Director of Sales and Marketing for OPTICOTE

Am I Managing My Business Or Is It Managing Me ?

YOU’RE a stand alone eye care professional or a multi-store chain, and you think you do a great job of either providing or selling anti-reflective (AR) lens treatments. Prove it! Your only source of information is your weekly or monthly analysis that tells you that you’re doing “x” dollars in AR sales. You think the number is pretty good, so you jump ahead with the assumption that your profit margins are pretty good as well. And then, the reality hits that you’re not even close to what you thought your numbers would be. At the same time, you find yourself clueless as to how you missed knowing that you weren’t going to hit your numbers. A new frustration begins to overwhelm you as you realize that you don’t know where to begin as well as what to do differently.

Questions to Consider:

There are two factors that need to be considered:

1) What am I doing? 

2) How am I doing it?

The bigger question being the first: What is my business doing on a daily, weekly, monthly, quarterly, and annual basis? This analysis must go further than “the numbers. If you are to be successful, today’s marketplace demands that you possess an in-depth understanding of both the business and the service side of the industry. Key to understanding these matters is the ability to generate quantifiable data that provides a tangible foundation upon which you can manage your business. As a small to medium sized operation, do you have the information support systems in place to provide data to gaining an understanding of your AR business?

Examine a couple of options that you may or may not have explored before.

It may be the right time to purchase that database that allows you to capture and answer many of the questions above. What support does my current vendor provide me to manage my business? What vendors are out there who can support me in improving my use of technology to manage my business? Having information rather than assumptions is a powerful basis upon which to make intelligent decisions. “Do I really need four anti-reflective treatments from different vendors when two command the majority of my business. Do all four fit my customers’ price range, and provide me with the ideal turnaround time and margin that I need?” “Did I lose a customer due to turnaround time, or was the root cause the vendor who was providing scratched and stained lenses from a manufacturer that had a quality control issue that resulted in a high number of returns?” What is the return rate from vendors I use? Do I understand the cause of the return? Is it an adhesion issue,crazing,erosion or scratches from improper care? Length of time after initially dispensing to my customers?

Many other questions can be asked and the answers are always found in quality of your data gathering. Information, regardless of the source, must continuously be collected, updated, and reviewed as an integral business practice. Whether produced from a database, handwritten tally sheet or from any other type of “source document,” there is an abundance of information that you can gather and thoughtfully consider. Key to this is that the business produces the information, and the information supports your decisions.

Michael can be reached at rxsales@opticote.com

So, you take the time to actually read the paper, you take the time to actually think about what the paper said and you take the time to reply or give feedback.

Why bother?

You get no reply, no reaction, no follow up and no indication that any of the feedback is being considered.

Here is what I had to say…

Mr. Sailer,

 The inside cover page on the recent “white paper” on The State of Opticianry states, “Please feel free to share your comments and opinions with the editor of the paper.”

 My first thought when I finished reading the paper was, here was another squandered chance to create some real change for the field of optical dispensing professionals.

Other thoughts:

How could it be that out of the nearly twenty people interviewed only three or four were actually working opticians? I see plenty of doctors, educators, editors, sales representatives, organization presidents, industry spokes-persons and consultants. Why would these people be in a position to know the future of a field that they do not practice in?

How could it be that a paper that claims to be about the future of an entire field devote half of its material to examining the past? Quite frankly, “Who cares?” It contributes nothing to the future. If we still have time to listen to, “When I was young I had to…” Then our time is not being well spent.

Why was this a paper based solely on what people think? There is not one supported statement. There is not one statistically supported position. There is not one person expressing a known verifiable fact. There is a difference between what we think and feel and what is known to be true.

Why would a paper that concludes that education is the key to progress in the field use methods of information gathering that require no educational thought process?

Real change in the field will occur when we have a real, open discussion, based on statistically accurate feedback from every individual related to the profession. When will Essilor and Jobson step up to the plate and provide a nationwide survey? When will they pay to analyze that survey and obtain real data that can be used in constructive ways? When will we have a “future search” meeting where every stake-holder has equal voice and the industry talking heads sit by the sidelines?

Thank you,

John Seegers 

The Optical Vision Site and OpticianWorks.com are generously giving away 3 sets of tools just for adding your comments below.

Tell us your favorite dispensing tool story or tell us a story about why you need these important tools.
Silly, funny, sad, fact or fiction it does not matter!

Feel free to post on The Optical Vision Site blog as well! 

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In addition to my job as courier I was also the ramp agent in charge of our departing flights from the airport each evening. That meant crawling around in the belly of a small aircraft, in the dark, soaked in de-icing fluid, often at temperatures below zero. 

