North America, a move which became effective in February 2014. Ferrigno has overall responsibility for guiding the organization’s future strategies and direction for the region.

Bob Ferrigno The role was formerly held by Andrew Sedgwick, who was named executive vice president of commercial strategy and business development for CooperVision last year. Prior to joining CooperVision, Ferrigno was with Becton Dickinson (BD), a global medical technology company, for 32 years. During his career with BD, he held numerous positions with increasing levels of responsibility.

Adlens Adlens, the Oxford-based company specializing in variable focus eyewear, has promoted Drew Oppermann to international sales manager.

He has more than 20 years of optical industry experience, and joined Adlens in late 2011, working on international business development Drew Oppermann with a primary focus on Latin America. In his new role, Oppermann will develop European markets for Adlens, adding value by growing strong optical and non-optical partnerships in each country. Oppermann has a strong background in international business development. In the 1990s he started an Italian subsidiary for Viva International Group in Treviso, Italy that became the company’s international headquarters.

Maui Jim Cohen’s Fashion Optical Cohen’s Fashion Optical has announced that Sheila Haile has joined the company as chief marketing officer. Haile brings over 15 years of combined agency and corporate experience to Cohen’s, including six years in the optical Shelia Haile industry, recently as marketing director at ClearVision Optical. At Cohen’s, Haile will drive overall brand strategy and marketing initiatives for the company and its 130 franchise locations.

Maui Jim has announced the appointment of Jay Black to vice president, global marketing.

According to Maui Jim, Black’s 17-year career in raising the visibility of some of the world’s foremost brands encompasses the development and execution of memorable programs for the Jay Black global spirits manufacturer, Beam, Inc., and leading worldwide brewer, Anheuser-Busch. He is known for impactful programs that transformed key brands including 180 Energy Drink, O’Doul’s, Tilt, and Bud Extra, the company said.

E Y E C A R E P R O F E S S I O N A L 35

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foam related injuries per month. “Soap in the eyes is like an excess of chlorine in a swimming pool,” said Dr. Mell. “But more common than eye injuries are falls that occur since people cannot see the contour of the floor beneath them which is hidden by the foam. It is easy for one person, off balance, to fall into another and before long we have a six body pile up with enough injuries to supply everyone involved.”

Groping was mentioned as an undesirable side effect during those mishaps.

The foam can bring on nausea and vomiting, if swallowed. Furthermore, it adds another slippery area for the party goers to contend with. This affected area is considered a ‘land mine’ by experienced party attendees. Emergency room doctors admit that they had never heard of foam parties until about 15 years ago. For those who work on a college campus it is not uncommon and doesn’t even arouse curiosity. Reporters noted the case of famous actress, Anne Hathaway, who mentioned in the New York Times that she attended a foam party in college and that half the guests had pink eye in the morning.

Dr. Mell suggests buying a pair of protective goggles and shower caps for your next foam soiree.

A bubble bath theme party would be a perfect venue for bath salt addicts. No one would be able to tell they reeked of lavender

and chamomile, the tell tale signs of a bath salt addict. Additional signs would be that they may insist on being permitted to commit mayhem upon your person. Observers advise that if you wish to attend a foam party, do so with a reliable buddy. There have also been a large number of reports of participants developing sore throats.

Another problem to be considered is the electrical equipment that could lead to electrocution by not being properly grounded. A critical group of students advise that partygoers should be informed of the risks at these parties. They suggest that drinks come in some form that can be closed or covered. Considering the fact that participating teenagers may be wearing skimpy clothing and dancing close to one another, we can only imagine the results of the physical contact that ensues. Adult supervision can help keep the party from getting out of hand. Sometimes the limited clothing may become a complete lack of clothing. The teens should be required to remain in the designated party area and not be permitted to wander off into unsupervised areas where sexual conduct may occur.

Furthermore, strict regulation of alcoholic beverages served on the premises should be enforced. Some foam parties are themed so that the dress will reflect the main topic to be followed. Examples are a

Pirate or Safari theme. A sign on the door should list the possible dangers that may be encountered. They see a similarity to claims of danger from smoking. “List the dangers,” they say, “And let the individuals make a judgment based on better information.”

