EyeCare Professional Magazine April 2014 Issue

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SPRING AND SUMMER SUNS / PAGE 6 TIPS ON BUYING GROUPS / PAGE 12 April 2014 Volume 8, Issue 75 www.ECPmag.com

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April 2014 Issue of EyeCare Professional Magazine.

Transcript of EyeCare Professional Magazine April 2014 Issue

Page 1: EyeCare Professional Magazine April 2014 Issue

SPRING AND SUMMER SUNS / PAGE 6 • TIPS ON BUYING GROUPS / PAGE 12

April 2014 • Volume 8, Issue 75 • www.ECPmag.com

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APR 2014

4Selling SunwearIncrease your sunglass sales by offering functionality and staying on top of the latest in shapes and styles.by Lindsey Getz

12Buying GroupsSome tips of how to evaluate if a buying group or business alliance is right for your practice.by Cliff Capriola, President, Focal Point Consulting

14Purchasing PatternsStudy your lens invoice sales data to spot trends thatcould help determine potential areas of growth.by Renee Jacobs, OD, MA

18Optical AppsSee the latest in fitting, dispensing, education, and lensdesign apps for smartphones and tablets.by Judy Canty, LDO

26All About EdgersHaving an edger with drilling capabilities gives your practice a clear advantage over your competitors.by John Seegers, M.Ed.,LDO

30Contact Lens GraffitiECPs still face challenges dealing with the various filmsand deposits commonly found on contact lenses.by Sam Winnegrad, MBA, LDO

38Homebound Eye CareNursing Home and Homebound eye care is a challenging but ultimately rewarding service.by Jason Smith, OD, MS

CONTENTSST

US Optical800.445.2773www.USOPTICAL.com

Vol. 8 – Issue 75

6Spring and Summer SunsLeave the winter behind and brighten up your practice with the latest in colorful sunwear. by ECP Staff

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On The Cover

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THere Comes the Sun!

THE MARKET for selling sunwear isunlimited. Unlike prescription eyewear,everyone should be wearing sunglasses.If you think of your sunwear in terms ofit being an add-on buy for patients whoare already purchasing Rx eyewear, you’relimiting your sales potential. The truth isthat sunwear can be positioned as a main purchase and you can aim to sell it to anyone that walks in your door.

Aim for a Variety

Sunwear consumers fall into everydemographic. Everyone from kids to seniors should be protecting their eyesfrom the sun’s harmful rays. If you’re serious about boosting your sunwear sales,the first step is to make sure you have awide variety of merchandise that will suitpatients of all ages and style preferences.Style preference relates to the fact thatsunwear can be considered within two keycategories: sports and fashion. Additionalcategories (crossover, prescription, etc.)could be considered but for simplicitysake, we’ll look at sunwear falling intothose two main subsections. The goal is to aim to have a variety of frames that suit both.

The objective is to find out what yourpatients might need sunwear for—is itsports or fashion? You can find out thiskey information by asking questions whilethe patient is in the waiting room or thechair. Don’t wait until they’re in the dis-pensary as it may be too late. After all, notall patients plan to stop in the dispensaryon a routine visit.

Surveys can also be an excellent tool forobtaining information. In addition tostandard paperwork, some practices have

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

Sports Sunwear

Those who are seeking out sports eye-wear have a specific purpose for their eye-wear in mind and if you can find out whatit is, you can help make the sale—and alsomake your patient happy. If you find outthat your patient is in the market forsports sunwear, the next step is to find outwhat sport they play. Are they a weekendwarrior or do they avidly participate in asport or recreational activity? Their levelof seriousness with the sport may help you determine how serious they are aboutgetting the right eyewear to enhance theirperformance. However, even the weekendwarrior might be willing to invest in a nicepair of frames if you can tell them how itwill not only make their activity moreenjoyable but will enhance their perform-ance as well. Once you know what yourpatients’ needs are, you can craft yoursales pitch to meet them. For instance,consider these three sports players and theeyewear pitch that would complementtheir needs...

Golfer

Golfers spend a lot of time with the sunbeating on their face, so a wrap style isideal since it protects not only the eyes,but the skin around the eyes as well.Lenses that are impact resistant to the

highest standards and 100 percent UVprotectant are also necessities.Photochromic lenses can also be helpful inreading greens and may help golfers per-form better by allowing them to noticesubtle differences in the course.

Tennis player

If you find out your patient is a tennisplayer, recommending a polarized sunglasscan help them to cut the glare from reflec-tion and therefore help them to betterspot the ball. In addition, tinted lenses canalso help them to see the ball more clearlyand allow them to make better contactwith their racquet.

OPTICAL MARKETING

Lindsey Getz

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

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

Continued on page 11

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Ranked #1 on every lens feature by real patients in independent studies, Varilux S Series™ lensesare undeniably in a class of their own, offering you a visual experience that is truly limitless.

Order Varilux S Series lenses from Luzerne Optical today!

©2014 Essilor of America, Inc. All rights reserved. Essilor, Varilux, 4D Technology, Nanoptix and SynchronEyes are trademarks of Essilor International.

DISCOVER LIMITLESS VISION™ WITH VARILUX S SERIES™

INTRODUCINGA REVOLUTION IN PROGRESSIVE LENSES

Now Processed In-House at Luzerne Optical

Phone: 800-233-9637 LuzerneOptical.com

“ From the moment I put them on, I could

see the difference.”

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Spring andSummer Suns

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1. VELVET EYEWEARRock the Velvet “Ava”. The perfect feminine Aviator inspired by Amelia.The frame is rich handmade Italianacetate offered in our newest TurquoiseLava. The lenses offer 100% UV protection and optical quality for clear, distortion free vision. Beautiful metalinlays add a touch of “Velvet.” www.velveteyewear.com

2. LINDBERGLINDBERG Sun frames combine thestyle, fashion and comfort benefits ofour award-winning eyewear with pre-scription lenses, and effective protectionagainst both glare and ultraviolet rays.These statement designs are based on the Strip and Acetanium collections,with high-quality sunglass lenses fromZeiss. www.lindberg.com

3. ADLENSWith all of the benefits of UVA and UVB protection, Adlens Sundials™ areinstantly adjustable for any distance atthe turn of a dial. They are suitable forover 90% of eyeglass and contact lenswearers who do not have astigmatism.Perfect for reading in the sun, garden-ing or sightseeing. www.adlens.com

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4. EVATIKEvatik Sun uptrend’s the classical avia-tor style with model E-1039; a modifiedflat metal aviator shape with a doublebridge. This model is a combinationsunglass model made with a stainlesssteel front and camo-inspired acetatetemples. Available in khaki camo and black camo, in size: 59-17-145.www.evatik.com www.classique-eyewear.com

5. ULTRA PALMBy Caviar: Pink w/Clear/Silver NightCrystal Stones w/Grey Lens (Model3008). The frames feature clear crystalembellishments with silver butterflyadornments. Pink is the new pretty and a great accessory for Spring andSummer fashions.www.caviarframes.com

6. ic! berlinWorlds collide. Day meets night meetsday. Berlin is a hybrid city where any-thing goes and everything is possible.ic! berlin, makers of screwless sheet-metal glasses presents its first collectionof hybrid sunglasses: superfine acetaterims inside a stainless steel frame.Available in three models in obsidian,white and blue. www.ic-berlin.de

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LAFONT

NIGHT is the sunglass crown jewel of the new 2014 Springand Summer collection and has 56 hand-placed SwarovskiCrystals adorning the frame front and temples. Available inthree exclusively LAFONT colors, the style is produced inlimited quantities and is already a highly sought after specialedition piece. www.lafontusa.com

theo

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

MARCOLINThe Just Cavalli Spring/Summer 2014Eyewear Collection features contemporarydesign and modern appeal combined with a youthful approach and iconic detailing.Unisex acetate JC559S sunglass style haspolarized lenses and a square profile withmodern, textural studs on the temples. In addition to classic black, this style isoffered in a number of color-blocked com-binations such as: bright green/ice, vividblue/violet (shown) and magenta/white. www.marcolinusa.com

REVOLUTION EYEWEAR

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

EYEBOBS

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

Marcolin, Unisex acetate JC559S sunglass style

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Publisher/Editor. . . . . . . . . . . . . . . . . . . . . . . . . Jeff SmithProduction/Graphics Manager . . . . . . . . . . . Bruce S. Drob

ADVERTISING & SALESVP, Advertising Sales . . . . . . . . . . . . . . . . Lynnette Blanton(215) 355-6444 • (800) 914-4322

Contributing WritersMary Armstrong, Judy Canty, Cliff Capriola, Elmer Friedman, Lindsey Getz, Renee Jacobs, Ginny Johnson, Jim Magay, Corrie Pelc, Anthony Record, John Seegers, Jason Smith

Opinions expressed in editorial submissions contributed to EyeCareProfessional Magazine, ECP™ are those of the individual writers exclusively and do not necessarily reflect the opinions of EyeCareProfessional Magazine, ECP™ its staff, its advertisers, or its reader-ship. EyeCare Professional Magazine, ECP™ assume no responsibilitytoward independently contributed editorial submissions or any typographical errors, mistakes, misprints, or missing informationwithin advertising copy.

EDITORIAL OFFICES111 E. Pennsylvania Blvd.Feasterville, PA 19053 (215) 355-6444 • Fax (215) [email protected]

EyeCare Professional Magazine, ECP™ is published monthly by OptiCourier, Ltd.Delivered by Third Class Mail Volume 8 Number 75TrademarkSM 1994 by OptiCourier, Ltd.All Rights Reserved.

No part of this magazine may be used or reproduced in anyform or by any means without prior written permission of thepublisher.

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

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It shall not be construed that OptiCourier, Ltd. endorses, pro-motes, subsidizes, advocates or is an agent or representative forany of the products, services or individuals in this publication.