It dawned on me one evening that if the work was hard and stressful at age thirty, what would it be like at forty, or fifty?

Could I even do the work at forty or fifty?

I began to think of making some other choices about work.

So, one afternoon I had a half hour free for lunch while working the route in-town and I went to the library and found The Occupational Outlook Handbook. I literally went through it page-by-page and focused primarily on jobs that I could imagine doing even as an old man or even as a disabled person. 

Opticianry met all the criteria I was looking for. Now I just needed to find a school…

I was never good in school or at least not in kindergarten through my senior year in high school anyway. My math skills were poor, my writing skills were weak and I had little reason to believe that I would ever do well as a student. Boy was I ever wrong!

My wife and I packed it all up and moved 500 miles south and I started an opticianry program at the local community college. It turned out that I was not a good student, I was a GREAT student. I excelled in my studies and even ended up holding my own tutoring sessions and helping other students with their studies. 

Don’t get me wrong. Obtaining my associates degree was the hardest thing I have ever done. I was still working for Federal Express loading aircraft cans from 4 – 11 every night. That was after school every day which ran from 9 – 3! On top of that I had 1:1 math tutoring session two to three times a week and then I had to study two to four hours a day, every day! 

Did I make the right choice? Yes I did in many ways. I am still a working optician after eighteen plus years. I still enjoy what I do. I make a very good hourly rate of pay and my hours are flexible. I still enjoy making glasses, I still enjoy seeing what is new in the industry and I still enjoy (most of) the time I spend with the  patient. 

Is retail tough?

Sure it is, but it sure beats driving down an ice covered road, at sixty-five MPH, in a two-wheel drive van, in the dark, forty miles from the nearest civilization, with a clock ticking over your head…

Renee is an Optometrist with a Master’s Degree in Curriculum and Instruction. She is the administrator of Practice Management Depot, a business resource for independent eye care professionals. Renee also writes for Optometry Times. Renee specializes in staff development. Her lessons combine product knowledge with business management training. Renee believes that your people are your greatest resource. They differentiate your practice by recognizing opportunity to increase sales, by creating messages that sell, and by measuring both effort and results that increase profitability.

In my opinion, the “Best Optician” thrives in a complex, ever changing work environment – and – thoroughly enjoys the experience! The right individual has strength of character and leadership talent, in addition to competence selling and delivering products that exceed each patient’s expectations for clarity, comfort, value, and peace of mind. This is a tall order requiring a unique personality, therefore opportunity is boundless.

Contrast this to the position of “Frame Stylist”, more of an entry level opportunity. In the more junior position, entry level individuals are expected to learn all of the competencies related to sales and dispensing. And in the right business culture, a “Frame Stylist” with strength of character plus work ethic can grow into the “Best Optician”.

The Hallmark of the Best Optician is An Ability to Build Successful Relationships and Deliver Consistently Exceptional Results.

In today’s eye care business, your patient’s experience and level of satisfaction depends upon a web of interrelated successful encounters. Think of a typical day in your office. Every patient meets staff in reception, pre-test, the exam room, and optical. We know that each face to face experience should inspire trust and confidence. The best optician interacts successfully with patients and co-workers. Words and behavior communicate respect and caring, the basis of a friendly and efficient medical environment.
The Best Optician builds successful business relationships outside the office too. Remember, our vendors help us deliver quality products, on time, with dependable warranties. For this reason, the Best Optician will build win-win relationships, a track record of partnerships with good results important to patient care and critical to business care.

The best optician for this complex work environment has strength of character, leadership talent, and competence selling and delivering products that exceed the patient’s expectations for clarity, comfort, value, and peace of mind.

Character is important. For an optician to be credible with patients, vendors, co-workers, business managers, and doctors, the optician must be honest, trustworthy, and a good communicator. The optician must be someone with personal integrity, company loyalty, a straight shooter without hidden motives or agendas. You know this kind of person, someone people can trust.

Leadership talent is important too, and it can be learned. A good leader will talk straight, demonstrate genuine concern and respect, and openly share in ways people can verify. This will be true even during difficult times like when the office is short staffed, when a vendor fails timely delivery, and when a patient becomes especially difficult.

The Best Optician will have life experience, because no classroom can fully prepare anyone for the real life challenges of patient care. A great leader continually improves, learning from mistakes, learning from the work environment, and learning from coursework too. And this individual will elevate the work environment through sharing knowledge, thereby contributing to the growth, competence, and success of colleagues, co-workers, and business associates.

Finally, the best optician is competent, able to deliver results. Patients are persuaded to purchase quality products, appropriate for the prescription and lifestyle needs. Orders are accurate. Product delivery is personable and personal. Every patient receives quality eyewear that meets expectations for vision, comfort, quality, and performance. The lab is organized, clean, and time efficient. The optical profit center is well managed and profitable.

