Sun, Sport + Safety - VCPN March 2019

SUN, SPORT + SAFETY

Building a

SPORTS VISION PRACTICE P24 Fitting Patients with PROTECTIVE

SUNWEAR P26

SUN, SPORT + SAFETY ABO CE P28

A Continuing Education Supplement to VCPN, March 2019. Approved for one ABO credit hour of continuing education, Technical Level II. vision care

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Cover image: Oakley Forager Eyewear

HOW TO CREATE AND ADVANCE A SPORTS VISION PRACTICE

HOW TO CREATE AND ADVANCE

A SPORTS VISION PRACTICE

Start small and simple with tints and safety glasses, then gradually add testing using existing equipment, and eventually you’ll be treating athletes at all skill levels.

COURTESY OF OAKLEY

Alex Andrich, OD, FCOVD

O

ptometry is a unique profession in that it can offer the optometrist many opportunities to practice a large variety of specialties. It is very common to hear that a practice specializes in dry eye or specialty contact lenses. Sports vision is a unique area that can be offered as a valuable service in your office.

A common misconception is that doctors who offer sports vision services only work with professional/semi-professional teams.

While it is true that many of us do work with high level athletes and professional teams, the field of sports vision encompasses any athlete at any level from baseball players on a youth travel team to “weekend warrior” golfers.

According to the Physical Activity Council’s 2017 Participation Report, 72% of the U.S. population ages six and older were active. This means that there is a large opportunity to offer this type of service in your practice.

The concept that “vision” can be improved is a relatively unknown and often misunderstood concept. If we look at vision as just a measure of static visual acuity, we will significantly limit ourselves in our ability to help an athlete. “Vision” is a global process that includes many visual skills such as acuity, contrast sensitivity, stereopsis, visualization, etc. When we talk about vision, we must also understand that vision is a key component in a complex network

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of sensory skills. Vision must integrate with our other sensory systems such as vestibular and proprioceptive when competing. On the field or court, our visual system tells our hands and feet what to do. Enhancing visual skills such as eye-hand coordination and peripheral awareness can make a significant difference in performance for the athlete who is looking for that extra edge.

GETTING STARTED One of the biggest hurdles in any new venture is getting started. Adding sports vision to your practice can seem like a daunting task at first, but with careful planning and execution it will be very rewarding. Just like any other specialty, becoming well versed in the concepts of sports vision will take some time.

The very successful glaucoma practice did not have all their equipment and knowledge on day one. The same is true for sports vision.

You can very easily start by making a few additions to your current process. Including a question about sports participation in your history questionnaire is a great start. It will allow the dialogue to begin during your case history. Discussing specific lens and tint options at the conclusion of the vision examination that relate to their sport is another great way to continue the discussion.

Depending on the sport, a special tint may make a significant difference in performance. It is also very important to discuss eye safety and offer a great selection of sports frames in your optical dispensary.

THE NEXT LEVEL Adding sport specific vision skill testing will take your sports vision practice to the next level. This type of testing can begin with just the equipment already in the exam lane. For example, if a competitive archery athlete comes to your office, you can test their accommodative skills to see how efficiently they can shift their focus from near to far and far to near. There are a growing number of companies in the market that offer functional vision skill testing.

These skills include: visual acuity (static and dynamic), contrast sensitivity, depth perception, multiple object tracking, eye-hand coordination and eye tracking to name just a few. A typical system will test 10 to 12 vision skills and include a report with normative data showing how your athlete compares to other athletes in same age group and/or sport. Included in these systems are training modules with drills to improve the vision skills that show deficits.

To continue growing your sports vision practice, reach out to members in your community who are involved in sports, such as athletic trainers for local high school or semi-pro teams. Most of these professionals have heard of or seen some type of sports vision training but often do not know of anyone in their area that offers this service.

Providing an in-service for them to demonstrate some of the testing and training drills is a great way to educate them on the benefits of sports vision training. Athletic trainers would also be very eager to hear about vision and concussions. Most concussions

MARCH 2019 | SUN, SPORT + SAFETY | VCPN

HOW TO CREATE AND ADVANCE A SPORTS VISION PRACTICE

will have some associated visual symptoms. Many of us who specialize in sports vision also offer visual rehabilitation after concussions. Optometrists, working collaboratively with other professionals, have many tools at their disposal to help in the diagnosis and treatment of concussion.