Many people who have one of these parties in a private home or building other than a private club must be aware of potential damages that may occur. The foam could penetrate the walls and floor or get absorbed into the carpets and subsequent mold that often develops. The foam may coat uncovered pipes so that in the colder, winter months they may freeze over. Some enterprising business men are now selling “The Foam Party Dance Kit.” It is an inflatable dance pit that allows a foam party without the risks. The wonders of life just keep coming.

My neighbor’s daughter was a student at Western Kentucky University. She announced to her dad that she wished to plan and pay for a foam party. The cost was more than she expected. She requested a loan from him saying, “Don’t worry. I’ll pay you back.” He replied, “Don’t worry about it. Just work hard, get good grades, and no Foam party drinking or sexual misconduct.” “Dad,” she replied, “couldn’t I just pay you back?” I

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2013 Project Highlights – Your Donations at Work!

With your help, Optometry Giving Sight was able to allocate $1.8 million to 46 projects in 28 countries in 2013, impacting on tens of thousands of individuals.

Thank you for your support.

Highlights: 34 students graduated from degree and diploma Optometry programs in Africa 12 Schools of Optometry received ongoing and new funding support* 2,440 people were given direct training and skills development 139,450 children were screened as part of Child Eye Health Programs 44,268 people received direct access to eye and vision care * Ongoing funding:

Argentina

Cameroon

Eritrea

New schools:

Haiti

Mexico

The first optometrists in Mozambique graduated in 2013!

Photo credit: Mozambique Eyecare Project

Moldova

Malawi

Mali

Mozambique

Nicaragua

Vietnam

Nine students graduated from Universidade Lúrio in Nampula in 2013, becoming the very first degree-qualified optometrists in Mozambique. Four of the graduates have been employed at the university and will become the first local members of staff.

Joel de Melo Bambamba graduated top of the class, he decided to study optometry because his grandfather was blind and his brother has serious vision impairment.

“I am very happy to have finished,” he said.

“To have reached a dream of mine, and for my parents.”

Joel was also awarded the Jill and George Mertz Fellowship by the American Optometric Foundation and is currently studying for his Masters.

For more 2013 highlights, check the news story on our homepage, givingsight.org

To donate visit

www.givingsight.org or call 1888 OGS GIVE

Watch Video

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OD PERSPECTIVE Jason Smith, OD, MS

Nursing Home and Homebound Eye Care

As a student at the New England College of Optometry, one of my clinical rotations was called “Mobile Eye Unit.” As a student, I went to different nursing homes in the city of Boston to provide eye care and to provide eye examinations to the residents and the patients. This was a clinical experience which affected me to the point that I have been providing the same type of care to the residents of many nursing homes as well as to homebound patients in Northeastern PA. When I was a student, I was required to carry a great deal of heavy equipment in order to provide the same type of eye care that would be provided in an office setting.

But thanks to computers and modern

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

portable technology, heavy equipment has been reduced in size and weight. Heavy lensometers that used to be transported in foot lockers can now fit inside a briefcase.

Small, lightweight Tono-Pen tonometers and portable non-contact tonometers can provide an accurate measurement of the intraocular pressure.

Hand held trial lenses and a trial frame can provide an accurate refraction.

Binocular indirect ophthalmoscopes are small and some fit on the face like a pair of glasses. Hand held 20 Diopter lenses can be used with an ophthalmoscope in order to check the general health of the eye including the cornea, aqueous, the lens, the vitreous, and the retina.

Taking care of a nursing home patient or a homebound patient is a wonderful experience. But, important questions need to be evaluated such as, why is the patient in the nursing home, how long have they been in the nursing home, and how long will they be staying at the nursing home?

Many patients come to a nursing home for short term rehabilitation treatment that may require weeks or months of care.

Patients who may have suffered an injury or a broken bone after a fall may require occupational therapy or physical therapy for several months before returning home.

Stroke patients may require longer rehabilitation care depending upon the severity of the stroke. A patient may require short term care or permanent long-term care.

