OptiQUICK Tips To Improve Your Optical Performance Today –
Converting From Bifocal to Reading or Computer Prescriptions
We often get asked, “How do you convert a spectacle Rx written for a bifocal into a single vision or computer Rx.” Here are the steps involved….
Step 1: Add the add power to the sphere power. For example, if the distance sphere is +1.00 and the add power is +2.00, then the new reading glasses sphere power is +1.00 + +2.00 = +3.00
Another example… If the distance sphere is -1.00 with a +2.00 add then the new reading glasses sphere power is -1.00 + +2.00 = +1.00
Step 2: Cylinder and axis remain the same.
To convert into a computer Rx, unless otherwise stated on the Rx, it is typically industry standard to cut the add in half. However, it is always a good idea to call the prescribing doctor to confirm this would be ok in your particular case. For example, if the bifocal add is written as +2.00, for a computer Rx you would use +2.00 / 2 = +1.00. With your new calculated computer add power of +1.00, you would then just use the steps explained above to add this +1.00 to your distance Rx to arrive at your computer Rx.
If the add power is not able to be cut in half, for example an add power of +1.75, then your closest choices would be to use either +0.75 or +1.00 add. To decide between them, ask the patient how far away his computer is. If it is slightly beyond arms distance go with the lower power, if it is slightly closer than arms distance go with the higher power.
Learn more by visiting www.OpticianTraining.com
Ophthalmic Lens Lifecycle
Unfortunately, dispensing opticians and lab technicians paths rarely cross. This can make the lab processes somewhat a mystery to many opticians. A more detailed explanation can be found in the members only area of OptiQuick, but this infographic will help you to visualize the steps involved in the creation of a pair of lenses. Click on image for larger view.
Easy Fix for Skew
Skewed eyeglasses are one of the more common reasons you will encounter a patient needing an adjustment. Skew refers to any time one side of the frame is higher, lower, sitting closer in, or sitting further out, than the other side of the frame. The proper adjustment for this is counter-intuitive, but easy to remember….
Remembering this will help you know what to do with the temple on the side needing the adjustment. For example, if the right side of the frame is down relative to the other side, adjust the right temple downward. If the left lens is sitting closer inward to the patients face than the other lens, adjust the left temple inward.
Remembering this simple mnemonic will help ease the anxiety of trying to figure out eyeglass fitting mechanics each time this skew issue presents itself to you.
Measuring a Better Seg Height
“My bifocal is too high or too low” is a common remake reason. “My optician never even showed me where they were going to put the line” is a common complaint. We find most opticians simply set the bifocal at the lower eye lid. However, having the patient experience your proposed seg height first is best.
We recommend applying a piece of Scotch tape at the proposed seg height and asking the patient to take a short walk around the optical. This way the patient can give feedback and cannot claim you never showed it to them first!
As opticians, we touch some pretty gross stuff. Need I remind you of that last pair of frames you handled? But germs are not the only thing we pick up from patients. What about that odor from the patients $5 bottle of perfume. That stuff will linger on your hands for hours, causing your next patient to think it is yours! Remember, you may actually be touching the patient more than the eye doctor did, wash your hands between EVERY patient for both your benefit and theirs.
Nighttime Driving and Rimless Frames
If a patient wants to minimize night time glare, of course we tell them about anti-reflective coating benefits. However, if the patient selects a rimless frame and you tell the lab to “polish” the edges, you may be doing the patient a disservice. The polished edges will add a ring of glare around the patient’s field of view when driving at nighttime. This can be a double edges sword, however. Patients will prefer the look of the polished edges, as it complements the appearance of the rimless frame nicely. However, patients will notice an increase in nighttime glare as opposed to unpolished edges. No one right answer for every patient, but it is important for you to be aware of the pros and cons of the polish so that you can properly address patient concerns and symptoms.
Mirror Coatings for Light Sensitivity
Mirror coatings are excellent at reducing light transmission and are ideal for people who want the maximum in light blockage. A common application of a mirror coating is a flash mirror coat, which is a lighter mirror coat for those who do not want an obvious mirror finish to their sunglasses.
Adding a mirror coating reduces light transmission more than the darkest tint alone. This is due to the high amount of light being reflected from its surface. As an added benefit, the light that mirror coatings reflect is disproportionately in the form of harmful UV and infrared light. As with any sunglasses, be sure to add a backside antireflective coating. The darker the lens, the more reflections the patient will experience.
Avoid the Dreaded Optician-Finger Infection
Screwdrivers pick up all sorts of little germy critters from your patients frames. Keep them clean by storing their heads in hydrogen peroxide while not being used. The next time you poke your finger with your screwdriver you wont have to worry about an infection. (Still a good idea to rinse broken skin with hydrogen peroxide just to be safe!)