RESOURCES As your sports vision practice grows, you will want to continue furthering your knowledge base. There are many opportunities to attend seminars both regionally and nationally. Some good resources for functional vision are The College of Optometrists in Vision Development (COVD.org) and The Optometric Extension Program Foundation (OEPF.org). They will provide an excellent starting point in the testing and training of functional visions skills.

Concussions and sport have received a significant amount of attention in recent years. The Neuro-Optometric Rehabilitation Association (NORAVisionRehab.org) is an organization focused on educating optometrists working with patients who have suffered a head injury.

The International Sports Vision Association (ISVA, SportsVision.pro) is an organization dedicated to improving athletic performance through visual skill enhancement. Attendance at an ISVA event is an opportunity to interact with colleagues practicing sports vision and an opportunity to see the latest in vision training technology.

Sports, just by their nature, are competitive. Giving an athlete that extra edge can help them reach the podium or beat their best friend on the golf course. Adding sports vision to your practice will differentiate your practice from others and is a very rewarding way to help your athletes. n

Cleveland Gladiators player conducts hand-eye coordination training on the Senaptec Sensory Station.

Costa’s sweat management system has evolved in 2019 with the addition of new ventilation ducting airflow through the endpiece.

Alex Andrich, OD, FCOVD, is a graduate of The Ohio State University College of Optometry and is in private practice in North Royalton, OH. In addition to serving as the president of the International Sports Vision Association, he is a vision coach for the Cleveland Indians baseball team, Cleveland Monsters hockey team and Cleveland Gladiators arena football team. The International Sports Vision Association is an interdisciplinary group of professionals dedicated to advancing the field of vision training for athletes of all ages and levels to help them achieve peak athletic performance. Visit SportsVision.pro, email Info@SportsVision.pro, or follow ISVA on Facebook and Twitter (@SportsVisionDrs).

VCPN | SUN, SPORT + SAFETY | MARCH 2019

COURTESY OF LIBERTY

5 SPORTS VISION PRACTICE TIPS 1. Include a question about sports participation in your history questionnaire.

2. Discuss lens and tint options at the conclusion of the vision examination that relate to their sports participation.

3. Offer a great selection of sports eyewear.

4. Reach out to local athletic trainers to make them aware of your services.

5. Participate in continuing education courses.

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SUNWEAR TO MANAGE LIGHT

Sunwear to

MANAGE LIGHT Understanding the many elements that impact vision is the first step toward prescribing and fitting patients with the right protective sunwear.

COURTESY OF TIFOSI

By Mary Seguiti

L

ight is key to vison, without it we would not see. The part for eyecare professionals is to help our patients manage light to provide the best visual acuity, comfort and protection. Changing light conditions can cause a great deal of discomfort, and this is where we need to provide direction for our patients to address their specific needs with tailored and customized glasses. The goal is to present a solution that provides protection, visual acuity and comfort from morning to night.

UNDERSTANDING THE SPECTRUM Many are not aware of the dangers of UV and blue light to their eyes. First, you should have an understanding of the electromagnetic spectrum. The entire visible light spectrum is 380-780 nanometers.

UV is the part of the spectrum from 100380nm. The UV range of 280-400nm is what is most damaging to the eyes.

• UVC at 200-275nm is mostly absorbed by the ozone layer. In areas where this is being depleted there is a higher incidence of skin cancers and cataracts.

• UVB at 280-315nm causes sunburn and can damage lids, conjunctiva and the cornea. This can increase the chance of developing a pinguecula and ptergiums.

• UVA at 315-380nm will penetrate the cornea and can have effects on the crystalline lens and the interior segments. This can cause an increase in cataracts and macular degeneration. The World Health

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Organization estimates that up to 20% of cataracts are from overexposure to UV. • HEV High Energy Visible light at 380500nm is the violet/blue part of the visible spectrum and can cause harm and discomfort to the eye.

