EyeCare Professional Magazine June 2012 Issue by ECP Magazine

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BACK TO SCHOOL EYEWEAR / PAGE 6 ABC’S OF KIDS’ DISPENSING / PAGE 12 June 2012 • Volume 6, Issue 54 • www.ECPmag.com

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JUNE 2012

EYECAREPROFESSIONAL

Vol. 6 Issue 54

Features 6

Courtesy of Kenmark Optical

Contents

Magazine

BACK TO SCHOOL EYEWEAR Take care of your youngest patients with the latest in safe and sturdy eyewear and sunwear by ECP Staff

THE ABC’S OF KID DISPENSING Treat your kids like the important customers they are and watch your practice grow.

by Judy Canty, LDO

DEAR MOM AND DAD An open letter from a young adult to his parents about what he expects from his eyewear. by Anthony Record, RDO

INTERVIEW: HOYA VISION CARE HOYA’s North American President Barney Dougher discusses their latest innovative lens products. by Paul DiGiovanni, LDO

NO KIDDING AROUND

Courtesy of Transitions® Optical, Inc.

Discover the top 5 concerns ECPs have when seeing children and how to handle them. by Corrie Pelc

INFANT VISION A number of significant developmental and psychological advances have taken place over the past decade. by Elmer Friedman, OD

On The Cover: PEDIAVISION www.pediavision.com

Departments EDITOR/VIEW .....................................................................................................4 MOVERS AND SHAKERS.................................................................................24 THROUGH THE LENS .....................................................................................30 MOBILE OPTICIAN .........................................................................................34 OD PERSPECTIVE ............................................................................................40 ADVERTISER INDEX .......................................................................................42 INDUSTRY QUICK ACCESS............................................................................43 LAST LOOK .......................................................................................................46

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EDITOR VIEW Jeff Smith

EYECAREPROFESSIONAL

Magazine

Earn an A+ in “Back to School” Sales!

IDS MAY GET A 3 MONTH retreat from school every summer, but marketing in the 21st Century never takes a break. With children more marketing conscious and brand savvy than ever before, why not treat every day like a “Back to School” sales opportunity?

Without the vast advertising budget of the big chains, a more practical strategy is necessary. In order to get more children, teens, and their parents into your store, you must think outside the box. One way to increase pediatric sales is to target events that involve kids and teens. Try and become involved in school activities, either in an educational or recreational setting. Educational events could include a PTA discussion about children’s vision, an optical lecture in a science class, or providing education at a health fair. Gift certificates for school fund raisers are another good option. Sports eyewear is more appealing than ever to kids, and a great way to reach them is through their parents. Over 40 percent of sports related eye injuries occur in children under 15 years old, yet 85 percent of children who play sports do not wear protective eyewear. Statistics like these provide a strong selling point to attentive parents. Also remember that children and tweens don’t always view eyewear as a way to make a fashion statement like teenagers do, so including parents in your presentation is important. A free examination/presentation for local sports teams could also be worthwhile. Many local merchants, in all fields, have had success with sponsoring a little league team, so why should eye care be any different? It is generally quite cost effective and is a nice gesture in the community. Don’t neglect more universal strategies for increasing traffic/sales. Finding a Pediatric MD within the vicinity for referrals is essential. Branding and repetition are crucial in standing out from the competitive retail crowd. Running a small Ad regularly in the local paper - especially one promoting a sale on name brand frames – can be effective. And regularly updating your website and Facebook page is a simple and affordable way of maintaining a local presence. I hope I have offered some useful tips and ideas. With just a few successful promotions, you could be top of the class in “Back to School” sales!

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

ADVERTISING & SALES (215) 355-6444 • (800) 914-4322 lgrande@ECPmag.com

EDITORIAL OFFICES 111 E. Pennsylvania Blvd. Feasterville, PA 19053 (215) 355-6444 • Fax (215) 355-7618 www.ECPmag.com editor@ECPmag.com EyeCare Professional Magazine, ECP™ is published monthly by OptiCourier, Ltd. Delivered by Third Class Mail Volume 6 Number 54 TrademarkSM 1994 by OptiCourier, Ltd. All Rights Reserved. No part of this magazine may be used or reproduced in any form or by any means without prior written permission of the publisher.

OptiCourier, Ltd. makes no warranty of any kind, either expressed, or implied, with regard to the material contained herein. OptiCourier, Ltd. is not responsible for any errors and omissions, typographical, clerical and otherwise. The possibility of errors does exist with respect to anything printed herein. It shall not be construed that OptiCourier, Ltd. endorses, promotes, subsidizes, advocates or is an agent or representative for any of the products, services or individuals in this publication.

For Back Issues and Reprints contact Jeff Smith, Publisher at 800-914-4322 or by Email: jeff@ECPmag.com Copyright © 2012 by OptiCourier Ltd. All Rights Reserved For Subscription Changes, email: admin@ecpmag.com Scan this barcode with your smartphone to go to our website.

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Choose Your Own Reward with

From June 1 through August 31, 2012 accumulate dollars toward an APPLEÂŠ GIFT CARD by purchasing SunSensorsÂŽ lenses as indicated below. To participate, register online at www.feaind.com anytime during the promotional period. KODAK Unique SunSensors KODAK PreciseÂŽ and KODAK ConciseÂŽ SunSensors NavigatorÂŽ and Navigator Short SunSensors SV, D28, D35 and 7x28 SunSensors

FEA Industries, Inc.

1 North Morton Avenue, Morton, PA 19070 t XXX GFBJOE DPN Promotion Rules: This promotion is open only to eye care professionals (â&#x20AC;&#x153;ECPsâ&#x20AC;?) located within the United States who are invited by FEA Industries Inc. (the â&#x20AC;&#x153;Sponsorâ&#x20AC;?) to participate in the promotion (â&#x20AC;&#x153;Eligible ECPsâ&#x20AC;?). During the promotion period, Eligible ECPs will accumulate dollars toward an Apple gift card by purchasing SunSensors lenses as indicated: $20 for KODAK Unique, $10 for KODAK Precise or Concise, $5 for Navigator or Navigator Short, and $2 for SV, D28, D35 and 7x28. Void where prohibited, taxed or otherwise restricted by law. ECPs licensed or practicing in the State of Vermont are not eligible to participate. This offer cannot be combined with any other KODAK Lens promotion. $ Â´-REÂľ LV GHĂ&#x20AC;QHG IRU WKH SXUSRVHV RI WKLV SURPRWLRQ DV WKH VDOH RI D SDLU RI 6XQ6HQVRUV OHQVHV WR D SDWLHQW XQGHU RQH SUHVFULSWLRQ WKDW LV SXUFKDVHG WKURXJK WKH 6SRQVRU ,Q RUGHU IRU D -RE WR EH HOLJLEOH LW PXVW QRW EH IRU D SDWLHQW whose reimbursement or payment comes from â&#x20AC;&#x153;ineligible payors,â&#x20AC;? which include, without limitation Medicare, Medicaid, CHAMPUS, or other payors considered to be â&#x20AC;&#x153;designated health servicesâ&#x20AC;? under 42 USC Section 1395n and UHJXODWLRQV WKHUHXQGHU RU VLPLODU 6WDWH VWDWXWHV DQG UHJXODWLRQV ,W LV 6SRQVRUÂˇV SROLF\ WR FRPSO\ ZLWK DOO DSSOLFDEOH ODZV KRZHYHU 6SRQVRU KDV QR ZD\ RI GHWHUPLQLQJ ZKHWKHU DQ\ VSHFLĂ&#x20AC;F -RE LV LQHOLJLEOH IRU WKH UHDVRQV VWDWHG LQ WKLV SDUDJUDSK $FFRUGLQJO\ LW LV WKH VROH UHVSRQVLELOLW\ RI WKH (&3 WR QRWLI\ 6SRQVRU RI DQ\ -RE WKDW LV LQHOLJLEOH GXH WR WKH UHDVRQV VHW IRUWK LQ WKLV SDUDJUDSK DQG WR HQVXUH WKDW LW GRHV QRW DFFHSW DQ\ EHQHĂ&#x20AC;WV XQGHU WKLV SURPRWLRQ WKDW DUH prohibited by Federal or State law. By participating in this promotion and accepting a prize, ECPs agree that compliance with such Federal and/or State laws are the ECPâ&#x20AC;&#x2122;s responsibility and the ECP will release, indemnify and hold harmless Sponsor for any failure of the ECP to notify Sponsor of an ineligible Sale. Kodak and the Kodak trade dress are trademarks of Kodak, used under license by Signet Armorlite, Inc. Precise, Concise and Navigator are registered trademarks of Signet Armorlite, Inc. Corning and SunSensors are registered trademarks of Corning, Incorporated, Corning, NY. Apple is a trademark of Apple, Inc. All rights reserved. Apple is not a participant in or sponsor of this promotion. ÂŠ2012 Signet Armorlite, Inc.