For Back Issues and Reprints contact Jeff Smith, Publisher at800-914-4322 or by Email: [email protected]

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TIFOSI

The Lore from Tifosi keeps you cool all summer long withopen lens construction and vented lenses. The lightweightframe features hydrophilic rubber on arms and nose piecesfor a no-slip fit, even under sweaty conditions. www.tifosioptics.com

RUDY PROJECT

The Nebula is a casual sunglass designed via the combina-tion of timeless and unique Rudy Project design elementsand ergonomic features. Durable and lightweight, this full-rim sunglass ensures maximum protection from the sunwhile upholding supreme style. www.rudyprojectusa.com

BCBGMAXAZRIA

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

COTTON CLUB

Cotton Club Polarized sunglass collection is constructed ofthe newest materials and defines the concept of style, qualityand luxury at affordable prices. This new line of 30 sunwearframes consists of men’s, women’s, unisex and sport models.(models pictured CC 1047 and CC 1059) Sold exclusively inNorth America by National Lens. www.national-lens.com

ZYLOWARE EYEWEAR

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

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Boater or Fisher (or other water sport enthusiast)

Anyone who spends a lot of time on the water knows that the reflected light canbe incredibly rough on the eyes. Polarizedlenses can help cut that glare factor andallow your patient to enjoy their watersport more thoroughly.

Fashion Sunwear

If protection from the sun and lookinggood are the two key reasons your patientis looking at frames, you may want todirect them to some of your more fashion-friendly eyewear. Brand name frames tendto be popular among the fashion-con-scious. But often people just want a framethat looks good on their face. It does alsohelp to keep up with the latest fashiontrends. Although it’s not easy since fashionchanges so quickly, it would help to at leasthave an idea of some of the key trends sothat you can ensure your dispensary isoffering the latest styles.

Fashion forecasters Stylesight andEyecessorize recently collaborated on the“Eyewear Product & Trend Review” forspring/summer 2014 and reported fourmajor trends in eyewear this season. These

included what they dubbed the “InstagramLook,” the “Mathematical Look,” the“Aquatic Look,” and the “Garden Look.”We summed up each...

The Instagram Look

This look is all about “throwback style”with frames that have a 1970s appealincluding gold-tinted lenses, tortoise print,and wooden frames. These retro designsare trending on the runway and makingtheir way to everyday wear.

The Mathematical Look

This trend is all about “angular cuts andneutral colors.” Frames with a combina-tion of geometric shapes and bold contrast(such as black and white patterns) roundout this sophisticated look.

The Aquatic Look

This trend is all about color and texture.Inspired by the ocean, the runway waspacked with blue, turquoise and tealhues—both in clothing and accessories.

The Garden Look

This look is all about earthy greens andvibrant pinks “evocative of spring foliage.”Some designers are even using floralembellishments to really drive this look home.

With just a little bit of forethought, youcan be ready to tackle the sun season withyour patients. Remember that regardless ofwhat style preference they’re looking for,all patients will benefit from education onthe importance of protecting the eyes fromthe sun. After all, it’s not just a sales tactic,it’s your professional duty to educate thepatient and make sure they are doing theirbest at maintaining good eye health. �

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DISCOUNTS WERE all the rageback then as they seemed the only method to increase ECP’sprofitability, especially in optical

and contact lenses. Of course, the optionsavailable to consumers were very limitedback then. You basically had your choice ofglass or CR-39 lenses, with or withoutscratch coating, or the new hi-index lenses.Anti-reflective lenses were in their infancy,great in theory but not in practice. In sunwear you had your choice of polarizedgrey or brown. In rural areas it was notunusual to find practices selling 50% oftheir eyewear in glass lenses. Needless tosay, the buying experience was heavilyfocused on frame selection.

Fast forward to 2014 and the options for consumers and eye care professionalshave grown exponentially. Buying groupsstill exist although many have expandedtheir focus to include staff training andpractice management. For independentECPs, the choices have grown fromwhether or not to join a buying group to which kind to join, the traditional discount-focused group or the newer business alliance groups.

When making a decision of whether andwhat kind of group to join, it’s importantto take into consideration only thosepotential benefits and vendor discountswhich apply to your practice. In fact, Iwould go as far as to change the focus fromdiscounts to growth. There are countless

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

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

Now let’s take a look at some of the stepsto take in evaluating a buying group orbusiness alliance:

1. Maximize your present discounts. Talk to your framereps and lab rep about your consideration of buying groups.Traditionally, vendors do not like to deal with buying groupsbecause they have to offer adeeper discount. You might discover that if you consolidateyour frame buying into five or sixmain vendors (a smart move fora lot of reasons), you mightmatch or come very close to the buying group discount.

2. Evaluate buying group discountsagainst your current discount level.The most efficient method for doingthis is to give each buying group youare considering the same threemonths of statements from yourvendors and ask them to run theinvoices at the buying group rate.This way you are comparing applesto apples and not oranges.

3. Ask your peers what they think ofthe buying group. Call the doctorsin your town and ask them whattheir experiences have been. Thenask the buying group for a list ofparticipating ECPs within a 50-mileradius; call some of them randomlyand ask the same questions.

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

PRACTICE MANAGEMENT

Cliff Capriola, President, Focal Point Consulting

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Buying GroupsBuying groups were originally started in the 1980’s as a way for independent eye care professionals to attain the discounts formerly offered only to larger optical chains. At the time, they seemed like the

best bet to level the playing field as local, regional, and national chain stores proliferated.

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and efficiency”. One of the niceperks of buying groups is that every-thing comes to you on one state-ment; with one check to write formany vendors. Another thought onthis subject: as ECPs find themselvesplacing more emphasis on the med-ical model for their practice, theyare turning ever-increasing tasks tostaff members. So efficiency reallymatters more than ever. Talk withthe person(s) who will be responsi-ble for inventory and writing thechecks every month.

5. What practice management toolsare available? Is there a forum forpeer discussion and review? It’s notunusual in today’s market for anECP to emerge from his or her darkexam room at the end of the dayand not know much about what hastranspired that day in their practice.It’s nice to have an outlet to discussmutual issues with their peers orindustry leaders.

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

length of the deal, control of yourpractice, web site design, hiddenfees, and how hard it would be toget out of the contract if they weredissatisfied. When you think youhave completely reviewed the con-tract, give a copy to your lawyer and ask them to do the same.

7. What is the cost of membership?Or as Groucho Marx once said,“I’d never join any club whichwould have me as a member”. Thereare some vast differences betweenthe cost of buying groups and business alliances. Is it a one-timeyearly fee? A percentage of yourgross income? Are there additionalcosts for accessing additional components of membership, such as national or regional meetings?

8. Are your current vendors participating in the buying group?While not a deal-breaker, it can be important if you are trying tomaintain continuity in progressivelens choices.

Evaluating the business alliance modelcan be a little trickier, and they reallyshould not be evaluated by discount levelsalone (or even at all!). I honestly believethat these came about because ODs are terribly underserved by their optometryschools. The bottom line is that each individual practice is a self-supportingbusiness; in fact optometry is the onlymedical discipline I can think of where themajority of its profits are expected to comefrom a retail shop. And how much businesstraining is available in optometry schools?Very little, if any. I have gone back andforth with a few schools on this subject;they just do not seem to understand thatthey can educate and graduate wonderfullyskilled optometrists but is all for naught ifthey cannot afford to keep the lights on.

Whether it’s a buying group or business-alliance model, they all serve a purpose andthey will continue to evolve as the needs ofprivate ECPs change. It’s up to each ECP tojudge for themselves what their needs areand which model serves them best. �

If there is a Practice Management subjectyou would like to see addressed, email me at:[email protected]

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

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

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MAXIMIZE YOURSAVINGS

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

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

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

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

Invoice ReviewInvoice Review is the study of customer purchasing patterns in your optical. A month oflens invoices can be viewed as a stack of raw data. You can study that data to determine ifyour patients understand the value of owning more than one pair of glasses. You can studythat data to determine if your patients understand the value of top tier lens products.In addition, you can determine if your business earns patient trust and loyalty over time.With study and some comparisons, discern if your business is growing, static, or in decline.

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

Study Purchasing PatternsMind The Gap To Your Business Success

THROUGH THE LENS

Renee Jacobs, O.D., M.A.

Continued on page 16

Then take appropriate action. Get ontrack toward business success. InvoiceReview is an evergreen strategy that youcan use to Mind the Gap. Move safelyfrom where you are into your successfulbusiness future.

Macroscopic: The ObviousStart by identifying where you standtoday, your station platform. Most lensvendors will make the macroscopicoverview easy for you by providing amonthly lens sales summary report.A typical report will list units of lensproducts sold plus calculations ofcommon key performance indicators like AR %, Photochromic %, Trivex %,and the proportion of top tier progres-sives sold. Upon request, your vendorrepresentative can help you understandyour current status, how your businesscompares to industry averages andregional averages, plus your best opportunities for improvement.

Summary reports are useful for anotherreason. You can evaluate key performanceindicators over time. Notice if your business is literally standing still. Observetrends in volume. Are jobs per monthincreasing? Evaluate variability in the keyindicators of Revenue per Patient. Aresales of top tier lens options increasing?Are multiple pair sales increasing? Is yourbusiness stable, growing, or in decline?

If your lens vendor representative is nothelpful, then do your own calculations.Perhaps your business management

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State-of-the-art digital lens design combined with sophisticated new lens blank technology

E A G L E ™ F R E E - F O R M L E N S E S W I T H C A M B E R ™ T E C H N O L O G Y :

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

software can display monthly sales indica-tors. Sometimes, your last resort is the bestmethod. Pull a month of spectacle lensinvoices. Tangible documents reveal facts.Sort and count them to measure yourAR %, Progressive Free Form %, SingleVision Free Form %, Photochromic %,Sun Wear %, and more.

Next, identify the indicators with greatestprofit potential, and then delve deeper. Anindicator has greatest profit potential whenevery patient can benefit, and your incomefor the option is greater than the wholesalecost after all discounts and vision plan savings are applied. Typically, these willinclude:

• Anti-reflective treatments to enhanceclarity.

• Impact resistant materials to improvesafety.

• Photochromic tints to increase comfort.

For these lens options, the target market iseveryone. Another big indicator, with highprofit potential, is second pair sales.