The most informative and best visited website in the optical trade, featuring all information on optical surface treatments from the fastest lens tinting system to anti-scratch treatments.

Have you ever had the chance and check a pair of lenses that were treated with a UV solution some three to six month after the were made and handed to the patient? There is a good chance, that you will have a big surprise, your UV Meter (if the instrument measures at 400 NM) will read no UV absorption or one that is way below an acceptable standard. Let’s try to analyze this fact.

The ultimate testing instrument to check UV transmission or absorbency is a PHOTO SPECTROMETER. A Photo Spectrometer measures light transmissions at any wavelength in the spectrum. These instruments are very pricy and nobody in the optical retail field would spend the big dollars to purchase one of them.

UV solution manufacturers started to produce simple units that would read the UV absorption or transmission at a set wavelength. The target wavelength is 400 NM.  Some of these instruments are quite acceptable and reasonably accurate.

Along the way, UV 400 solutions came on the market that claimed to have no yellowish tinge.  Without the yellowish tinge, a lens will not absorb UV up to 400 NM.  Very simple, the UV Meters were adjusted to read at the maximum level the UV 400 solution would reach. Therefore we now have UV Meters on the market that are telling you that you have a full 100% absorption (they claim at 400 NM) when in fact the lens absorbs only up to 382 NM. Of course the instrument that reads at 382 NM shows a full 100% absorption at any value from 382 up to 400 NM.

The retailer, when he shops for a UV Meter, shops for price and assumes he gets a perfect, standardized Instrument It would be wise to ask any manufacturer or supplier of a UV Meter to certify at which wavelength the instrument measures. A UV Meter that measures at the 400 NM level will show a reading that is not acceptable for any UV treatment with a clear UV solution. (The reading would show about 23% transmission) So much for the measuring device…

Now that we know how to deal with measurement and checking, we should know the basic how UV solutions react while treating a lens.

UV Solutions are made with chemicals called Benzophenones. These are the same chemicals as have been used in sun creams but adapted for use in an aqueous solution under heat. Benzophenones will crystallize when in a water solution that is cooling off. When reheated they become liquid again at approximately between 89 and 93 C depending on the batch.

The lens, made from CR39 or equivalent has a surface that is very porous. When under heat, the lens becomes soft and opens its pores. The lens immersed in the UV solution will act as a magnet and attracts the chemicals. The Benzophenones penetrate the open pores of the lens surface. Once the lens is removed from the solution, it should be cooled off to room temperature before cleaning. This will let the lens pores close up and the Benzophenone will crystallize inside the lens surface.  When properly treated, a lens will not only give permanent protection, it will improve over time, and with exposure to natural UV light. There is nothing that will remove the Benzophenones from the lens pores. A good UV 400 treatment will be good for the life of the lens.

If a lens is inserted into a UV solution that has not reached the full working temperature, a problem will occur. The Benzophenone crystals in a semi-liquid state (sludge) will force their way into the lens surface. A lens that is not soft will not have open pores. The result a damaged lens surface, that shows small crater holes. We can correct this problem by inserting the lens into hot Neutralizer for 1.5 to 2 hours. (It is not necessary to redo the UV treatment)

How Much Ultra Violet is Absorbed by an Untreated Lens?

Every plastic lens sold today, will absorb 75% of UV light passing through it. The manufacturers have been adding UV absorbers for years, mainly to keep the plastic lenses from yellowing. A plastic lens will therefore absorb UV from 270 NM to 360 NM. (324 NM being the wavelength where our skin burns on the beach)

We have been told by the UV “specialists” for years, that we should protect our eyes from long wave UV light that can create long-term damage on the eyes. Therefore we have to eliminate the balance of UV transmission in a lens from 360 to 400 NM. This is the starting point of the discussion and controversy that most retailers are not aware, because, they are not told the complete truth.

Clear UV Solutions

These products are made with UV absorbers that have been adapted for use with clear products so they will not yellow, as for example a lens. Perfect, but this product should not be called a “UV400 Solution”. The UV filtering capacity of these products ends at somewhere between 382 and 385 NM. These products are only protecting your patient half way between the existing protection of the lens at 360 NM and the 400 NM it should cover. Some manufacturers are marketing UV meters that read at 382 NM. This means, that it is claimed to absorb 400 NM when in fact the protection stops at 382 NM. Therefore the retailer is selling and marketing a lens that does not give the protection wanted, needed or prescribed. The yellowish tinge on a UV treated lens is usually the visible sign that the lens has been properly done. Ultra Violet at 400NM is a slightly visible color that can only be neutralized by the yellowish tinge on the lens. A laboratory or a retailer might pay a premium for a UV solution that does not give the full protection wanted.