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EYESTYLES

Back to School EYEWEAR

1. A&A Optical

PEZ style Jump Rope: The two toned Jump Rope exudes whimsy and bright color â&#x20AC;&#x201C; perfect for the back to school season. Receive a free PEZ sun frame with each PEZ frame purchased. Minimum quantities apply. www.aaopticalco.com

2. OGI Eyewear OK74: Inspired by the distinguishing elements of modern architecture, the OK74 is a bold, contemporary eyewear piece designed to stand apart from the prevailing. The OK74 creates a sleek, fashionable aesthetic through the use of diligently placed details and fun colors. www.ogiframes.com

3. REM Eyewear Five new optical designs from Lucky Kid Eyewear donâ&#x20AC;&#x2122;t leave it to luck that kids can see the board or spot the ball on the field! Girls get a twirl of bohemian magic in the Gypsy, with temples filled with translucent flora on a matte metallic frame. Favorite is created from a pretty palette of popping pinks and bright blues, in witty combinations that will make your eyes sparkle. www.remeyewear.com

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4. Kenmark Optical Lilly Pulitzer Girls “Sumner” features temples decorated with a limited-edition Lilly Pulitzer floral print; a perfectly sweet complement to a little girl’s face. This zyl frame is available in Colors: Navy, Tortoise, & Raspberry, in Sizes: Size: 46-15-125, 48-15-30, & 50-15-130. www.kenmarkoptical.com

5. Allison America Moschino keeps on playing with iconic elements in order to meet also the needs of little girls: three-dimensional bows made of metal, Swarovski crystals on temples, double colored acetates and patterns are the main feature of this collection (MO 172 shown). New sunglasses and ophthalmic frames full of colors and humor are offered to the Moschino Teen girls. www.allisonamerica.com

6. Viva International Group A lively mix of patterns and colors makes the new girl’s ophthalmic styles from SKECHERS Eyewear an ideal collection for today’s younger audience. Design elements

feature playful details including shooting stars, flowers and paisley swirls. Colorful stars in rubber decorate the temples of model SK 1509, delivering a dose of fun. www.vivagroup.com

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EYESTYLES

Tifosi Optics

Designed to fit small face frames, the Scout is styled to appeal to the younger set in colors for both boys and girls. Tifosi eyewear offers 100% protection against harmful UVA/UVB rays. www.tifosioptics.com

Aspex Eyewear

Best Image Optical

“Moody” by Dolabany Kids Eyewear is a bright choice for kids going back to school. With special spring hinges, tough Italian made acetate, and a stylish rectangle shape frame, it’s a great way to start the school year. Find “Moody” in three colorful combinations: Purple/Emerald (shown), Demi Olive/Mint, and Black Demi/Fuchsia in Size 44-7-125. www.dolabanyeyewear.com

Liberty Sport

A new addition to the bestselling F8 Street Series collection from Liberty Sport, the Shatter frame is suitable on the field or off. These sports protective frames are ASTM F803 tested and approved. www.libertysport.com

EasyTwist frames are some of the most flexible frames on the market and are made of a memory metal called Trilaston that is highly elastic and immediately recovers its shape, even after wrapping the metal 360 degrees around your finger. They are very resistant to stress, shock, corrosion and temperature changes, and are nickel-free and hypoallergenic. www.aspexeyewear.com

Revolution Eyewear The Toy Story collection features 12 styles, 5 for girls and 7 for boys, from cable to zyl temples with three dimensional character embellishments bringing the characters to life on the temples. Bright primary colors make up this collection with round and square shapes. A character branded hard case is provided for boys and girls. www.revolutioneyewear.com

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EYESTYLES

Hilco

Baby Banz

Hilco’s Leader Rx Sunglasses collection is one of the fastest growing lines in the business, for good reasons. All styles feature sporty 8-base wraparound styling with the processing ease and optics of standard Rx lens mounting. The Sprint collection features a junior size that is ideal for Kids 8 to 12 years of age. www.hilco.com

Europa International Junior BanZ feature UV400 Polarized polycarbonate lenses and sturdy frames, while offering new shapes and temples for the protection and style older kids want. Junior BanZ come with their own color coordinated neoprene carrying case complete with zipper clasp as well as a removable neoprene strap. usa.babybanz.com Introducing Cool Cat by db4k, one of 13 new Kids styles debuting this season. This new acetate cateye style features a whimsical cartoon cat print along the temples. Available in 2 sizes (46 & 48) and 3 colors (shown here in violet) with spring hinges for comfort, Cool Cat is for kids that like to have a little fun with their look. www.europaeye.com

Ficklets

Solo Bambini Solo Bambini® “Infant & Children’s Eyewear” manufactured in the USA. This frame is from the Infant Collection in three sizes and twelve beautiful colors: Itsy Bitsy 30, Teeny Weeny 35, and Toddler 40. Larger sizes are available: Rascal 43 and Scout 45. www.solobambini.com

Ficklets adds the “happy” to kids’ eyeglasses. With a fun collection of designs from flowers to animals to sports balls, kids can jazz up their frames with personality, color and style. www.ficklets.com

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Nouveau Eyewear

nations â&#x20AC;&#x201C; two-tone blue, light pink on crystal, and purple on pink. www.nouveaueyewear.com

Trevi Coliseum Eyewear

Nouveau Eyewear The Victorious Spotlight is a rectangular-style, combination frame that provides a perfect blend of youthful fashionability and girlish charm. It features a multi-layered acetate front, and iridescent butterflies along its metal temples. This doubleaction spring-hinged frame is available in three color-combi-

Cotton Club Teen Model #215 is constructed of the highest quality materials with Mazzucchelli Zyl and spring temples for added comfort and durability. Backed by a two year warranty, these Italian made frames are available in 3 youthful colors, Black, Blue and Pink. Sold exclusively in North America by National Lens. www.national-lens.com

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DISPENSING OPTICIAN Judy Canty, LDO

Kids (Eyes) Count! I get it...not everyone likes working with kids. They can be noisy, stubborn, spoiled and altogether unpleasant little human beings. However, according to Anup Shah, who blogs on Global Issues, “Children (under 12) and teens influence parental purchases totaling over ...$670 billion a year.” Pre-teens and teenagers now marshal “$200 billion in spending power” each year, a total that has risen dramatically over the past ten years. Not tapping into this market is to miss more than just a demographic, it means closing your dispensary to an important and influential source of revenue. There was a time when kid’s frames were much smaller versions of adult frames. Think “Clark Kent” rectangles and pastel colored cat eyes. Kids wore eyeglasses because they had to, not because they wanted to. Now they can choose to look like their favorite cartoon, TV, music or movie star. Marketing to kids is huge business. Kenmark’s Thalia Girls 6 piece display The good news is that glasses are cool. Kids have traded in Steve Urkle’s oversize goggles for Justin Bieber’s uber-cool geek chic. The bad news is that nearly every frame manufacturer has collections for kids of all ages and you get to plumb the depths of the very young psyche to discover how to attract them (and their parents) to your dispensary and which collections to highlight. Where to start? Location, location, location. Don’t relegate the kids section to a dusty, out-of-the-way corner. Don’t fill it with pint-sized furniture and splashes of primary colors from floor to ceiling. Rather, incorporate kid’s eyewear into your current dispensary layout. Why separate kids from their parents? Statistically, a child will ask for an item nine times before a parent will give in and purchase. Tweens admit to asking their parents more than 50 times for products they’ve seen advertised.

Marilyn Read, an associate professor of design and human environment at Oregon State University found that in (preschool) spaces with one red wall, versus uniformly white walls, children were more cooperative. However when spaces offered a multitude of colors, children became over stimulated and often anxious. She concluded that a single color in a classroom... seems to offer a sense of security. In a current study involving young children with sensoryprocessing issues, the evidence seems to suggest that such kids are better able to focus in the presence of a single color fabric hanging no matter what the color. “If people want children to act in a calmer way, they should go with blue or another cooler color,” she advises.

Soft furnishings, like floor pillows or bean bag-style seating can help continue the calm vibe that color creates. A small table, not a short table, and adjustable height seating will work for both fitting and dispensing. Just be sure that there’s an extra chair for Mom or Dad. In addition to the POP displays provided by frame manufacturers, look for photographs of current young celebrities wearing cool (and Rx-able) glasses. Because today’s kids are exposed to every imaginable media source, consider mounting digital picture frames programmed with cool looks in glasses, sports eyewear and sunglasses. Those images won’t fade and are easily changed as trends change. What’s hot or cool or whatever. Kids change their “favorites” almost as often as they change their “best friends forever” pinky-swears. If you don’t have kids to help you keep up with trends, find some. Corral nieces and nephews, grandchildren or neighbors kids of all ages. Ask them to help. Make them your “official consultants.” According to the Kaiser Family Foundation, by the time the typical child enters 4th grade, they Continued on page 14

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EYESTYLES

Ooh la-la de Paris

SWING Eyewear SWING Eyewear products are made for children and built from TR90. TR90 is anti-bacterial, hypoallergenic, extremely lightweight and virtually unbreakable. The immense and expressive color offerings are achieved using organic candy dye. SWING Eyewear is also economical, making it ideal for the active modern family. www.swingeyewearUSA.com

Randy Kazandy Eyewear by ooh la-la de Paris. Designed and based on the award winning book â&#x20AC;&#x153;Randy Kazandy Where Are Your Glasses.â&#x20AC;? Watch the frames rotate on line at: www.oohlaladeparis.com