Identify Populations that DO NOTUnderstand Product Benefits

Ultimately, for business success, you desireto identify which patient populationsunderstand lens benefits and which patientpopulations do not understand lens benefits. The evidence is buried in theirpurchasing patterns. If you know whichpopulations are not persuaded to purchaseoptions like AR treatments, high indexmaterials, and automatic tints, then youcan improve how you communicate product benefits.

Consider anti-reflective treatment as anexample. Calculate your AR % for progres-sive lenses, lined multi-focals, computerlenses, and single vision lenses. This willhelp you notice which patient populationsunderstand benefits and which patientpopulations are not persuaded. If your AR% is respectively: 75% of Progressive lenses,100% of Computer lenses, and only 45% ofSingle Vision lenses, then you know thatmost progressive lens wearers, and all computer lens wearers, understand thevalue of AR. You also know that decision

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

Photochromic sales might represent another opportunity for improvement.Years ago, doctors thought a multiple pairsale included “Clear” and “Sun” lenses.

Today, many businesses have renamed the“Clear” pair. Now it is called “Every DayWear” because patients can enjoy a varietyof light activated tints that enhance com-fort without replacing actual sunglasses.The Every Day Wear can have TransitionsSignature VII, XtrActive, or Vantage tech-nology. Hoya has SunTech. Vision Ease has LifeRx. Carl Zeiss has PhotoFusion.The options are continually expandingbecause automatically adjusting tintsimprove all-day comfort.

Remember, photochromic Every Day Weardoes not replace the need for sunglasses.First, everyday photochromic lenses do notget as dark as true sunglasses. Second, theVantage everyday polarized technology isnever 100% polarized, like a great sunglass.Finally, in general, sunglasses have largerframes for better coverage blockingextraneous light. Patients need Every DaySun Wear, even when their Every Day Wearis photochromic.

Some offices have evolved multiple pairsales to include more than Every Day Wearand Every Day Sun Wear. Some offices areoffering Media Use prescription lenses.These might include the full variety of nearvariable focus lenses for presbyopes andanti-eyestrain lenses for single visionpatients. As work and study behaviorsevolve toward greater use of smart phones,tablets, and computers, the symptoms ofcomputer vision syndrome increase. Newerlens solutions, with AR treatment, can offerboth accommodative relief plus protectionfrom the harmful effects of excessive bluelight. When you match patients to lensproducts best for them, and communicatevalue, then Revenue per Patient willincrease.

Microscopic: MINE the Gap

It is one thing to Mind the Gap, identifyingopportunities to better communicate lens

benefits with specific patient populations.It is something else again to MINE the Gap.

Take invoice review to the microscopiclevel. Review a single day. Study every individual, who had a comprehensive eyeexamination. Evaluate two things: First,evaluate Capture Rate. For that day, calcu-late the number of patients who received aspectacle prescription that can be filled inany optical. Of those patients, what per-centage then purchased eyewear in youroptical? This is a one-day Capture Rate.

Second, evaluate optical treatment planscompared to invoices. For each patient,review the treatment plan of multiple lenssolutions that the doctor prescribed.Compare the doctor’s optical treatmentplan to actual products purchased.

With this knowledge, you can mine formissed opportunities. Discuss each patient’sexperience. Determine if conversationabout product benefits started during pre-test or sooner. Learn how the doctorcommunicates product knowledge duringthe exam. Review all product messages that occurred before, during, and after the point of sale. Figure out strategies forimprovement. When you implement yourstrategies, monitor success with additionalInvoice Review. Success is defined asincreasing Revenue per Patient, plusincreasing Capture Rate as more patients decide to purchase from your optical instead of purchasing from yourcompetition. The gap, between what thedoctor prescribes and what the patientbuys, identifies your treasure trove of opportunity.

When you improve messaging, until mostpatients experience top tier lens productsfrom your optical, then your business will thrive.

Invoice Review is an evergreen strategy thatyou can use to Mind the Gap. Use it at themacroscopic level to identify your statusquo plus obvious opportunities. Minedeeper to maximize Revenue per Patientand Capture Rate. Move safely from yourcurrent platform, across the gap, into your success. �

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w w w . i c a r e - u s a . c o m

“I was thrilled when I saw this instrument at the 2008 AOA

meeting because individuals hate to be shot in the eye with a puff of air

and I have been looking for 30 years for something not so barbaric. This

instrument removes the need to place a puff of air in the eye, while meeting

both the quality and ease-of-use requirements of larger tonometers.”

This handheld device delivers accurate IOP measurement

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

FAST, EASY, PAINLESS.GOOD COMPLIANCE AND

RELIABLE RESULTS.

U.S. CONGRESS AUTHORIZES FIRSTOPTOMETRIST FOR ADVISORY PANEL

ON IMPROVING HEALTHCARE SYSTEMS

For the first time, the Patient-Centered OutcomesResearch Institute (PCORI) has appointed an optometristto its advisory panel on Improving Healthcare Systems.On Tuesday, Feb. 25, the board of governors of PCORIapproved the American Optometric Association’s (AOA)chief public health officer, Michael R. Duenas, OD, for athree-year term on its advisory panel on ImprovingHealthcare Systems.

The panel, authorized by the U.S. Congress, guidesnational priorities for research and improving health caredelivery. It is one of four PCORI panels established April 1, 2013 in accordance with federal law to prioritize clinical research that helps develop the best evidence-based information for patients and caregivers to reference and make informed decisions that lead to an overall improvement in health care outcomes. While PCORI’s advisory panels do not make policy, their guidance helps the institute refine its research and other activities to improve health care delivery and outcomes nationwide.

Nearly 300 systemic diseases have ties to vision andeye health, but without the evidence base, those tiesare not as tight as they may need to be to protect andpreserve the public health, according to Duenas. Hisresearch includes public health and epidemiology, linkages between chronic disease and visual impairment,environmental health, risk assessment, disease preven-tion and measuring access to care to improve quality of life at all life stages.

“This is a well-deserved recognition for one of ourown, Dr. Duenas, for the AOA, and for our entire profes-sion,” said Mitchell T. Munson, OD, AOA president. “Dr. Duenas will be at the table as an equal partner witha wide range of other health care stakeholders as thisnew panel takes on its national role in improving healthcare delivery and outcomes.”

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

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NOT LONG AGO, a group of tech and marketing gurusannounced the development of an online refractive exam.The app expects to become available in the summer of 2014 andadvertises a valid prescription, signed by an Ophthalmologist in 10 minutes.

A number of ECPs lost their minds.

Why are we freaking out about apps? Before there were apps,there were software programs and before that there were catalogues and pricelists that were guarded like the crown jewels.Are we afraid that apps, easily available to the general public will displace us or take some of the mystery out of what we do?Probably.

So, what are we going to do about it?

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

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

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

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

and technology behind polarized lenses. This is a great tool fornew hires or as a refresher for everyone in the office. The basicinformation is generic, but it does recommend NuPolar lenseswith links to their website. This one has been on my iPad for awhile and it has been very handy when explaining the value andeffectiveness of polarization.

Know Your Eyes—is an app based on activity sheets from theAmerican Optometric Association circa 2006-2011. At least,that’s what the introduction said. This is another tool that couldbe used to provide some basic knowledge for new hires or to pro-vide information for patients while waiting for an appointment.There are enough questions in the 4 sections to spark meaningfuldiscussions between patients and ECPs.

My New Frames—is a simple photo app that can be customizedwith practice information. It will take up to 6 different photos to compare and allow the pictures to be shared with friends for those all-important second opinions. The pictures are watermarked with practice information.

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

Silhouette—offers a virtual try-on app that is interesting, but notthe easiest thing to use, especially for presbyopic me. If I took myglasses off, I had trouble seeing the outline to use for the picture.Once I figured it out, it was fun to try shapes and colors. I didhave trouble visualizing the temples on most of the mountings.

i.Demo—is a consultative app from Zeiss. It is free, but availableonly to selected Zeiss Opticians. According to the app descrip-tion, it interactively assesses the patient’s visual needs and recommends available options using Zeiss spectacle lenses.

TECHNOLOGICAL ECP

Judy Canty, LDO

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

APP HAPPYAPP HAPPY

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OTTO—is VSP’s virtual assistant app. The download is free, butrequires a username and password to enter. That’s probably notfree. It does look like a powerful app, including patient check-in,vision screening and measurement functions.

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

I found this little gem after reading the wails and moans of ECPswho need to learn the next new system:

ICD-10 Search—is for all of you coders out there who are strug-gling to learn a whole new generation of insurance codes. This isanother limited free app. You get 5 free searches and then youneed to subscribe to a monthly or annual app. The beauty of thisone is that it will cross link ICD-9 and ICD-10 codes in anattempt to un-muddy the waters a bit.

Now to the real nitty-gritty, perhaps the one app that reallygrinds our lenses:

Glasses.com for iPad—this is the app with the try-on technologythat one major player just paid a lot of money to get. To tell thetruth, it’s pretty cool. If you’re used to taking selfies in the bath-room mirror, this app’s for you! Having played around with it forabout an hour, I can see the attraction. It’s easy, once you get theselfie you want. The try on features, especially the side-to-sideviews are impressive. However, and this is where you brick-and-mortar types can really shine, the lens options are almost non-existent. You must choose between SV and Progressive/Bifocal;CR-39 or two levels of polycarbonate; free No Glare or Elite NoGlare and Transitions Grey (not available in SV CR-39).

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

Here are the assumptions:

1. The color on my iPad is the same as the actual color of the frame.

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

3. The eye size actually works with the unknown PAL.

4. The measurements, which you cannot take until the eyewear is actually purchased, are accurate.

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

Brick-and-mortar businesses are still ahead in this game, butwe’ve got to be calmer, smarter and more adaptable to remainthere.

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

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

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Filters

IT’S FUNNY HOW the mind works.I was working on the front lines ofmy optical shop the other day, and a

client I hadn’t seen in a very long timewalked through the door. In the interestof not offending any HIPAA sticklers outthere, we’ll call him Mr. Hoover. Mymind immediately drifted back to thefirst time I met him – about 20 years ago.