Story Telling Your Way to Better Sales
Storytelling is crucial to retail sales. Simply showing hundreds of frames is not enough. Telling the patients the pain staking way a frame was made, the back story about a specific collection, or how the materials were mined can be what makes the sale. Help patients become impassioned about the frames story. Is the collection a limited edition, featured in a movie, or inspired by the rocks of Tanzania? If so, let your patients know. Include a brief story card by the frames in your displays.
One of my favorite marketing coachs, Ash Ambrige, tells a story of going into an antique store despite the fact that she hates antiques. What drew her in and made her buy? A note next to a jewelry box in the window.
“Imported directly from Paris. Previous owner: Collette, a French dress-maker & artist. Believer in lust as much as love. Greatest obsession: Brave truths. Happiest when: Painting humanity in Parc des Buttes Chaumont. Favorite thing to do on Sunday: Bordeaux Blanc & a sinful little book in the sunshine. Used this jewelry box: To keep an old love letter, an old engagement ring, and an old photograph of once upon a time.”
She goes on to report her reaction… “Holy crap. Suddenly I don’t care what this thing costs! I want it more than anything in the world. I must have this gold, glass intricate, delicate, Parisian jewelry box. Because now, it is not just a jewelry box. It’s a desire. A desire to be a woman like Colette. A desire to be effortless. A desire to roam cobblestone streets wearing black flats and red lips. A desire to be an artist, and never apologize once for it. A desire for a life that you imagine hers to be, full of interesting people and interesting music. A desire to be someone I’m not…if only once a day when I place my own mementos into this jewelry box.”
Now, compare that with the average shop who would have likely placed a yellow sticker on an item like this with nothing more than a dollar sign on it: $59.
What sign would have made you buy?
The problem isn’t the cost of your frames — the problem is that there’s no context for the cost. Because anyone can buy a pair of glasses from Sears for $99 bucks. So why spend $599 for yours?
The answer: Because of story. Because when you’ve got context, you’ve got meaning. And where there’s meaning, there’s emotion. And where there’s emotion, there’s desire. And desire is what drives the purchase.
What does it mean when patients complain that flat surfaces look tilted? If tilted right/left, this is likely due to an astigmatism change. The brain will adapt to this. If the table is seen tilted toward/away from the patient, this is likely due to a change in vertex distance, base curve, or pantoscopic tilt compared to the patients old glasses. This is harder to adapt to since it is not the prescription, but rather the physical lens (external factor) difference.
Does Your Office Brand Stand For Something?
For customers who have stated that they have a strong relationship with a single brand or office, over 64% said it was because they had “shared values” with the company. According to findings from recent research, people don’t seem to be very loyal to companies at all. They are loyal to what the company stands for. One great example is TOMS Shoes, customers love their policy for donating a pair of shoes for each pair sold. Standing for something, in this case helping the underprivileged have shoes, has made this company a huge success.
What can you begin to do today to convey a shared value with your patients? In our office we offer 50% off a second pair of glasses if the customer donates an old pair to the Lion’s Club (we have a Lions Club donation box in our office making the transaction easy for the patient). Second pair sales DOUBLED in our office as a result, a small additional profit is made, and we are helping contribute to a worthy cause we feel good about. Patient’s word-of-mouth advertising about our program drives additional new patients into our doors.
Reduce Pain Points With Bundling
Neuroeconomics expert George Loewenstein studied consumers preference in completing a purchase in one bundled step versus purchasing the same options, but individually. The study used the car buying experience and discovered how difficult it is for the brain to justify each individual upgrade (“Yes, I will pay extra for navigation … and … leather seats … and …,” etc). These individual purchases create additional “pain points”, whereas a bundled purchase creates only one pain point, even if the price is much greater. Loewenstein’s research showed most consumers are willing to pay more for complete bundles rather than individual products and accessories: not only is it less of a hassle, but it also prevents additional “pain points”.
Here is an example of your own office’s “Bundles”. Click on it for a full size copy you can print out and customize.
Does a Patient Need Slab Off?
Many opticians only look at the sphere component to see if there is a 2 Diopter difference between the eyes, but the amount of cylinder can make this misleading.
OD: Plano – 2.00 X 090 +2.50 add
OS: Plano – 2.00 X 180 +2.50 add
Does this patient need slab off?
When determining the need for slab off, we only care about the power at axis 90 in each eye. The sphere power will be the power at the prescribed axis, and the sphere PLUS the cylinder will be the power found 90 degrees away from the prescribed axis.
Therefore, in this case…… In the right eye the power at the 90 degree axis is 0 (the sphere power is power found at the prescribed axis). In the left eye the power in the 90 degree axis is -2.00D (0 is the power at the prescribed axis 180, but we don’t care about axis 180. 0 + (- 2) is the power 90 degrees away from the prescribed axis, which gives us a power of -2.00D at axis 90).
Therefore, this patient has 2 diopters of imbalance in the 90 degree axis and so DOES need slab off. Many opticians would have missed this, but now you wont. Not a bad idea to run through a bunch of examples at your next meeting. This is an important concept that can greatly reduce your remakes.