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will have memorized 300-400 brands and will be exposed to the equivalent of 8 1⁄2 hours a day of media content. What will appeal to the elementary school set will not work for a middle-school-er. It goes without saying that tweens and teenagers wouldn’t be caught alive in the kids section of anything. They consider themselves young adults and expect to be treated as such. Brands like Disney and Nickelodeon will always be popular with younger patients. SpongeBob SquarePants has nearly 30 million Facebook fans, though about a third of them are adults. That’s Lady GaGa territory! Disney is a marketing empire that carefully controls its image, so much so that they now promote vacation packages to adults without children at home as well as families. SmartyPants® is a consulting company specializing in families and children. Their annual study of brands that American kids and parents love most and why, called Young Love™, ranks 250 brands by their Kidfinity™ and Momfinity™ scores. These are proprietary measures of kid/tween and Mom brand awareness, popularity and love based on more than 100,000 responses across 20+ categories. At the top of the list—Wii. At number 9—Disney and at number 17— Nickelodeon. These are brands with staying power, the brands that your practice can count on to hit their target market year in and year out. According to a study conducted through the University of Michigan, kids as young as 3 recognized brands including: • McDonalds(“They have a playground”) • Burger King • Hot Wheels • Lego(“If I have it, everyone wants to come to my house and play”) • My Little Pony

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• Bratz • Coke(“The bubbles are really fun and you can blow bubbles and it’s like a volcano”) • Pepsi The tween and teen markets rely on “image” almost as much as they do a specific brand name. These are the years when young people are defining themselves in many ways. It’s often a strange mix of jaw-dropping individuality and an intense need to be accepted by their peers. You cannot be as “cool” as they perceive themselves to be, so don’t try. Talk to them the same way you talk to older patients, asking the same kinds of questions about how and when they wear their glasses and what they like or don’t like about their current specs. Now, about the lenses. Most kids don’t care; all parents do. Both Trivex® and polycarbonate materials are the accepted norm for active children, tweens and teens. Since they spend an inordinate amount of time in front of video monitors, a durable anti-reflective treatment should also be recommended. In fact, packaging those options is a smart move. Call it the “gamers package” or the “geek chic package” and create a “try-on” area complete with a video monitor for demonstration. If you have the space, create a sports eyewear “try-on” area to demonstrate sport-specific eyewear and lens options, such as polarized, sport-specific tints and variable tints. However you look at it, kids are consumers. They are “brand aware” and they represent a huge block of spending power. Love ‘em or not, you really can’t afford to let them slip away from your practice. ■

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T R U E

T O

L I F E

She’s got a full schedule. So do her eyes. 6:05AM 3-mile run 7:26AM Get kids to the bus stop 11:00AM Fit patient’s ﬁrst bifocals 2:00PM Fit in quick workout 3:45PM Update patient database 6:15PM Pull together family dinner 9:05PM Read story to kids Even an ordinary day can place extraordinary demands on eyes. That’s why the eyewear that you prescribe for your patients—and yourself—starts with the lens material that will always be true to the ever-changing vision needs of everyday life. Only Trivex® material provides the perfect balance of precision optics, lightweight comfort, strength and protection for every patent.

Learn more about Trivex® material. Visit the e-Learning program at ppgtrivex.com. Now available in 13 languages!

Christa Eyecare professional Mom Triathlete

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MANAGING OPTICIAN Anthony Record, ABO/NCLE, RDO

Dear Mom and Dad In a bit of an ECP twist, we thought it might be nice to write a message from the perspective of a child to his or her parents to help them make a better choice of eyewear. Maybe you could copy it, laminate it, and place it in your waiting room...just a thought. By the way, it might also serve as a friendly reminder to all of us eye care professionals as well, in terms of what we should think about in the sales and dispensing process to help kids and their parents make better eyewear choices. Hey Mom and Dad: I know I’ve been giving you a hard time about going to get my eyes checked and getting new eyeglasses, but really I’m kind of looking forward to it. After all, the only thing worse than getting teased by my socalled friends about wearing glasses, is getting teased because they’re taped in the middle. Nerd city! So thanks. I know you work hard for your money, but if you want me to wear them all the time, maybe there are some things you ought to think about – five things actually (I’ve been doing a lot of research on the Internet). Here they are:

1. Look, if you want me to wear them, there are three things you have to think about: thickness, fashion, and something I’ve learned about called AR – I think that stands for anti-reflection. Anyway, as far as the thickness thing, there are some lenses out there called high index or polycarbonate lenses. In some cases these lenses can help me see the same as the thicker ones, but they can be only half the thickness of my old lenses. And as nearsighted as I am, that could make a huge difference in how they look. Oh, and check this out: They’re safer too! I mean like when I’m playing hockey. If I had

16 | EYECAREPROFESSIONAL | JUNE 2012

gotten smacked with a puck while wearing these old plastic lenses last year, they could have shattered and injured my eye. Guess what? Not these poly-whatever lenses. They could stop a bullet! As far as fashion is concerned, I would like to get the kind of lenses that get dark when you go outside. They are a little more expensive than clear lenses, but I wouldn’t mind kicking in a few bucks from my allowance for a few months to help pay for them. Just consider it. Now about this AR thing: Not only will it make my lenses appear even thinner, there are studies that show it improves contrast in my vision by letting in the most light possible – which will make my eyes less strained when I work on the computer. And in a couple of years when I get my learner’s permit to drive, they also help to improve vision and reaction time when driving at night. That’s a fact! 2. Now that we’ve settled on some thin, lightweight, safe and comfortable lenses, we have to talk about the frames. I know you’ve always insisted I get these plastic frames because you think they’re sturdier, but that’s just not true anymore. Most all of the cool, metal frames are just as strong, and they all come with springy hinges like my old ones. There are some that are made of titanium that are so strong and flexible that I saw a video on YouTube that showed a guy wrapping the sidepiece right around his finger. I sent you a link to your iPhone so you could watch it. It’s unbelievable! But I wouldn’t need one like that – maybe they are too expensive. But now that I’m older, I would take care of a frame a little better than I have in the past – just think about it. Okay? Continued on page 18

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We Connect You ǁŝƚŚ zŽƵƌ WĂƟĞŶƚƐ

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Julie, We have an opening today at 3:00 pm. Please call ASAP if you would like to see Dr. Chamberlain. Thank you! Alpine Eyecare 801.331.7100

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3. Now Mom and Dad, this one’s a little tricky, but hear me out. That optician we’ve been going to for the last few years is a real loser, I don’t know how else to say it. I was talking to Johnny about getting glasses, and he was telling me that when he goes to pick them up the eye guy actually like adjusts them and sort of custom-fits them for his face. Our guy just kind of hands you the glasses and asks if they’re okay. I always say they are, but they’re not! The side things are too long so the hurt behind my ears. The part on my nose never seems to fit right – they pinch. And they’re always slipping down. For all the service they give us at the place we’ve been going, we might as well buy my glasses over the Internet – and I know how you guys feel about that. Can we at least try Johnny’s guy this time? I’ve already checked and they take our insurance plan – so there’s no extra cost there.

“I know I’ve been giving you a hard time about going to get my eyes checked and getting new eyeglasses, BUT ...” 4. Guess what? Remember last year when my frame broke the first time and it cost almost $100 to replace it? I was reading that the warranties on this stuff can be way different from place to place. That is one thing that parents don’t think much about – that they ought to factor in future

replacements due to breakages. So I made some calls and found out that at the place Johnny goes to, they have a one-year, unconditional warranty on their frames! That means if something like that happens again (breaking them, I mean) it wouldn’t cost a thing to repair or replace it for a whole year! That’s got to be worth something. And if we do get those AR or Transitions lenses...they’re even guaranteed against scratching. About the only thing that would cost anything is if I out and out lost them...and that’s never happened...yet. 5. I left this one until last Mom and Dad, because I know it would be something we’ve never done before, but I think it’s important. It doesn’t have to be just like the first pair...it can be something less cool...anything...but I think I need to have a spare pair. When the last pair broke and I had to wait a few days to get a replacement frame, I went three days at school and I couldn’t see a thing past two feet in front of me. I don’t think you really get how I see without my glasses, but trust me, it isn’t great! Johnny said that his eye doctor actually showed his dad how he sees without glasses and that gave his dad a better understanding of what we go through when we don’t have them. I think you’d be surprised. Anyway, I just wanted to talk to you about all this before we go to the optical shop, not in front of everybody there. Thanks for listening. ■

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HOYA Vision Care Cutting Edge Lens Technologies EyeCare Professional’s Paul DiGiovanni, LDO, speaking with Barney Dougher, President, HOYA Vision Care, North America. What is your optical background? I am a third generation optical person, and as my brother and business partner will tell you, we started in the business as any family member does— for cheap labor. I have built labs, sold labs, bought labs, and have performed many different jobs from my beginnings as the lawn and flower bed technician at my family’s lab to my current position as President of HOYA Vision Care North America, a position I’ve held for the past seven years. What do you see the future of the optical industry to be? In terms of product; Free Form, more Free Form, and even better Free Form as the current mix of Free Form products available on the market today will evolve to focus on patients’ needs and use through personalization. Currently, personalization is in its infancy and as new processing technology and measuring technology advance there is every reason to believe that every pair of eyeglass lenses we make will be dedicated to the individual wearer’s work, hobbies, and lifestyle. In terms of the industry in general; I am positive the available market is going to expand as more baby boomers enter the market, which will force new and more sales opportunities with advanced manufacturing processes, creating cost savings and consolidation at all levels. Please tell us about Spectangle. No, our competitors want to know…just kidding. We’re really looking forward to Spectangle hitting the market. For ECPs who believe in personalized Free Form lenses they will have a tremendous tool on hand. From the patient’s perspective they will see the doctor or optician using the iPad, something every patient can relate to. Seeing through an App, just how much detail goes into getting the measurements right will help the average patient appreciate all the data we’re analyzing and configuring in order to get their lenses precise and just for them. 20 | EYECAREPROFESSIONAL | JUNE 2012

