eyecare professional - september 2009 issue

September 2009 • Volume 3, Issue 21 • www.ECPmag.comSeptember 2009 • Volume 3, Issue 21 • www.ECPmag.com

THE COOLEST IN FALL EYEWEAR / PAGE 6 RUNNING AN EFFICIENT LAB / PAGE 18

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High quality photochromic monomer - Mid-Index (1.56).In-Mass technology. Lighter than polycarbonate.Excellent value for the money.

High performance photochromic monomer - Mid-Idex (1.56).In Mass technology. Superior tensile strength.UV cut-off improved.

High performance photochromic coating for high indicesand polycarbonate - Coating technology - 100% UVA/UVB blockage.Ideally suited to high-end lens designs.

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Photochromic diversity ...up to your wildest ophthalmic dreams !

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Courtesy ofR

evolution Eyew

ear

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

SECOND GLANCE ............................................................................................32

ABO PREP..........................................................................................................38

ADVERTISER INDEX .......................................................................................44

INDUSTRY QUICK ACCESS ............................................................................47

LAST LOOK .......................................................................................................50

NEW RELEASES FOR THE FALLKeep your practice fashionable this season with the latest in eyewear and sunwear.by Amy Endo, ABOM, CPOT

RECLAIMING CONTACT LENSESContact Lenses were once a large part of an Optician’s dispensary,and they can be again.by Warren McDonald, PhD

THE ART OF LENS TINTINGTinted lenses offer various colors, design options, and benefits to your patients.by Judy Canty, ABO/NCLE

RUNNING AN EFFICIENT LABProcess your Lab orders quickly and efficiently and maintain a successful practice.by Timothy Coronis, ABOC-NCLE

ALL ABOUT ARAnti-Reflective Coating is the ideal product to help your patientsand increase your bottom line.by Carrie Wilson, BS, LDO, ABOAC, NCLEC

WWW.YOURPRACTICE.NOWStart an internet presence and ensure your practice doesn’t followthe Yellow Pages into obscurity.by Lindsey Getz

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SEPTEMBER2009

Vol. 3Issue 21

Features

Departments

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On The Cover:ARCH CROWN800-526-8353 www.ArchCrown.com

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Publisher/Editor . . . . . . . . . . . . . . . . . . . . . . . Jeff Smith

Production/Graphics Manager. . . . . . . . . . . Bruce S. Drob

Director, Advertising Sales . . . . . . . . . . . . Lynnette Grande

Contributing Writers . . . . . . . . . . . . . . . . . Thomas Breen,

Judy Canty, Dee Carew, Harry Chilinguerian, Timothy

Coronis, Amy Endo, Bob Fesmire, Elmer Friedman, Lindsey

Getz, Jim Magay, Warren McDonald, Anthony Record,

Ted Weinrich, Carrie Wilson

Internet Coordinator . . . . . . . . . . . . . . . . . . . . Terry Adler

Opinions expressed in editorial submissions contributed to EyeCareProfessional Magazine, ECP™ are those of the individual writers exclusivelyand do not necessarily reflect the opinions of EyeCare Professional Magazine,ECP™ its staff, its advertisers, or its readership. EyeCare ProfessionalMagazine, ECP™ assume no responsibility toward independently contributededitorial submissions or any typographical errors, mistakes, misprints, ormissing information within advertising copy.

ADVERTISING & SALES(215) 355-6444 • (800) [email protected]

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 3 Number 21TrademarkSM 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.

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

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.

Purpose: EyeCare Professional Magazine, ECP™ is a publication dedicated to providing information and resources affecting thefinancial well-being of the Optical Professional both professional-ly and personally. It is committed to introducing a wide array ofproduct and service vendors, national and regional, and the myriad cost savings and benefits they offer.

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

Copyright © 2009 by OptiCourier Ltd. All Rights Reserved

EEYECAREPROFESSIONALMagazine

Let AR Reflect on your Bottom Line

Editor / viewby Jeff Smith

4 | EEYECAREPROFESSIONAL | SEPTEMBER 2009

There are three general components to every lens: the material it is madeof; the style or type of correction; and coating. Virtually every lens has allthree, and each is important in delivering clear, comfortable vision to thepatient. Most ECPs are comfortable with the first two, and do a pretty

good job of recommending appropriate products. However, all too often, thethird... coatings... is left hanging.

Don’t believe me? The numbers speak for themselves. According to a recent VisionCouncil survey, only 29% of U.S. eyewear featured AR Coating, compared to over50% for the rest of the world (see Carrie Wilson’s article on pg 22 for more info).

Not too many years ago, the only coatings readily available were UV protectionand scratch coat. With polycarbonate, and later many of the high index plasticlenses, these were either unneeded or considered a relatively expensive option.Unfortunately, that caused the development of an attitude of presenting theseoptions as not really necessary, if at all.

When AR was first introduced, there were several problems associated with it thatgave the coating a bad reputation. They were prone to crazing (thin cracks), cra-tering (pits), and even peeling. They were difficult to clean and delicate, so specialattention when cleaning the lenses had to be observed to avoid scratches. Advancesin coating chemistry and manufacturing have all but eliminated these problems,and in some cases have exceeded the characteristics of even the best lens materials.

The benefits of the coating are obvious when compared to a non-coated lens. Thecoated lens appears cleaner and clearer, in most cases dramatically so. Because lit-tle of the light is reflected back, the lens appears to disappear, and with the properframe selection, the appearance of wearing glasses is almost eliminated.

Another benefit, perhaps the most significant to the patient, is not so obvious untilthey actually wear the lenses. Because more light passes through the lens withoutbeing reflected off, overall vision is improved. Colors are more vivid, contrast isimproved so reading is less tiring, and low light vision is improved.

One of the keys to presenting these rather complex coatings is to keep the presen-tation simple, use language the patient can relate to, and take advantage of anydemonstration aids you might have available. Of course, if you wear eyeglasses,they most certainly should have AR on them.

Wouldn’t it be nice to be able to offer your patient clarity, cleanability, and scratchprotection with warranties that often cover all instances for up to two years? So,how do you sell premium AR? Simple: tell them the benefits!

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1. KliikKL-401 is a rectangular full rim metal frame featuring softbrush strokes on the temples. With the addition of colors suchas Brown Pumpkin, Khaki Lemon, Black Turquoise and PurpleDemi, this frame clearly brings out the wild and stylish traitsof the petite frame wearer. KL-403 is an acetate rectangularframe featuring a laser cut, wood carving motif on the templesthat creates a three dimensional effect. This model is availablein 4 earth tones; Brown Fuchsia, Taupe Teal, Caramel Purpleand Grey White. www.kliik.com

2. Allison USAThe Moschino MO57002 is an acetate frame that has a threecolor combination, the front is Black, the outside of thetemples is Red, and the inside of the temples is Leopard print.This sunglass is also available in a solid Black color and solidlight Havana color. Again this is exhibits Moschino’s twist onthe retro look. www.allison.it

3. BBH EyewearThe new Humphrey’s Collection features an array of dazzlingcolor-contrasts, including a stainless steel look with richly-contrasting galvanized finishes inside and out. The acetatesides, rich in detail, have a fashionable two-color wave designfor every personality, from a sophisticated black-silver to afunky violet-pink. The decorative flame designs boast a starklycontrasting yet harmonious symphony of colors.www.bbheyewear.com

FALL IS FINALLY IN THE AIR, and what bettertime to keep your practice current with the season’smost exciting new releases. Look for an assortmentof eyewear companies and offer a variable price range that is appropriate for most of the clientelewho grace your practice.

