Eyeglasses.com Blog

Articles for August, 2010

ClearVision Optical presents the evolution of its Cole Haan (Link: Cole Haan Eyeglasses) line. Targeted to metropolitan professionals, the new collection contains 15 men’s ophthalmic styles, 14 women’s frames and 10 sunglasses. Frames are made of acetate, titanium, stainless steel, flat metal alloys and metal/acetate combinations. Designs reflect simple styling with an edge and range from cat eye, butterfly and P-3 styles to pillowed, rectangular and aviator shapes. Some frames feature the signature weave pattern on the temples, wood, leather and carbon-fiber insets, and enamel mosaic and chain-link trim. Described by ClearVision as a broadening of the Cole Haan demographics without losing its base customers, this modern yet sophisticated collection—“classic meets cool”—has all the quality and artisan detail of a typical Cole Haan collection. (Article reprinted with permission from Jobson Publishing at 20/20 Lenses & Technology.)

Photographed by Matt Lambros/Black Box Studio

MARKETING:
Merchandising materials include a counter visual display, in-case display, posters, countercards and mirrors. Each frame comes with a hard case in signature Cole Haan weave material and cleaning cloth.

PHILOSOPHY:
“We are extremely exited about our newest Cole Haan offerings,” says Jennifer Coppel, ClearVision manager of product design and development. “Taking a slightly new direction, we are offering the same quality materials and stylish innovation but at a more conservative price point. We are confident this collection will be well-received in the optical world.”

PRICE POINT:
$$$. For additional information, contact ClearVision Optical, (800) 645-3733; web site: www.cvoptical.com

INSIGHT
Cole Haan is a fashion label founded in Chicago in 1928 by Trafton Cole and Eddie Haan. Originally Cole Haan was a men’s footwear label; today it boasts a range of products from men’s and women’s clothing and outerwear to footwear, belts, handbags and accessories.

There were big dreams for the name iWear, the traditional moniker for the category of eyewear addressed in the last few years for this June issue of 20/20. Quite honestly, 20/20 was gambling on the fact that Apple would license out its branding to an eyewear collection and the name iWear would be a perfect fit. The rights to the name would be sold and everyone associated with 20/20 would retire immediately, rich and frame-us.

That didn’t quite happen. BUT... there is now a collection out there with the iWear name so 20/20 needed to come up with a new I.D. for this category of eyewear appealing to young eyewear aficionados looking to walk that cutting edge of design and oh-so-current pop tart and taste.

(Article reprinted with permission from Jobson Publishing at 20/20 Lenses & Technology. By James Spina)   So... low (or should that be “high”?) and behold: GenEYE eyewear that’s just right for Gen X, Gen Y, Gen Net and... Oh NO, here they come yet again... Baby Boomers, all gazillion of them and still growing (up).

Well, if it appeals to all demographics what the heck is it? Definitions can be difficult when something as solid as product AND elusive as cultural impact blend. It’s also tough when the easiest route is to direct readers to the cover GenEYE feature where one can get a look at the eyewear and sift through the intro and trendsetting tips. Yes, in a direct sense the GenEYE tag denotes eyewear with a definite young appeal.

But to do JUST that limits it. Contrary to naysayers there is a young, well-informed generation (including teens, tweens and older children) literally bursting with a keen sense of awareness for who they are, where the world is at and what it takes to live and prosper in these challenged times. The critical and wise perception of a well-read teenager identifying with Holden Caulfield in “The Catcher in the Rye” has been superseded by word-savvy third graders aligned to the cautious optimism and cynical shielding of Greg Heffley in “Diary of a Wimpy Kid.”

Do NOT underestimate GenEYE. Do not bully them with junk and do not dismiss their power to affect both the marketing of eyewear and the importance of seizing better vision. Your livelihood depends on them. So get to know them... WELL.

You are a dedicated optical pro but you want to make more money and you want to do it with an additional location. I’m dedicated to that position. It’s a natural step. You are doing well with one location. You work hard to remember the needs of everyone who walks through your store’s door. The level of service you and your staff provide is second to none especially compared to that mega-chain down the road.

(Article reprinted with permission from Jobson Publishing at 20/20 Lenses & Technology. By Brad Childs)   Call your vendors. Give them an order for a second location. Set up the phones. Order new utilities. Buy a new edger. Of course much of it is fun, but there is so much more to it than just the fun stuff. Let’s continue. Display Cases. Mirrors. Tables. Tools. Doctor’s equipment. Carpet. Tile. Special lighting. The list goes on. And it’s never REALLY done. Contact lens samples. Sample solutions. Solutions. Solutions! Signage. New advertising.