UNDERSTANDING YOUR PATIENTS ECPs need to ask their patients if they work indoors or outside, if they are on a computer or other digital devices all day, if they hunt, fish, ski, golf or bike or pursue any other activities that will expose them. Provide solutions with photochromic lenses, anti-reflective lenses, blue light filters, mirrors, polarized lenses, tint colors and more.

The color of the lens is very important to the type of activity or sport and overall eye health. Present tinted lens samples to your patients. Even the same sport such as deep sea fishing (gray) or fishing the flats (brown) will require a different lens color for premium visibility. Yellow/orange provides the best contrast and filters blue.

Gray allows for the most normal color recognition. Golfers prefer a lens color with contrast to enable them to see the course better, such as amber, brown and rose.

Lenses with variable/changeable tints can be helpful as lighting conditions change throughout the day.

When trying to find the proper balance, it is seldom a one-lens-for-all approach.

Photochromic lenses are a great replacement for clear lenses, but they will not solve all light issues. Tinted lenses are fashionable once again, and technology now provides different color options in

photochromic lenses along with coordinating mirror coatings.

UNDERSTANDING GLARE Focus on glare! Determine whether it is distracting glare, discomforting glare, disabling glare or blinding glare. Addressing the areas where patients are experiencing glare will be helpful to determine the best lens choice. Find out if the glare is coming from headlights at night and is distracting, or if it is blinding glare from looking directly into the sun during a morning or evening commute. Polarized lenses block the horizontal light reflected off a surface such as the road, snow or water. Light reflected off a horizontal plane causes glare. This could be disabling or blinding glare. Educate and show patients a demonstration of glare reduction.

Patient education is the key to providing the best option to control light. Work with your labs and vendors as they have many tools to assist with educating your patients. Stay abreast of new technology and provide in-office training. Focusing on protection will benefit you and your patients by providing the best visual experience, comfort and protection. Your office staff should wear premium lens products to help with communicating the many resources and options available when deciding the right lens for your patients. n Mary Seguiti is on the faculty of the Hillsborough Community College Opticianry Program and serves on the executive board of the National Federation of Opticianry Schools.

MARCH 2019 | SUN, SPORT + SAFETY | VCPN

ABO TECHNICAL LEVEL II

Protective Eyewear

SUN, SPORT+ SAFETY

APPROVAL: ABO APPROVED FOR 2 HOURS, TECHNICAL LEVEL II COURTESY OF WILEY X

ONLINE COURSE: STWFVM003-2 ISSUE DATE: MARCH 1, 2019 EXPIRATION DATE: FEBRUARY 6, 2022 APPROVAL: This course has been approved for two hours of Technical Level II continuing education credit by the American Board of Opticianry. NOTE: This course is only available with online testing.

Please see instructions at the end.

COURSE DESCRIPTION: Eye injuries in industry and in sports continue to be a major concern with risk to vision and millions of dollars spent in emergency rooms and physician visits. This course will teach eyecare professionals how to identify and interact with patients who may be at risk and help them choose proper eye protection for work or play.

By Richard W. McCoy BA, LDO, ABOC, NCLEC

S

afety and sports eyewear represent two significant categories of eyewear sales that ECPs can capitalize on for increased revenue and patient satisfaction. In addition, these categories do not suffer price pressure related to managed care and various insurance plans.

Furthermore, these two categories of eyewear represent a continuity of vision care that complements traditional dress eyewear, sunwear and contact lens sales.

Workers’ health and workplace safety concerns grew so much that the Williams-Steiger Occupational Safety and Health Act (OSHA) was passed and signed into law on Dec 29, 1970, by President Richard Nixon. An important aspect of OSHA is that it is attached to the Department of Labor, thereby having law enforcement powers

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over employers. This is one of the primary drivers for safety eyewear whether plano or Rx use.

The eye is a critically exposed organ and can suffer a montage of injuries including abrasions, contusions, corneal lacerations, abrasions and detached retinas as a result of blunt force trauma. Eye injuries are common in the workplace with over 2,000 injuries occurring each day.

Of these injuries approximately 1 in 10 will require a minimum of one day recovery time. Of the total of work injuries, 10-20% of affected workers will suffer temporary or permanent vision loss. Eye injuries have a monetary downside, resulting in $300 million in losses per year attributed to lost revenue, medical bills and employee leave.