I vividly remember that day, and thelesson Mr. Hoover eventually taught me,like it was yesterday. I first spied himearly that first morning as he shuffleddown the aisle toward our shop. His hairwas disheveled and it appeared as thoughhe had just rolled out of bed, not bother-

ing to shower before he went to order hisnew eyeglasses. He was about 75 poundsoverweight, the extra girth located in oneof the biggest beer bellies I’ve ever seen.That belly was held in place by a filthy,threadbare T-shirt and a grimy pair ofrainbow-striped suspenders, which struggled to barely suspend a pair offaded, holey Dungarees. His eyeglassframe was taped together at the bridge,and I was bracing myself for a $49 sale to start my day.

Long story short: Mr. Hoover ended upordering not one, but two pairs ofFlexon® frames, with Transitions®, Varilux®

lenses, with anti-reflective treatments ofcourse. He ended up paying for them infull, up front, in cash! It’s also worthtelling you that despite his appearance, hewas well-spoken and intelligent. Nowdon’t get me wrong: I know we’ve allbeen taught from the time we were inOptical Kindergarten not to prejudge ourpatients, clients, or customers (whicheveryou choose to call them).

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

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

There are several different mental filters which subconsciously frame ourperspective. Being aware of them is thefirst step to keeping them at bay, andkeeping them at bay is a surefire way tonever prejudge again.

One type of filter that stymies ourapproach could best be described as aClassification Filter. This filter is all aboutrecognition. It causes us to compare whatwe are experiencing to similar things we have experienced before. So in thereal-life example of the first time I metMr. Hoover, I automatically “recognized”that he was just like most (but of courseas I soon discovered, not all) of the people I had met in the past who dressedthe way he did; he probably didn’t have alot of discretionary cash on hand. Boywas I wrong.

Whenever you find yourself reacting tothat Classification Filter of recognition,and assuming something about some-one’s finances, fashion sense, or anythingelse, remind yourself that that’s all it is –an assumption. Try to develop the habitof consciously assuming the opposite ofyour initial assumption. It takes a littleeffort, but I can assure you it’s possible.

Another type of Classification Filter isone that could best be described as one ofcontext. This filter causes us to assumethings based on the time and situation weexperience it. In other words, because Iwas seeing Mr. Hoover in the environ-ment of my optical shop...and since helooked out of place...I assumed the worst.Had I seen him in his element – in thehighly successful blue-collar business heowned – I would have seen him for whathe is: a successful businessman of meanswho only wants the best.

MANAGING OPTICIAN

Anthony Record, ABO/NCLE, RDO

Continued on page 22

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

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FEB2014_opticom.qxd 1/31/14 9:41 AM Page 1

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A second example is an Interests Filter.This one is a filter our unconscious minduses to assess the thousands of bits ofinformation we encounter every day, andhelps us choose which to pay attention toand which to disregard. There are twotypes of Interests Filters. One is what Ilike to call a Criteria-for-Success filter,which causes us to disregard most of theinformation around us until we actuallyneed it.

For example: Did you notice all theCorvettes you passed on the road as youdrove to work this morning? Probablynot. Why? Because you don’t own aCorvette and you’re not thinking of buy-ing one. Regardless of that, trust me, youpassed several Corvettes on your way towork today. If you do own one or arethinking of buying one, you would havenoticed them all.

How did that filter affect my encounterwith Mr. Hoover? It caused me to notnotice his bulging wallet, his Rolexwatch, and the fact that the taped framewas also a Flexon®. The other type ofInterests Filter is a filter of relevance.

This one causes us to evaluate the degreeof relevance of what we encounter basedon how that information can best serveour needs.

The third type of filter is commonlyreferred to as a Future Filter. This oneaffects our ability and desire to anticipatewhat might happen next. And youguessed it – there are two types of FutureFilters: one is called a filter of forecast;the other a filter of expectation.

The “forecast” Future Filter inspireshope or alerts us to danger. For example,when you arrive at the party and first layeyes on that special someone...youapproach... engage in conversation...hit itoff...and exchange phone numbers. Asyou drive home alone you think, “I hopehe calls!” That is your forecast filterinspiring hope. When you get home andlook him up on Facebook and find hisstatus listed as “married,” hopefully yourforecast filter causes you to switch gearsand alerts you to possible (probable)danger. Obviously, the latter was in playwith Mr. H.

The fourth and final filter is aJudgment Filter, which is ever-evolvingbased on our past experiences with aspecific, individual person or organiza-tion. As I had never met him before theencounter I described, this one didn’tapply to my first exchange with him. Butit could in subsequent visits. Since he hasalways made expensive purchases in myoffice, my Judgment Filter kicks in everytime I have seen him since we first met.It causes me to assume that he alwayswill drop significant coin with every visit.And sadly that’s not true with Mr.Hoover. After all, sometimes even he simply needs an adjustment.

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

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TRO_0414.qxd 4/3/14 9:46 AM Page 3

Page 26: EyeCare Professional Magazine April 2014 Issue

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

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

Bright colors, hand-painted designs and funky shapes stand out, but for trulyindividual self-expression, nothing makes astatement like a rimless pair of glasses thatwas designed just for you. Let’s face it, whenyou buy off the board, you are buyingsomething that hundreds, thousands, maybeeven tens of thousands of others are wear-ing as well. Like tailored clothing, your eyewear only becomes truly unique when itis made just for you. Rimless eyewear allowsfor customization on so many levels.

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

Whether or not you are into creating custom eyewear, having an edger withdrilling capabilities gives your store an

advantage. Having an edger gives you thepotential for advantages like reduced turn-around times, tighter quality control andreduced lab costs – the things that arealways mentioned – but let’s not forget thegenuine pride you get from making a beau-tiful pair of glasses instead of just opening abox from the lab and inspecting the finishedproduct. Drilling can be as simple or ascomplex as you want it to be. For basicwork, where lens shapes are called up frommemory, your work can be as simple aspushing the “start” button. For those whowant to get a little adventurous, having anedger allows the ECP to play with the shapeand size of a manufacturer’s shape settings.For the artist in the “anything goes” catego-ry, having an edger with advanced featuresmans they can work a lens like a sculptorworks clay.

For just a little flavor of what can bedone, see the above examples from the winners of Santinelli’s recent “ThinkOutside the Box Edge” Rimless EyewearContest. The company asked their drillinglens edger clients to create a pair of highlyimaginative rimless eyewear using theedger’s innovative Design Cut technology.

Regardless of your creative desires, thereare a few features you will want to look forin an edger with drill capabilities. Be sure ithas a user-friendly interface. Keep in mindthat your best lab person may not be there

24/7, so others may need to use it, as well.Be sure the edger has a full range of anglepositioning. Drill holes must be placed inrelationship to the lens base curve, the lensthickness and the position of the holes onthe lens. Drilling mounting holes is not amatter of holding the lenses and keepingthem straight! Last, be sure that the drill bitor router bit can be easily swapped and/ormaintained.

Look at what Briot offers in their awardwinning AltaPulse edger, which Briot sayshas these features:

• In the plastic version: Three 90 mmwheels: plastics roughing wheel (all plasticsCR 39, polycarbonate, high index), beveland rimless finishing + TBS wheel, beveland rimless polishing wheel.

• Integrated drilling function: Countersunkholes, notches, blind or open oblong holes.Drilling angle tilts depending on the program from 0

o

to 30o

.

• Visual preview of lens on request, beforestarting roughing cycle.

• Tracing prior to roughing with accuracy of1/100th of a millimeter. Feeling front andrear curvature and lens thickness.

• Four different bevels: Normal, Mini-Bevel,Tilted Bevel, and Mini-Tilted Bevel. Sixdifferent programs: Front face, percentage

EQUIPMENT CORNER

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

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

The Hole Truth: Edgers That Drill

Continued on page 28

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

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

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

800.644.3343 (option 6) www.santinelli.com [email protected]

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

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

• Minimum edging diameters: Rimless finish 17 mm, grooved finish18.2 mm, bevel finish 18.6 mm, safety bevel finish 21 mm.

• Grooving: Front and rear face with adjustable depth and width.Grooving angle adjusted automatically according to the curveand the height of the lens.

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

Coburn offers the Excelon 8000 series, of which Coburn says,“Seamlessly finishes plastic, hi-index, polycarbonate, and Trivex®

and offers the widest range of bevel options available. With accelerated long-life milling technology super hydrophobic axistwisting is eliminated, and with the optional drill unit, virtuallyany lens shape or hole pattern is possible.”

• Integrated, accelerated long-life milling technology to eliminateaxis twisting

• Widest range of bevel options available including: Standard,Mini Bevel, Asymmetric, Semi U, and customizable beveling forhigh curved frames

• User friendly touch screen and graphical user interface

• Advanced 3-Dimensional digital technology

• Detailed edging status is displayed graphically in real-time

• Dual CPU system supports full multitasking, editing and loading

The 8000 series is a modular system, where the edger can beupgraded by adding the external drill unit, tracer and blocker.The drill unit is the HDM-8000 which features:

• New systematic data profiling algorithm significantly reducesjob processing time

• Process and cut your next lens while drilling is in process withSmart Job Manager software

• Sleek design allows for a smaller footprint

Santinelli has the Me1200, of which they say:

“Enabling Finishing Labs to make the impossible – possible,Santinelli International’s Flagship Me 1200 Lens Edger, the mostcompact, feature-rich lens edger ever introduced. Wholesale Labsand retail ECPs alike looking for differentiation and increasedprofits can now deliver even the most complex and sophisticatedeyewear to the highest level of quality standards with ease.”

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

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

I know I say this in every article I write on edgers, but there’s a reason to repeat it. Every optician or non-licensed optical professional should be able to make a pair of glasses for a patient.Modern edgers have push-button input and auto-everything.There is simply no excuse for us not to be able to make thoseglasses. With these feature-packed edgers, there is not even anexcuse for being unable to run a basic 3-piece mounting!