What are we forgetting? Let’s get to the meat. We haven’t even mentioned the most important piece to this puzzle. If you guess this correctly then you should open another store. Go ahead. Guess.

Did you guess staff and service? RIGHT. How much are you willing to allow the service to drop because you can not be in each location at the same time? And if you think your newly hired seasoned optician is as good as you are, you are wrong. Your customers want to see you and they want to speak to you and have you help them as they patronize your business. When they purchase a digitally surfaced Trivex Transition AR lens they want to tell YOU how good they feel.

My brother Norm and I live to open locations. We breathe service and enjoy the pressures of success. Every time we open a store we put our best people in places where they can be successful and we hope they internalize our business philosophies, transferring that experience to clients. Yet it is always different when one of us is on location. The energy is powerful. The staff is motivated. And the client feels great.

This is what cannot get lost in translation. You are the single most important driving force in any effort to expand. Go for it. Grow for it.

Back in eighth grade, my English teacher introduced us to foreign words and phrases that are part of our lexicon. In one of our first lessons, we learned the Latin expression, caveat emptor—let the buyer beware. This ancient admonition comes to mind as I think about the growing number of consumers who are purchasing prescription eyewear online. These eyeglass wearers are seeking out “e-tailers” offering convenience, a vast product selection and, often, low prices. (Article reprinted with permission from Jobson Publishing at 20/20 Lenses & Technology. By Andrew Karp) There’s nothing wrong with selling prescription eyewear online, as long as the seller informs the buyer that there is a difference between buying from a virtual dispensary and buying from a real one. The difference, of course, is that the real dispensary offers the services of a dispenser. Online consumers are sacrificing the skill and knowledge involved in expertly selecting and properly fitting eyeglasses that only an experienced dispenser can offer. It’s a paradox that the state-of-the-art in e-tailing eliminates the dispenser at a time when the state-of-the-art in ophthalmic lens technology calls for dispensers to be more involved in selecting lenses and fitting eyewear. That’s why ECPs who operate virtual dispensaries should encourage online customers to visit their dispenser to be properly measured and fit for their new eyewear. Ultimately, consumers want choices. Some will be happy buying Rx eyewear online. But others, in their quest for convenience, will end up with badly fitting, uncomfortable, under-performing eyewear. Before Rx eyewear shoppers click the “purchase” button on the screen of their computer or mobile device, we need to advise them, “caveat emptor.”

Photograph by BLACK BOX STUDIO  Tools: HILCO; Frame: CK Calvin Klein 5154 from Marchon

(Article reprinted with permission from Jobson Publishing at 20/20 Lenses & Technology. By Andrew Bruce) 

In their effort to provide patients with the best frame and lens technology, opticians sometimes lose sight of the fact that the eyewear they dispense is onlwy as good as the way it fits the patient. The patient’s satisfaction with their new eyewear depends upon the optician’s ability to pre-fit it prior to taking measurements and then adjust the eyewear to maximize the patient’s vision, comfort and appearance.

Pre-fit Techniques
Pre-fitting a frame prior to taking measurements has a major bearing on how well the finished product performs for the patient. The pre-fit also provides the patient with their first impression of the optician’s skill level.

There are several steps involved in the pre-fit:

• Adjust the nose pads, if present.
• If a zyl frame without nose pads is selected, make sure the frame sits well on the bridge.
• Make sure the size of frame selected is actually going to work for the lens style prescribed.
• Apply the appropriate pantoscopic tilt (usually 5 to 15 degrees).

Note that for every two degrees of pantoscopic tilt added to the frame front, the optical center (O.C.) of the lens is effectively lowered 1mm. To make sure the visual axis of the eye coincides with the visual axis of the lens it is imperative that the necessary pantoscopic tilt be applied prior to measurements being taken. If the frame is not pre-fit, it opens the door for patients’ complaints of visual discomfort with their new lenses (Figure 1).

Final Dispense and Nose Pad Adjustment
When performing the final fit, place the glasses on the patient in case substantial adjustments are needed. If that’s the case, you can remove the eyewear quickly to avoid a negative impression for the patient.



If the frame has nose pads, fine-tune them so the frontal/spread angle, the splay angle and the vertical angle are all correct for the patient. Slim pad arm adjusting pliers (Figure 2) work well for this. The frontal/spread angle is how far apart the pads are. The splay angle is their angle to the nose, which should complement the angle of the nose at the point at which the nose pad is sitting. The vertical angle is controlled by the size of the loop of the pad arm. The standard position requires the bottom edges of the pads be closer to the eye wires than the top edges of the pads. The objective is to make all three angles sit flush with the skin to achieve superior comfort (Figure 3).