Slab off calculations Part 2
When we try to find powers in the 90-degree axis for slab-off decisions, it can seem impossible with an oblique axis. A simple rule of thumb in this case is to add half the cylinder to the sphere. The result is the power in the 90. Example: What is the power at 90° in lens of -3.00 + 2.00 × 135? Adding half the cylinder (+1.00) to the sphere (-3.00) we find a power of -2.00D at 90°. Not 100% accurate, but useful in a clinical setting to determine if a patient needs slab-off.
Looking for more clinically relevant tips such as this, visit us at www.OpticianTraining.com
Useful Little Desk Reference
Recall, higher index means thinner, higher Abbe means fewer aberrations, higher specific gravity means heavier.
So, the million dollar question…. At what point does the weight of high index materials offset the benefit of incrementally thinner lenses? Where on the chart does your preference take you for the higher prescriptions? No one right answer, but at least with this chart you will understand the tradeoffs and be able to come up with your own answer. Click on the image to get a full size chart you can print out and keep at your desk.
Presbyopia – Thinking beyond the glasses
Presbyopia is the gradual loss of your eye’s ability to focus on near objects once you reach your early 40’s. Most people first become aware of the symptoms when needing to hold reading material further away to make it clear. The exact mechanism is still being investigated, but it widely accepted to be related to the crystalline lens within the eye thickening, hardening, and therefore becoming less flexible. This flexibility is necessary for the eye to focus on near objects. The ciliary body, the muscle responsible for flexing the lens, is likely also undergoing age related changes at the same time. It is an annoying, but natural, part of aging.
Despite what you may read on many internet sales pages, no exercise program, eye drops, or vitamins can prevent or reverse presbyopia. However, current methods to relieve the symptoms of presbyopia are numerous and new methods are being researched. Opticians often think of glasses-type correction, but it is important to understand other forms of correction as part of any optician training program.
The oldest, and still most widely used, method for relieving the symptoms of presbyopia are multifocal glasses. With multifocal glasses, your distance prescription is placed in the upper half and your reading prescription in the lower half. These glasses can either be made with the tradition line (bifocal) or without a line (progressive). Progressives have the added benefit of also providing midrange vision, such as computer distance, which a bifocal cannot.
Contact lenses can also correct the symptoms of presbyopia. With contacts, there are two ways to accomplish this, either through monovision or multifocal contacts. With monovision, one eye is corrected for distance vision and the other eye for near vision. Although sounding difficult to get used to, most patients are unaware that they are only seeing clearly though one eye at a time. With multifocal contacts, in contrast, both eyes continue working together at all times. They accomplish this through simultaneously combining your distance and reading prescriptions. However, as with most things in life, trying to do two things at once rarely does both perfectly. There is typically some small sacrifice in distance or reading clarity since you are looking through some distance power when reading and some reading power when looking far away. However, for many patients who have difficulty with monovision this is an acceptable tradeoff in order to be free from glasses.
Lasik can correct the symptoms of presbyopia using monovision, as we saw with contacts. One eye, typically your “dominant” eye (the eye you would sight a telescope with) is corrected for far vision and your non- dominant eye is corrected for near vision. You will typically be given a pair of contacts for a trial period to insure you adapt well to monovision and that the reading eye is set for an appropriate distance before the procedure is performed.
Lasik software developers are working on a way to provide both distance and reading vision simultaneously through a laser. In a method similar to multifocal contacts, the laser would shape the central cornea (the front clear surface of the eye) to provide reading vision and shape the peripheral cornea to provide distance vision.
Corneal inlays are physical rings inserted into the cornea. Similar to multifocal Lasik software, this ring modifies the central curvature of the cornea to provide reading clarity. The inlay can be removed easily if the need arises. Although this method is currently being performed across the country, most of the procedures are being done as part of clinical studies.
As you can see, turning 40 means having to choose among methods of vision correction you have never been presented with before. The good news is you have many options and your optometrist will work with you to choose the one that best meets your lifestyle goals in a way that keeps you from missing a step in your daily activities.
FOLDAR your way to a good history
A good history alone will often diagnose the problem a patient is having with their glasses (or tell you if the doctor should evaluate it).
To get a good history, FOLDAR the problem….
F: Frequency. How often does problem occur?
O: Onset. When did problem first occur?
L: Location. One eye or both eyes?
D: Duration. How long does problem last?
A: Associated symptoms. Are there any other symptoms?
R: Relief. Does anything help? Pushing up the glasses, etc?
Duty To Warn
Here is a copy of the exact “Duty to Warn” form we use in our own office. Feel free to copy it and use it in your own office. Our OptiQuick Rapid Optician Training has many more forms designed to make your daily office work easier and more efficient.
Click here to download the “Duty to Warn” Form
Learn more at www.opticiantraining.com