More serious disease processes and problems such as mild heart attacks will have to be evaluated by the patient’s family doctor as well as members of the social service staff at a nursing home. Rehabilitation for any patient involves diverse processes as well as many medical services that a nursing home offers. As an optometrist and an eye care professional, I am sometimes asked to intervene on behalf of a patient.

Opticians and ophthalmologists also play a role in a nursing home patient’s care.

Opticians will fabricate glasses and ophthalmologists will be involved when there is a higher level of eye care needed, such as eye surgery. After cataract surgery, it will be my role to provide post-operative care as well as to check the refractive status of the eyes. It is also my role to coordinate any secondary or tertiary care that a patient may require. Under most circumstances, cataract surgery can be done in an outpatient surgical center. If the medical circumstances are more complicated as in the case of a medically “unstable” patient or a morbidly obese patient, cataract surgery

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may be more appropriately done in a hospital setting where other necessary medical precautions are available.

As an optometrist providing this type of care, the eye care needs of every patient are varied and specific. The needs of this patient base is very diverse and will depend upon age, medical problems, general health, previous vision problems, as well as current health problems. It is extremely important to involve other medical personnel as well as family members in order to solve the problems of the patient. It is also important to recognize that this is a “stressed” population base. Patients are now experiencing major change-of-life or end-of-life health problems. Family members who are coordinating the care of their parents or grandparents are also experiencing added, new problems that are personal, medical, and financial.

I have been surprised and dismayed at times when I have been asked to see a patient in a nursing home who may have a complaint that “their vision is blurry.”

Unfortunately, their vision has been blurry for some time. It is only when medical personnel go through a thorough case study that the vision problem is mentioned.

Quite often, a patient was supposed to go back to see their eye care professional. But something happened and the appointment was missed. Sometimes accidents, injuries, or other disease processes occur that may have derailed the plan of having the patient have their cataracts removed, to have their eye pressures re-evaluated, or to get new glasses. Patients with diabetes need to have their eyes dilated every year for preventive reasons. Unfortunately, not everyone is aware that annual dilated exams are required. And it is unfortunate that diabetic or hypertensive retinopathy which can be treated with lasers and can prevent more serious retinal problems sometimes is forgotten or neglected.

It is now my job to re-coordinate the patient’s vision care and to get them back to their previous eye care professional, if that is possible. I often receive phone calls from the social service department, from

the physical therapist, or the occupational therapist stating that the patient cannot see their food in front of them or they are having problems with their therapy. There are many times where eyeglasses need to be repaired, broken lenses need to be replaced, or new eyeglasses need to be prescribed.

Using trial lenses and doing a trial frame refraction can easily resolve this vision problem. I have found that keeping it simple is always the best policy. At times, I have had to prescribe 2 pairs of glasses for those patients who are in bed most of the time.

Leaning back in bed and looking at the TV will be blurry when looking through the reading segment of the bifocal. So those patients would be better served with a TV/distance pair of glasses as well as a pair of reading glasses.

In providing this type of care, the eye care professional must have a high level of communication with the nurses, therapists, social service staff, family members, and other medical doctors. It is important to maintain any continuity of care with the patient and any previous eye care professional. In many situations involving this patient population, it is not possible for the patient to be mobile enough to return to their previous eye care professional. That is why these patients need home eye care or nursing home care. It is important that I communicate with any eye care professional that there has been a change as to why I am now seeing them. And I always send the previous eye care professional a copy of my exam findings.

In communicating with any patient, especially an elderly patient, talking slowly and a little louder may help the patient understand their vision problems. Many patients have hearing problems and may have a hearing aid. Charts or models may help the patient understand what therapies may be needed. I use an iPad because it is large and colorful, but any hand held device may help with communication issues. This is a time when “keeping things simple” is an important philosophy. Many elderly patients have multiple medical problems and possible cognitive problems.

I have encountered many new patients who

do not speak English and have recently immigrated to the United States from many Spanish speaking countries. It may sometimes be necessary to have an interpreter present or a family member who speaks Spanish to help in the communication during an exam. Compassion is something that all eye care professionals should exhibit, always, for any patient.