Fall New

Releases1

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4. Fusion EyewearSJP125S is one of the 13 new sun releases from Jean Paul

Gaultier, the 1980s-style model made entirely of continuousmetal threads. The end pieces join onto the temples by

means of a trim stud with Swarovski crystals. The openmetal temples are particularly light in design, giving a sense of

elegant movement. Available in Gunmetal Grey, Matt Black,Bronze and Palladium, with contrasting lenses.www.fusion-eyewear.com

5. Revolution EyewearTrue Religion’s “Jesse” is a unisex, modified aviator shape that features leatherette wrapped temples and top bar. Pictured isthe “Jesse” in beige with a brown flash gradient lens. The“Jesse” also comes in Black with a Grey lens, Gold with a Goldflash gradient lens, Gunmetal with a Silver flash gradient lens,and Rose Gold with a Rose flash lens.www.revolutioneyewear.com

6. TuraLulu Guinness model L497 “Evie” is a feminine modified ovalfront with Lulu’s identifiable initial metal décor on the tem-ples. “Evie” features Lulu’s classic polka dot pattern on theinside on the temples. For the Glamour girls that desire to beall the more noticeable, model L497 is available with the polkadot pattern on the outside of the temples. Available in eyesize56 x 16 x 130 and in colors: Black, Teal, Tortoise and Blackwith polka dot temples. www.tura.com

7. Viva International GroupFeatured in the women’s optical collection are GU 1602ST andGU 1603ST, showcasing sleek plastic temples that seamlesslyblend into metal endpieces, creating a fluid design. A raised“G” logo adorned with glistening crystals completes the lookof this innovative metal detail. GU 1602ST features a soft rec-tangular front in full plastic, while GU 1603ST features a fullmetal front in a satin finish, also in a soft rectangular eyeshape.www.vivagroup.com

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Marcolin

This ultra sexy style from Roberto Cavalli has a tastefuldesign and modern feel that is perfect for women of all ages.The intriguing, open cut lens transitions into a smooth circu-lar end piece, where you can see the Roberto Cavalli mono-gram encrusted with white rhinestones. The RC 457s is alsoequipped with signature RC adjustable nose pads, for addedcomfort and a better fit. www.marcolinusa.com

LBI

ST. MORITZ Ice 220 is the favored frame for feminine funand fantasy. It features a full-suspension stainless steel andnylon wire front, and the décor is an intricate combination of rhinestones and sparkling motif suggestive of a butterfly.Available in colors Ebony, Grey and Rose, Ice 220 also features soft nose pads and is provided in size 54 x 18 x 135.www.lbieyewear.com

Enni MarcoEnni Marco style IV 01430 issimple, but never boring.This is weightless metalframe with zyl temples thatfeatures striking white con-trasted with red color combi-nation temples, and perfectedwith contemporary metalplate embellishment.www.ennimarco.com

ProDesign

Introducing the elegant and exclusive ZENSE frame with aspecial hinge, which means that you rotate the temples tofold it. The front itself is quite classical in shape, the templesare slender and the long end tips are made of rubber in terrific colors. Rubber attaches well to the skin so that theframe is held in place, even in very hot weather. There are 4models in four colors each, and they are suitable for progres-sive lenses (7342-45 shown). www.prodesigndenmark.com

Luxottica

The new Tiffany Sunburst TF 2011B features a dazzlingintensity that is achieved with a dramatic sunburst that is cleverly incorporated into the hinge mechanism of rectan-gular frames. The Tiffany & Co. varnished logo appears ontemples, with ‘T&CO.’ logo plaque on the inside. Colors rangefrom Black and Dark Havana to Pearly Pink.www.luxottica.com


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UltraPalm

The Caviar 1706 is a bold modern design exclusively from the Caviar Collection featuring an open end piece with allhand set crystals. The 1706 is simply a stunning frame and is available in colors: Gold and Brown.www.ultrapalm.com

EyeQ Eyewear

The Apollo Collection continues its successful fitting andstyling concepts, featuring fuller eyesizes, larger bridges withincreased flair, and longer temples. The Apollo 147 is a complimenting oval shape with a dazzling temple treatment.www.eyeqeyewear.com

Live Eyewear

Low Vision Cocoons® are designed to be worn over prescrip-tion eyewear and are available in four absorptive filters;Boysenberry, Hazelnut, Lemon and Orange. The filters feature a balance between contrast enhancement and glarereduction to maximize visual acuity in a variety of light conditions and daily applications. Each tint filters 100% ofdamaging UVA and UVB light. Low Vision absorptive filtersare available in all sizes of Cocoons and include a limited,lifetime warranty. www.cocoonseyewear.com

MarchonPoised and refined, the S845 from Coach is a double laminatezyl, emblazoned with gleaming Swarovski crystals to form around Coach logo while revealing a rich layering of color. It is

available in five charming tones of Black, White, TortoisePlum and Tangerine. www.marchon.com

Gripping EyewearParis Hilton makes her debut in the eyewear category with aclassic, oversized white/crystal frame detailed with elegantfashion forward quilting on the temples. This sensational sun

sports a Tinkerbell magnetic icon embedded in the temples.Distinctly feminine flowing with the popular trend ofgradient lenses...the blue/pink lenses are a reflection ofParis’s personal palette and keen sense of design.www.grippingeywear.com

Whether your patient is looking for a new pair of trendy,elegant, conservative or durable glasses, show them your sampling of new releases. By providing their dream of bothgreat customer service and a superb quality product, they willcreate word of mouth referrals. Add to that the capability tofully tailor your glasses based on their correct needs, andyou’ve got a recipe for success and loyalty for years to come.

Amy Endo, ABOM, [email protected]


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The 21st Century OpticianWarren G. McDonald, PhD

Professor of Health AdministrationReeves School of Business / Methodist University

CONTACT LENSES:The Optician’s Role

PROFESSIONAL JOURNALS are filled withOpticians articles, and many of the country’s bestlecturers on contact lenses are Opticians. Why thendo Opticians in most places around the country not

fit contact lenses on a regular basis? This article addresses con-tact lenses as an opportunity for Opticians, and will attempt toobjectively describe how Opticians can reclaim some of thecontact lens marketplace relinquished to ODs in the 1970s.

Demand

Is there still a demand for contact lenses? Many see the marketas declining or at best remaining static, so why even be con-cerned about it? Many practitioners see Lasik as a cash cow, andlimit their involvement in contact lenses to easy, simple fits and

even tell patients they cannot wear lenses if the first attempt doesnot go as planned. This leaves a huge void. There are thousandsof patients who still are fearful of surgical correction and wantto wear contact lenses. They may now be presbyopic, which inthe past was a concern, but today there are many different vari-eties of lens choices to meet their needs, if the savvy practition-er simply takes the time to work with each patient as an individ-ual. It will take chair time to find the appropriate design, but itcan be done. Opticians can provide those services.

Many people are not aware of gas permeable designs today. Inmany schools and colleges of Optometry, we understand fromcolleagues that they are not gaining experience in the fitting ofgas permeable lenses. For that reason, soft lenses are recom-mended as the best alternative. In reality a more rigid (Iknow....not a pc term today, but I felt this term would provideemphasis for descriptive purposes) design would actually pro-vide the best vision.

These are but two examples; there are others. The point is thatthere is a demand, and as our OD colleagues move to a moremedical model, Opticians can work to fill the void in contactlenses.

Lens Design

Specifically, there are a number of lens designs that providetremendous opportunities in the opinion of this author. Let’stake a look at several of those.

Multifocal/Bifocal Designs

There are a plethora of multifocal/bifocal designs on the mar-ket today, so a specific lens design will not be mentioned. Theyinclude Soft lenses, Gas Permeable lenses, Silicone-hydrogellenses, all with the ability to correct presbyopia. The baby

In year’s past, Opticians played a major role in the fitting and dispensing of contact lenses in most places in the US. Clearly some

of the nation’s best contact lens practitioners are Opticians.

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boomers, many of whom grew up wearing contact lenses, donot want to hear that they must now wear spectacles because ofpresbyopia – and they do not have to any longer. Opticians canhelp these people solve their visual problems.

A caution – fitting these, and any specialty design, takes time. Ifyou cannot commit to spending significant time with thesepatients, then do not undertake the case. Also, do not think onesize fits all. You would be wary if a contractor came to buildyour house with only a hammer and nails, and you must havea number of lens designs and types in your “tool kit.”

CRT/Advanced Ortho-K

Corneal Refractive Therapy (CRT) www.paragoncrt.com is analternative to refractive surgery. It is a lens that is worn during sleep that gently reduces myopic correction and hasproven itself over the last several years as safe and effective. Infairness, this author served as a consultant to Paragon VisionSciences, the developer of CRT, but has not had an involvementwith them for several years. Paragon has a certification programthat is a requirement to fit and dispense these devices.Take the course, and see what a great addition CRT can be toyour practice.

There are other advanced Ortho-K designs as well. The WAVEsystem is an example www.wavecontactlenses.com. The computer-assisted lenses utilize existing materials to provide asimilar alternative to refractive surgery.

Bausch and Lomb www.bausch.com/en_US/ecp/visioncare/product/general/ortho_ecp.aspx also has a number of selectlens designs that combine to form their Vision ShapingTreatment. You will find their system works equally well, and istime proven.

All of these lenses/devices allow for reduction of myopia, andsoon will be utilized for the correction of additional opticalanomalies. They can be fit by Opticians with the specific equip-ment required, and in the correct clinical environment.