UV Solutions for Fast Treatment: No Time to Wait

The market is flooded today with solutions that are supposed to do the job in a short time. There are some products on the market now that claim a 60 second immersion time in the hot solution will do the trick.

A lot of laboratories claim that they do not have the time for long treatments. As long as the lens measures the proper absorption when the job gets out the door, everything is OK. Never mind what happens in three months from now.

The lens takes time to open its pores under heat. The UV absorber takes time to penetrate the lens surface, and it takes its time to re crystallize.

What happens when treating with the short time products?

The lens surface has no time to open its pores because of the short time span. The UV absorbing chemicals can only deposit themselves on the surface. They cling to the surface as well as they manage. When checked with a UV Meter or Spectrometer these lenses will show a good absorption level.

What had not been taken into consideration, is, that all these chemicals had to be dissolved at the point of manufacturing, in order to mix into the solution. This operation is mainly done with the help of solvents.  UV absorbers can be removed with a solvent. Further we should not ignore the fact, that most lens cleaners on the market contain some solvents. As these UV absorbers adhere to the surface instead of having crystallized inside the lens pores, they will eventually be rubbed off through the abrasive action of cleaning, with the help of lens cleaners and other solvent containing products. The great danger is, that having gone through the work and expense to do a good job, the patient who expects full protection for his money, unknowingly has no, or very little, protection. While saving time, the laboratory applies more expensive products that can be much less efficient

What Can We Do to Get the Right Products?

Ask your supplier or manufacturer for certified test results on their products.

These tests should be made by an independent testing laboratory that has the use of a good photo spectrometer.

There was a study made at the School of Optometry, University of Waterloo Ont. on different UV absorbing products.

Stay away from the quickie Products. The long-range protection cannot be guaranteed for all the reasons described before.

Non-yellowish UV absorbers are only acceptable if the UV absorption up the 400NM mark is not wanted.

Why should we give our patients only a half way protection?

Just because of good looks?

We could cover the yellowish tinge with some lens dye and give the patient the full value he or she is entitled to.

Rich Palmer is a 35 year veteran of the optical industry having served as national sales manager for an equipment manufacturer, vice president of a multiple wholesale laboratory organization, and as director of engineering for a nation-wide optical wholesale-retail company. Mr. Palmer is the owner of Practical Engineering, LLC, a consulting firm to the ophthalmic community providing process engineering services, strategic planning, and classes on basic optics to clients throughout North America, Asia, and West Indies. The firm has consulted with leading laboratories and equipment and lens manufacturers and may be contacted through the company web-site www.practical-engineering.com.

History

Any discussion concerning the color spectrum must first pay respects to the experiments on the subject performed by Sir Isaac Newton in the later years of the 1660’s. Newton’s early work entitled “Celebrated Phenomenon of Colors” has provided us with more than ample reason to believe that he was indeed the first to understand the rainbow.

Our modern understanding of color and light has its founding in Newton’s acclaimed experiment whereby he set up a prism near a window and projected the color spectrum onto a distant wall within his laboratory. With the refraction of light through the prism Newton was able to determine the spectrum’s component colors; red, orange, yellow, green, blue, and violet.

The Color Spectrum

At the time of Newton’s work on this subject many of his contemporaries believed that color was actually a mix of light and darkness and that a prism actually “colored” the light. This theory was proven false when Newton, with the aid of a second prism, reconstituted his array of colors back together into white light as that which entered his initial prism.

Newton hypothesized that light consisted of components of different colors and that the components or particles moved at varying speeds through different media. Additionally he surmised that the speed of these particles was totally dependent upon the density of the medium. For instance “red” light was determined to travel at a faster pace than “violet” light within a glass media.

The Visible Spectrum

The visible spectrum, often called the “optical spectrum of light”, is that part of the electromagnetic radiation spectrum (sorry, but sometimes “techno-babble” is required) that can be discernable and visibly recognized by the human eye. It is these wavelengths of light that determines a perceived color.

The electromagnetic spectrum is a range of different energy frequencies such as X rays, infrared waves, microwaves, and ultraviolet rays to name but a few. Our visible light or the frequencies of the energy wavelengths we see lie between those of ultraviolet rays and infrared waves.

This visible spectrum, or that which we commonly refer to as a rainbow, appears to be continuous in that there seems to be no finite boundaries between the colors. The most prominently displayed colors within the spectrum are Red, Orange, Yellow, Green, Blue, and Violet. This order of wavelengths, or “color order”, can perhaps best be recalled using the mnemonic of “ROY G BIV”.