For those eye care professionals that are enrolled in Medicare, house calls and nursing home visits can be billed for this type of service. Many patients have funds that are set up to cover incidental expenses and glasses sometimes need to be paid for through these accounts or through family members who handle a patient’s expenses.

Anytime there is a need to bill a patient for glasses or to refer a patient for eye surgery, this information should be pre-approved by the patient, the nursing home, or by the patient’s family members or power of attorney.

If you want to provide a worthy service in the world of eye care, home care and nursing home care is certainly a rewarding and challenging opportunity professionally.

You may get some added exercise carrying equipment and traveling to a patient’s home or to a nursing home. You should keep track of gas or traveling expenses to see if you are entitled to any tax credit. This should be something you discuss with your accountant and will vary depending upon your state’s tax laws. This opportunity will provide you with an out-of-office experience which will make you appreciate how fortunate we are to be eye care professionals, no matter how or where you provide your services. I

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DISPENSING OPTICIAN Dee Carew, MLS, ABOM, NCLEC, LDO

Nurturing the OPTICIAN PATIENT Relationship When the exam is over and the doctor brings the patient to you, it’s your chance to begin nurturing the relationship; it’s one-to-one time.

The lens design and material depend very heavily on how the eyewear will be used.

You can explain the pros and cons of each design and material. Concerning design or brand of progressive, you may have your favorites. It will serve you to educate yourself on the brands you carry or the most popular designs so you can educate the patient about her choices. Some are economically priced, some have wider zones, some have less aberration and on and on.

EEP IN MIND that relationships, even business relationships, are more emotional than intellectual, especially for the patient. She is there to have a personal need or want fulfilled and to feel good about it. That’s almost completely emotional. It’s important that you understand her needs and wants and to do what you can to provide them.

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Start by taking note of her attire and her demeanor. But don’t prejudge her ability to purchase premium products. Observe her general presence. Is she dressed to the nines or have cut-offs and flip-flops? Does she smile or is she aloof? Is she shy or assertive?

Observing her will help you begin to get to know her.

A short personal chat can break the ice and make her feel comfortable. Comment on her wardrobe, hairdo or accessories and ask open-ended questions. Then listen, really listen. Not only to what she says, but to how she says it. Listen to her tone and inflection. Listen for emphasis on words and phrases. Are her tone and vocabulary formal? Sophisticated? Casual? Friendly?

Chatting with her can make her feel like she’s talking to a friend and clue you in on what may be appropriate to fill their eyewear needs.

Then respond with smiles, nods, short phrases to let her know you are really listening. Be genuine! If you are phony, she will know in an instant. And use her name!

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

Once the lenses are chosen and it’s time for the frame selection, you’ll most likely start with dress eyewear. Explain the best type of frame as it relates to the lenses.

Some facts to point out include • Smaller, more symmetrical frames are best for high power lenses Patients don’t often feel like they’re important to the staff. So being respectful, considerate and concerned about them sets you and your office apart from your competition.

• Drill-mount or semi-rimless frames are not a good choice for high plus lenses because the center will be thicker so the lens edge can accommodate a groove or drill mount holes

Make a connection and do it with courtesy, empathy, and professionalism. You can review her Lifestyle Questionnaire together.

This is an excellent opportunity to address multiple pairs or specialty eyewear and to explain lens and frame options. Explain to your customer that it’s generally best to decide on lens style and material before choosing a frame. The lenses are the most important aspect of the eyewear and can influence the frame choice.

• Drill-mount or semi-rimless frames are not a good choice for high minus lenses because the thick edges will be exposed • A frame needs a B measurement of at least 24 mm for a progressive lens. This measurement depends not only on how much reading area there will be, but also on how much lens is left for the distance zone. The more lens area the frame style will allow, the better.

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Once you’ve agreed on the functionality of the frame, you can focus on the fashion aspect. You can discuss face shape and frame style. Also consider colors to correlate with wardrobe, skin tone, complexion and preference.

lenses to show how Transitions lenses turn under ultraviolet light. Show the Polarizing effect with a demo picture and polarized lenses. There are many and varied ways to demonstrate lenses and lens treatments.