Common causes of workplace eye injuries include but are not limited to: • flying objects & debris • chemicals • tools • a co-worker doing work in the same vicinity • harmful radiation • a combination of these hazards and (welding) and others Experts agree that 90% of eye injuries could have been prevented or lessened in severity with proper eye protection.

Proper eye protection include the following: (In many cases more than one eye protection product can be worn in conjunction with another).

• goggles • non-Rx & Rx safety eyewear • face shields • welding helmets A number of factors come into play when selecting safety eyewear. They must be functional for the job at hand and must be fit properly by an ECP. Fit is critical as the individual may be using safety eyewear in conjunction with a face shield, hearing protection or chemical goggle. In addition, the working environment itself can be a challenge with conditions ranging from everything from a hot shop or factory area to breezy conditions on a 10-story building under construction. Poorly fitted eyewear that fogs and needs constant attention will quickly be discarded by the employee. A major concern for all company safety officials and risk managers is acceptance and compliance of issued safety equipment.

MARCH 2019 | SUN, SPORT + SAFETY | VCPN

VCPN | SUN, SPORT + SAFETY | MARCH 2019

ABO TECHNICAL LEVEL II

Fortunately, for the ECP, frame manufacturers have responded with a number of innovative designs that rival the appearance of today’s dress eyewear. ANSI Z87-certified frame offerings include updated designs in zyl and other plastics, metal, titanium and rimless. Frames can have optional side shields added where there is a risk of flying debris or particles in the area. Side shields are further divided into two categories, permanent and detachable. The permanent side shield, as the term indicates, is fixed to the frame and cannot be removed easily by an employee. A detachable side shield gives the employee the option of wearing standard safety glasses and adding side shields when in an area where flying debris hazards exists.

Another innovative design that safety frame manufacturers offer are wide temples. What has been long fashionable in dress eyewear frames are now used in safety frames for the added function of acting as a side shield.

Furthermore, depending on the frame design, the tops of the zyl frames are sculpted to function as a brow guard to help protect a worker’s eyes from a debris hazard above the worker. The major change that has allowed manufacturers to create these breakthrough frame designs is the American National Standards Institute (ANSI) change in 1989 where frames were now certified as to performance as opposed to design. The two major performance tests are: • High Velocity Impact Test • High Mass Impact Test High Velocity Impact Test: A series of ¼-inch steel balls traveling at 150 feet/second are directed at 20 different parts of the glazed frame.

High Mass Impact Test: A pointed conical tipped projectile, 1 inch in diameter weighing 17.6 ounces is dropped 51.2 inches through a tube onto the eyeglasses.

• The lens must not break or become dislodged from the frame.

The ECP’s role in eyecare often revolves around the educational aspect of a product or service. Non-compliance regarding the wearing of safety eyewear may simply be that the worker does not understand the difference between dress and safety eyewear and protection values.

The major component of safety eyewear is the lens itself utilizing a number of different materials. Lens materials have been segregated by updated ANSI Z87.1 standards.

The two basic categories of lens materials are Basic Impact and High Impact material.

COURTESY OF TIFOSI

BASIC IMPACT • 3mm minimum thickness (crown glass and CR-39 plastic) • 1-inch steel ball dropped from 50 inches for impact test (glass) • must have safety markings/monogram or trademark on lenses • warning that lenses are not recommended for high-impact exposure HIGH IMPACT • minimum thickness 2.0mm polycarbonate and Trivex • must pass impact of ¼-inch steel ball traveling 105 feet/second • must have a plus symbol (+) on lens in addition to monogram or trademark Each material has positive and negative attributes and should be discussed with the patient. Employers at times will dictate what lens materials, frame styles and lens options the employee will have. In other cases, they will leave this to the discretion of the ECP. Due to liability concerns, many practitioners will default to high-impact materials.