However, science tells us that in reality there are seven colors in our spectrum when Indigo, which lies between blue and violet, is added to the mix. Additionally the wavelength frequency of indigo cannot be readily distinguished or recognized by the human eye and as such has been dropped from the generally accepted spectral chart and considered as merely as “shade” of either violet or blue.

The Color Spectrum

This blending of colors within the spectrum has led some scientific sources to vary significantly the numerical value of the wavelengths associated with each color. (See table below) However the visible spectrum is generally thought to lie between 400nm and 700nm.

Color	Wavelength (nm)
Red	620 – 750
Orange	590 – 620
Yellow	570 – 590
Green	495 – 570
Blue	450 – 495
Violet	380 – 450

Our Optical Window

An often referred to “normal” or light-adapted human eye is thought to have its greatest sensitivity to colors / wavelengths at or near the 555nm range or in the green region of the spectrum.

It should be noted that our spectrum does not encompass all of the colors that our eyes and brain can distinguish. Colors like pink and magenta are absent due to the fact that these examples can only be had through a fusion or mixture of multiple wavelengths.

The optical window through which visible wavelengths pass is a portion of the electromagnetic spectrum that travels mostly unattenuated through Mother Earth’s atmosphere. Clean air will distribute blue light more than wavelengths that tend toward the red portion of the color order which gives rise to the reason that on a clear day the sky appears blue.

Color has been defined in the most general of terms as a characteristic of any object that can be expressed in terms of hue, saturation, and lightness. Hue is that facet of color normally associated with red, orange, yellow, etc. Saturation also known as tome or chrome relates to the purity of a color, or the mixing of vivid color with varying amount of white which would produce a paler “shade” of blue for instance. And finally lightness is allied to a color’s intensity which is dependent of the energy level present.

The Color Spectrum

Newton decided to use the seven names of color as an analogy to the seven notes of the musical scale. Perhaps early on Sir Isaac realized and appreciated that color sensitive vision was music to our eyes and not necessarily only to our ears.

By: Kathy McNelis, COA, NCLC, ABOC,

The optician – contact lens practitioner relationship

Many people think that the fitting of contact lenses is strictly the role of optometrists but historically, opticians dominated the contact lens field. As a matter of fact, it was a California optician, Kevin Touhy, who invented and patented the first corneal contact lens in the United States in 1948. And not long after that, on the other side of the world, another optician was making a corneal lens with the same material, Polymethylmethacrylate. Kyoichi Tanaka was the young man, using only his father’s bamboo tools to carve the base curve and power curves into the lens. He and an ophthalmologist, Yutaka Mizutani, began fitting the contact lenses and started the journey that would make Mr. Tanaka the chairman of Menicon, one of the largest technology companies in the world.

Many opticians fit contact lenses, as a matter of fact; fourteen of the twenty two states that require licensing for dispensing opticians use the National Contact Lens Exam (NCLE) as part of the test requirement to get a license. If you are seeking a career that will give you a sense of purpose and the satisfaction of truly helping people, and if you have a commitment to providing excellent health care and believe in continuing and ongoing education for yourself and others; then, becoming a contact lens dispensing optician is the perfect fit for you.

Only about one percent of opticians own their own stores nowadays and in most states independent opticians cannot fit contact lenses without an optometrist or ophthalmologist on the premises. So opticians who fit contact lenses usually work in a physician’s office. Working with an optometrist or ophthalmologist is a win-win for the optician and the doctor. Since contact lens fitting is a time consuming venture; the doctor who has a great optician doing the bulk of the fitting saves time and improves customer service.

According to the national labor statistics opticians who work for ophthalmologists earn 10 percent more than those who work for optometrists. There are probably a variety of reasons for this but most likely the MD office is a larger business and the optician will have more management responsibilities.

According to the Bureau of Labor Statistics:

• Dispensing opticians help select and fit eyeglasses and contact lenses for people with eye problems, following prescriptions written by ophthalmologists or optometrists.
• Employers increasingly prefer dispensing opticians to complete certification or graduate from an accredited 2-year associate’s degree program in Opticianry; some large employers may provide an apprenticeship.
• A license to practice is required by 22 States.
• Employment growth is projected to be average and reflect the steady demand for corrective lenses and fashionable eyeglass frames.
• Job opportunities are likely to be very good.

• Employment change. Employment in this occupation is expected to rise 13 percent over the 2008–18 decade. Middle age is a time when many individuals use corrective lenses for the first time, and elderly persons generally require more vision care than others. As the share of the population in these older age groups increases and as people live longer, more opticians will be needed to provide service to them. In addition, awareness of the importance of regular eye exams is increasing across all age groups, especially children and those over the age of 65.

“Kaigen (epiphany /enlightenment) is one of my favorite words.  