Post-Refractive Surgery/Irregular Corneas

The post-refractive surgery contact lens is something we needto learn more about. Many lens designs are now readily available from a variety of sources, and provide excellentopportunities to assist those who are not pleased with theirrefractive surgery outcomes, or with irregular corneas. I knowthe surgeon on your block is probably the latest and greatest,but according to a variety of sources, there are a percentage ofpatients we can help with these lens designs.

Examples

SynergEyes www.synergeyes.com is a hybrid lens design with a

gas permeable center, and a soft lens skirt. It allows for fitting ofmany complications including corneal scars, grafts, PMD,Kerataconus and others.

Lens Dynamics www.lensdynamics.com offers the Dyna-ZIntra-Limbal lens for irregular corneas. It is an example of themini-scleral lens mentioned above, and is one that is well rec-ognized for great comfort and has a proven history.

Education and Training Requirements

Here lies the problem. Opticians must undertake moreadvanced education and training requirements to successfullyand safely fit contact lenses on a large scale. Great understand-ing of the technical aspects of fitting is important, and mustinclude course work on anatomy and physiology. Most ofthe schools of Opticianry include those courses today, butunfortunately most Opticians do not attend a school, but aretrained in woefully inadequate “apprenticeship” programs thatin reality provide little training and education to these future“professionals” We must do better!

In a study conducted by this author, only 40% of respondents(n= 200) fit contact lenses actively, but in reality many of thoseonly dispense boxes of disposables to patients, or help do inser-tion and removal. The true number is left unknown, but is suspected to be small. It can grow, however!

The study population indicated that they felt Opticians shouldassume a greater role in the fitting of contact lenses. 69.5%strongly supported the idea, while 9% felt Opticians should notfit contact lenses at all. 20.5% were neutral. This indicates thatOpticians do want to do more in the area of contact lenses.

Next Steps

What do we do? It appears there is no one out there seeking toreview and advance the professional activities of Opticians.What needs to happen is two-fold. First, we must educate andtrain Opticians to assume a larger role as a contact lens practi-tioner. It will not happen overnight, but one thing I can tellyou, it will never happen if we do not take the initiative.

Second, we must develop leaders in professional organizationswho respect education themselves and will seek to expand therole of Opticians beyond the boundaries that currently exist.

Conclusion

It is imperative that we, as a community of professionals, stepup to the plate. We must strive to do more, and reach for greaterheights. Contact Lenses are a part of our past, and we mustmake them a larger part of our future. I encourage you to inves-tigate how you can play a role in contact lens advancement. ■

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53 Brown Ave., Springfield, NJ (800) 672-1096www.21stcenturyoptics.com / www.quickcareframerepair.com

Xtreme AR™ is a registered trademark of 21st Century Optics. Crizal, Crizal Alizé, Crizal Avancé are registered trademarks of Essilor International.

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TintsONCE UPON A TIME, tints were easy. The lens material wasglass and the choices were pretty basic...

✓ Clear ✓ Pink ✓ Yellow ✓ Green ✓ Grey

Clear for everyday use and of course for night driving. Pink ifyou worked in an office with fluorescent lighting or for post-cataract eyeglasses. Yellow for the sportsman. Green or grey foryour sunglasses, if you wore them. Life was simple.

And then the Pittsburgh Plate Glass Co. gave us CR-39(Columbia Resin 39).

I like to think that Sunshine Somebodyorother was tie-dyingsome t-shirts when her brand-new, lightweight plastic lensesfell out of their frame into the dye and voila! Custom tintedlenses were born! We could literally look at the world throughrose-colored glasses, or purple-tinted lenses in a round metalframe, a la John and Yoko. Our Mothers were coming homefrom the Opticians with “blue on the top and pink on the bot-tom” cool new lenses. Life just got a little less simple, at leastoptical life got a little less simple.

The tint you can’t see for the light you can’t see

Ultraviolet light is not a good thing for eyes and skin. It makesthings deteriorate, or degenerate as in age-related maculopathy(ARM) or macular degeneration. It can make things grow, likecataracts, pterygium or pinguecula. All eyes should be protect-ed from UV damage, even patients with UV-absorbing lensimplants. That’s right! Grandma needs sunglasses too!

Certain medications can make us more susceptible to UV dam-age, including sulfanomides, tetracyclines, diuretics, tranquiliz-ers and oral contraceptives. Although the questions are sensi-tive, we need to know about these things when we’re designingthe perfect lenses for our patients.

If you can’t see the tint, how do you know it’s there? Simplycover a plastic photochromic lens with the lens in question andexpose it to sunlight. If the photochromic lens darkens, there’snot enough UV protection on or in the lens. Use the same testto prove to your patients that cheaply made sunglasses maylook good, but can be bad news for their eyes.

Choose the right tint for the right use

Pink was once the color of choice for post-cataract glasses andfor office workers sensitive to fluorescent lighting. It does notaffect the colors seen through it. Currently, pink (rose, flesh)tones are popular for cosmetic tints while the preferred treatment for glare control is the application of an anti-reflec-tive coating.

Yellow is arguably the most controversial of tints. Many long-distance drivers swear by their yellow tinted lenses for comfortand increased visibility at night. However there are no definitivestudies that draw that conclusion. Most studies report thatthere is no increase in visual acuity through yellow lenses, infact visual performance is slightly worse than through no filterat all. In certain circumstances, a yellow lens can darken a bright

Dispensing OpticianJudy Canty, ABO/NCLE

Let’s Talk

Tints

UV Index(US Weather Service,

Environmental ProtectionAgency, World Health

Organization)

Exposure Level

0 1 2 Low3 4 5 Moderate6 7 High

8 9 10 Very High11 and greater Extreme

16 | EEYECAREPROFESSIONAL |SEPTEMBER 2009Photo: Courtesy of Transitions Optical, Inc.

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blue sky therefore increasing the contrast and making some thingseasier to see, like perhaps your golf ball in the deep rough. A tint-ed lens of any color, yellow or otherwise is never recommend-ed for night driving. The reduction in visual acuity (20/20 to20/32) in dim light is significant enough without further reduc-ing acuity (20/46 behind a tinted windshield at night) byadding even a slight tint (20/46 to 20/60 at night behind a tint-ed windshield with an 18% tint).

Green lenses transmit light on a curve that is very nearly thesame as the color sensitivity of the eye. For many years it wasthe color of choice for sunglasses, beginning with sunglassesmade for the military. Green tinted glass lenses demonstrategood absorption for both UV and IR rays.

Gray, or Grey if you’re British, is the most popular color tint forsunglasses. It does not distort the colors seen through it and isconsidered a neutral color. It is also the preferred color for people with red-green color deficiencies, since the ANSIrequirements for sunglass and cosmetic tints are related to traffic-signal recognition. Interestingly, brown and yellow lensesdo not meet the ANSI standards for non-prescription sunglasslenses, but are readily available in prescription lenses. A normalperson will not be troubled by those colors, but a color defectiveperson (red-green color deficiency) would not be able to correctlyidentify traffic signals. That’s another piece of valuable informa-tion, like medications, that you should get from your patients.

Brown is a very popular sunglass tint in Europe. Brown tintsshare some of the same qualities as yellow tints, in that itreduces the transmission of blue light and enhances contrast onbright or hazy days.

Interestingly, the majority of “sport-specific” lens tints fall intothe yellow-orange-brown family of colors, some polarized,some not. These particular families of colors filter blue light toenhance acuity and contrast. All are either polycarbonate orother mid- to high-index materials for safety.

Is it me, or do all those sport-specific tints have odd names?Some days, I miss Gray 88 or G-15.

To polarize or not to polarize, that is the question

For the vast majority of wearers, polarized lenses are the bestsun/glare protection available. They reduce fatigue while driv-ing, reduce glare from water and snow or ice and they blockUV. However, there are situations where polarized lenses cancreate hazardous situations.

✓ Some wearers may be sensitive to the stress patterns on car windshields. Polarized lenses may enhance thosepatterns, which are similar to the “cross” patterns seenon tempered glass lenses when viewed through a polariscope.

✓ Skiers who turn and lean may find that their ability tojudge the constantly changing surface of the snow.Think black diamond, trees and ice patches at speedstopping 100mph.

✓ Golfers may find it difficult to judge the condition of acourse. That’s probably why pro golfers seem to be wear-ing their sunglasses on the backs of their hats.

✓ Pilots may encounter several different problems withpolarized lenses:

• Polycarbonate windshields may display distract-ing stress patterns

• Some cockpits may have polarized displays whichmay disappear with polarized lenses.

• Horizontally reflected light from oncoming air-craft is eliminated and the aircraft may not be seenas soon as it should be.

So polarized lenses are the best sunglasses for glare reductionand comfort, except when they’re not.