What we look for in edgers is what we look for in most products, these days. We want reliability, technologicallyadvanced features, accuracy and speed. No matter which drillingedger you choose, these feature-packed units are bound to meetyour needs. As always, be sure you test any machine you are considering in a real-life setting, and run a series of lenses in bothplus and minus prescriptions of your choosing. Even if you arethe financial decision-maker, be sure to have the person who will actually be performing the work there with you as you’reconsidering which edger to buy, and be open to their feedback.You may find that you spend a little more, or perhaps a little lessthan you’d planned, but the person who will actually work withthe edger every day will be able to do a better job if they’vehelped to make the right choice! �

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Essilor Finalizes Acquisition of Transitions Optical

Essilor International announced April 1st that it hasfinalized the acquisition of PPG Industries’ 51 percentownership stake in Transitions Optical, the leadingprovider of photochromic lenses to ophthalmic lens manufacturers, and 100 percent of the capital of Intercast,a manufacturer of premium sunlenses.

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

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

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

The transaction, first reported on July 29, 2013, wasapproved without conditions by competition authoritiesin Australia, Brazil, Germany, New Zealand, Portugal,Spain, the U.K. and the U.S.

Founded in 1990 and based in Pinellas Park, Fla.,Transitions Optical reported sales of $844 million in 2013, of which $279 million with lens manufacturers other than Essilor.

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

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

According to Essilor’s estimates, the integration ofTransitions Optical will have a positive impact on Essilor’sfinancial indicators, notably with:

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

• An accretive effect on earnings per share as from2014, representing at least 5 percent a year in subsequent years.

• A positive impact of around 50 bps on the Group’slike-for-like growth in consolidated revenue as fromyear three of the integration.

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YOUR BODY HAS a way offormally complaining against abiologically foreign intruder –the contact lens. Various films

and deposits commonly found on contactlenses serve to remind us that the biocom-patibility of these lenses, though markedlyimproved, still faces many challenges. Evenafter an incalculable amount of money hasbeen spent researching and developing newlens technologies, we are still left to managean imperfect product.

Educating our patients on proper wearschedule, disinfection and storage habitswill decrease incidence and severity of thesedefacing blemishes. Of the multiplicity ofgraffitious (just made that word up)deposits, this article will mainly focus onfilms evolving from protein, lipid, bacterial,mineral, and cosmetic origins.

Factors affecting deposition are almost asnumerable as the stars in the heavens –exacerbating the difficulty in resolvingsome cases. Qualitative and quantitativenature of the tear film, blink rate, workenvironment, computer use, air quality,disregard for wear schedule, and, above all,poor contact lens hygiene have all beencited as instigators. Newer two-week anddaily disposable modalities, though greatlyreducing deposition, are no panacea. Thebattle continues...

As the primary molecule, it is only prop-er that we start our discussion with protein.Derived from the Greek word protos,

meaning primary or first protein is thebuilding block of life. Unfortunately,protein has an unquenchable affinity;yearning to court, betroth, and wed contactlenses. As soon as your patients insert a setof lenses into their eyes, protein will beginclinging to and interfacing with the surface.Protein will primarily attach to the anteriorsurface of the contact lens creating anopaque, grayish-white film. Most of theprotein that is absorbed into the lens isformed from albumin, lysozyme, lactofer-rin, and immunoglobulins originating inthe precorneal tear film.

As adsorption takes place, both watercontent and oxygen permeability decreasedramatically. Protein deposition translatesto problems associated with comfort, visualacuity, and various eye health issues such as papillary conjunctivitis or corneal ulceration. Protein adsorption is accumula-tive and will not resolve unless a thoroughsurfactant cleaning and disinfection processis in place. Newer hydrophilic technologieshave entered the market and dramaticallyreduced incidence of protein deposition.Silicone hydrogels, which comprise thebrunt of the contact lens market, performquite well at resisting protein.

Incorporating silicone into the composition of the lens increases oxygenpermeability and nutrient transmission tothe corneal epithelium while minimizingthe need for water to move throughout thecontact. High water content hydrophiliclenses seem to accumulate much greaterlevels of protein. Switching patients with

high protein levels distributed within their tear film to a silicone hydrogel willaide both patient satisfaction and clinicaloutcome.

While silicone hydrogels might be wonderful at resisting protein deposition,they fall short when thwarting off lipids.These films will appear both white andgreasy and are generally more translucentthan protein deposits. Fingerprints on contact lenses are consistent with lipidhabitation, though this is not always thecase. Lipid deposits originate from thesebaceous meibomian glands lining therims of our eyelids. These glands producethe outer lipid layer of the tear film necessary to reduce evaporation rate.

Dysfunction of the meibomian glandsresulting in excess or abnormal lipid production can lead to a deposition issue.Other factors contributing to lipid depositsmight include oily hands secondary totouching the face as well as diets that arehigh in fats or alcohol consumption.Dietary abnormalities have a way ofmanifesting themselves in our bodily secretions, including the tear film.

It has also been noted that a reduction inthe watery aqueous layer of the tear filmmakes it more likely for a lens to develop anoily, lipid-based film. Silicone hydrogels,which are praised for their ability to resistprotein deposits, will usually accumulatemore lipids than non-silicone basedhydrophilic lenses. Cleaning these lensescan be a difficult task; though newer

Sam Winnegrad, MBA, LDO

Continued on page 32

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Contact Lens GRAFFITI

CONTACT LENS CORNER

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Luxottica Group S.p.A. and Google Inc. announcedlast month that they will join forces to design, developand distribute a new breed of eyewear for Glass, whichwill include the involvement of Ray-Ban and Oakleybrands from within Luxottica’s portfolio. In its ownstatement, Google added that “Luxottica’s retail andwholesale distribution channels will serve us well whenwe make Glass more widely available down the road.”

Luxottica’s statement described “a far-reachingstrategic partnership between Luxottica and Google to work together across multiple efforts on the creationof innovative iconic wearable devices. Through thisrelationship, Luxottica and Google will match up high-tech developers with fashion designers and eyewearprofessionals. In particular, the two corporations willestablish a team of experts devoted to working on thedesign, development, tooling and engineering of Glassproducts that straddle the line between high-fashion,lifestyle and innovative technology.”

Luxottica said that the two major proprietary brandsof the group, Ray-Ban and Oakley, will be part of thecollaboration with Glass. Luxottica cited Oakley’s “10-year heritage in wearable technology that hasevolved from MP3 to HUD devices.” The company saiddetails about these new products will be disclosed at alater stage.

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

Astro Teller, Google vice president and head ofGoogle X, of which Google Glass is a part, comment-ed, “We are thrilled to be partnering with them as welook to push Glass and the broader industry forwardinto the emerging smart eyewear market.”

Google and Luxottica Announce Partnership for Glass — Will Include Ray-Ban and Oakley

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

Bacterial deposition, though less ubiqui-tous than proteins and lipids, can be muchmore dangerous and requires immediateaction. Many microbes can establish residence within the contact lens matrixincluding fungi, yeast, protozoa, and vari-ous viruses. These depositions will usuallymanifest in a filamentary pattern with colors ranging across the spectrum.

Hydrophilic lenses with elevated watercontent levels have also demonstrated agreater likelihood to deposit bacteria sec-ondary to protein. Many times these micro-organisms will first engage with a lenswhere it has already been compromisedthrough sustained damage or deposition.Transcending new anti-microbial surfacetechnologies, patients that refuse to followproper hygiene and disinfection protocolare likely to experience infection related tobacterial deposition.

Patients that practice unsanitary habitssuch as reusing or “topping off” theirmulti-purpose solution, storing contactsfor prolonged periods of time without disinfecting, as well as even using tap wateror saliva to re-establish moistness are placing themselves at a much greater riskfor serious complication. Lenses harboringany type of microorganism must be disposed of immediately. Wearing contactlenses in the shower, neighborhood pool,Pacific Ocean, or anywhere else bacteriasuch as the Acanthamoeba protozoa isfound is a dangerous practice. Patients withbacterial deposition should be switched to a reduced wear schedule, such as a dailydisposable modality with strict instructionon hygiene.

Inorganic minerals such as calcium phosphate can also bind to lens surfacesdecreasing both acuity and comfort.Segregated mineral deposits appear whiteand granular under slit lamp microscopy;however, rarely will there be just one particular type of deposit on a lens. Onefrequent cohabitation of deposits is lenscalculi or jelly bumps. These are raised protein, lipid, and calcium formations

protruding from the anterior surface of thelens. Jelly bumps are a sign of poor hygieneand lens care (this point is further exacer-bated if present on disposable lenses). Onceagain, re-education and possible refittingapply for a patient that is wearing lenseswith this type of formation. Any contactswith lens calculi deposits are not candidatesfor disinfection and must be discarded.

Telling someone that their eyes have aradiant sparkle is a nice thing to say, unless,of course, you are referring to misplacedglitter gel. Cosmetics and contact lenses are not friends, yet in most cases, it is notsocially acceptable for practitioners to man-date discontinuation of mascara, eyeliner,and all things glittery. “Ma’am, I am goingto need for you to stop using foundationbecause I am afraid it is going to compro-mise your visual acuity” probably wouldnot be the best business builder. Educationis our best bet.

Patients should be informed that contactlenses are to be inserted prior to any cos-metics and that they are able to be removedbefore cleansing the face. One easy way toremember this is to tell patients that theyshould be able to see what they are doingwhen they apply their make-up, but thatthey are expected to remove their cosmetics“blind”. Make-up, however, is not the onlyculprit. Almost all lotions, hair gels, andbeautification products can find their wayonto contact lenses and cause problems.Though some of the films created by cosmetics can be removed through cleaning and disinfection, others can be less cooperative.

For example, oil based makeup is muchmore difficult to remove from a contactlens surface than water based products.Even worse than diminished visual acuityand lens comfort is the increased incidenceof infection related to cosmetics and con-tact lens wear such as blepharitis and bacte-rial conjunctivitis. The summer is justaround the corner; a time when peoplewear over-the-counter sunglasses and con-tacts in lieu of prescription eyeglasses. Assuch, remember to tell your patients thatcontacts should also be inserted prior toapplying suntan lotion or they just mighthave to end up discarding their beloved

lenses. After all, there are far better ways toachieve ultraviolet eye protection thanaggravating the cornea with SPF-50!