• crown glass: crisp optics, very high scratch resistance, heavy material • CR-39: lighter in weight, resistant to weld spatter, inexpensive • polycarbonate: high-impact material, lighter weight • Trivex: high-impact material, lighter weight, better optics The ECP has a rich montage of lens styles and options that can be chosen for the patient. They include plano, single vision, bifocal/trifocal, progressive

and occupational lens designs. The plano lens option is an under-prescribed lens option. Although plano safety eyewear is a mass produced “commodity” product there are many patients who would appreciate the choice to upgrade to good prescription-quality plano-based eyewear made for them. These patients include hospital, nursing staff where blood-borne pathogens are of concern. In addition, first responders, EMTs, firefighters and law enforcement would all benefit from plano safety eyewear.

All conventional lens designs can be made into an Rx safety eyewear product selected by the ECP and the patient. An “old school” lens design that continues to be an effective occupational choice is the occupational bifocal or double “D” style.

The profile of the lens includes a flat top 28mm segment at the bottom of the lens and a 28mm segment at the top. Segments (depending on the manufacturer) are separated at least 13mm to 13.5mm. This separation contains the distance portion of the Rx. To fit a lens of this type, the dispenser positions the frame on the patient’s face where they are accustomed to wearing their eyewear then takes the appropriate measurement for the bifocal. A piece of frosted tape is then applied horizontally across the glazed lens where the measurement was taken. The dispenser then measures from the top of the tape 13mm to 13.5mm vertically and applies a second piece of frosted tape. This easily simulates to the patient where the different segments 29

ABO TECHNICAL LEVEL II COURTESY OF LIBERTY SPORT

will be and enables the patient to give feedback to the dispenser as to positioning. If the patient prefers a different height, the measurements are simply retaken, tape applied and a new simulation can be experienced by the patient. Once the final height has been selected, the patient is fully aware of the location of the bottom and top segments and the area for distance viewing in the new eyewear. The same process can be utilized if the dispenser is fitting an occupational quadrifocal. The dispenser simply positions the tape on the bottom segment to account for the trifocal line. This lens is an effective choice for a multitude of people working in various trades and occupations such as auto mechanics, electricians, carpenters and drywall hangers.

In the continued evolution of the modern workplace, new eyewear has been developed to counter serious computer vision syndrome or CVS. Computer eyewear has long been considered the “occupational eyewear of the 21st century.” Although not safety eyewear in a physical sense, the ECP has a multitude of lens solutions for these visual problems in the workplace.

Breakthroughs by lens manufacturers in digital surfacing and lens designs have provided the ECP with modern progressive lens designs that are “task specific.” That is, a much wider intermediate corridor for computer use. Distance vision is very limited; therefore the eyewear functions well in the office work space or cubicle. Standard bifocals and single vision lenses are additional choices when the Rx is compensated for the patient’s working distance.

In addition to prescribing the proper safety or occupational eyewear the ECP can function as a “light manager” by building the lenses with the appropriate tints. Depending on the occupation, variable tints may be added to control harsh sun, or polarized lenses 30

can be worn when the patient may spend working hours near the water in intense sun for long periods of time. In respect to computer eyewear, anti-reflective coatings effectively inhibit glare from computer screens, harsh environmental lighting and light emanating from building windows.

Not only do ECPs provide goods and services to patients, they can also provide services for potential employers as a practice outreach. To have a strong safety eyewear practice the ECP should consider “partnering” with employers to create a win/win scenario for all involved. An excellent tool a practice can utilize for employers is a sight or vision screener. Today’s vision screener or “battery instrument” can easily test potential employees and paid staff for a number of vision issues. Once found, they can be directed for a full exam and the appropriate Rx correction can be made. Many screeners have data link capability that allows test results to be downloaded to a printer to become part of the employee’s file. Depending on the practice location this is a valuable service that can assist the industrial nurse, safety director and human resource initiatives. In addition, the screener can be taken to health fairs and various other public events to act as an additional business driver for the practice.

The vision screener offers a battery of tests and is much more effective than the common Snellen chart. Depending on need, tests can be added as necessary. Basic primary vision skills tests include the following: • Central Visual Acuity: at a simulated 20foot distance • Central Visual Acuity: at 13-16 inches • Central Visual Acuity: at intermediate for computer users and equipment operators who operate machinery with computer controls and displays • Depth Perception Test: important for workers who operate forklifts and specialized

vehicles in the course of their job.