Spectangle and all quality measuring devices add an additional layer of perfection and consumer confidence, but it still remains the ECP’s personal responsibility to believe and understand how the customer will benefit from personalized eyewear. With technology going “Digital” we have heard that HOYA has a solution for this with a new lens called Sync, can you tell us more? Yes, Sync is part of a larger concept that we’re calling New Media Optics™. The way we live and use technology today is vastly different than it was just five years ago. Everyone from the ages of 2 to 102 now uses computers, iPads, smartphones and games. So if you think about the strains that are put on our eyes at those different developmental stages when alternating among many visual media, there are a lot of unmet patient needs. How do you see MyStyle expanding in 2012? We expect it to grow and within the year become the standard to which all other personalized lenses are measured, including Single Vision designs. Can you give us more information on Distortion Free Optics? The number one thing I want to say about HOYA Distortion Free Optics is that it has really brought to life all of the benefits that are embedded in HOYA lens technology but have been difficult to share with patients on a level that they could understand. By placing HOYA lenses in the patented Avantek mounting system it opens the door to a discussion about the benefits of our designs, materials and treatments that before was a little abstract. It also helps that it is a great product, voted best new product at Vision Expo East 2012. The product continues to grow and Avantek group has some very exciting and new options coming soon so look out for the product to expand and become the new rimless. Continued on page 22

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Summer SUNsation Your patients want sunglasses for protection, comfortable outdoor vision and fashion. You want 2nd pair sales. Revolutionize your practice by getting in the habit of prescribing 2nd pairs – and for a limited time, HOYA will contribute a FREE pair of lenses with Diamond Tint. t 0SEFS B RVBMJmFE DMFBS QSFTDSJQUJPO QBJS BOE receive a complimentary Rx in HOYA Diamond Tint between June 1 and August 31, 2012 t 67" BOE 67# QSPUFDUJPO TUVOOJOH looks, durability, and no fading with new pressurized-pore technology t 7BMJE GPS TBNF QBUJFOU QSFTDSJQUJPO PSEFST submitted simultaneously 'PS B MJTUJOH PG RVBMJmFE MFOTFT BOE QSPHSBN details, visit: www.thehoyafreeformcompany.com/diamond. 5IF 4VNNFS 46/TBUJPO QSPHSBN BMMPXT ZPV UP NBLF ZPVS QBUJFOUT TVNNFS 46/TBUJPOBM XJUI B complimentary pair of HOYA Diamond Tint lenses. Now, you can provide the radiance of Diamonds! If you’re not already a HOYA partner, we want to make it easy for you to join The HOYA Free-Form revolution.

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For HOYA it is really a brand differentiator for independent practices as you can not get HOYA DF anywhere else. Tactically new for 2012, Avantek will be introducing two new bridge sizes as well as new colors and shapes so we can appeal to more people with the HOYA DF system. Does HOYA have any upcoming national promotions? We have a game changing promotion this summer. We really want to accomplish two things, one is to help the independent ECP ramp up their capture rate and improve multiple pair sales. The second thing we want to do is educate patients that more than one pair of glasses should be an expected outcome from their visit. Here’s how we’re doing it. The Summer SUNsational national campaign will allow patients to buy their first pair of clear prescription glasses and get the same prescription in sun lenses courtesy of HOYA.

As for the recovery it took a lot of HOYA people with one mission; get back to normal as fast as you can, our customers need us, and we can’t let them down. And we can’t forget the many suppliers of materials, lenses and equipment who really stepped up to help us. Does HOYA have any new or upcoming Social Media tools? Through the Summer SUNsational campaign we are testing a consumer driven FaceBook page. So we are using that as a way to drive patients to independent practices. Plus we’re providing our accounts with content they can use on their social media channels to support the campaign as well. How can an ECP learn more that HOYA’s lab network? A great place to start is www.thehoyafreeformcompany.com. Then invite your local representative to come in and show you what HOYA can do for your practice.

By doing this with sunwear, the benefits this time of year to the second pair are obvious. And the idea is to get the ECPs, their entire staff and their patient base used to this process of more than one pair with each visit. Our objective is to create a long term position in the consumer’s mind that it’s normal to have at least two pair of glasses.

One thing that many ECPs don’t know is that 98% of HOYA’s business derives from independent practices. If you think about that for a minute, you’ll realize that our motivation and what drives our success also needs to motivate and drive the success of the independent. Take all of the things we just talked about, MyStyle, Sync, Summer SUNsations, HOYA Distortion Free Optics. What are all of those things for? They are all created to help the independent to differentiate in the market place. The big idea is you have to be different. You have to be noticed. What you offer your patients has to be the best, it has to be special.

I am hopeful that ECPs will take advantage of this limited time offer to give their patients something we all know they want—two pairs!

We believe in the quality of care, sense of community and innovation that exists at independent practices and everything HOYA does is in support of that belief.

Can you elaborate on the flood tragedy in Thailandwe are amazed at how HOYA was able to react and overcome this obstacle with minimal issues. Today it’s business as usual, yet I still think about my colleagues in Thailand who lost their homes, and for a while their livelihoods. I am thankful they are back to work as the healing begins.

How is HOYA Free-Form technology different? No other manufacturer can do what we do with integrated double surfacing designs. We hold the patents. The HOYA Integrated Double Surface® technology uses complex algorithms to separate the horizontal and vertical components of the prescription. The horizontal component is generated on the back of the lens and the vertical component on the front. This allows us to achieve visual performance for the wearer that was never before imaginable.

So we’re really removing as many barriers as possible to that second pair sale. All the doctor has to say to the patient is, “Here is your prescription and today you can get your sunglass prescription lenses courtesy of our lens supplier during this special limited time offer.”

For me personally, when something like this happens and I talk to customers I’ve known my whole life, I am amazed at the level of understanding and support they displayed. It was just overwhelming. These customers are people with businesses too, toughing it out in the current business climate. I’m just so thankful that all of us at HOYA are truly blessed by our customers. They are the reason we made it through.

22 | EYECAREPROFESSIONAL | JUNE 2012

Combined with our direct surfacing technique, this allows us to go beyond the sphere, cylinder, and axis, computerized soft sponge polishing to maintain the integrity of the complex curves. We can go from software design to a finished lens product that delivers a better visual experience for the patient. ■

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MOVERS AND SHAKERS The Vision Council

OOGP

Mike Daley has joined The Vision Council as a full-time employee and will serve as the new Liaison to the Optical Lab Division. He will represent the viewpoint of the Lab Division, and interact with the individual members to Mike Daley understand their unique perspectives. Daley began his career in the industry more than 40 years ago. He was president and chief operating officer of Essilor of America’s U.S. Lens Division, and retired in 2008. In his most recent role, he served as the president and executive director of the Foundation for Eye Health Awareness.

Kenji Hamada, OD, founder and president of OOGP, has retired after leading the company for 27 years. Jeff Duncan, a veteran executive with OOGP’s parent, Essilor of America, is taking over from Dr. Hamada in the role of generKenji Hamada al manager/vice president. Dr. Hamada remains an advisor to the president and CEO of Essilor of America, John Carrier. OOGP is one of the largest authorized ophthalmic distributors and buying groups in the U.S. The company was co-founded by Dr. Hamada and his wife, Lillian in 1985.

National Optometry Hall of Fame

REM Eyewear

The National Optometry Hall of Fame, administered by Optometry Cares, the AOA Foundation, will welcome five new inductees into its group of optometrists during Optometry’s Meeting in Chicago on June 28. Kevin Alexander This year’s inductees include: Kevin L. Alexander, OD, Ph.D., from Fullerton, Calif.; James A. Boucher, OD, from Laramie, Wyo.; William E. Cochran, OD, DOS, from Cordova, Tenn.; Frank Fontana, OD, from St. Louis, Mo;, and Thomas L. Lewis, OD, Ph.D., from Dresher, Penn.

Julia Ritchie has been named brand manager for Converse Eyewear. With her finger on the pulse of the edgy target Converse customer, coupled with results driven marketing experience, Ritchie is a valuable asset to the REM Julia Ritchie Eyewear team. She was formerly part of the marketing and event coordination team for Niche Media’s Aspen Peak and Philadelphia Style magazines, equipping her with crucial consumer outreach techniques, and brand immersion and promotion.

Bob Smith passes away Abbott Medical Optics Jim Mazzo, president of Abbott Medical Optics (AMO) announced that he is retiring from the company at the end of 2012. He is also retiring from the position of senior vice president of Abbott Laboratories, AMO’s parent. Upon Jim Mazzo Mazzo’s departure, Murthy Simhambhatla, PhD, head of Abbott’s Ibis Biosciences business, will assume the role of president. The two executives will work together to ensure a smooth transition, AMO said. Mazzo has served as president of AMO since its February 2009 acquisition by Abbott.