After considering some of the morenotorious contact lens deposits, it is onlyproper that we review some basics aboutproper lens cleaning, disinfection, and stor-age. First off, remind your patients to washtheir hands before attempting to remove orinsert their contact lenses. One recent studyconcluded that only 5% of people using apublic restroom wash their hands wellenough to kill bacteria (let that sink in, punnot intended). After washing their handsand removing the lenses from their eyes,your patients should spend at least twentyseconds rubbing their contacts with multi-purpose solution to loosen any deposits.This should be immediately followed with a rinse using the same solution.

Next, it is imperative that your patientsplace their contacts in their lens case andfill it with fresh solution; leaving them forat least 4-6 hours. Lastly, the old solutionmust be discarded after use, as it is likelycontaminated and will no longer be effec-tive. Tell your patients to replace their lenscase every thirty days and to never storetheir lenses in pure saline; just because it’s sterile does not mean that it has disin-fecting properties. Ask your patients openended questions such as, “how do you takecare of your contact lenses?” This is a muchmore efficacious way to uncover problemsthan the usual, “are you following yourwear schedule and cleaning instructions?”

If your patients see more graffiti on their contact lenses than at a New Yorktrain station, there may be a problem; ifyour patients view more ‘films’ than aHollywood critic, there may be a need forintervention. Practitioners that take anactive role in educating their patients aboutlens deposit prevention are more likely tohave healthier, happier clients. While wecan rest assured that there will continue tobe improvements in both contact lens andsolution technology, we can also remainconfident in the fact that there will alwaysbe a need for managing the biocompatibili-ty of these wonderful devices. �

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OptiSource Internationalhas developed a first-of-itskind 3-in-1 lens inspectionstation.

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

a Polariscope that identifies hiddenstress in mounted lenses and injection molded lens blanks; and a Final Inspection lamp with a whitelight that allows the user to identifyany abnormalities in the finishedeyewear. This product is built withan ergonomic counter-height designwhich allows the user to comfortablyview mounted or un-mounted lenses.

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

for the same price or less than a PAL Identifier only, without requiringany additional counter space.” TheLens Inspection Station featuresinterchangeable lenses that can berearranged by the user, and an LED light source which eliminatesthe need for replacement bulbs.

OptiSource is a leading providerof lens processing consumable supplies and eyeglass accessories.Their extensive product line includesexclusive products such as: Snapitpatented frame screws, Cobalt Kingblocking pads, All Off progressivemarking ink remover, OptiPets eyewear holders, Titanium handtools, and The Clear View family ofpersonalized lens cleaning products.

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

1-800-OPTICALwww.optogenics.com

• Digital Capacity DOUBLED

• Crizal® Prevencia™

• Varilux S Series™ Lenses

• All Produced Locally

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

OptiSource Introduces the Lens Inspection Station

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FOAM PARTIES:A Danger to the Eyes

MODERN TIMES have witnessed anumber of fads, fetishes and addictions.The gamut is wide as it encompasses hulahoops and glue sniffing to Facebook usesand abuses. One of our human foibles isyearning to experiment with new and exotic ideas and the strange equipment that accompanies them.

The latest intrusion on the usual andcustomary spare time amusements is “thefoam party”. These exciting parties can beseen on a daily basis on college campuses,night clubs, school dances, church events,birthday parties and picnics across theUnited States. Special equipment can provide the foam at these parties. The original idea can be found in a 1936 film,“A Rhapsody in Black and Blue” in whichLouis Armstrong struts about and plays histrumpet in a room filled with foam.Recently, European followers were activelyspreading the word about this new andstimulating event. American youth has nowbecome enamored with this amusementand attached itself to this strange practice.

Have you ever been to a foam party? No,I didn’t think so. Picture this: soap bubblespour down from the ceiling or from foammakers on the floor. The bubbles are dis-tributed by blowers so that several feet offoam can accumulate. Foam parties can lastfor several hours while the foam keeps pacewith the activities at the event. Some of thefoam formulas are created from event toevent, so that standards for chemical compositions and concentration areunknown for each particular occasion.Depending on the solution being used, theeye risks may vary. Some may experienceonly mild discomfort, while others maysuffer serious corneal damage exacerbatedby contact lens wear.

To the followers of foam parties, the ideaof being hosed down with a weightlessspray of soap bubbles sounds like fun. Butwhen heavy drinking, slippery surfaces andreduced visual coordination is introduced,we are confronted with a hazard that maybe disastrous. Dr. Howard Mell, aspokesman for the American College ofEmergency Physicians, said on MSNBCthat slips and falls and damage to breakableitems are only part of what makes thoseparties so dangerous. The bubbles them-selves could be harmful if not prepared correctly; the soap could be an irritant,causing a burning sensation in the eyes and even temporary blindness. Dr. Mellsaid, “At the end of the day, it’s not thesmartest way to spend a Saturday night.It doesn’t take a whole lot of common sense to figure that out.”

College fraternities were the earliest usersand planners of foam parties. However, themost celebrated case demonstrating foamdamage to the eyes occurred on May 25,2013 at a Naples, Florida night club. About40 people sought emergency room treat-ment for eye injuries suffered after a foamparty. The most outspoken victim was 22

year old, Lauren Martin. She reported,“I have never felt so much pain in my life.I felt like I had shards of glass in my eyes.My mom had to feed me and I couldn’topen my eyes until Monday afternoon.”

Emergency room doctors agree that asthe trend is growing in popularity, foamparties are potentially dangerous. Officialinvestigations still are not absolutely surewhat went wrong at the Naples club butthey feel that the concentrated soap was not diluted correctly and thus became anirritant to the skin and eyes. The Centersfor Disease Control feel that better regula-tions and management of the chemicalsand concentration could greatly reduce theaccidents waiting to happen. According tothe New England Journal of Medicine, itwas reported that, “Six young men werepresented with various degrees of kerato-conjunctivitis due to alkaline chemicalburns they had received during an eveningof dancing on a dance floor covered withseveral feet of foam.”

Dr. Mell also reported that while workingin two college towns within the last fiveyears he encountered about one or two

Elmer Friedman, OD

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SECOND GLANCE

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Transitions OpticalAfter 40 years of service to PPG Industries,including nearly 24 with Transitions Optical,Richard C. Elias, senior vice president, opticaland specialty materials, and CEO, TransitionsOptical, Inc., will be retiring, effective now.Elias joined PPG in 1975 and became programmanager for photochromic lenses in 1989. He

was named vice president of sales and marketing whenTransitions Optical, Inc. was established in 1990, and he becameits president in 1995 and chief executive officer in 2007. Elias wasnamed general manager of optical products for PPG in 1998 andwas elected vice president, optical products, in early 2000.He was named senior vice president for the optical and specialtymaterials reporting segment at PPG in 2008.

National Federation of Opticianry SchoolsThe National Federation of Opticianry Schools(NFOS) elected new officers during its 2014 annual business meeting. New officers arepresident Prof. Robert J. Russo, New York CityCollege of Technology; vice president Prof.Kimberly Strickler, K.S., MA, LDO, ABOC,NCLC, New York City College of Technology;

secretary Sheri Red Shirt, Southwestern Indian PolytechnicInstitute; and treasurer Sheldon O’Guinn, Tri-Service OpticianSchool. Prof. Randy Smith of Baker College is the executive director, and Kristi Green of J. Sargeant Reynolds CommunityCollege is past president.

Williams GroupGilan Cockrell, OD, FAAO, has joined WilliamsGroup as executive vice president of corporatestrategy. In private practice in Emporia, Kan.,since 1980, Cockrell graduated from OklahomaState University and received an optometrydegree from the Southern College of Optometry.He was president of the Kansas Optometric

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

Cohen’s Fashion OpticalCohen’s Fashion Optical has announced thatSheila Haile has joined the company as chiefmarketing officer. Haile brings over 15 years of combined agency and corporate experience to Cohen’s, including six years in the opticalindustry, recently as marketing director atClearVision Optical. At Cohen’s, Haile will drive

overall brand strategy and marketing initiatives for the companyand its 130 franchise locations.

Prevent BlindnessPrevent Blindness has announced the election ofKate Renwick-Espinosa, chief marketing officerof VSP Global, to the Prevent Blindness Board ofDirectors, as voted at the organization’s winterboard meeting. Renwick-Espinosa works indevelopment and management of marketingstrategies and programs across the VSP Global

companies, which include VSP Vision Care, Eyefinity, VSP OpticsGroup and Marchon Eyewear. Renwick-Espinosa has served VSPfor 22 years, where she has been instrumental in expanding therole of marketing within the company.

CooperVisionCooperVision, Inc., a unit of The CooperCompanies, has appointed Bob Ferrigno as president, North America, a move which becameeffective in February 2014. Ferrigno has overallresponsibility for guiding the organization’sfuture strategies and direction for the region.The role was formerly held by Andrew Sedgwick,

who was named executive vice president of commercial strategyand business development for CooperVision last year. Prior tojoining CooperVision, Ferrigno was with Becton Dickinson(BD), a global medical technology company, for 32 years. Duringhis career with BD, he held numerous positions with increasinglevels of responsibility.

AdlensAdlens, the Oxford-based company specializingin variable focus eyewear, has promoted DrewOppermann to international sales manager.He has more than 20 years of optical industryexperience, and joined Adlens in late 2011,working on international business developmentwith a primary focus on Latin America. In

his new role, Oppermann will develop European markets forAdlens, adding value by growing strong optical and non-opticalpartnerships in each country. Oppermann has a strong background in international business development. In the 1990s he started an Italian subsidiary for Viva InternationalGroup in Treviso, Italy that became the company’s international headquarters.

Maui JimMaui Jim has announced the appointment of JayBlack to vice president, global marketing.According to Maui Jim, Black’s 17-year career in raising the visibility of some of the world’sforemost brands encompasses the developmentand execution of memorable programs for theglobal spirits manufacturer, Beam, Inc., and

leading worldwide brewer, Anheuser-Busch. He is known forimpactful programs that transformed key brands including 180Energy Drink, O’Doul’s, Tilt, and Bud Extra, the company said.