The loop of the pad arm should be small in order to keep the vertex distance to a minimum. When fitting patients with very flat bridges, such as those of Asian ethnicity, frames with nose pads are usually the best option. In these cases, the splay angle has to be changed so the pads are sitting almost parallel to the face. Also, the loop of the pad arm may need to be made larger than standard to keep the frame off the patient’s lower cheeks by changing the vertical angle. Bent snipe pliers are good tools for this purpose (Figure 4).

Adjusting the Frame Tilt
In order to achieve premium vision, the optical centers of the lenses should be horizontally level with the pupils. However, if the eyes are vertically uneven, the patient is not going to be happy with a crooked frame. In a situation like this, try to achieve a compromise. If the frame front is tilted, always correct it in the direction of the error. Use a pair of wide jaw angling pliers for this task to secure the temple and end piece together so as not to put excessive strain on the hinge (Figure 5A and 5B). Example: If the right side of the frame front is tilted down, either increase the pantoscopic tilt of the right side down, or reduce it on the left.

After leveling, verify the amount of pantoscopic tilt is between five and 15 degrees. Have the patient rotate 90 degrees so the angle of tilt can be evaluated from the side. The need to precisely measure the pantoscopic angle is becoming increasingly necessary due to the increased use of freeform lenses. There are PD rulers that display protractor markings, making this possible when necessary.

The correct frame tilt is especially important with multifocals, making sure the segment is in the correct position when looking down to read. If there is an insufficient amount, the patient may be looking under the frame, or at least, the field-of-view for near work will be narrowed due to the increased vertex distance between the eye and the segment. As the eyeball rotates around the horizontal axis to look down to read, having the pantoscopic tilt of the frame set at the recommended angle maintains equi-distance between the lens and eye maximizing field-of-view and visual comfort.

Check for Equidistance
When checking if the lenses are equidistant to each eye, with the patient seated and tilting their chin down, observe the frame front from above by standing and looking down on it. If one lens appears closer to the eye than the other, the patient’s eyes may simply be more inset on one side than the other. Another reason may be due to the temples being at unequal angles to the frame front when extending backwards. Whichever lens is closer to the eye, the same side temple needs to be brought closer to the head by reducing the horizontal angle between the frame front and the temple—using a pair of flat/round metal pliers at the end piece (Figure 6). Conversely, increasing the angle between the frame front and the temple of the opposite side is also an option, effectively moving the temple away from the head.

The same way pantoscopic tilt affects the vertical placement of the lens optical center, face form—positive or negative—will also affect the horizontal placement of the lens optical center. However, it is not recommended to compensate for this since lateral prism would be induced. Applying positive face form so the frame follows the natural horizontal curve of the face is a good rule of thumb.

The Fitting Triangle and Temple Adjustment
The frame should be touching the head at only three points which form “The Fitting Triangle”—the nose and the top of each ear. When adjusting behind the ears, the temple should curve just above the ears and follow the line of the back of the ear. Temple bending pliers can be used to aid in this process (Figure 7). It should be at an angle of approximately 45 degrees from the temple and it should not put excessive pressure on the back, or top, of the ear (Figure 8). If the bend begins too soon before the top of the ear, it will rub and irritate the top of the ear. If the bend begins after the top of the ear, the temple will either not conform to the curve of the ear, or it will need to be bent at a greater angle than 45 degrees and the tip will rub and irritate the back of the ear.

Regardless of the optician’s skill level, a visual inspection of the temples behind the ears should always be done to ensure optimum comfort for the patient. The temple bend should follow the line of the side of the head. In order to do this the tip will need some angling in towards the head. In addition, the temple tip should not just be touching the head at the top of the ear leaving a space between the head and temple tip at the bottom. Conversely, it should not just be touching the head with the lower tip of the temple creating a space between the head and the temple at the top of the ear. In the first scenario, if the temple is in contact with the head only at the top of the ear, adjust the temple tip so that it angles in towards the head just enough to gently touch. In the second scenario, if there is a space between the temple and head at the bend, adjust the temple tip so that it is not bending in quite so much. Occasionally, in this case, the temple itself may need angling in a little at the end piece, again using flat/round metal pliers to reduce the horizontal angle between the temple and frame-front, in order to provide a snug fit.

Regardless of the technology available to opticians, all is lost if the optician does not possess the necessary fitting knowledge and skills to put the final piece of the puzzle in place. Eyewear fitting is the optician’s specialty and area of expertise and such a crucial part of the entire process.

The steps outlined here may appear time consuming, but with practice and perseverance, they will become second nature and help raise the bar for the standard of care provided.