Bob Smith, inventor of the fog-free ski goggle and founder of Smith Optics, died at his home in La Quinta, CA on April 18, at age 78. An orthodontist by trade, Dr. Smith developed the first sealed thermal (dual) lens and breathBob Smith able vented foam ski goggle in 1965. He made the goggles at his kitchen table by hand using his dental tools. Dr. Smith originally sold his hand-made goggles to skiers on his visits to ski resorts, and after dealing with a few partners, Smith was developed, manufactured, and distributed as a stand-alone company. Smith Optics was acquired by Safilo in 1996.

Bausch + Lomb

Bud Bargman passes away

Bausch + Lomb have named John Barr as global president of the company’s surgical business. In this capacity, Barr will oversee the company’s full suite of ophthalmic surgical products, intraocular lenses and delivery systems, which John Barr include such brand names as enVista, Crystalens, Stellaris PC, Storz and VICTUS. Prior to joining Bausch + Lomb, Barr was president and CEO of AGA Medical, a pioneer of minimally invasive devices to treat structural heart defects and vascular abnormalities.

O.R. “Bud” Bargman, formerly of Hawkins Optical, passed away on May 15 in Topeka, Kansas at age 81. Bargman was associated with Hawkins Optical Laboratories in Topeka for 62 years, fabricating prescription eyewear for “Bud” Bargman optometrists, ophthalmologists and opticians. He was the co-owner and worked in production and sales from 1949 to 1968 before becoming president in 1969. In 1992 he became chairman of the board, and retired in 2010.

24 | EYECAREPROFESSIONAL | JUNE 2012

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Survey Finds Increase in Polarized Sales, but ECPs Reluctant to Recommend Second Pairs A newly released survey from the Vision Council found that polarized lens sales are rising, but more rapid growth is being stymied by the reluctance of ECPs to recommend that their patients purchase a second pair of glasses because they fear patients may be unwilling to do so due to the extra cost. Polarized lenses represented an estimated 7.2 percent of all Rx lenses shipped at the wholesale level in the U.S. in 2011, up from about 5.5 percent in 2008, according to the Vision Council’s Rx Polarized Lens White Paper Report. Nearly 60 percent of ECPs surveyed said that, compared to two years ago, their Rx polarized lens sales were higher or significantly higher today. Among practices with increased polarized sales, the Vision Council report said that “premium” and “super premium” polarized lenses had seen the largest increase in sales activity.

However, the Vision Council found that independent ECPs were much more reluctant to recommend polarized lenses to patients than they were to recommend AR lenses. This is most likely because ECPs fear that patients will take their business to a less expensive retailer upon hearing the higher price associated with acquiring eyeglass lenses with polarization, the Vision Council’s whitepaper report concluded. Yet lens experts interviewed by the Vision Council said that, for the most part, patients are actually not fearful of hearing about higher prices, but instead would like to hear the recommendation from ECPs that will give them the best vision possible.

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PATIENT CARE Corrie Pelc

No Kidding: The Top 5 Concerns ECPs Have When Seeing Kids and How to Handle Them

with people and they’re connected to you. I feel that’s one of the reasons why you get in to the entire profession.” And Dr. Karen Griffith, who sees children from ages 6 months on up at Westside Optometry in Petaluma, CA, says if an ECP is not seeing their adult patients’ children, then probably no one is, so they will end up doing more for that child by seeing them than not seeing them. “They could definitely pick up a problem that goes undetected or that would otherwise go undetected – they’re going to help that child out in the long run,” she adds. Still not convinced that seeing children is right for your practice? To help, a few ECPs with years of experience tackle the top five concerns when it comes to treating a child in their practice. 1. Getting Children Through the Door in the First Place Before an ECP can treat children, they have to get them through the front door of their practice. And that can be a concern due to the confusion or misconception as far as when children can have their first eye exam, Dr. Franzel says.

PUT A BUNCH OF ECPs in a room and ask them whether or not they enjoy seeing children in their practice and you are bound to get a mixed bag of responses, ranging from those that focus only on children to those that for whatever reason, do not like to see children in their practice. However, some say ECPs that do not treat the younger set are missing out on some golden opportunities. For instance, Dr. Aaron Franzel, assistant clinical professor and chief of pediatric/binocular vision services at the University of Missouri-St. Louis College of Optometry – who sees children 16 and under at the University’s vision clinic – says seeing children can help build a practice by drawing in entire families through helping a child. “There’s a very significant bond and relationships that you can establish that you don’t really see much in general practices anymore,” Dr. Franzel explains. “You’re sharing an experience

“There will be educated parents who know they have risk factors for certain conditions, but they’re convinced or have been told that we can’t really measure visual skills until (children) know their letters and are confident,” he explains. “I’m not exactly sure where that comes from, but it’s a difficult thing to overcome because we hear it all the time.” To help overcome this obstacle, Dr. Bruce Meyer of Newport Vision Center in Jersey City, NJ, and Riverdell Family Vision in Oradell, NJ, makes sure to talk to parents and posts the recommendations of the American Optometric Association (AOA) in his offices. “Many parents are getting a different perspective if they broach it to their pediatricians that if the kid passes or seems reasonable on a (pediatric vision) screening that they can just wait to have their child’s eyes examined,” Dr. Meyer continues. “Those of us in the trenches know that screenings, while they’re wonderful, are not perfect and we see plenty of kids come in with lazy eyes and other issues that would have been nice to have been picked up earlier on.” Continued on page 28

26 | EYECAREPROFESSIONAL | JUNE 2012

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2. Making Kids Comfortable and Happy in the Office Once you educate parents on the age their child can have an eye exam, the children will start flooding in, leaving ECPs with the concern of how to make kids comfortable and give them something to do while they wait for their appointment. Dr. Samuel Oliphant of Advanced Family Eyecare in Oklahoma City, OK, has found the answer to be in “the cave” – a designed child play area complete with toys and television in his waiting room. “It is actually like a cave, so they can go inside there, play and make noise that doesn’t seem to filter out into the waiting area,” he explains. “We do see adults and they don’t want the noise of the kids.” Dr. Franzel also has a play area in the pediatric clinic he manages, including a kids’ table with activities. Additionally, he says many times he is able to get valuable information just by observing the kids at play at one of the tables. “It really gives us a pretty good idea as to what they like to do, what they avoid, some of their visual habits, how does their head tilt or turn,” he explains. “All of these things can be cues for us to look at specific things that might not have been picked up by the parent.” 3. No Exam Room Battles When it comes time to bring a child back to an exam room, how can ECPs continue to keep a child at ease while still extracting the information they need? “The practitioner needs to have a clear-cut understanding of what information they need to extract and the goal is to be able to do it as efficiently as possible with the kid feeling as comfortable as we can,” Dr. Meyer says. Dr. Franzel says bringing yourself down to the child’s level – such as maybe performing a cover test from your knees rather than a chair so you’re eye-to-eye with the child – can help make the child feel you are on their level. And he says ECPs need to trust their objective test, cover test and first impression if a child is not responding in the manner they need them to. “Most practitioners have done this on adults hundreds of thousands of times, so you have to trust your observational skills,” he explains. “(Kids) are not going to tell you what they see all that accurately – you need to use objective means to measure these things and you need to rely on those.”

4. Dealing with Tweens & Teens Working with kids is one thing – working with tweens and teens is quite another. What can ECPs do to meet the ever-changing needs of the angst-ridden set? Dr. Oliphant says first off to not have parents in the exam room because tweens and teens “can play their parent like a violin.” “It seems to help when we have the children just one-on-one – they seem to be much more respectful,” he adds. “We prefer to do it that way because then the parent doesn’t answer for the child, which happens often.” Dr. Franzel advises ECPs not try to be “cool” and talk like a teen as that will only cause more issues. “You can’t turn yourself into a teenager, you can’t fake it – that is something they will definitely detect,” he explains. He says ECPs acting as an authority figure and giving them information on their condition is the way to go. He even gives his tween and teen patients his card, instructing them to call him directly if they have any questions after the exam. “With adolescents you sometimes just have to be that outside authority and many times – not all the time – but many times they do respond to it just as long as you’re not their parents,” he adds. 5. Making It a Team Effort Now that you’re ready to see kids in your office, one last concern to tackle – how can you ensure your staff is just as ready? Dr. Oliphant says he tackles this issue by hiring kid-friendly assistants with great personalities, because you can’t train personality. “You just have to have assistants that are kid people – they like kids, like playing with them, like teasing them,” he says. “We always kid around with our kids.” Additionally Dr. Oliphant and his staff dress to make young patients feel at ease. “I don’t wear white coats because it seems to make (children) think they’re going to get a shot or something like that,” he explains. “All of the assistants do have scrubs, but they’re bright colors or they have patterns on them.” Dr. Meyer says he and his staff work to try to engage any children that come in to their practice. “Both the staff and I try to engage them, talk to them, and get them (to tell us) what they like, what they like to do, what they like to watch – just to try to make them more comfortable,” he adds. ■

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THROUGH THE LENS John Dick, ABOC, FNAO

Polycarbonate vs. Trivex : How Do They Stack Up? ®

As ECPs, we are prone to handling difficult patients and difficult situations. We attempt to balance the wants and needs of the patients with the product availability and the limitations or trade-offs associated with these products as well as their prescription requirements. We do our best to educate the patient, which is often times not an easy task because so much of what we do as dispensers is an alien concept to the general public. When you throw children and their visual needs into the mix, the stress level can creep up as you mediate between the parents, children and availability of eyewear products and visual needs. On occasion, the ideas parents have as to what their children need, what the children want and your recommendations will often lead to a source of frustration for all parties. This source of frustration typically stems from frame selection with little consideration given to the most important aspect of the eyewear; the lenses. I have often watched how many of us barely spend any time going over options with parents about lens materials and benefits. It’s almost as if our brains go to a default setting as we automatically put down polycarbonate as the lens material of choice for children’s eyewear since it is probably the safest material available. Next time you’re tempted to do this, take a minute and consider the benefits of Trivex, which is also a very safe lens material. Trivex Doesn’t Have To Be a Tough Sell Price In the world of retail, most shoppers know that you don’t always get what you pay for. This is simply untrue in the world of ophthalmic lenses and it’s up to us as dispensers to point this out. Given the economic climate of the past few years, parents have grown accustomed to watching the value of every dollar spent. Unfortunately, eye care is not always high on the list of priorities for most families unless they have insurance or their child is having problems. However, despite concerns over the family checkbook, parents will usually spend the extra money for eyecare if the expense can be justified. After all, parents only want the best for their kids and if an extra $30 to $40 can provide it to them they are more than willing to dole out the extra money.