Finally, tints can be fun and they can be necessary. The key tohelping our patients decide which lens, lens tint and/or lenstreatment is to ask the right questions including medications,hobbies, occupation and driving habits. Our function as eye-care professionals is to know which combination of material,style, tint and treatment will satisfy those requirements. ■

Primary Function and Shade Light Transmittance

A cosmetic lens or shield (light) More fashion than function

Transmission of greater than 40%

A general purpose lens or shield Normal sunglasses

Transmission of between 8% and 40%

A special purpose lens or shield (very dark) Very intense light Transmission between 3% and 8%

A special purpose lens or shield (strongly colored)Filters specific spectral colors

3% minimum transmission

—from ANSI Z80.3-2001

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OUTSIDE, IT WAS A SUNNY DAY. White clouds were slowly inching across the blue sky. Inside, the office wasrunning like a well-oiled machine. There were routine

exams, complicated exams, and walk-ins.

Each patient was being handled. Complex eyeglass orders wereplaced aside, to be ordered when things settled down to a simmer. For now, rush jobs were the priority. Red trays enteredand left the in-house lab smoothly and easily. The staff was notso much hurrying as buzzing. It looked kind of effortless.

From the front, a patient began to raise his voice. “If I’d knownthis, I wouldn’t have waited,” said the patient, and soon he wastalking with the office manager. Following some activity at theback, a red tray briefly left the lab, was scrutinized, and went back in. Apparently it had been forgotten, or promised,depending on whom you asked.

Lens technology is moving forward at a quick pace, and lensesare becoming increasingly complex. For the most part, top tierlenses are no longer fabricated in-house. More often, we are edging them in-house. There’s still one area in which we can stillprovide eyeglasses quickly.

There are several things you can do as a team to contributetoward the success of your on-site finishing lab to consistentlydeliver the rush job ahead of schedule.

Do promise jobs clearlyThis is what went wrong at the top of the story. The smoothflow of the day was interrupted in a screech. It wasn’t laziness,carelessness, or forgetfulness, but inconsistency. For example, ifyour lab staff agrees to edge the job “by three o’clock,” don’t tellthe patient, “any time this afternoon.”

Do askIt’s always more effective to ask your lab staff what they can do.Asking gives you an opportunity to say what you need, andgives the lab an opportunity to tell you what they can do. Takea page from reception policy: when doctors take emergencywalk-ins, it puts everyone behind, so reception lets the nextpatients know there will be a longer than usual wait. Ask the labif they are on schedule. Sometimes, you’ll receive finished jobssooner than expected, and other times there may be manyincoming jobs or an emergency job. Always find out what toexpect for turn around times.

Do under-promise and over-deliverThe law of the lab is to under-promise and over-deliver. Thefirst prerequisite for working in the lab is comfort in a place ofshifting priorities. Jobs flow in a random pattern. In constantchange,“under- promise and over- deliver” is the only constant.It has avoided and resolved countless problems.

Do let the lab own the trayOnce you deliver a tray to the lab, let them own it. I onceobserved a dispenser taking a frame out of the tracer to copyframe numbers and colors. Although those lenses weren’t beingedged at that moment, the frame was “on deck,” and moving itfouled up the lab’s system. Don’t bring it to the lab until you’reready to let them own it.

Follow the protocolThere’s an after hours rush job. It might seem like a time saverto scribble axes on the lens envelopes, and throw them in thetray. But ask yourself how much time this really saves. Now con-sider how many mistakes could result from going about thingshalf cocked. Doctors don’t write their charts on scraps, andappointments aren’t scheduled on scrap paper. Your officealready has a protocol for doing things, and it was established topromote efficiency. Follow it 100% of the time.

Lab CornerTimothy Coronis, ABOC-NCLE

How to Run an Efficient Lab

Photo: C

ourtesy ofFEA

Industries,Inc.


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Do be completeEverything is signed, dated, and all fields are completed? Beingcomplete is not only professional; it makes your edging requestcarry more weight. Incomplete orders can be a big problem.Material, frame, PD, segment heights, and AR all need to beclear. Rush jobs are for busy time, and that’s the worst time totry to track down a busy dispenser to get a measurement, or tofigure out why the invoice says 1.67, when polycarbonate lens-es are in the tray. (see below)

Do showA co-worker stood out. He brought trays to me and wouldpause and say, “Here are your frame and lenses. How soon canI have them made?” He approached me this way every singletime, whether the office was busy or slow. Don’t dismiss thisformality. It gave us a helpful moment to look at the materials(frame and lenses). Cut out problems were avoided, remakeswere reduced, thick enough lenses were ordered for grooving,and wrap optics were improved. (Thanks, Erik)

Don’t cry wolfFinding out that hour job you asked for wasn’t really neededright away can be discouraging to your staff. You want them totake your rush jobs seriously, so pick and choose them and youcan be firm the next time you need something pronto.

Do assistIf you are able to pitch in without disrupting the flow, the nexttime you have some down time, see if you can spot someincoming lenses, and verify a few finished jobs. Sometimes a lit-tle help with even a few jobs makes all the difference in theworld to a maxed-out lab. The key here is to not disrupt theflow out back or the coverage out front.

Don’t jump the gunIt’s true that good customer service means exceeding customerexpectations. But is it really necessary for each job to be anhour job, or might it be wiser to evaluate each situation?There’s an art to exceeding customer expectations on one hand,and under-promising on the other. It usually is possible to keep

all parties happy. The key is not responding automatically.Glasses needed by the end of the week? Maybe you can prom-ise them for tomorrow. If they want them tomorrow, considerpromising for later on today. Patient needs them today? Wowthem with one-hour service.

Don’t assumeTrays seem to be piling up in the lab? Maybe they’re standingstill because other trays are moving out. Your lab staff is aware,too. Edgers only grind one lens at a time. In order to edge anyjob, other jobs have to wait. It only makes sense. The lab is upto their elbows in work, and won’t be able to get your rush jobdone quickly? Maybe they are prioritizing, and are letting non-rush jobs pile up. When we are all busy, it can be hard to readour co-workers, so it’s important to not assume.

Do appreciateLab staffers are there because they like what they do. They cravechallenges and thrive on multi-tasking. They want to get thehighest priority jobs finished and approved the soonest. Yourlab staff likes challenges. The best challenges usually are thosegiving the best optics with the least compromise.

Show interestBe considerate. Instead of saying “I only want to know if a standard lens will work,” listen to your lab staff ’s suggestion ofthe proper way to do things. Otherwise, you are sending themessage that you just want to get through things. The lab wantsto help when a lens is problematic and falls out of the frame.This is why they suggest the right material choice, such asaspheric high index for high plus. Lab staffers have a hands-onappreciation for lens form, and thickness. You might not beable to take their suggestion every time, but it’s important tohear reasonable advice. Polycarbonate lenses might be best fora particular grooved job to avoid chips, flat high index lensesmight be incompatible with a curved frame, and a thickerframe might cover lens thickness and conceal the effects ofprism in the Rx. You can take lab tips like these and turn theminto dispensing tips in the future, so don’t dismiss them. ■

SEP2009.qxd 8/27/09 10:04 AM

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ANTI-REFLECTIVE (AR) COATING is commonly seen on anECP’s glasses, but not seen as often on the lenses of theirpatients. According to the Vision Council, only 28.5% of eye-wear dispensed in the United States in 2005 had AR coating onthe lenses. This is far behind the foreign market rate of 50% to99% penetration. Why is this? Common reasons may be theECP is wary of the new coats due to past failure rates of ARcoatings, an incomplete understanding of the way AR worksand the benefits it provides, or they are unsure how to presentthe product to the patient in an effective way.

What is Anti-Reflective Coating?

Anti-Reflective (AR) coating is a series of layers that is adheredto the back and front surface of a lens, or just the back if the lensis polarized, to help reduce the amount of reflections on thelens. Consisting of metal oxides, each layer is a thin film that isdesigned to block a specific wavelength of light. The more lay-ers of film, the more wavelengths that are blocked. Working bythe destructive interference, AR causes the light that reflectsfrom the inner and outer surfaces of each film layer to becomeequal, thereby canceling each other out.

Coatings of Today

Gone are the days of single layer AR coatings that craze,scratch or smudge easily. Today’s premium AR coatingshave extra hard coatings that increase its scratch resistance,as well as oleophobic, hydrophobic and anti-static layersthat help repel oil, water, and dust. Not only do these layersdecrease the amount of debris and dirt that stick to the lens,but they also make the lenses easier to clean and therebyreduce surface scratches from excessive cleaning.

• Oleophobic layers are especially important with themultilayer coatings because the more effective the coating, the more likely it is to show smudges.