Ask your lab reps for demo materials.

Keep up on the latest eyewear fashions and technology so that while educating and recommending you come across knowledgeable and confident. No “I think” or “I’m not sure” unless you follow it with “but I’ll find out”.

When we broach the subject of second pairs, we are doing our patients a great service. There are many situations when a second pair is beneficial. Oftentimes patients don’t think of getting a pair for their hobby or a sun pair or a spare reading pair. Many patients don’t realize that an occupational lens, such as the Double D, is even available. Or they’ve never heard of special glasses for golf, a loupe or a protective shield with an insert.

When the patient has chosen his dress eyewear, we approach the topic of lens treatments. Of course, AR is recommended on every pair and we can offer a fashion tint (if it is in style). If the dress pair is the only eyewear he is purchasing, we can suggest a photochromic lens so he will have sun protection.

Use demonstration materials. Most coating laboratories provide a “donut” or “bullet” lens to demonstrate anti-reflective (AV) coating. These lenses have a circle in the center that has AR treatment with an uncoated ring around the edges of the lens.

This donut lens clearly shows the difference between a coated lens and an uncoated lens.

Another comparison method is to have a frame with one coated plano lens and one uncoated plano lens. When the patient puts on the frame, he sees the difference between the lenses. When the dispenser puts on the frame, the patient can see the difference in the look of the lenses, and can understand the cosmetic benefit of AR coating.

You can use a Transitions® light box and

Once, again, it’s our job to be proactive instead of reactive and to introduce, explain and recommend eyewear that will fill our patients’ needs. Just before you discuss the cost of the eyewear, review with the patient her choice of lenses, frame and treatments and to finalize the order.

Before the patient leaves, give her a realistic turn-around time. Of course, it’s better to overshoot than undershoot. You want to surprise her with sooner than disappoint her with later. Then keep track of the job so you know how it’s going. You can do this by calling the lab after a few days or checking online if that is an option. If there is a delay, call the patient to alert them and tell them you will keep them posted on the progress.

When the job comes in, make sure it’s finalized carefully. Clean and adjust it and call the patient to make a pick-up appointment or to invite them to come at their

convenience, however your office works.

Dispense with all the care you gave to their first visit! Take time to discuss how lovely or stylish the glasses are and how pretty she looks or how attractive he looks in them. Discuss how to use the occupational lens, the golf lens, the variable focus lens. Explain to new bifocal wearers how to use each optical zone. Discuss with new AR wearers how to care for their lenses. Make sure every patient understands and is comfortable with her or his new glasses.

Be sure to not hover over the patient as he inspects his new glasses. Be close enough to adjust, but not so close as to intimidate.

Recommend cleaners, cloths and accessories for them or for gifts and make sure they have a nice case.

Before they leave your office for the last time, offer a percentage-off or dollar-off coupon to use with their next purchase or suggest they pass it along to someone else who may need eyewear.

Invite them to come back anytime for a complimentary cleaning and adjustment.

Invite them to visit your website to learn more about eyecare and to see the latest in eyewear. Suggest they follow you on Facebook to keep up on what’s new and fun at your office. And thank them for coming to you for their eyecare and eyewear needs.

Words such as “Personal”, “Individual”, “Special” and “Unique” are key to providing excellent customer service and to nurturing a solid optician-patient relationship. This will ensure that your patients will return time after time to seek your expert advice and fashion consultation. I