• Peripheral Vision Test • Color Vision Test • Muscle Balance and Eye Coordination These tests cover a broad spectrum of occupational groups summarized here: Group I: engineering, administrative and clerical workers Group II: vehicle operators Group III: inspectors, precision machine workers and assemblers Group IV: machine operators Group V: mechanical trade workers Group VI: general labor With each of the tests that can be performed with the vision screener a pass/fail answer key is provided, thereby eliminating any guess work on the part of the testing.

By using an instrument of this type, potential employees receive immediate feedback as to whether a comprehensive eye exam is called for. In the case of an existing employee, it shows a red flag in which their ocular health and prescription need to be reviewed.

The operation of the instrument is relatively simple with a variety of staff being able to use it in a short period of time. The instrument is lightweight and only requires a small space on a tabletop. Finally, after testing, this gives the ECP or staff member a further opportunity to educate the potential or veteran employee as to the importance of good safety eyewear and that standard dress eyewear does not have the protection factor in an industrial climate.

Safety and sports eyewear share a close brother-and-sister relationship with respect that eye injuries occur in both categories for different reasons, however, the solution is germane to both, quality fitted protective eyewear.

Eye injuries are the leading cause of blindness in children in the U.S., and most injuries occurring in school-aged children are sports related. These injuries account for an estimated 100,000 physician visits per year at a cost of more than $175 million. Three out of four American families with school-aged children have at least one playing in an organized sport, approximately 45 million children.

One in four adults in the U.S. play one or more sports. Sports have been classified by the National Eye Institute into three categories according to risk—High Risk, Moderate Risk and Low Risk. The chart below illustrates the sports in these categories:

MARCH 2019 | SUN, SPORT + SAFETY | VCPN

MODERATE RISK

LOW RISK

baseball

football

bicycling

basketball

golf

diving

boxing

badminton

skiing

hockey

soccer

swimming

paintball

tennis

wrestling

racquetball softball squash

The human factors are significant in eye injuries when playing sports. These factors include: • experience in the particular sport • athletic ability • level/intensity of play • maturity (With respect to children, abilities, physical strength and maturity can differ widely in a group.)

Sports can be further broken down into two categories: Dynamic Sports, which involve considerable movement, and NonDynamic (static) Sports.

DYNAMIC SPORTS

NON-DYNAMIC SPORTS

baseball/softball

golf

basketball

archery

cycling

target shooting

racquet sports

In order to safely and fully enjoy a sporting activity the individual should have an updated eye exam and ocular health examination. The vision screener can be utilized for basic testing, and examinations can be scheduled promptly. Once the eye examination has been completed the ECP can review the corrective options for the patient. These options include: • dress eyewear • contact lenses • computer eyewear • sunglasses • sports sunglasses • goggles With the diverse lifestyle of the patient and the vast number of products available, the ECP may wonder how to effectively present a plan to suit a patient’s needs. An effective tool developed by the late Paul Berman, OD, FAAO, director of professional relations and education for Liberty Sport, is very helpful to the ECP and support staff: “Use the three I’s to protect eyes.” This tool

is not only effective for sports eyewear, it can be used with equal success with regard to industrial safety eyewear. The three I’s are Inquire, Inform, Introduce.

• Inquire by using the lifestyle questionnaire filled out by the patient so the ECP can review the various sporting activities the patient participates in now and what sports may be planned for the future.

• Inform the patient of the possible ocular risks involved with activities and the corrective vision solutions available.

• Introduce various products that can suit the patient’s visual needs for a particular sporting lifestyle. It is not unusual for a customer to require several different options past traditional dress eyewear and or contact lenses.

As a business driver, the ECP may offer financial incentives in the way of discounts or package pricing to help ensure the patient is getting the best eye protection value.

When the ECP makes a recommendation for a goggle-type product for the customer, whether plano or Rx, the particular device must meet the standard for the intended sport. The recreational standard for eyewear falls under the American Society for Testing and Materials (ASTM). The specific standard is F-803 and covers the following sports: • racquet sports (badminton, tennis, paddle tennis, handball, squash and racquetball) • soccer • basketball • cycling • paintball (ASTM F1776) An important consideration when dispensing these products relates to the hang tags and or warning labels that are attached to the product. They are to be read and removed by the user so the customer completely understands the capability of their newly purchased ophthalmic body armor.