For those living with weak vision, contact lenses are, indeed, a Kaigen (eye opener)… Among Buddhist artists, Kaigen refers to the moment the eyes are completed in a painting or statue of the Buddha. The eyes are the window to the soul, and completion of the eyes is the moment the soul enters the work of art. In my life, the path to Kaigen has been the making of contact lenses.”

Kyoichi Tanaka

There are real advantages to dual discipline of opticianry and contact lens fitting. First the optical principles needed to be an optician and a contact lens technician are quite similar, both contact lenses and spectacle lenses are vision corrections made of plastic polymers, they are precision ground to give the patient optimal visual acuity. Of course, any contact lens practitioner will tell you that the vision with a well fit pair of contact lenses is better than glasses. The advantages of contact lenses are improved peripheral vision, truer image size quality and better depth perception. When fitting first time contact lens patients it is always helpful to reinforce these benefits, especially when they are confronting their natural instinct to blink and resist lens placement. The same type of problem solving thought processes that are used in solving eyeglass problems are necessary to sort out contact lens complaints. One must be keenly aware of how a person who has astigmatism sees the world and how high prescriptions are affected by movement as small as a few millimeters. The lensometer is a key instrument in measuring contact lenses; but a contact lens technician must also be proficient in the use of an ophthalmometer (Keratometer), a biomicroscope (slit lamp), and a Radiuscope.

As stated; only twenty two states require opticians to have licenses and of those, fourteen require specific training in contact lenses. So what about the rest of the states? In the other twenty states you can be an optician if you say you are, but it is usually easier to get a job if you have certification by the American Board of Opticianry and the National Contact Lens Certification (ABO and NCLC). Some employers offer apprenticeship programs that include online training and on the job work experience. In most of the licensed states there are schools that offer training in the form of a two year associates degree program. Although as an optician one can work independently, only about one percent actually have their own stores (Statistics, 2009), most work for retail chains, optometrists or ophthalmologists.

Work environment

In the course of a day in a contact lens fitter’s life one is called upon to perform a variety of tasks. In addition to regularly scheduled fittings and dispensing, it may be necessary to clean and polish a pair of Gas Permeable lenses for a patient being seen by the doctor. Before starting the lenses should be carefully examined, measure the base curve using a Radiuscope and the power is measured using a lensometer. Some practitioners use a reticle magnifier to check the surface quality of the lenses and measure the diameter of the lenses. Look for a dot on one lens which would usually identify the right lens. Also check for any variations in the thickness of the lens to determine if any prism has been added to orient the lens (front toric designs or some multifocals).

When a new patient comes for a contact lens fitting and he or she has never tried contact lenses before the job of the contact lens fitter becomes counselor as well as optician. The optician must satisfy the requirement that patient has had a complete eye examination prior to the contact lens visit and in most states insure that the doctor is on the premises before proceeding. The first task is to determine the best contact lens for the patient and that requires a thorough discussion of the patient’s occupation needs, hobbies and general expectations of the contact lenses. The next step is to determine if the patient will be able to handle the contact lens, the optician places the lenses on the eyes or, if your doctor prefers, the patient can be given the trial lens and attempts to place it on the eye with your guidance. This is simply the most important part of the fitting, sometimes one must be very patient and encouraging while the patient struggles to overcome their natural instinct to blink. Patience and kindness are the two most important tools to bring to this experience. It is also important to bring a sense of wonder to the process. Once in awhile the patient is so happy to see without glasses that they can be overcome with emotion, if this is treated with dignity and respect you have a patient for life.

The actual fitting of the lenses begins with reading the doctor’s prescription and measuring the shape of the cornea, this is done with a Keratometer (a brand of ophthalmometer). Next the contact lens fitter must have a thorough knowledge of every contact lens; several thousand products are available from hundreds of manufacturers and laboratories. One has to know the material, water content, oxygen permeability, modality, and the available parameters, i.e.: base curve, diameter, power etc. A trial lens is placed on the eye, vision is measured and adjusted, and the fit of the lens is evaluated with a biomicroscope. The lenses must not interfere with the normal function of the cornea and tear film, the lenses mustn’t be too tight or too loose or there is a risk of serious corneal irritation. The disinfection systems for the different contact lens products are another part of dispensing, a complete and thorough understanding of care systems, how they work, and how they are used is critical for success.

Some of us have the privilege of working with patients who need contact lenses for medical reasons. It is important to have specialty training to work with this population because their needs are highly specialized and the general rules of contact lens fitting often won’t apply. Sometimes infants are born with cataracts and after surgery require contact lenses, some eye diseases cause the cornea to become extremely irregular (Keratoconus) and only specially designed gas permeable lenses will give them adequate vision, sometimes only a hybrid lens will work, sometimes following a corneal transplant the patient has residual irregular astigmatism, and some eye disease causes the cornea to become disfigured and special prosthetic lenses are needed. These special patients bring a world of joy to a contact lens fitter and they require a lot of chair time and skill.