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Justifying these expenses with Trivex lenses can be easy or difficult depending on how the benefits are presented to the parent. For example, instead of getting into a discussion about the aspheric properties of Trivex, try simply telling the patient it will provide their child with a wider field of view which makes them ideal for sports or other activities where visual information must be interpreted quickly. Abbe values are another selling point. Instead of getting into a highly technical discussion concerning abbe value and chromatic dispersion, simply let the parent know that it will allow more light to reach the eye and allow their child to see better. Durability Let’s face it. Kids are kids. If you’ve been in the optical game for a while you know kids generally don’t take care of their glasses. Kids will lay their glasses anywhere, clean their lenses with whatever is lying around and occasionally let the family dog play with them. It’s important to iterate to parents these lenses are one of the toughest on the market and they’re scratch resistant. Also inform the parents about your office policy regarding warranties and provide them reassurance they won’t be back every month with horribly scratched lenses impossible to use so long as the child makes at least a half-hearted attempt to take care of them. Safety is typically paramount when recommendations are made for children’s lenses. Parents want to keep their kids safe and Trivex definitely fits the bill. It has an interesting history. Trivex was developed within the last decade for the military as a type of “visual armor.” The polymers used in the production of Trivex are more closely bonded together, providing tensile strength, but at the same time weighing a fraction less than polycarbonate. It’s also important to review the more technical aspects and the intrinsic value of the material itself. Understanding Optical-Ese New dispensers may hear certain words or phrases used by the doctor, more experienced staff or professional publications that they may not fully understand: asphericity, abbe value, chromatic dispersion, refractive indices, etc., etc. The optical world has a language all its own. So here goes: a crash course in “optical-ese” and how it applies to Trivex. Continued on page 32

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Refractive Index and Abbe Values Advising our patients about lens options is basically a presentation of priorities. The optical game is one of trade-offs. “Yes, Mr. Jones, we can provide you with photochromic lenses, but they won’t get as dark in the car as they do outside.” “Mrs. Smith, your progressives are great for viewing objects at a myriad of different distances, but you will experience some distortion along the edges of the corridor.” Is Trivex a material you want to use in every situation? The short answer is, no. Refractive indices assigned to different materials are no exception especially when comparing Trivex and polycarbonate lenses. Trivex is thicker than polycarbonate and caution should be taken when advising patients with higher prescriptions. The basic rule for using Trivex is for any prescription between +3.00D to -3.00D. Anything beyond this range or with a substantial amount of prism or decentration should have you looking at other options such as polycarbonate or high index materials. The refractive index of a material is the speed at which light travels through the material as compared to a vacuum. For example, CR-39 plastic lenses have a refractive index of 1.498 as

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compared to a higher index lens with a refractive index of 1.67. This means that the light would travel faster in the CR-39 lens material than in the 1.67 material. The denser material, 1.67, would slow the light more and also bend the light more. Therefore you need less of the 1.67 material to do the same job that the 1.498 material will do. As the light travels through a refractive medium it slows, allowing dispersion of the components of light to break up and divide into rainbows and other chromatic aberrations. Light is necessary for the process of vision to take place. Breaking up visible light before it reaches the retina into chromatic components will somewhat compromise their visual acuities. The amount of dispersion taking place in the medium, i.e. the lens, as light passes through it is assigned a value known as the Abbe number or value. When comparing how well polycarbonate lenses stack up to Trivex lenses it’s important to remember polycarbonate has a higher refractive index. This is why it, or an even higher index material, will be more cosmetically appealing when filling prescriptions that go beyond the recommended range of +/-3.00 diopters. Polycarbonate can also have a center thickness of 1.0 mm because of its strength. The smaller center thickness automatically substantially reduces the edge thickness. However, since we’re weighing trade-offs, it’s important to

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remember the Abbe value of Trivex is better in optical terms than polycarbonate. However, if you fit polycarbonate with the proper horizontal and vertical decentration along with a close vertex distance the patient will not experience any issues with the lower Abbe value. Also, the specific gravity of Trivex makes it fractionally lighter than polycarbonate. So it’s important to ask the patient, or in this case the parents, which they prefer: thinner or lighter and optically clearer lenses? Leave it up to the parents and patients to decide what they prefer. Asphericity The concept of asphericity and the implications it will have for the finished lens should always be explored with weighing recommendations for higher prescriptions. The word “aspheric” literally means “not spherical.” The question becomes, “how does this apply to ophthalmic lenses?” The power of a lens is determined by its ability to refract light to a specific point allowing the patient to see clearly. This ability to focus is determined by the curvature on the front and backside of the lens. For example, a lens with a +9.00D front base curve and a -2.00D back curve will result in a power of +7.00 D for the lens. The power of this lens requires a relatively steep curvature. In addition to a protruding curvature, the lens will magnify (at

+7.00 D) the appearance of the patient’s eye as well as bend light more prominently around the peripheral edge as the patient’s gaze moves away from the optical center. This amount of peripheral distortion will limit the amount of available field of view to the patient. To combat this problem, aspheric lenses will slowly alter the base curve of the lens from the optical center towards the periphery. In the case of plus powered lenses, the base curve will flatten toward the edge of the lens. This results in a less steep curvature allowing the prescription to be processed with a wider field of view and less distortion at the periphery for the patient. It’s important to note that even with single vision prescriptions you should specify the optical center and height of each eye to maximize the benefits of this design and allow the lens to function at its greatest potential. Trivex is not a miracle product for children’s lenses. Its refractive index prevents it from being as thin as polycarbontate or other higher index lenses for sure. However, it can no longer be dismissed as too costly or its benefits ignored because it does have its place in our lens arsenal. The next time you begin to discuss with parents lens materials for their kids keep these in mind. What they choose may surprise you. ■ With contributions from Brian A. Thomas, P.h.D., ABOM

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THE MOBILE OPTICIAN Ginny Johnson, LDO, ABOC

School’s Out For Summer No more CEs, no more books No more patient’s dirty looks... SUMMER IS HERE! It’s time to ditch the books and pack your brains. This is gonna be so cool. Wait ‘til you see it. We’ll be tripping on Eye on Kids camp where we are free to act like kids. Camp enrollment is limited to all ECPs so act out now! Working with patients, co-workers, colleagues, superiors and vendors on a day to day basis is no child’s play. From having to break the news to parents that their toddler, tween or teen requires corrective lenses to fitting, fabricating, dispensing and beyond, ECPs are tested on many patient levels. Working with various personalities ages 2-102 on their vision solutions from start to finish while juggling optics requires many different brains. Identifying ourselves as certified, advanced, licensed, nonlicensed, master, optician, technician or doctor is totally irrelevant when it comes to acting like a bunch of kids. So take those ECP letters of the alphabet that follow your name (O.D., M.D., ABOC, ABO-AC, NCLE, NCLE-AC, ABOM, LDO, RDO, COA, COT, COMT...) and put them away for now. Eye Spy Friends To get to know each other at camp the kids form a circle and play Eye Spy Friends. Each kid has to tell the group two true statements and one lie about themselves. The rest of the group tries to guess which statement is the lie. Once the group announces their decision, the kid reveals the correct answer. At the end of the game the camp leader talks about how being truthful with others from the moment you meet is the first step to building solid friendships.

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Kids can become burdened with labels attached to them by the people involved in their everyday lives. Labels are avoided at camp and everyone is treated equally. Every kid is an original and uniquely created without duplication. No comparisons are necessary at camp since nothing compares to originality. Their strengths are used to help others and their weaknesses are not addressed in a shortcomings way. Zero Bull The camp leaders put on a skit about bullying that requires audience participation. The kids learn how to identify bullying and where to get help if they ever need to. They are encouraged to be open and talk about feelings. The topic of how their parents handle stress and conflict at home is one that camp kids usually have no problem talking about. If you think the kids aren’t taking mental notes of adult behavior then you’re crazy. Instead of roasting s’mores or each other be someone that is cool to work with. We are grown professional kids that know right from wrong with kids that are always looking up to us. Are the contents of your work emails, tweets, texts, social media and online forum posts something that a group of kids would be proud of? Or are they full of bull?