• Hydrophobic layers are thin layers of silicone that areplaced on top of the AR. It provides a smooth surfacethat decreases the wetting angle of the lens. The result isthat liquids form small beads that can be easily removedfrom the lens.

• When oleophobic and hydrophobic layers are usedtogether, they create a seal that acts as a secondary scratchcoat.

• Anti-static or Electro Magnetic Interference (EMI) layersare place on the lens to prevent static build up. By reduc-ing static on the lens, airborne particles are a lot less likely to be attracted to the lens and adhere to it.

• Premium AR coatings are actually bonded to the lens surface, becoming one with the lens. This decreases thelikelihood of crazing that was a problem with earlier AR coats.

Reaping the Benefits

Now, how does all this scientific data actually help the patient?Well, AR allows 8% more light to enter the eye. The result isclearer, sharper vision and reduced eyestrain, which would benefit everyone, however in some situations, the benefits aremore noticeable.

Through the LensCarrie Wilson, BS, LDO, ABOAC, NCLEC

Anti-Reflective Coating:The Perfect Finishing Touch

SEP2009.qxd 8/27/09 10:04 AM

• Occupational – Fluorescent lighting, computers, cash reg-isters, etc, all cause an increase of reflections in the work-place. This increase in reflections causes eyestrain,headaches, fatigue and a decrease in work productivity.

• Night driving – External reflections are a major problemwhen it comes to driving safely at night. The reflectionsfrom oncoming headlights, streetlamps, and the road cancause distractions and discomfort to the driver. Internalreflections can cause ghost images and result in a decreasein reaction time.

• Sunwear – Backside AR can eliminate a couple of problemsrelated to sunwear. First is the annoying image of the eyethat is reflected in the center of the lens and can be verydistracting. The second is the glare hazard that is caused bythe mirror effect of a dark lens. With sun lenses, light from behind the wearer can be reflected direct-ly into the eye from the back of the lens surface causingdiscomfort. Be sure not to place AR on the front surface ofa polarized lens because it affects the polarization processand can reduce the darkness of the polarized lens by asmuch as 8%.

• Cosmetic – Shakespeare once said, “The eyes are the win-dow to the soul.” If reflections are inhibiting eye contactand eye visibility, much can be lost. AR coating enhancesnot only the appearance of the patient but can increase theeffectiveness of communication by enabling better eyecontact.

Premium AR coatings on the Market

Getting premium AR coatings are easier than ever. Several man-ufacturers have developed AR coatings that work best with theirlens substrates. Some of the most common manufacturers andtheir AR coatings are:

Hoya and HiVision has developed a process that matches theindex of the coating to the individual lens substrate and sand-wiches it between a super hard scratch resistant coating and ahydrophobic top layer.

Essilor has a family of AR coatings under the Crizal® name. Thenewest member of that family is Crizal Avancé™ with ScotchGuard™. Crizal coatings go through an eight step process thatcombines super scratch resistance with hydrophobic, oleophobicand antistatic topcoats to the AR coat.

Seiko has a patented AR coating called SuperClean AR. It has asuper hyprophobic top coat, a high index non-tintable hard coat,and a high index shock absorbent primer. The result is an ARthat repels dust, dirt and grime and is easier than ever to clean.It is found on the Seiko 1.74 and 1.67 hi index lenses. In theirPentax family of lenses, Seiko has developed the Surpass® ECPAR coating. Surpass combines hydrophobic and oleophobic lay-ers to create a super top coat that prevent AR deterioration fromtemperature fluctuations, UV, and humidity.


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24 | EEYECAREPROFESSIONAL |SEPTEMBER 2009

Carl Zeiss has a wide range of AR coatings available. In theSOLA line, the AR is Teflon® with clear coat. In the Zeiss line, ARcoat is available with either the Carat® family of AR coats or theET family of AR coats. The newest member of the Carat family,Carat Advantage® has a new super hydrophobic coating.

Recommending AR to the Patient

Although some surveys show that 60% of patients would pur-chase AR coated lenses, only about 25% of them do. It is up tothe ECP to bridge this gap. The easiest way to prove the benefitof AR coating is to demonstrate it. With this in mind, everyonein the dispensary should be wearing the product. It is hard to tell a patient that the product will benefit them if the ECPdoesn’t believe in the product enough to wear it.

Also, seeing is believing when it comes to a product, so be surethat there are multiple types of AR displays available in thepractice. These displays should show a specific benefit of theproduct. Very effective types of displays include:

• The doughnut. The doughnut is a plano lens with ARcoating applied just to the center. When placed against adark background, it is very easy to see the difference in theamount of light reflected between the coated and uncoat-ed portions.

• Glasses with a coated lens and a non coated lens. This dis-play is very effective for the fashion conscious consumerbecause it really highlights the cosmetic benefits to thepatient, so be sure to place it in a stylish frame. With thisdisplay, the patient can see how the coating will actuallylook when being worn.

• An oleophobic/hydrophobic lens and a permanent mark-er. Patients are familiar with permanent markers so theyare impressed when the ink of the marker beads up on thecoating and is easily wiped off without leaving a mark.

A word of caution, although everyone can benefit from ARcoated lenses, AR coating does not work well under certainenvironmental conditions. If a patient works in an extremelydusty environment, it would probably benefit them to buy a second pair of occupational glasses without AR coating appliedto the lenses. Also, be sure to explain proper care and cleaning –as detailed by the manufacturer – so that the patient can get thelongest possible life out of the lenses.

AR coatings are the icing on the cake when it comes to lenses.They enable the wearer to see things clearer, reduce eyestrain,increase productivity as well as participate in activities moresafely. With all these benefits, it is important to recommend ARto every patient. By believing in the product and showing thebenefit, the ECP can provide their patient with the care theydeserve. ■

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JULY2009_PPG.qxd 8/28/09 4:16 PM Page 3


WITH NEARLY 75 percent of our nation’s popu-lation accessing the worldwide web, it’s becomemore important than ever for successful eyecarepractices to have an Internet presence. While it

may seem intimidating, you don’t have to be tech savvy to getup and running. We spoke with several different ECPs who havelaunched or are in the process of launching a site, about whythey did it and what’s involved.

“In today’s world people are using computer search enginesmore and more as their first choice in locating doctors,” saysTherese C. Deschenes, OD, Deschenes Eye Associates inTrooper, Pa., who at press time was in the midst of developingan interactive website. “Websites areavailable for people to browse attheir own leisure. You can convey somuch more information through awebsite than in a printed ad or evena phone call.”

Joni Schrup, owner, Discerning Eye inIowa City, Iowa agrees. She says it washer kids that pushed her to get on theweb. In fact, her son Sam was respon-sible for creating her site, before hereyecare practice even launched inDecember 2005. “Talking to my kids,I realized their generation doesn’teven know how to operate a phonebook,” she says. “We’re based in a col-lege town and I think it’s made me alittle more aware of the fact thatyounger crowds no longer use the

Yellow Pages. So it was always important for me to have a goodonline presence, from the very beginning.”

Visibility is definitely one key benefit of being online, but awebsite is also a way for patients to get a feel for your practicebefore they even set foot through the door. It was important forRachel Cohn, OD, optometrist and owner of Wink EyecareBoutique in Potomac, Md., to have a catchy look to her site.“Myboutique has a hip feel to it, and you get a sense of that from justvisiting my website,” she says. “It was important to me that mysite was completely reflective of my brand so everything fromthe logo to the colors we used and the photos on the site con-veys that same feeling.”

Another, perhaps unconsidered, ben-efit of a website is making sales. Whilemany ECPs think in terms of recruit-ing local patients through theInternet, Schrup says her websiteactually helped her make a sale withan out-of-state customer. “We justrecently had a man from Californiacall us because he was looking for aspecific frame line and ended up find-ing it on our website,” she says. “Hebought a pair of frames that we’regoing to be mailing to him.”

And a website isn’t the only way to getsome web presence. For instance,Schrup created a Facebook page forher practice. Staff photos and photosof frame reps are posted on the page

Managing OpticianLindsey Getz

ECPs on the WebDon’t get left behind—more ECPs than ever before

are plugging into the worldwide web

ECPs on the Web

SEP2009.qxd 8/27/09 10:07 AM

regularly. It’s also a space for her to let existing and prospectivepatients know about events and happenings taking place at herpractice. And of course, it’s yet another way that patients canget in touch with her.

Justin Bazan, OD, owner, Park Slope Eye in Brooklyn, N.Y., alsomakes use of various social media and networking tools, whichare linked on his website. In addition to a Facebook page, healso uses Twitter. “Social media and networking gives us theability to create more of a fan base,” he says.“And fans are exact-ly the type of patients we want to have here. We want people tofeel an extreme loyalty to our practice and that’s something thatcan be generated through the interactions we have on theseforms of online media.”