Because of revised gudelines on sports eyewear designs the ECP has a rich selection of sport goggles to present to the customer for consideration. The ECP should have a good selection of sizes in adult and youth designs for proper fit and functionality.

A major consideration in goggle use is fogging. Due to physical exertion, fogging can easily occur if the goggle is too tight against the face or lacks proper vents to circulate air.

Another consideration is protective padding inside the goggle itself. These pads should make comfortable contact on the sides of the temples and bridge area of the face.

VCPN | SUN, SPORT + SAFETY | MARCH 2019

ABO TECHNICAL LEVEL II

HIGH RISK

These help dissipate the force of a glancing blow or a direct impact to the individual.

A further breakthrough for goggle selection is the Rx range capability. With the advances in digital surfacing and lens-beveling techniques many patients now enjoy the stylish wrap look of 6.00D and 8.00D base curves and panoramic vision that was all but impossible years ago. Manufacturers of goggles will provide information to the ECP as to the Rx parameters their goggles can accommodate.

Digital surfacing and beveling techniques have advanced sports sunwear as well. More patients enjoy wrapped sunwear in Rx versions than ever before. Additional shielding from harsh sunlight is an important environmental consideration. Stylish wide temple designs have found a place in sports sunwear as well and serve two additional benefits.

Wide temples block out harsh sun and glare from the sides and act as a wind dam to help eliminate dry eye issues. This is an important advantage for the contact lens wearer, cyclist, boater or motorcyclist. Manufacturers of sports sunwear also include snap-in brow guard inserts to further block sun and wind from above. Finally, many companies provide matching straps or lanyards to ensure the eyewear will not slip off in rigorous conditions.

Lens options and materials are quite varied and provide the ECP a diverse selection to their patients with respect to their sports lifestyle. Modern lens-manufacturing techniques continue to make glass a very popular choice for today’s sports sunwear. Lens tints in glass include traditional gray, green, G-15 and brown.

Variable tints are available as well as polarized options. Although heavier than modern resin lenses, glass has an advantage of crisp optical clarity and superior scratch resistance, highly valued features in sunwear. The material itself lends itself well to two other upgrades for sunwear, mirrors and anti-reflective coatings. The ECP acts as a “light manager” with these two additional add-ons. The mirror coating adds an additional layer of protection by blocking harsh sunlight multiplied many times when the customer is around water or a sunny day on a hard-packed snowy ski slope. Colors include blue, green and copper mirror coatings, all with the distinct advantage of helping the user with comparison and contrast in different environments. The longevity of these coatings is considerable as they are able to be applied to the glass material at a much higher temperature than resin lenses. Digital surfacing allows a much broader selection of 31

ABO TECHNICAL LEVEL II

Rx’s in high wrap frames utilizing 6.00D and 8.00D base curves. Resin lenses, due to their light weight and impact resistance, continue to be popular in single vision, multifocal and progressive sunwear.

For the ECP who has post cataract/LASIK patients, high risk and current macular degeneration patients and contact lens wearers, a lens with a blue-light-filtering lens can be prescribed to aid the patient. This lens will filter out +/- 20% of the blue light spectrum in the 415-455 nanometer wavelength. Lens type with this filtration property is available in polarized for outdoor use. This is a true sun lens with an added medical benefit.

For the ECP who has a number of contact lens wearers, sport goggles and sunwear continue to be important aspects for the patient. Although Rx eyewear may now be partially eliminated, it must be emphasized that the possibility of an eye injury is not. They do, however, now have better functionality with safety equipment as the inserted lenses are now planos. In addition, the patient may want sport contact lenses in addition to regular lenses. Sport contact lenses are tinted and in many cases give the patient better visual comfort and help with reaction time to moving objects. Popular tint options include amber for baseball, tennis and soccer and gray-green tints for golf.