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Sink or Swim One of the kid’s favorite activities at camp is swimming. The kids are taught to have great respect for the water since it is much larger than they are. The buddy system is practiced and each kid is paired up with another for safety reasons. No swimming is allowed without adult supervision and a buddy. Tread water lightly in all business transactions. Give more credit than you take whenever possible. Verbally pat each other on the back for a job well done. Catch people doing something right. Discuss any power imbalance among staff members that are drowning other’s morale. Only when what gets stirred up settles down can we see ourselves and others more clearly. Good Sportsmanship The kids are allowed to be competitive as long as they are playing as a team that is practicing good sportsmanship. At the end of any competitive camp activity the kids shake hands and congratulate each other on a game well played. They quickly learn that if you don’t play well together as a team you’ll be blindsided. We’ve all known someone that has accepted a job because it pays the bills and their quality of work revolves around that mentality. Or how about the miserable ECP working in a position where there is no room for advancement and retirement is nowhere in sight? Let’s not forget about the newbies that are placed in positions with no direction or training and told not to worry they’ll catch on. Remember our common denominator, the patient, when making good sportsmanship decisions for your office. Yo Good Kid Yoga classes are offered throughout the day for any kids that choose to participate. Yoga helps the kids with concentration and boosts their attention span. The kids become more creative and are allowed to invent and name some of their own yoga poses. When flexibility and balance are improved, the kids are less likely to suffer from sprains and fractures. The kids learn how to breathe and relax which can be a plus for their parents. Do you know how to breathe and relax when work takes its toll on you? Buy a yoga mat and keep it at your office. Set aside some time to practice yoga as a group. Neon smiley face stress balls take a back seat to yoga when you get all bent out of shape. Whether you are driving all day to see appointments, have a short commute to work or dealing with a patient that is running late, the psychology of traffic deserves an office yoga mat. If you aren’t surrounded by a bunch of happy campers then be the first to change that. You can have all the education in the world but (yes, I said but) until you are smart enough to play nice with others no one really cares how ECP book smart you are. ■

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SECOND GLANCE Elmer Friedman, OD

Babies See More Than You Think YOUR BABY’S VISION DEVELOPMENT begins before they are even born. The mother must care for her body during pregnancy to insure that the child will receive the proper nutrition for development. This is vitally important for the proper development of your baby’s body and mind, including the eyes and the vision centers in the brain.

ollow the appropriate guidelines for proper nutrition, supplements and the proper amount of rest you need during your pregnancy. Smoking, alcohol and drugs can cause many problems for the baby, including serious vision problems. Even common medications like aspirin can be dangerous to the baby during pregnancy. Aspirin tends to increase the risk of low birth weight and problems during delivery. Low birth weight has been associated with vision problems in infants. Over the counter medicines and herbal supplements should be screened by the OB/GYN doctor because seemingly innocent supplements can have poor consequences.

A quick look at the research shows the newer findings of infant developmental and psychological advances that have taken place over the past decade. The vision of the infant is a complex subject and requires the scrutiny it deserves. A baby’s eyes are not very sensitive to light in the first month of life. The amount of light required for a 1 month old infant to be aware that light is present (light detection threshold) is 50 times higher than that of an adult. Therefore, it’s alright to leave lights on in the nursery. It won’t affect their ability to sleep despite the wives tales. Infants, at first, lack the necessary control for the ciliary focusing muscles to respond properly to visual tasks. This phenomenon is noted during their first two months of life. After this 36 | EYECAREPROFESSIONAL | JUNE 2012

rough initial stage, they begin to focus somewhat clear images on the retina. The apparatus for focusing is operating but the optical system cannot produce a perfectly clear image as yet. In order to normalize their vision, a connection to the vision centers of the brain is required. The optical system of the eye is mature but in order to be useful the eye develops the ability to see clearly through a functioning fovea. At this stage detail vision is appreciated by the infant. A research team at Smith Kettlewell Eye Research Institute in San Francisco have, amazingly enough, measured the visual acuity in many babies and toddlers. They are able to obtain results even though a baby doesn’t know letters on the chart. Non verbal testing can be conducted (objective tests) to detect refractive errors and muscle skill. They discovered that in the first month of life, babies have a visual acuity (VA) of about 20/120. This is equivalent to the line below the big “E” on the Snellen chart. By four months of age the acuity has reached 20/60 and by 8 months of age has improved to about 20/30. The most important changes in infant vision take place during the first 8 months of life. Over the next several years, acuity gradually increases to adult expectations. However, the baby at early vision stages still enjoys a rich visual world. Remember that their world means they can easily see the things that matContinued on page 38

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ter most to them: your eyes, your lips, your smile, your nose, his own hands, fingers, feet and toes. Experts understand a parent’s concern when they notice that at birth the baby’s eye color is blue but it changes soon after. The doctors answer that at birth the darker pigments do not appear at first. Over a period of time more dark pigment is produced which will often change your child’s eye color from blue to brown, green, or a mixture of pigments.

important to check with an eye care professional if this picture continues. By the age of three months the infant’s eyes are usually very well coordinated. New born infants have the ability to track moving objects if it is large enough, has enough contrast and is moving at the right rate of speed. Their eyes will have a jerky or saccadic motion. Infants may have difficulty tracking if their room has a lot of distracting activity or other objects are present to compete for attention.

Conventional wisdom has stated that Infants prefer to look at things that present the most contrast. Large black and white patterns present the highest possible contrast and are most visible and attractive to babies. But it has been discovered that they can see more than that bold contrast. They are able to distinguish subtle shades of gray. By about 2 months of age your baby is capable of perceiving almost all of the subtle shadings that contribute to their visual world and make it so interesting.

At the ages of 7-12 months children are more mobile. They are crawling, often quite rapidly and for unexpectedly great distances. They improve their distance judging and are improving their grasping and throwing of objects as well as appreciation of grasp release. They are developing a better awareness of their overall body and are learning how to coordinate their vision with their body movements.

For instance, they can compute shadings in clouds, shadings that are unique to a parents face and even make out a white teddy bear on a white couch. Parents often remark that they believe their baby’s exhibit preferences for certain colors, usually bright blue or red. It is difficult for examiners to tell if the infant truly sees the color or is merely attracted to the color because of its brightness, darkness or the contrast of the colored object against its surroundings. Studies performed at the University of California in Berkeley revealed that infants as young as two weeks of age possess color vision and can tell the difference between a red object and a green one even though their brightness is equal in intensity. Infants may not be able to tell the difference between subtle color differences until the state of development between retinal receptors at the fovea and the brain vision center have matured. Many parents have depended on black and white mobiles for ideal stimulation. However, research informs us that a normal visual environment without black and white toys is still very rich and stimulating to your toddler. A change from the usual black and white objects might be a wise consideration so that a direction toward the sort of colors that are appropriate for the parent could work just as well or better for the child. It gives the child a chance to explore more subtle and more important objects. At this stage of development it is important for the parents and examiners to note the baby’s eye movements. This will be paramount in the development of hand-eye coordination and depth perception as the child matures. Coordinated eye movements are also essential in the development of visual acuity and contrast sensitivity. During the first 2 months of life an infant’s eyes are not well coordinated. An observer may note that one eye “wanders” or the eyes appear crossed. This is normal for the newborn. However, it is 38 | EYECAREPROFESSIONAL | JUNE 2012

A common question from a parent to eye care professionals is “When will my baby recognize my face?” Researchers at the University of Minnesota in the 1970s found that newborn infants will tend to look at the borders of objects, especially if the borders are presented in high contrast. Studies show that babies prefer human faces to all other patterns and images. At two months of age they begin to appreciate the appearance of a hairline or the edge of a face. They will pay more attention to internal features of the face such as eyes and mouth. By 4 months of age they can recognize your face from all others in the world. To encourage visual interaction with your newborn child, keep your hairstyle the same and avoid altering your appearance. Your baby’s eyes, brain and body undergo a dramatic change in physical size and coordination during this time. It requires constant readjustment in order to preserve the accuracy of vision, eye movements and eye-hand coordination. Russell D. Hamer, PhD, has a doctorate in Sensory Science and is presently an Associate Scientist at the Smith-Kettlewell Eye Research Institute in San Francisco. He says, “Imagine trying to learn to hit a tennis ball or a baseball if your arms and legs were constantly changing in size and strength.” The very latest findings come from Florida Atlantic University. New research suggests that babies learn to talk during a stage when the baby’s cute babbling gradually changes into syllables and eventually into that first “mama” or “dada”. They actually become lip readers. Scientists have discovered that at about the age of 6 months, babies begin shifting from the intent eye gaze to studying mouths when people talk to them. Developmental psychologist, David Lewkowicz says,“Babies, in order to imitate you, have to figure out how to shape their lips to make that particular sound they’re hearing. It’s an incredibly complex process.” ■

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OD PERSPECTIVE Jason Smith, OD, MS