Through his Facebook page, Bazan posts interesting content inthe hopes of generating discussion. It’s also an outlet for him toanswer patients’ quick questions. He started the page inNovember and now has close to 500 “fans.” Patients looking for

additional information can also log on to Bazan’s blog, whichhe updates regularly with educational content. “I look at theblog as more of an educational tool and put up posts that helpour patients find useful medical information,” he says.

Getting Started

Your website’s content is definitely the first thing you shouldconsider when launching a website. The most important itemsto include are where you’re located, what your hours are, andhow to get in touch with you. Often times web visitors are onlylooking to pop on to your page to get some quick info, so it’shelpful to have these three pieces of information on yourhomepage. Some practices are even doing their scheduling

through their website. This allows patients to go online andmake an appointment 24/7, though it obviously requiresupkeep from your end as well, making sure you are staying ontop of appointments booked this way.

“In today’s world people are using computer search engines more and more astheir first choice in locating doctors,” says Therese C. Deschenes, OD,

Deschenes Eye Associates in Trooper, Pa.


SEP2009.qxd 8/27/09 10:08 AM

Besides the obvious, there are many other features and piecesinformation to consider adding to your site. For Schrup, high-lighting some of the frame lines she carries was very important.Besides the fact that it helped her make a sale just by having thelist online, it also helps her recruit new patients who areimpressed by her selection.

Some information on the office staff is also vital so that thepatient can feel more familiar with the practice. “I think it isvery important for patients to be able to meet the doctor andview credentials and experience,” notes Deschenes.“Patient tes-timonials are also important, as is listing services offered and[the practice’s] specialized areas.”

When it comes to design, how barebones or fancy you wantyour website is entirely up to you. Linda Fain Hatton, OD andpresident of Optix EyeCare and Gallery in Dallas, even includesEyeCyclopedia™ on her website, giving patients an opportunityto look up eye conditions and definitions. She also has down-loadable videos available. Bazan has a highly interactive sitethat has a bold color scheme and makes use of Flash withunique graphics and other features, allowing it to have a lot ofimpact on visitors. No matter what you decide to do, keep inmind that launching a site is a chance for you to be creative. Justdon’t forget the type of message and the overall feel you wantto convey to your visitors as you come up with ideas.

Once you determine what features and information you’regoing to include, you’ll have to decide if you plan to create thesite yourself using an Internet domain registrar. There are a lotout there, Go Daddy being one of the most well-known, mostlikely due to their flashy Super Bowl ads. Others choose to havea web developer do the work. This is a more expensive route,but can save a lot of time and ensures a professional look.Deschenes says she did her homework before settling on thedeveloper she planned to use for her site. “I researched manyweb developers and viewed samples of their sites,” she says.“I also did price comparisons for the services that are offered.”

And Deschenes feels the cost is certainly worth it. “The cost ofhaving a website for a busy practice should be an expected oper-ating cost in this day and age,” she says. “Before it used to be thetelephone book was the first resource for finding businesses ordoctors. Simply reallocating those expenses to your website isvery easily done. Web developers are very willing to help thosewhom are not very computer savvy. And it’s an investment thatwill definitely give a good return on your dollar.”

Creating a Facebook page or blog is often easier than launchinga website since it walks you through the steps and is perhaps agood place to start out for the web newbies. The bottom line isthat no matter how you go about it, creating an online presenceis an excellent way to market your practice to new patients andmake important connections with your existing patient base. ■

SEP2009.qxd 8/27/09 10:09 AM

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SEP2009_FEA.qxd 8/28/09 12:22 PM Page 1


Giving Hopeto the BlindIt’s like a lollypop. With an inch squaregrid containing 625 small metal receivingsensors. A wire leads from it to a cameramounted on a pair of sunglasses and thenconnects to a hand held instrument muchlike a BlackBerry.

THE CAMERA SENDS its image to the tongue device whichemits a low voltage pulse to the tongue. Concentration andtraining allows the subject to visualize a picture. The subject canidentify the shapes of images before him, even though the condition of blindness exists. The tongue is more sensitive thanother skin areas.

The nerve fibers are close to the surface, there are more of themand there are no outer layers of dead cells that may interfere. Itrequires less stimulation. Five to fifteen volts is all that is need-ed in comparison to 40 to 500 volts for areas like the fingertips,abdomen or back. Electrolytes contained in the saliva helps tomaintain the current between the electrode and tongue tissue.The area of the cerebral cortex that receives the data from thetongue is larger than areas serving other body parts, making thetongue a logical choice for this process.

Amy Nau is an optometrist at the Univ. of Pittsburgh and isinvestigating the effectiveness of the instrument. She said dur-ing a Washington Post interview, “It’s kind of like Braille thatyou use with your fingers. Instead of symbols, it’s a picture andinstead of fingertips, it’s your tongue.” The magic lollypop iscalled the BrainPort Vision Device. It is made by Wicab, Inc., abiomedical engineering company in Middleton, Wisconsin. Itutilizes sensory substitution. This is a function that becomesoperative when one sense is damaged. The part of the brain thatwas meant to control that skill can be taught to perform anoth-

er function in its place. The visual cortex is asked to learn tactile recognition. The supposition is that we do not see withour eyes. The optical image rests on the retina where a neurochemical process takes place and it becomes a nerve impulsealong the optic nerve fibers. The brain receives the impulses andprojects a recreation of the image. And that is an uncomplicat-ed version of how we see.

There are numerous pathways that carry sensory informationto the brain. The eyes, ears and skin are all set up in a similarmanner to perform their special activities. All this informationis carried to the brain by nerve fibers in the form of impulsepatterns. Each ends up in different brain areas for interpreta-tion. To substitute one pathway for another – as has been suggested – an accurate encoding of the nerve signals for thesensory activity is required and thence transported to the

Second GlanceElmer Friedman, OD

Credit: A

ssociated Press

Injured Marine Corps Cpl. Mike Jernigan uses the BrainPort


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parietal area of the brain. The brain has the facility to be trainedto read inputs for interpretation and to react accordingly. Theencoding of the electrical pattern attempts to mimic the inputfrom the non functioning sense.

Usually, the parietal lobe receives touch information, the tem-poral lobe receives auditory information, the occipital lobereceives vision information and the cerebellum receives balanceinformation. Experts agree that it is a mystery as to how this alltakes place but the brain accomplishes this miracle if the cor-rect information is given to it. Further study is being made tohelp the hearing impaired, the balance impaired and those whohave lost their sense of touch in certain areas of the skin due tonerve damage. A seemingly impossible endeavor is being con-sidered to use electrotactile stimulation for sensory augmenta-tion or substitution to sense colors.

Marine Cpl. Mike Jernigan was blinded by a roadside bomb inIraq. The doctors gave him no hope of retrieving any part of hislost sight. After five years of sweat and tears, he and his supportgroup of people have brought him beyond the “white cane”scenario. He is one of an experimental group of 100 blind peo-ple who are testing the instrument.

Jernigan reports, “It is designed for stationary tasks. If the cam-era were to transmit images of a moving scene, there would betoo much information to process at once. However, when your

sink gets clogged up and you have pieces lying on the floor, my‘lollipop’ helps me to find the pieces.” His camera equipped

sunglasses were made by Oakley. Jernigan adds, “For five yearsI have stared at a blank, black screen. Now, people are thinkingoutside the box and by doing so, this allows someone like me tohave hope of the possibility that I might see again.”

Bob Beckman is the president and CEO of Wicab. He says,“When you were a child, did anyone ever draw a picture onyour back with a finger tip?” He continues, “Receiving infor-mation by the BrainPort is similar to the perceptions caused bythe finger on the back drawing experience.”


SEP2009.qxd 8/27/09 10:10 AM

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younger_0909.qxd 8/27/09 12:34 PM Page 5


Dr. Nau suggests that the image sensations produced are veryrudimentary. Stereopsis is unattainable and images are per-ceived as blocks and shapes in black and white. Beckman feelsthat his mission is to provide information to the blind, not tocure blindness. “I feel that we are in the infancy of this technol-ogy.” he said. Mr. Beckman added that he feels the instrumentmay be commercial by the end of 2009. It is estimated that itwill cost about $10,000. The Univ. of Wisconsin has patentedthe concept and gave Wicab the exclusive rights of licensure.

Veteran Navy Diver, Michael Zinszer used the BrainPort systemto sense compass direction and depth while in a swimmingpool. He said it felt like having soda pop bubbles on his tongue.Zinszer added, “You are feeling the outline of the image. WhileI was in the pool they directed me to a very small object and Iwas able to locate it very easily.”