Richard C. Elias

Robert J. Russo

Gilan Cockrell

Shelia Haile

Kate Renwick-Espinosa

Bob Ferrigno

Drew Oppermann

Jay Black

MOVERS & SHAKERS

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

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foam related injuries per month. “Soap inthe eyes is like an excess of chlorine in aswimming pool,” said Dr. Mell. “But morecommon than eye injuries are falls thatoccur since people cannot see the contourof the floor beneath them which is hiddenby the foam. It is easy for one person, offbalance, to fall into another and before longwe have a six body pile up with enoughinjuries to supply everyone involved.”

Groping was mentioned as an undesir-able side effect during those mishaps.The foam can bring on nausea and vomiting, if swallowed. Furthermore, itadds another slippery area for the partygoers to contend with. This affected area isconsidered a ‘land mine’ by experiencedparty attendees. Emergency room doctorsadmit that they had never heard of foamparties until about 15 years ago. For thosewho work on a college campus it is notuncommon and doesn’t even arouse curiosity. Reporters noted the case offamous actress, Anne Hathaway, who mentioned in the New York Times that sheattended a foam party in college and thathalf the guests had pink eye in the morning.Dr. Mell suggests buying a pair of protectivegoggles and shower caps for your next foam soiree.

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

and chamomile, the tell tale signs of a bathsalt addict. Additional signs would be thatthey may insist on being permitted to com-mit mayhem upon your person. Observersadvise that if you wish to attend a foamparty, do so with a reliable buddy. Therehave also been a large number of reports of participants developing sore throats.

Another problem to be considered is theelectrical equipment that could lead to electrocution by not being properlygrounded. A critical group of studentsadvise that partygoers should be informedof the risks at these parties. They suggestthat drinks come in some form that can beclosed or covered. Considering the fact thatparticipating teenagers may be wearingskimpy clothing and dancing close to oneanother, we can only imagine the results ofthe physical contact that ensues. Adultsupervision can help keep the party fromgetting out of hand. Sometimes the limitedclothing may become a complete lack ofclothing. The teens should be required toremain in the designated party area and not be permitted to wander off into unsupervised areas where sexual conduct may occur.

Furthermore, strict regulation ofalcoholic beverages served on the premisesshould be enforced. Some foam parties arethemed so that the dress will reflect themain topic to be followed. Examples are a

Pirate or Safari theme. A sign on the doorshould list the possible dangers that may beencountered. They see a similarity to claimsof danger from smoking. “List the dangers,”they say, “And let the individuals make ajudgment based on better information.”

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

My neighbor’s daughter was a student atWestern Kentucky University. Sheannounced to her dad that she wished toplan and pay for a foam party. The cost wasmore than she expected. She requested aloan from him saying, “Don’t worry. I’ll payyou back.” He replied, “Don’t worry aboutit. Just work hard, get good grades, and noFoam party drinking or sexual miscon-duct.” “Dad,” she replied, “couldn’t I just pay you back?” �

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The first optometrists in Mozambique graduated in 2013! Photo credit: Mozambique Eyecare Project

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

Highlights:34 students graduated from degree and diploma Optometry programs in Africa12 Schools of Optometry received ongoing and new funding support*2,440 people were given direct training and skills development139,450 children were screened as part of Child Eye Health Programs44,268 people received direct access to eye and vision care

2013 Project Highlights – Your Donations at Work!

To donate visit www.givingsight.org or call 1888 OGS GIVE

* Ongoing funding:

Argentina Cameroon Eritrea Malawi Mali Mozambique Nicaragua Vietnam

New schools:

Haiti Mexico Moldova

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

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

“I am very happy to have finished,” he said. “To have reached a dream of mine, and for my parents.”

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

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

Watch Video

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As a student at the New England Collegeof Optometry, one of my clinical rotationswas called “Mobile Eye Unit.” As a student,I went to different nursing homes in thecity of Boston to provide eye care and toprovide eye examinations to the residentsand the patients. This was a clinical experi-ence which affected me to the point that Ihave been providing the same type of careto the residents of many nursing homes aswell as to homebound patients inNortheastern PA.

When I was a student, I was required tocarry a great deal of heavy equipment inorder to provide the same type of eye carethat would be provided in an office setting.But thanks to computers and modern

portable technology, heavy equipment hasbeen reduced in size and weight. Heavylensometers that used to be transported infoot lockers can now fit inside a briefcase.Small, lightweight Tono-Pen tonometersand portable non-contact tonometers canprovide an accurate measurement of theintraocular pressure.

Hand held trial lenses and a trial framecan provide an accurate refraction.Binocular indirect ophthalmoscopes aresmall and some fit on the face like a pair of glasses. Hand held 20 Diopter lenses canbe used with an ophthalmoscope in orderto check the general health of the eyeincluding the cornea, aqueous, the lens,the vitreous, and the retina.

Taking care of a nursing home patient or a homebound patient is a wonderfulexperience. But, important questions needto be evaluated such as, why is the patientin the nursing home, how long have theybeen in the nursing home, and how longwill they be staying at the nursing home?Many patients come to a nursing home forshort term rehabilitation treatment thatmay require weeks or months of care.Patients who may have suffered an injuryor a broken bone after a fall may requireoccupational therapy or physical therapyfor several months before returning home.Stroke patients may require longer rehabili-tation care depending upon the severity ofthe stroke. A patient may require shortterm care or permanent long-term care.

More serious disease processes and prob-lems such as mild heart attacks will have tobe evaluated by the patient’s family doctoras well as members of the social servicestaff at a nursing home. Rehabilitation forany patient involves diverse processes aswell as many medical services that a nurs-ing home offers. As an optometrist and aneye care professional, I am sometimes askedto intervene on behalf of a patient.

Opticians and ophthalmologists also play a role in a nursing home patient’s care.Opticians will fabricate glasses and oph-thalmologists will be involved when there isa higher level of eye care needed, such aseye surgery. After cataract surgery, it will bemy role to provide post-operative care aswell as to check the refractive status ofthe eyes. It is also my role to coordinate any secondary or tertiary care that a patientmay require. Under most circumstances,cataract surgery can be done in an outpatient surgical center. If the medicalcircumstances are more complicated as inthe case of a medically “unstable” patient ora morbidly obese patient, cataract surgery

OD PERSPECTIVE

Jason Smith, OD, MS

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

Nursing Home and Homebound Eye Care

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E Y E C A R E P R O F E S S I O N A L 39

may be more appropriately done in a hos-pital setting where other necessary medicalprecautions are available.

As an optometrist providing this type ofcare, the eye care needs of every patient arevaried and specific. The needs of thispatient base is very diverse and will dependupon age, medical problems, generalhealth, previous vision problems, as well ascurrent health problems. It is extremelyimportant to involve other medical person-nel as well as family members in order tosolve the problems of the patient. It is alsoimportant to recognize that this is a“stressed” population base. Patients arenow experiencing major change-of-life or end-of-life health problems. Familymembers who are coordinating the care of their parents or grandparents are alsoexperiencing added, new problems that are personal, medical, and financial.

I have been surprised and dismayed attimes when I have been asked to see apatient in a nursing home who may have acomplaint that “their vision is blurry.”Unfortunately, their vision has been blurryfor some time. It is only when medical personnel go through a thorough casestudy that the vision problem is mentioned.Quite often, a patient was supposed to goback to see their eye care professional. Butsomething happened and the appointmentwas missed. Sometimes accidents, injuries,or other disease processes occur that mayhave derailed the plan of having the patienthave their cataracts removed, to have theireye pressures re-evaluated, or to get newglasses. Patients with diabetes need to havetheir eyes dilated every year for preventivereasons. Unfortunately, not everyone isaware that annual dilated exams arerequired. And it is unfortunate that diabeticor hypertensive retinopathy which can betreated with lasers and can prevent moreserious retinal problems sometimes is forgotten or neglected.

It is now my job to re-coordinate thepatient’s vision care and to get them backto their previous eye care professional, ifthat is possible. I often receive phone callsfrom the social service department, from

the physical therapist, or the occupationaltherapist stating that the patient cannot see their food in front of them or they arehaving problems with their therapy. Thereare many times where eyeglasses need to berepaired, broken lenses need to be replaced,or new eyeglasses need to be prescribed.Using trial lenses and doing a trial framerefraction can easily resolve this visionproblem. I have found that keeping it sim-ple is always the best policy. At times, I havehad to prescribe 2 pairs of glasses for thosepatients who are in bed most of the time.Leaning back in bed and looking at the TV will be blurry when looking throughthe reading segment of the bifocal. So thosepatients would be better served with aTV/distance pair of glasses as well as a pair of reading glasses.

In providing this type of care, the eyecare professional must have a high level ofcommunication with the nurses, therapists,social service staff, family members, andother medical doctors. It is important tomaintain any continuity of care with thepatient and any previous eye care profes-sional. In many situations involving thispatient population, it is not possible for the patient to be mobile enough to returnto their previous eye care professional. Thatis why these patients need home eye care ornursing home care. It is important that Icommunicate with any eye care profession-al that there has been a change as to why Iam now seeing them. And I always send the previous eye care professional a copy of my exam findings.

In communicating with any patient,especially an elderly patient, talking slowlyand a little louder may help the patientunderstand their vision problems. Manypatients have hearing problems and mayhave a hearing aid. Charts or models mayhelp the patient understand what therapiesmay be needed. I use an iPad because it islarge and colorful, but any hand helddevice may help with communicationissues. This is a time when “keeping thingssimple” is an important philosophy. Manyelderly patients have multiple medicalproblems and possible cognitive problems.I have encountered many new patients who

do not speak English and have recentlyimmigrated to the United States from manySpanish speaking countries. It may some-times be necessary to have an interpreterpresent or a family member who speaksSpanish to help in the communication during an exam. Compassion is somethingthat all eye care professionals should exhibit, always, for any patient.