Refraction Changes and Vision Problems in Children ONE OF THE THINGS THAT ECPs can count on is the fact that the human visual system will change as one ages. Myopic, hyperopic, presbyopic and astigmatic changes allow us to regularly provide the needed eye care to facilitate those changes. We are also fortunate to have products such as clear and colored plastic lenses, polycarbonate, Trivex, Transitions lenses, soft contact lenses, and gas permeable contact lenses to help those people in need. Lens treatments with ultraviolet protection or anti-reflective coating can also add a comfort level to a minus or plus prescription. Besides refraction changes that occur throughout our lifetime, vision problems can occur due to the aging of the different anatomical structures of the human eye. There are functional developmental changes that occur as a newborn ages including the ability to determine sizes, shapes, orientation, and distances of objects. Some visual abilities are inherited, some are learned, and some are affected by one’s environment. Within hours after birth, a child can move their eyes together and make compensatory eye movements in response to head movements. By 2 months of age accommodation and convergence can be demonstrated. There is rod and cone function in infants, although the time when color vision is actually achieved is debatable. Some experts state that color vision does not develop before the age of 4-6 months. Experts have some disagreement as to whether color vision is actually present or if this is a learned cortical/brain function which has not developed fully at this very young age. Other researchers have stated that red, blue, and green cone functioning may be present from 7-11 weeks of age. Other changes that will occur through the growth and early maturation process include acuity and pattern vision, spatial vision, perceptual-motor skills, cognition and learning, the ability to understand language, and to read. According to Dr. Jack Richman, “The earlier in life that deficits in visual acuity can be determined, the better are the chances in finding visual disorders that may have a harmful effect on the child’s learning and developmental process.” The National 40 | EYECAREPROFESSIONAL | JUNE 2012

Society for the Prevention of Blindness estimates that 5% of the 3-5 year age group has vision problems, even though the eye is at an adult stage by age 3. Growth can still occur to a lesser degree after this age. The length of the eye increases from its size at birth to approximately 28 millimeters by the ages of 8 to age 13, with most of the growth reached by age 8-9. The prevalent vision disorders in the preschool population are myopia-1%, hyperopia-7%, astigmatism-2%, anisometropia-2%, and amblyopia-1.5-2%. 67% of infants show 2-3 diopters of against-the-rule astigmatism with retinoscopy but by age 1-2, the astigmatism flips to a small amount of with-the-rule astigmatism. Perhaps the most active period for changes in the magnitude of refractive errors is during the first years of life. Large fluctuations can be seen especially in children with anisometropia or astigmatism. Studies done by Dr. Hirsch and Dr. Baldwin found that females exhibit myopia at an earlier age than males. From ages 6-11, girls have a higher mean refraction, but at age 11 the trend reverses. A higher percentage of females show refractive changes from age 6-13. At age 13-17, females were found to show less of a change towards myopia than males. At age 5-6, hyperopia increases for both females and males, but after this age hyperopia decreases more for males than for females. More females reveal myopia by ages 10-13 than males, but this number increases in males after age 13. The presence of high myopia in premature infants was first identified with a condition called retrolental fibroplasia (retinopathy of prematurity-ROP) due to the use of high amounts of oxygen used in incubators. A study that was published in the American Journal of Ophthalmology by Dr. M.C. Fletcher and Dr. S. Brandon found that all premature infants had myopia whether they were affected by retrolental fibroplasia or not. Premature infants weighing more than 3.74 pounds had myopia ranging from 0.25 to 6 diopters. Those premature infants weighing less than 2.75 pounds had myopia ranging from 10 to 20 diopters. One of the first large-scale studies of the refraction of 370 newborn infants was done by Dr. R.C. Cook and Dr. R.E. Glassock and was also published in the American Journal of Ophthalmology. The refractive error findings were

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diverse, ranging from 11-12 diopters of myopia to 11-12 diopters of hyperopia. Eye care professionals have always known that myopia was determined by the axial length of the eye combined with a possibly steep cornea or crystalline lens. But new research at the Ohio State University College of Optometry is finding that myopia develops in children when the crystalline lens stops adapting to the eye’s continued growth. According to Dr. Donald Mutti, “this work is trying to show that it is not just about the length of the eye, it is how the length of the eye relates to the rest of the eye. The onset of myopia is really a sudden occurrence of an imbalance between the growth of the eye and the development of the crystalline lens.” This research was published in the March issue of Optometry and Vision Science. Dr. A. Sorsby, Dr. B. Benjamin, and Dr. M. Sheridan concluded that the growth of the eye during infancy is extremely rapid. The length of the globe increases 5 mm from 18-23 mm between birth and age 3. Between the ages of 3 and 13, the increase in axial length averages about 0.1 mm per year. In studies done of 333 school children age 6-8, Dr. G. Kemph, Dr. S. Collins, and Dr. B. Jarman found that the great majority of children are emmetropic. The refractive error distribution of this age group was 2 diopters of myopia to 3.75 diopters of hyperopia with a peak incidence of 1 diopter of hyperopia. In a study published in the American Journal of Optometry, Dr. M.J. Hirsch concluded that “if a child has any myopia at all at ages 5-6, the myopia will be sure to remain and will probably increase. If a child has hyperopia in excess of +1.50 diopters at age 5-6, that child will very likely remain hyperopic by ages 1314. If a child has a spherical refraction between +0.50 and +1.25 diopters, there is a great chance of being emmetropic by age 13-14. If a child has a spherical refraction between 0 and +0.50 diopters at age 5-6, then there is a high probability of becoming myopic by age 13-14. This probability becomes even greater if against-the-rule astigmatism is present.”

with-the-rule astigmatism was 16-20% for all age groups. The percentage of those children having against-the-rule astigmatism increased from 3-11% during their school years. In a study done by Dr. Matsumura and Dr. Hirai of Japanese students age 3-17, the prevalence of myopia increased from 43.5% at age 12 to 66.0% by age 17. Their results showed a considerable increase in the incidence of myopia among those 7 years of age or older and there was a greater shift towards myopia especially in students older than 10 years of age. Other studies done showed a considerable increase in the incidence of myopia among those 7 years of age or older, and changes in mean refractive errors also demonstrated a greater shift toward myopia, especially in students older than 10 years. Also, the prevalence of myopia increased from 49.3% to 65.6% in 17-year-old students. The National Center for Health Care Statistics states that other eye problems in this age group include inflammation, eye injuries, allergy problems, strabismus, congenital disorders, convergence and divergence problems, tropias, and amblyopia. Medical eye problems that may require special attention and higher levels of primary, secondary, and tertiary eye care include blocked tear ducts, Sturge-Weber’s syndrome, ptosis, congenital cataracts, and congenital glaucoma. Red eyes, conjunctivitis, projectile eye injuries, sports injuries, and blepharitis are commonly seen by eye care professionals. Statistics and data are important in guiding us in what to expect in a certain population group. As ECPs we should remember that this population group may need special attention in order to prevent a lifetime visual disability. ■

In another study, Dr. Hirsch found that the percentage of children having

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LAST LOOK Jim Magay, RDO

I WANT TO GET TO THE HEART OF THE MATTER, deeper than anyone has delved before, into the arcane world of glasses for little people. I figured I’d talk to real experts. No, not my fellow scribblers, not sales reps, not The Vision Council (Sorry Ed), but the real experts – my granddaughters who are 6 and 8.

Kid’s Glasses? What’s the Deal? Sure we sell glasses and buy them in great quantities from companies who announce with great fanfare when they land a cool name to market them (They pay for these designer names and said designer named usually had little to do with the actual designing). Have you ever noticed they are all the same generic styles with different names on them? Of course there are some really creative ones by the top names like J.F. Rey, Little Colette, etc., but unless you live or work in a place where the wealthy reside, you don’t sell a lot of those. Kids less than 14 years old represented 15 percent of most ECP’s customer base in 2011, the same as in 2010. Children’s eyewear and related products also accounted for 15 percent of total gross dollar sales for most ECP’s—the same as it has since 2008. Also according to a 2011 survey, 47 percent of the reporting retailers said their average children’s complete eyewear retail sale per patient has increased in the past year versus five years ago. About 8 percent indicated a decline. Interestingly, the median retail sale ($129) for kids’ frames (excluding exams, lenses and lens treatments) has remained the same since 2009 for most. On the other hand, the median retail price for children’s spectacle lenses, which remained steady at $100 between 2006 and 2009, climbed to $105 in 2010 and rose again this year to $110, probably because more parents are allowing A/R and Transitions® treatments on those lenses. So it does pay to discuss lifestyle issues and lens options, also sport glasses, and sunglasses. Of course at a minimum all our kids get poly – and we introduce them to Trivex® as our lens of choice. In these tough economic times most young parents are very concerned with money – so our recommendations are not always followed. We find most of our school age kids are slaves to branding even though the frames may be generic in style – wilder colors and cute shapes do better on preschool kids (before peer pressure gets to them). 46 | EYECAREPROFESSIONAL | JUNE 2012

Frames with demonstratable product features are selling best – things like Flexon frames, or Aspex frames with Turbo Flex hinges, or tough sports frames by Liberty, Leader, and Julbo and great little frames from Menizzi, Bongo, and Guess Kids. But I digress, what do the kids tell us? “Poppa, we love all your frames!” “But kids, how do you feel about glasses on other kids at school?” “Well...it depends if we like the person, if we like them we like their glasses, if we don’t...well!” “So it depends, hmmm?” “Yup, when can we wear glasses – can we have them with no prescription?” “Sure – anything you like!” I believe in not spoiling my granddaughters – well maybe just a little! ■

Photo courtesy of Transitions® Optical, Inc.

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