Erik Weihenmayer lost his vision at the age of thirteen due to acongenital eye disease. He is a 40 year old mountain climber,author and inspirational speaker. He states that he can see size,shape, location and motion of objects in black and white. Blackobjects on a white background afford better contrast comparedwith images of low contrast such as people dressed in pastels setagainst foliage in a park. He adds that the picture, even with

high contrast benefits, is much cruder than that of a sightedperson’s normal vision. To Mr. Weihenmayer’s delight, heregales in telling how he caught his daughter cheating at cards.In another celebrated case, a woman who has been blind sincebirth and never developed any idea of what a rubber ballshould look like was tested with the BrainPort instrument. Theinvestigating director rolled a ball in her direction and she putout her hand to stop it.

Paul Bach-y-Rita, a neuroscientist at the Univ. of Wisconsin,was the founder of Wicab and reported his discoveries morethan thirty years ago. Other researchers who have becomedeeply involved with developing the progress of the BrainPortdevice are: Dr. F. Owen Black at the Legacy Clinical researchand Technology Center in Portland, Oregon and Dr. MauricePtito of the Univ. of Montreal School of Optometry and Dr.Eliana Sampaio of the National Conservatory of Arts andTrades in Paris. It is expected that with the advent of electronicminiaturization and more powerful computer properties, thetechnology will become less cumbersome and more practicalwith improved results. ■

“Anything one man can imagine, other men can make real.”JULES VERNE

SEP2009.qxd 8/28/09 11:36 AM

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AUG2009_3Rivers.qxd 2/13/09 2:19 PM Page 1


OPTICAL PRISM IS DEFINED as a wedge-shaped transparent object that deviates light. The light deviates, orbends, toward the base, and when you are looking through theprism, the image moves toward the apex.

Unwanted prism can cause discomfort including visual distortion, headaches, nausea and blur. It is often caused by laberrors in surfacing, laying out or edging or optician errors inmeasuring the seg height or PD.

Lenses Contain Prisms

Ophthalmic lenses inherently contain prisms. Minus lenses aretwo prisms apex to apex and plus lenses are two prisms base tobase. Depending on where light passes through the lens, it goesstraight or bends. The optical center is where there is no prismand light goes straight through. When light passes through atany point other than the optical center, it bends and affects thevision. This is called prismatic effect.

The Major Reference Point (MRP) of the lens is the place wherethe prescription is its clearest and most accurate. The PupillaryDistance (PD) is the distance from center pupil of one eye tocenter pupil of the other eye. The Optical Center (OC) is thepoint on the lens where light passes straight through and wherethere is no prism. Ideally, the PD and the MRP are at the sameplace. If there is no prescribed prism, we want the PD, MRP andOC to be at the same place.

If the prescription calls for prism, the MRP and PD are at theplace corresponding to the amount of prism required in eacheye. If no prism is prescribed, but the MRP and OC are notpositioned at the same place in the lens, prism is induced. Thishappens because when the wearer looks anywhere other thanthe OC, he is looking through some point in the prisms thatmake up the lens. When the wearer’s MRP is not positioned atthe OC, he is looking through the lens prisms. Because he islooking through the lens prisms, his vision is altered. The far-ther away from the OC that the light passes through the lens,the more prism is induced.

The way to calculate how much prism is induced is by usingPrentice’s Rule. (This is an approximation and becomes lessaccurate in lower lens powers.)

�� = D x d �10

�� is the symbol for prism diopterD is the symbol for power of the lensd is the symbol for decentration in millimeters

The 10 is used to change the distance values from centimetersto millimeters. Since opticians are used to using millimeters, wechange everything into millimeters to better understand themath. In the case of this formula, the end result is in prismdiopters.

If the power of the lens is -6.50 and the eye is looking throughit 2mm away from the optical center, the amount of prism is figured by Prentice’s Rule:

�� = D x d �10D = 6.50 x 2 mm �10D = 13 �10D = 1.3 or 1.3��

Base Direction

As for the direction the light bends, called base direction, weconsider whether the lens is minus or plus. You must considerwhere the eye is looking, not where the light is striking, to deter-mine base direction.

Our eyes are sensitive to unwanted or unfamiliar prism. Themore prism there is, the more discomfort it can cause.

Excessive Base Down Prism causes the sensation of standing ina bowl. The wearer feels like he is walking uphill and verticalobjects appear taller than they really are.

Excessive Base Up Prism causes the sensation of standing on ahill. The wearer feel like he is walking downhill and verticalobjects appear shorter than they really are. Excessive Base In orOut Prism causes the wearer to see horizontal objects as slanted.

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SEP2009.qxd 8/27/09 2:28 PM

SEP2009_LBI.qxd 8/25/09 2:38 PM Page 1


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Canceling prism

When each lens contains the same amount of vertical prism andin the same direction, both base up or both base down, the prismin both eyes cancels each other out and there is no effectiveprism in either eye.

When each lens contains the same amount of horizontal prismand in opposite directions, one base in and one base out, theprism in both eyes cancels each other out and there is no effec-tive prism in either eye.

Compounded prism

When each lens contains horizontal prism with the bases in thesame direction, the prism is compounded, wherein the prism inboth eyes is added together for a total amount of OU prism.

When each lens contains vertical prism with the bases in oppo-site directions, the prism is compounded, wherein the prism inboth eyes is added together for a total amount of OU prism.

Split prism

To even out the lens thickness that prism can cause, the amountof prism can be split in half with each half assigned to a lens.Vertical prism in the prescribed lens will have the base directionprescribed, while the other lens will have the opposite base direc-tion.

For example, the Rx calls for 8D of prism base down OD. To splitthe prism evenly, the OD lens will have 4D of prism base downand the OS lens will have 4D of prism base up.

Base direction for horizontal prism will be the same in each lens.For example, the Rx calls for 8D of prism base out OD. To splitthe prism evenly, the OD lens will have 4D of prism base out andthe OS lens will have 4D of prism base out.

Yolked prism

Yolked prism is prism in the left and right lens that have the samebase direction and do not cause the eyes to converge or diverge,either horizontally or vertically, relative to one another. Yolkedprism is also used in progressive lenses to make the upper por-tion of the lens lighter and thinner. This is called prism thinning.

Image Jump

When a bifocal wearer’s gaze moves from the upper portion ofthe lens to the lower portion of the segment, the image sudden-ly appears closer and magnified. This is called image jump. Thishappens because prism is induced when looking away from the


SEP2009.qxd 8/28/09 11:37 AM

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optical center of the upper portion to the OC of the lower por-tion. The amount of image jump depends on the placement ofthe optical center in the segment.

When the gaze moves from the upper portion of a plus lens tothe top of the segment, base up prism is created and the imagemoves down slightly. The prism is base up because the base ofthe prism in the upper part of the lens is at the distance opticalcenter. As the gaze continues to move down into the segment,the base direction of the prism in the segment determineswhether there is image jump and how much.

When the gaze moves from the upper portion of a minus lensto the top of the segment, base down prism is created and theimage moves up slightly. The prism is base down because thebase of the prism in the upper part of the lens is at the outsideof the lens. As the gaze continues to move down into the seg-ment, the base direction of the prism in the segment deter-mines whether there is image jump and how much.

Anisometropia

A difference in prescription or MRP between the lenses is calledanisometropia. When the wearer lowers his gaze below the dis-tance optical center anisometropia causes Vertical Imbalance,which is prismatic effect usually felt when the differencebetween lenses is greater than 1.5 prism diopters. The personaffected by vertical imbalance is the bifocal wearer with goodvision in both eyes. If one eye is defective or blind, the differ-ence between the lenses will not matter.

Slab-Off

When anisometropia causes vertical imbalance in a set of bifo-cal lenses, we can have prism ground into one lens’ segment tocancel out the prism created by the different prescriptions. Baseup prism equaling the amount of prism caused by the Rx isground into the reading segment of the lens with the moreminus in the distance portion. This is called bi-centric grinding

or slab-off. This method is limited to compensating for a maximum vertical imbalance of six diopters.

Verifying prism

To verify prism when the prescription is known, dial in the pre-scription on the lensometer and place the mires at the pre-scribed place for the prism and spot the lens. After doing thison both lenses, measure the distance between the dots and theresult should match the PD.

When the prescription is unknown, we can estimate theamount of prism by placing the higher powered lens on thelensometer stage where the PD would most likely be and not-ing where the mires are positioned. Then we carefully shift theglasses to place the other lens on the stage. If the mires are posi-tioned somewhere other than in the center, make a note of theposition. The positions of the mires will indicate that there isprism and approximately how much between the two lenses.