The beautiful photo that adorns the cover of this month’s L&T was created by Charles Grover, a California-based artist. Charles is part of group of visual artists whose work is currently being spotlighted in a unique art exhibition called “Shared Visions” at the Southern California College of Optometry’s Eye Care Center in Fullerton, Calif. The exhibit, which began last fall runs through mid-August, features the art of 49 visually impaired and totally blind artists.
(Article reprinted with permission from Jobson Publishing at 20/20 Lenses & Technology. By Andrew Karp) 
We selected this photo to complement our feature article, “A High Profile for Low Vision,” which discusses how new technologies and changing demographics are creating opportunities for eyecare practitioners to treat the exploding patient population suffering from age-related macular degeneration and other eye diseases. If you currently treat low vision patients, or if you are thinking about adding this speciality to your practice, you might also consider decorating your office or waiting room with artwork created by one of the “Shared Vision” artists. To view the ’09-’10 “Shared Visions” catalog, visit www.sccoeyecare.com/documents/svcatalogWEB.pdf. Most of this striking art is available for purchase by calling (714) 449-7464. Ninety percent of the funds go to the artist with the remaining 10 percent to be placed in an Artists’ Assistance Fund to aid artists in future “Shared Visions” exhibits.

The imagination and skill of these talented artists allows those of us who are sighted to see the world from their perspective, while reminding us of the indomitable human spirit that animates the creative process.