How much time is needed to develop the skills and become a competent contact lens fitter? Most optician programs are two year associate degree courses and have an associated externship in a doctor’s office or retail store. The instrumentation takes hands-on practice to become competent. At least two years more with an experienced contact lens fitter helping to guide the way should prepare one for most of the contact lens experiences that will come your way. But contact lens fitting is an ongoing learning process. New equipment and contact lens designs are always being developed to assist us in providing the best technology for our patients. Continuing education is a requirement for certified contact lens fitters, so regular attendance at conferences and reading journal articles are a regular part of this rewarding career.

References:

Jojima, Akihiko, Kaigen, Kyoichi Tanaka’s Half Century with Contact Lenses, 2004. Menicon Co. Nagoya City, Japan

Bureau of Labor Statistics Occupational Outlook Handbook 2010/2011 Edition www.bls.gov/oco/oco098.htm

American Board of Opticianry National Contact Lens Examiners, Website: www.abo-ncle.org

OK, here is a challenge for you: Name one other practice that has been with us for seven hundred and twenty four years and we still do not know how to do it right?

Seven hundred years is a very long time. Why can’t we get this right and why isn’t there a protocol for determining what is going wrong? I know that we see with our brains and not our eyes so maybe the answer belongs in a new area of research ophthalmic psychiatry?

How can dispensing a pair of eyeglasses be this hard?

After a careful examination, you put your patient in the latest and greatest lens design and in a frame made from space age materials. Their prescription changed a quarter diopter in each eye and they come back three days later saying, “I can’t see anything out of these new glasses, I like my old ones better”.

Their old ones by the way are eight years old and one of the first progressive designs on the market. On the new pair the fit is correct, Rx is correct, height is correct, frame bends are correct, and the material is the same that they had before.

I have been at this a long time now and this is NOT a unique occurrence. I know that I am not the only one who fights this battle everyday.

How can it be that patient after patient after patient presents with visual acuity problems in their new glasses? We have had seven centuries to figure this out and we are no better off than we were one hundred years ago.

We have computers, virtual eye charts, free-form designs, auto-refractors, pupilometers and we still cannot make a pair of glasses that people like. In many ways, to me it seems that we are going backwards instead of forward. It seems that we are more focused on asking, “can we do it” than asking, “does it actually work”.

Do not tell me about any “adaptation period” for the new lens designs because that is a line of poop. These patients have really tried wearing them and cannot do it.

It should be like rejecting your 1985 Toyota Corolla over your 1978 Chrysler K car! Well yes, my Toyota is much more powerful, more reliable, less expensive, more comfortable, and it actually starts in the morning, but I really would like to have the K car back… but it is not is it?

When I was a kid I loved jokes. One of my favorites went like this…

A guy walks in to a men’s shop to buy a suit.

The salesman shows him a beautiful suit that the man loves.

He tries it on and notices that the one sleeve is a little longer than the other. The salesman says well if you just drop you shoulder a little it will look good. It really is a beautiful suit.
The man admires himself in the mirror and thinks it is a beautiful suit. Then he realizes the lapel is sticking up. The salesman says well just hold your chin down on your shoulder and it will flatten out, it is a beautiful suit.

Last he notices that the one pant leg is a little short so the salesman says just lean down a little on that side and it will look fine, it is a beautiful suit.

The man pays for the suit and leaves the store. As he walks down the sidewalk his head jammed against his shoulder, his arm drooping and walking with a limp he passes by two women heading the other way. They pass him and the one woman says to the other, oh that poor man, and the other says yes but that sure is a beautiful suit.

A guy walks in to an eyeglass shop to buy…

Thursday March 17th before Vision Expo East, First Vision Media Group will be leading a panel on Opticianry in the US.

In this 2 hour discussion leading opticians and optical industry professionals will share their thoughts on:
Should Opticianry have national licensing or certification?
Does Opticianry need uniform education and continuing education?
How do Opticians promote opticianry as a health career
How to build respect for the profession?
Led by Ed De Gennaro, the other panelists will be Kristi Green (NFOS) Danne Ventura (NAO, Barry Santini (ORBA), Laurie Peirce (Society to Advance Opticianry) Kathryn Ring, The Guild of Prescription Opticians_
The event will be held at the Jabob Javits Center, Room 1E-08 from 10-12 am.

I often say that opticians are their own worst enemies.
Every so often they prove me 100% right…

I am not big on this blogging thing and you all know the saying about opinions, however, every once in awhile some thing comes across my desk that just makes me say, “What?”