Another method used to check for prism when the prescriptionis unknown is to place the stronger lens on the lensometer stageand center the mires. Then evenly shift to the other lens andnote where the mires are positioned. This will tell approxi-mately how much prism is present between the lenses, but notwhich lens it’s in or if the prism is split between the lenses.

To verify or check for prism in a progressive lens, we use theprogressive mask that covers the lens when a job comes fromthe lab. Under the fitting cross is a dot and we put this dot atthe center of the eyepiece on the lensometer. We check bothlenses at this dot and if there is no prism, the mires for bothlenses will be at the same place on the reticle. If there is prism,the mires of each lens will be at different places on the reticle.

Understanding prism may be a little daunting at first, but if youtake the information one concept at a time, it will fall into placeand you will better understand why prism affects vision—whether we want it to or not. ■

SEP2009.qxd 8/27/09 1:31 PM

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21st Century Optics 15 800-221-4170 www.21stcenturyoptics.com

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Enni Marco 9 866-648-2661 www.newlineoptics.us

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Luzerne Optical 33 800-233-9637 www.luzerneoptical.com

ADVERTISER PAGE # PHONE # WEB SITE

Monterey Symposium 2009 29 800-877-5738 www.montereysymposium.com

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National Lens 23, 45 866-923-5600 www.national-lens.com

Nellerk Contact Lens Cases 49 607-748-2166 —

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Opticom 24 800-678-4266 www.opticom-inc.com

Optogenics 40 800-678-4225 www.optogenics.com

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SEIKO Eyewear INSIDE BACK COVER 800-235-LENS www.seikoeyewear.com

Tech-Optics 47 800-678-4277 www.techopticsinternational.com

Three Rivers Optical 37 800-756-2020 www.3riversoptical.com

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email: [email protected]

Click, click, click, your lens order is done.

Use one website to order all of your stock lenses electronically. With no usage or ordering fees!

Interested in sharing your

Optical insight with fellow ECP’s?

If you would like to write for the fastest growingpublication in the industry, email a brief descriptionabout yourself and your areas of expertise to: [email protected]

SEP2009.qxd 8/27/09 10:18 AM


Op-Tags™, Labels & Bar Code Systems...

Your most cost effective merchandising tools!

Arch Crown, Inc.460 Hillside AvenueHillside, NJ 07205

Toll Free: 1-800-526-8353Fax: 973-731-2228

e-mail: [email protected]

INC.

TM

Rudy is Sport RX. Rudy Project is Italian for cutting

edge technology and innovations inplano & RX eyewear/sunwear.Increase your sales to athletes!

Contact us.www.rudyprojectusa.com or

888-860-7597

National LensAmerica’s Leading Discount

Contact Lens Distributor

Phone 1-866-923-5600Fax 1-866-923-5601

www.national-lens.com

Framedisplays.comis the leading provider of opticalframe displays for ophthalmic

dispensing professionals. Productsinclude optical eyewear and

sunglass displays in addition tolockable, rotating, standing, wall

mount and slatwall frame displays.Call 877.274.9300

for info and catalog.

LOW PRICE LEADER SINCE 1949

Factory Direct Savings on Fully Stitched Slip-in Cases

Clamshell Cases Lowest Pricesin the Industry

Molded Plastic & Children’s Cases

Huge Saving on Microfiber CleaningCloths and Spray Cleaner

Call: 800 249-1058See our complete case catalog at:

http://www.LBI.biz

INDUSTRY QUICK ACCESS EEYECAREPROFESSIONALTo advertise please call 8

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NELLERKCONTACT LENS CASESNELLERKCONTACT LENS CASES

9¢ONLYEACH

12¢ per unit Printed!

607-748-2166 Fax: 607-748-2273

A case with a double lock & your name imprinted on it!

CEABO/NCLE APPROVEDCONTINUING EDUCATIONDry Eyes and Its Effects on Contact Lens Wear$12.99 for 1 NCLE Credit Hour

Available at: www.ecpmag.com/CETake the course online and receive your certificate within 5 days!

WHEN SKILLED HANDS usingstate of the art technology come

together the result is precision bench work. We pride

ourselves in producing edge workthat is light years ahead of our

competition.

(800) 221-4170www.21stcenturyoptics.com

RECONDITIONED SPECIALS!!EdgersBriot Accura CX RC . . . . . . . $13,950Essilor Gamma RC . . . . . . . $12,950Essilor Kappa RC . . . . . . . . . $17,950

Safety bevels and Grooves!

InstrumentsReichert Keratometer . . . . . . . . $595Chart Projectors starting at . . . . . $395Marco Radiuscope . . . . . . . . . . $695

Optical Finish Equipment and SuppliesGrimes Optical Equipment

Co.800-749-8427

www.grimesoptical.com

National Lens, a leading independentdistributor of Contact Lenses is pleasedto announce their Exclusive Distributionrights of Impression Colored ContactLenses in the U.S.A.

According to the director of sales David Roberts, these Opaque Lenses areextremely comfortable are available innine colors and offer a major priceadvantage over the leading competitor’slenses.

For more information they can bereached Toll Free: 866.923.5601 or you can go the website: www.national-lens.com

AUG2009.qxd 7/31/09 11:28 AM


SO YOU may have seenthe recent article in theNYT Science section

about a new product calledTrufocals. It is a fluid filled Rxlens that adjusts power with abridge-mounted slider thatadjusts the near power fromnone to +2.75 and back again.

The design consists of three parts; a back glass, a fluid-filledinner membrane that is essentially a piece of plastic-wrap-likematerial stretched across a ring whose surface curvature can bealtered mechanically, and an outer prescription lens attachedwith magnets to the eyeglass frame. To change the focus, theuser moves the slider on the bridge.

It is the brainchild of inventor Steven Kurtin – and HarryPotter would love them – they are perfectly round. (If you wishto have a liquid filled adjustable lens it must be round – no ifs,ands, or buts about it!) Steven is a long time inventor with aCal-Tech degree in applied physics. Lest you think this is a dilettantish pursuit, Kurtin and his wife and many associateshave invested millions in the research. The basic idea of a fluidlens whose focus can be changed mechanically goes back to apatent awarded in 1866, so obviously it is an insanely complexmechanical problem or we would have seen many iterations ofthe idea by now.

Another approach was tried by Luis W. Alvarez, (who in 1968won the Nobel in physics), who posited a two-part lens thatchanged focus by sliding two lens components of opposing“saddle-back” shapes across each other.

Several international efforts areunder way to adapt both fluidlenses and the Alvarez approachto the 1.3 billion people at thebottom of the economic pyra-mid that the WHO estimates ashaving no access to eyeglasses.Both the Center for Vision in theDeveloping World in Oxford,

England, and U-Specs in Amsterdam (using the Alvarez principle) are working on glasses that can be distributed at afraction of the price that glasses cost in the developed world.

Then there is Professor Joshua Silver who has invented a verybasic silicone filled user adjustable lens and frame combination.The user injects more silicone fluid into the interstices in thelenses to sharpen their focus, then breaks off, or locks thesyringe, once the wearer is satisfied with the vision obtained(No – the syringes can’t be used for anything else).

On top of this our friends at PixelOptics are developing an elec-tro active lens that was demonstrated last spring at Vision Expoand may come out next year. This would probably be a logicalcompetitor to Kurtin’s glasses when it comes on the market.

But first to market honors must go to Trufocal at a whopping$895.00 retail. Multicolored temples are available and thebridge sizes vary with PD.

Beauty is in the eye of the beholder, a group of Trufocal wearers would not make the fashion gods quake, but they mightincite a bit of jealousy among Harry Potter fans. ■

Last LookJim Magay, RDO

“Are They Trifocals?” –

“No, Trufocals!”

SEP2009.qxd 8/27/09 10:16 AM

See us at Vision Expo West in Booth 9033*Available in October ‘09

Largest selection of finished Transitions!

SEIKO THE LEADERin finished Transitions® lenses, introduces new SEIKO 1.74*

www.seikoeyewear.com

Transitions and the swirl are registered trademarks of Transitions Optical, Inc., Pinellas Park, FL 33782

Seiko Quality. Transitions Performance.

Transitions and the swirl are registered trademarks of Transitions Optical, Inc., Pinellas Park, FL 33782

SEP2009_SEIKO.qxd 8/25/09 12:57 PM Page 3

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eyecare professional - september 2009 issue

Documents

pm page

efficient lab page

fall eyewear page

mass technology

amy endo

warren mcdonald

judy canty

arantireflective coating