THE SUCCESSFUL SPORTS AND SAFETY EYEWEAR PRACTICE The modern eyecare practice has multiple opportunities to capitalize on these two niche markets and create consistent income generators. Consistency and commitment are the keys to long-term success. Have tasteful displays of top quality sports and safety eyewear products featured around the practice. Provide financial incentives to the patient with bundling packages in addition to their dress eyewear and contact lens purchases. Have quality literature on sports and safety eyewear with business cards attached and given to patients after completed transactions. Make follow-up calls to perspective customers two weeks after the initial sale to answer any possible questions.

Have staff meetings on a regular basis and bring in lens and frame representatives

who sell sports and safety eyewear products to educate and train staff. Add additional training as needed to make sure everyone is delivering a clear consistent message to patients, children and parents.

Have patients fill out a lifestyle sheet and detail their sports, hobbies and occupations.

Computer use should be noted and addressed when presenting eyewear options.

With respect to safety eyewear needs, ask the patient how many people use safety eyewear at work. By contacting the owner of the company, safety director or risk manager, the ECP could have an opportunity to put together a safety eyeglass program for the company that could include the following: • discounted eye exams • discounts for dress eyewear and sunglasses and contact lenses • specials on children’s eyewear Establishing a professional relationship with a small company can result in a number of long-term revenue streams. Assign a staff member to do a business outreach to local businesses within a 5- to 10-mile radius of the practice, and provide them with information regarding services. The local library is one very effective tool to get pertinent information regarding local businesses. Simply access the industrial or business directory located in the resources area of the library, and look up the businesses in the county where the practice is located and the surrounding areas as well. Contact phone numbers, addresses and names of current management will be available. An important tool that can be utilized by the ECP is an employer data sheet, which can be customized to suit the needs of the

practice. It essentially is a fact sheet with all the pertinent information regarding the business, including the type of business, number of employees and if a safety eyeglass program could be started. If one is already in place the ECP can drop off practice information with the prospect of being a secondary vendor Trunk shows have long been popular for dress eyewear products, and the same concept can be used by the ECP to promote sports eyewear and sunwear. In addition, to inviting the existing patient base, teachers and coaches from nearby and surrounding schools as well as concerned parents could attend. Finally, employees from various sports and golf shops could attend and be educated on the newest technology in sports and sports sunwear.

Public outreach by the ECP can reap enormous positive results for the practice in the eyes of the public. Write a short article on an eyewear topic for publication in the local free paper and or newspaper. Have lectures prepared to present to schools, colleges and civic clubs on the importance of eye safety and products for sports and eye protection.

Further outreach incentives can include health fairs set up by the health departments, schools, hospital outreach programs and others. Brochures can be distributed as needed at the venue, and the vision screener can be put into service to make people aware of the importance of getting an eye exam and/or updating their existing prescription. n Richard W. McCoy, BA, LDO, ABOC, NCLEC, was an instructor for the Hillsborough Community College Opticianry Program in Fort Myers, FL.

This course is ONLY available for online testing.

TO TAKE THE TEST ONLINE: Go to VisionCareProducts.com/Education 1. Under the black Log-In Bar, – log in (Note: Use the “register” link to register for online education, and record your user name and password for future access.)

2. Click on the course you would like to complete.

3. Review the course materials.

4. Take the test, and at the end of the course, after you submit your answers, your results will automatically appear on your screen!

5. All passing tests will automatically be submitted to ABO at the beginning of each month. You may print a copy of your certificate for your records.

This content is subject to change without notice and offered for informational use only. You are urged to consult with your individual business, financial, legal, tax and/or other advisers [and/or medical providers] with respect to any information presented. CareCredit, Synchrony Financial and any of its affiliates (collectively, “Synchrony”) make no representations or warranties regarding this content and accept no liability for any loss or harm arising from the use of the information provided. All statements and opinions in SUN, SPORT AND SAFETY EYEWEAR are the sole opinions of the author, Richard W. McCoy BA, LDO, ABOC, NCLEC. Your receipt of this material and/or participation in this presentation constitutes your acceptance of these terms and conditions.

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THIS COURSE IS SUPPORTED BY AN UNRESTRICTED EDUCATIONAL GRANT FROM CARECREDIT.

MARCH 2019 | SUN, SPORT + SAFETY | VCPN