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PAGE #

PHONE #

WEB SITE

ADVERTISER

ABS Smart Mirror

23

888-989-4227

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Baby Banz

11

877-333-0074

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National Lens

My Vision Express

Briot

28

800-292-7468

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Nellerk Contact Lens Cases

C&E Vision Buying Group

13

800-346-2626

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Opticom

CNS Frame Displays

23

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Coburn Technologies

29

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EAG Labs

36

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Eyevertise

37

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INSIDE FRONT

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FEA Industries

Fatheadz Eyewear

15, INSIDE BACK

800-327-2002

www.feaind.com

Grimes Optical

43

800-749-8427

www.grimesoptical.com

PAGE #

PHONE #

WEB SITE

44

877-882-7456

www.myvisionexpress.com

31, 41, 45

866-923-5600

www.national-lens.com

44

607-748-2166

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21

800-678-4266

www.opticom-inc.com

Optogenics

33

800-678-4225

www.optogenics.com

Optometry Giving Sight

37

888-0GS-GIVE

www.givingsight.org

Prevent Blindness

42

800-331-2020

www.preventblindness.org

BACK COVER

888-860-7597

www.rudyprojectusa.com

Santinelli International

27

800-644-3343

www.santinelli.com

Tech-Optics

44

800-678-4277 www.techopticsinternational.com

Rudy Project

Three Rivers Optical

icare-usa

17

888-422-7313

www.icare-usa.com

Trevi Coliseum

i-see optical

19

800-257-7724

www.iseelabs.com

US Optical

Luzerne Optical

5

800-233-9637

www.luzerneoptical.com

Vision Systems

24, 25

800-756-2020

www.threeriversoptical.com

9

866-923-5600

www.national-lens.com

FRONT COVER, 22

800-445-2773

www.usoptical.com

43

866-934-1030

www.Patternless.com

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Assistant Professor - Vision Care Technology CUNY NYC College of Technology FACULTY VACANCY ANNOUNCEMENT: The Vision Care Technology department seeks a full-time faculty member. This program, the only one of its kind in the CUNY system, prepares students for a career in eyeglass dispensing, ophthalmic fabrication and contact lens fitting. The curriculum includes a balance of theory and clinical practice in all aspects of the eye care profession. A graduate of the program may become a proprietor of an optical dispensing business or may secure a position as an ophthalmic dispenser, contact lens fitter, manager, ophthalmic assistant, ophthalmic sales representative or optical research technician. Our faculty is made up of licensed opticians who are active in the field.

Responsible for teaching a range of vision care technology courses, academic advisement, curriculum development, and research leading to publication and professional presentations. Committee and departmental participation is required, as well as professional development activities.

Performs teaching, research and guidance duties in area(s) of expertise. administrative, supervisory, and other functions.

Shares responsibility for committee and department assignments including

QUALIFICATIONS: The candidate must have a Master's Degree, ABO and NCLE certified, and licensed in New York State in Ophthalmic Dispensing. The candidate must be a practicing optician with ten years of experience. The ideal candidate will be well qualified to teach Ophthalmic Dispensing, Business Management, Ophthalmic Fabrication, Anatomy and Physiology of the Eye, Contact Lenses and Optics. Prior teaching experience at a college level in opticianry is preferred, as well as excellent communication and computer skills. Experience in curriculum development, instructional technology and innovative pedagogy desirable. Candidates who are certified and licensed outside of New York State will have one year after the initial appointment to secure certification and licensure in New York. Information link is below: http://www.op.nysed.gov/prof/od/odlic.htm. The license is in Ophthalmic Dispensing and the examination is given twice a year, in October and in April. Ph.D. degree in area(s) of experience or equivalent. Also required are the ability to teach successfully, demonstrated scholarship or achievement, and ability to cooperate with others for the good of the institution.

COMPENSATION: CUNY offers faculty a competitive compensation and benefits package covering health insurance, pension and retirement benefits, paid parental leave, and savings programs. We also provide mentoring and support for research, scholarship, and publication as part of our commitment to ongoing faculty professional development.

HOW TO APPLY: Visit www.cuny.edu, access the employment page, log in or create a new user account, and search for this vacancy using the Job ID (9628) or Title. Select "Apply Now" and provide the requested information. Candidates should provide a CV/resume and statement of scholarly interests.

CLOSING DATE: Applications will be accepted until the position is filled. Review of resumes will begin 12/16/13.

JOB SEARCH CATEGORY: CUNY Job Posting: Faculty EQUAL EMPLOYMENT OPPORTUNITY: We are committed to enhancing our diverse academic community by actively encouraging people with disabilities, minorities, veterans, and women to apply. We take pride in our pluralistic community and continue to seek excellence through diversity and inclusion. EO/AA Employer.

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INDEPENDENCE® Mirrors Mirror AR Coating with a Lifetime Warranty

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