For those eye care professionals that are enrolled in Medicare, house calls andnursing home visits can be billed for thistype of service. Many patients have fundsthat are set up to cover incidental expensesand glasses sometimes need to be paid forthrough these accounts or through familymembers who handle a patient’s expenses.Anytime there is a need to bill a patient forglasses or to refer a patient for eye surgery,this information should be pre-approvedby the patient, the nursing home, or by the patient’s family members or power ofattorney.

If you want to provide a worthy servicein the world of eye care, home care andnursing home care is certainly a rewardingand challenging opportunity professionally.You may get some added exercise carryingequipment and traveling to a patient’shome or to a nursing home. You shouldkeep track of gas or traveling expenses tosee if you are entitled to any tax credit. Thisshould be something you discuss with youraccountant and will vary depending uponyour state’s tax laws. This opportunity will provide you with an out-of-officeexperience which will make you appreciatehow fortunate we are to be eye care professionals, no matter how or where you provide your services. �

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KEEP IN MIND that relationships,even business relationships, aremore emotional than intellectual,especially for the patient. She is

there to have a personal need or want fulfilled and to feel good about it. That’salmost completely emotional. It’s importantthat you understand her needs and wantsand to do what you can to provide them.

Start by taking note of her attire and herdemeanor. But don’t prejudge her ability topurchase premium products. Observe hergeneral presence. Is she dressed to the ninesor have cut-offs and flip-flops? Does shesmile or is she aloof? Is she shy or assertive?Observing her will help you begin to get toknow her.

A short personal chat can break the iceand make her feel comfortable. Commenton her wardrobe, hairdo or accessories andask open-ended questions. Then listen, real-ly listen. Not only to what she says, but tohow she says it. Listen to her tone andinflection. Listen for emphasis on wordsand phrases. Are her tone and vocabularyformal? Sophisticated? Casual? Friendly?Chatting with her can make her feel likeshe’s talking to a friend and clue you in onwhat may be appropriate to fill their eye-wear needs.

Then respond with smiles, nods, shortphrases to let her know you are really lis-tening. Be genuine! If you are phony, shewill know in an instant. And use her name!

Patients don’t often feel like they’re important to the staff. So being respectful,considerate and concerned about them sets you and your office apart from yourcompetition.

Make a connection and do it with cour-tesy, empathy, and professionalism. You canreview her Lifestyle Questionnaire together.This is an excellent opportunity to addressmultiple pairs or specialty eyewear and toexplain lens and frame options. Explain toyour customer that it’s generally best todecide on lens style and material beforechoosing a frame. The lenses are the mostimportant aspect of the eyewear and caninfluence the frame choice.

The lens design and material depend veryheavily on how the eyewear will be used.You can explain the pros and cons of eachdesign and material. Concerning design or brand of progressive, you may have yourfavorites. It will serve you to educate your-self on the brands you carry or the mostpopular designs so you can educate thepatient about her choices. Some are eco-nomically priced, some have wider zones,some have less aberration and on and on.

Once the lenses are chosen and it’s timefor the frame selection, you’ll most likelystart with dress eyewear. Explain the besttype of frame as it relates to the lenses.Some facts to point out include

• Smaller, more symmetrical frames arebest for high power lenses

• Drill-mount or semi-rimless frames arenot a good choice for high plus lensesbecause the center will be thicker so thelens edge can accommodate a groove ordrill mount holes

• Drill-mount or semi-rimless frames arenot a good choice for high minus lensesbecause the thick edges will be exposed

• A frame needs a B measurement of atleast 24 mm for a progressive lens. Thismeasurement depends not only on howmuch reading area there will be, butalso on how much lens is left for thedistance zone. The more lens area theframe style will allow, the better.

DISPENSING OPTICIAN

Dee Carew, MLS, ABOM, NCLEC, LDO

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

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

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Once you’ve agreed on the functionalityof the frame, you can focus on the fashionaspect. You can discuss face shape andframe style. Also consider colors to corre-late with wardrobe, skin tone, complexionand preference.

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

When the patient has chosen his dresseyewear, we approach the topic of lenstreatments. Of course, AR is recommendedon every pair and we can offer a fashiontint (if it is in style). If the dress pair is theonly eyewear he is purchasing, we can sug-gest a photochromic lens so he will havesun protection.

Use demonstration materials. Most coating laboratories provide a “donut” or“bullet” lens to demonstrate anti-reflective(AV) coating. These lenses have a circle inthe center that has AR treatment with anuncoated ring around the edges of the lens.This donut lens clearly shows the differencebetween a coated lens and an uncoatedlens.

Another comparison method is to have a frame with one coated plano lens and one uncoated plano lens. When the patientputs on the frame, he sees the differencebetween the lenses. When the dispenserputs on the frame, the patient can see thedifference in the look of the lenses, and can understand the cosmetic benefit ofAR coating.

You can use a Transitions® light box and

lenses to show how Transitions lenses turnunder ultraviolet light. Show the Polarizingeffect with a demo picture and polarizedlenses. There are many and varied ways todemonstrate lenses and lens treatments.Ask your lab reps for demo materials.

When we broach the subject of secondpairs, we are doing our patients a greatservice. There are many situations when asecond pair is beneficial. Oftentimespatients don’t think of getting a pair fortheir hobby or a sun pair or a spare readingpair. Many patients don’t realize that anoccupational lens, such as the Double D,is even available. Or they’ve never heard of special glasses for golf, a loupe or a protective shield with an insert.

Once, again, it’s our job to be proactiveinstead of reactive and to introduce, explainand recommend eyewear that will fill ourpatients’ needs. Just before you discuss thecost of the eyewear, review with the patienther choice of lenses, frame and treatmentsand to finalize the order.

Before the patient leaves, give her a real-istic turn-around time. Of course, it’s betterto overshoot than undershoot. You want tosurprise her with sooner than disappointher with later. Then keep track of the job soyou know how it’s going. You can do this bycalling the lab after a few days or checkingonline if that is an option. If there is adelay, call the patient to alert them and tellthem you will keep them posted on theprogress.

When the job comes in, make sure it’sfinalized carefully. Clean and adjust it andcall the patient to make a pick-up appoint-ment or to invite them to come at their

convenience, however your office works.

Dispense with all the care you gave totheir first visit! Take time to discuss howlovely or stylish the glasses are and howpretty she looks or how attractive he looksin them. Discuss how to use the occupa-tional lens, the golf lens, the variable focuslens. Explain to new bifocal wearers how touse each optical zone. Discuss with new ARwearers how to care for their lenses. Makesure every patient understands and is com-fortable with her or his new glasses.

Be sure to not hover over the patient ashe inspects his new glasses. Be close enoughto adjust, but not so close as to intimidate.Recommend cleaners, cloths and acces-sories for them or for gifts and make surethey have a nice case.

Before they leave your office for the lasttime, offer a percentage-off or dollar-offcoupon to use with their next purchase orsuggest they pass it along to someone elsewho may need eyewear.

Invite them to come back anytime for acomplimentary cleaning and adjustment.Invite them to visit your website to learnmore about eyecare and to see the latest in eyewear. Suggest they follow you onFacebook to keep up on what’s new andfun at your office. And thank them forcoming to you for their eyecare and eyewear needs.

Words such as “Personal”, “Individual”,“Special” and “Unique” are key to providingexcellent customer service and to nurturinga solid optician-patient relationship. Thiswill ensure that your patients will returntime after time to seek your expert adviceand fashion consultation. �

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ADVERTISER PAGE # PHONE # WEB SITE

ABS Smart Mirror 23 888-989-4227 www.opticvideo.com

Baby Banz 11 877-333-0074 usa.babybanz.com

Briot 28 800-292-7468 www.briot.com/usa

C&E Vision Buying Group 13 800-346-2626 www.cevision.com

CNS Frame Displays 23 877-274-9300 www.framesdisplays.com

Coburn Technologies 29 800-262-8761 www.coburntechnologies.com

EAG Labs 36 888-EAG-3696 www.eaglab.com

Eyevertise 37 847-202-1411 www.eyevertise.com

Fatheadz Eyewear INSIDE FRONT 800-561-6640 www.fatheadzeyewear.com

FEA Industries 15, INSIDE BACK 800-327-2002 www.feaind.com

Grimes Optical 43 800-749-8427 www.grimesoptical.com

icare-usa 17 888-422-7313 www.icare-usa.com

i-see optical 19 800-257-7724 www.iseelabs.com

Luzerne Optical 5 800-233-9637 www.luzerneoptical.com

ADVERTISER PAGE # PHONE # WEB SITE

My Vision Express 44 877-882-7456 www.myvisionexpress.com

National Lens 31, 41, 45 866-923-5600 www.national-lens.com

Nellerk Contact Lens Cases 44 607-748-2166 —

Opticom 21 800-678-4266 www.opticom-inc.com

Optogenics 33 800-678-4225 www.optogenics.com

Optometry Giving Sight 37 888-0GS-GIVE www.givingsight.org

Prevent Blindness 42 800-331-2020 www.preventblindness.org

Rudy Project BACK COVER 888-860-7597 www.rudyprojectusa.com

Santinelli International 27 800-644-3343 www.santinelli.com

Tech-Optics 44 800-678-4277 www.techopticsinternational.com

Three Rivers Optical 24, 25 800-756-2020 www.threeriversoptical.com

Trevi Coliseum 9 866-923-5600 www.national-lens.com

US Optical FRONT COVER, 22 800-445-2773 www.usoptical.com

Vision Systems 43 866-934-1030 www.Patternless.com

Advertiser Index

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To advertise, call 800.914.4322,or visit www.ecpmag.com

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Assistant Professor - Vision Care TechnologyCUNY NYC College of Technology

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

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

Performs teaching, research and guidance duties in area(s) of expertise. Shares responsibility for committee and department assignments includingadministrative, supervisory, and other functions.

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

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

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

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

JOB SEARCH CATEGORY: CUNY Job Posting: Faculty

EQUAL EMPLOYMENT OPPORTUNITY: We are committed to enhancing our diverse academic community by actively encouraging people with disabilities,minorities, veterans, and women to apply. We take pride in our pluralistic community and continue to seek excellence through diversity and inclusion. EO/AAEmployer.

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