I like to think of myself as being part of the modern age of opticianry. That age being the period after the introduction of CR-39 and the switch from opticianry being a care based field to a fashion-based field.

How can it be that after forty plus years in the modern age of opticianry we are still holding public forums at events as large and as important as Vision Expo and be asking these questions?

Let us start with the last question listed as a bullet point, “How do we build respect for the practice of opticianry?” The answer is a simple one, “You don’t.” At least not until you get answers and results for the preceding questions!

Bullet point one: “Should opticianry have national licensing or certification?”

Are you kidding me?

Why isn’t the question, “After forty years why doesn’t opticianry have national recognition and who is to blame?” The answer to that question is, we don’t because we are still asking the first question starting with, “should” instead of the second one asking why we don’t already have it.

We don’t have national recognition because as a profession we are lazy and complacent. Look at any opticianry related site and all you see are the same people making all the contributions. The “gurus” of our profession are out of touch with the industry and out of touch with why we are stuck where we are. Until some fresh blood steps up to the plate and shakes things up we will still be seeing seminars like this one, asking the same old inappropriate questions, popping up at Vision Expo 2021.

Let us look at bullet point two: “Does it need uniform education and continuing education standards?”

Why isn’t the question, “After forty years why have we failed to bring about a uniform level of education?”

We don’t have a level of uniform education because the opticianry schools and education programs are not delivering what the industry wants. Opticianry schools, training programs and most of all, certification exams, need to provide experience in sales, inventory management, insurance, basic dispensing skills, and business sense. We need to insist on students that have communication and computer skills above a fifth grade level! If you want an industry to support you, you need to supply that industry with what they need, just look at nursing as the prime example, why do you think that hospitals have nursing schools?

And the third bullet point: “How do we promote opticianry as a health care career to students?”

This one really makes me angry.

You are asking, “How?” when the answer is, “We don’t because it is not!”

This is where, as a profession, we make a mistake and why we will always be a second shelf product. Opticianry is about making money. We are NOT providing health care, that is the doctor’s job, not ours. We are in a optical practice to make it successful. If we are not doing that then we are a liability and do not deserve to be treated as a profession, as an important part of an industry or as being worthy of support and a living wage.

You want respect?

Earn it!

You want change

Stop sitting on your butt listening to the same old people say the same old things.

The responses on optiboard were actually frightening!

The fear and ignorance that came through when reading between the lines was horrifying.

Why are we so scared to say, “I don’t know the answer.”

Or, “I have intellectual strength in one area but I do lack it in another.”

Why are we unable to have a discussion and recognize others points of views as valid and challenge our own beliefs so we can grow and expand our our world?

I cry out to the wilderness, “What opticianry needs is a good liberal education!”

Sadly my tree falls in the forest and no one hears.

I was going to put up one last post but decided for my mental health I would just let my rant flow here instead…

In addition to my Associates degree in opticianry, earned the old fashioned way at a brick and mortar school in the late nineties, I have a Bachelors of Independent Studies in Adult Education and a Master of Education degree in Adult Education with a minor in Human Resources Development. Human Resource Development is about creating effective workplaces through cooperation and education.

My mentor, and professor at school was Dr. Lex Dilworth the author of Action Learning and Its Applications, among others. Action Learning is a problem solving technique that begins with a simple premise, “If we knew the answer to the problem, then we would not be having this conversation.”

The optiboard seems full of people that are sure that they know it all and know the answers. Which leads me to ask, then why are we still having this conversation? The level of defensiveness and fear that comes through in the majority of the posts is really quite startling. Experience, intelligence and knowledge come in many forms. Until we are willing to admit that the majority of individuals that make up our field are of average intelligence (like me!) we are doomed to remain where we are.

And, yes, as cliché as it is, the old saying is true, “If you are not part of the solution, then you are part of the problem.” Talking heads and industry insiders are not going to solve anything here. Until you have a forum where every contributor or stakeholder is on equal ground, with equal say, and their input is given equal weight you will never get anywhere.

I suggested methods to gather the information necessary to begin a real conversation on the future of opticianry or a variation of what we now think of as opticianry. The methods suggested are the recognized way of gathering data for interpretation and analysis so a group can begin to see patterns and find out what is and what is not important to solving a problem.

Instead of addressing the post the usual people went off in the usual directions trying to show others that they are smart and know the answers.

By the way, in addition to being a Family Nurse Practioner my wife is a full professor of nursing and a PhD. So, yes, when I speak of having an understanding of health care and what makes a field “health care” versus one that is more quasi-health care I do have some idea of what I am talking about.

Sincerely, The Optical Curmudgeon