If you think cell phone, PDA and WiFi computer technology has changed your life for the better, imagine how it can change the lives of those with low vision. With innovative, new low-vision-friendly electronics, these patients can carry a digital magnifier, read Kindle books, magnify email text, watch TV and have hope restored for maintaining their independence and dignity. There has never been a better time to add low vision evaluation and product sales to a practice. New products abound and with an exploding age-related macular degeneration (AMD) patient population, the need for service providers is growing. Over 20 million Americans have early or intermediate AMD and one in five will lose some vision, according to an article by A. Loewenstein in Retina 2007; Vol. 27. Add the updated National Eye Institute (NEI) and Prevent Blindness America’s Vision Problems in the U.S. report, and we see that cases of AMD indeed grew a stunning 25 percent between 2002 and 2008—the largest increase of all major eye diseases. (Article reprinted with permission from Jobson Publishing at 20/20 Lenses & Technology. By Patrick Dundas) An American Academy of Ophthalmology (AAO) survey conducted in December 2009 identified the breakthrough in anti-vascular endothelial growth factor (anti-VEGF) injectable medicines for treatment of wet AMD as the single most significant advance in ophthalmology over the past decade. The escalating incidence of AMD combined with successful wet AMD treatments are driving low vision product innovation and the availability of breakthrough products. All this is opening the door for eyecare professionals to fill the needs of this patient base with positive outcomes and resulting incremental revenue. NUTRITIONAL SUPPLEMENTS The NEI’s landmark Age-Related Eye Disease Study (AREDS) completed in 2001 is the first to show a decreased risk of macular degeneration progression in the high-risk group when treated with a high-dose combination of vitamin C, vitamin E, beta-carotene and zinc (www.nei.nih.gov/amd). This success has led to AREDS2, an NEI follow-up study with a modified formula designed to increase effectiveness. The Nutrition Business Journal reports that following the publishing of AREDS, the U.S. vision supplement market exploded from $63 million in 2001 to $223 million in 2007. Not surprisingly, there are now a number of supplement products available with AREDS and AREDS2 formulations for ECP recommendation and/or dispensing to AMD and at-risk AMD patients. DIAGNOSTIC INSTRUMENTS AND TESTING Recommending supplements calls for identifying patients with significant risk factors. Leading the way are age, smoking, obesity, hypertension and perhaps most importantly, family history. Recent breakthroughs in genetic profiling have yielded a way to identify an individual patient’s risk of inheriting AMD. Macula Risk, a one-time “in-office” saliva swab from ArcticDx, can detect and analyze certain genetic markers known to be responsible for vision loss. Low macular pigment optical density (MPOD) is another risk factor. Using a Heterochromatic Flicker Photometer from MacuScope or ZeaVision, MPOD can be measured and monitored in advance of any vision loss or signs of extracellular material buildup (drusen) in the retinal layers. Test results provide a guide to recommending dietary nutritional supplements and measuring their effectiveness. Preferential Hyperacuity Perimetry Early detection of wet AMD is even more critically important. Usher in Preferential Hyperacuity Perimetry (PHP). PHP is a specialized perimeter that detects and measures subtle misalignment of an object on the retina or elevation of retinal pigment epithelium. This highly sensitive instrument is able to objectively identify advancing AMD that has not yet changed visual acuity and detect the conversion to choroidal neovascularization or “wet” AMD. With the advent of effective treatments for wet AMD, doctors can catch and stop or slow the progression of the disease. The Foresee PHP in-office device is made by Reichert Technologies, which acquired the product from Notal Vision in November, 2009. The instrument is easy for the staff and patient to use and represents a giant step in helping practitioners with early detection of abnormalities consistent with wet AMD. Notal Vision retained the rights to a soon to be available home-based PHP where high-risk patients can test themselves daily and transmit the data over a phone line to Notal Vision. The test results are then available to the patient’s doctor through a secure online connection where they are able to monitor suspected wet AMD patients for early detection so critical to the decision to proceed with macular treatments. Optical Coherence Tomography Advances in laser scanning technology have brought us Optical Coherence Tomography (OCT) that provides high-resolution cross-sectional retinal images for diagnosing and monitoring a wide range of ocular disease states. In the AAO survey, OCT trailed only anti-VEGF treatments as the most significant advance in the last decade. The newest, most dramatic improvement in OCT technology uses spectral-domain 3D imaging. With SD-OCT, a virtual HD image of the retina and its individual layers are viewed in three dimensions making it possible to see pathology in detail that might have been missed in a single OCT image. For AMD diagnosis and tracking, SD-OCT makes it possible to clearly see drusen detail buried in the retinal layers. There are several SD-OCT instruments on the market with similar core components. Differences exist in the peripheral features such as built-in fundus camera, angiographic system, retinal tracking and anterior segment modules. LOW VISION AIDS The explosion in imaging and optics technology for the consumer electronics and communications industries are being applied to low vision magnification and adaptive products with a resulting surge in popularity. Portable Video Magnifiers While conventional hand-held and stand magnifiers are often the most cost effective and practical for certain patients and certain tasks, new portable video magnifiers are rocketing ahead in sales to motivated and competent seniors. Rich with features like variable magnification, multiple contrast viewing modes and freeze frame capability, these devices have become a very popular choice. Seemingly overnight, whole families of hand-held and pocket video magnifiers have become available from the leading low vision device companies. Choices range from tilting 7" screen models to pocket magnifiers that are smaller and lighter than a cell phone like the 3"x 3 ½" Mini from Optelec and i-vu with a two-inch screen from Clarity. SenseView Duo from GW Micro has near magnification features with the added capability of a distance viewing camera that allows the user to shoot, pan and zoom saved images. The Ash Technologies Quicklook 2 from Eschenbach features a second side-mounted camera for writing, plus touch screen focusing and magnification control. Desktop Video Magnifying Systems Closed circuit television units of old have been replaced with newer technology desktop video camera systems. These systems are so versatile that patients can use them for reading, writing, real-time hobbies, self grooming and other daily tasks. Today’s desktops come equipped with ultra-thin pivoting telescoping HD flat screen monitors, auto-focus, crisp LCD image resolution, multiple viewing/contrast modes, adjustable magnification ranges from as low as 2X to more than 70X in a single device. For patients and tasks needing no magnification but improved contrast with multiple background viewing modes, Optelec has recently added 1X magnification to their ClearView+HD product. With SmartView from HumanWare, the user can capture/store up to 10 book page images, reformat the text and then zoom in for automatic or manual scrolling. For portability, Vision Technology has designed a 15-inch screen battery-operated unit that folds together like a laptop and opens up into a fully operational desktop video system for home, office or travel. Several desktop models are computer compatible so that the user can split the screen to view magnified print materials alongside their own computer files. Bierley Associates make a full line of portable computer mouse-like cameras with multiple viewing modes for video output TVs or with USB computer connectivity. Images are magnified on screen as the mouse is moved across the page. Lightweight foldable video cameras for use by on-the-go laptop computer users are now available from several manufacturers. Newest is the battery operated Transformer from Enhanced Vision. Weighing less than two pounds, it features USB connectivity with multiple viewing options. These products are equipped with an adjustable rotating camera for near, mid-range and distance viewing of classroom chalkboards or meeting room presentations. The user can snap a picture and store it for later viewing. They also feature split screen capability for magnifying external images alongside computer files. With the ABiSee portable text-to-speech systems, laptop computer users view and listen to printed material as the camera snaps and starts reading automatically with the turn of a page. Users can read along with the words magnified and highlighted as the text is read. Part 2 of this article explores the use of low vision aids such as video eyewear, optical magnifiers, magnification software and low vision friendly keyboard as well as lighting and sun filters, and wireless GPS systems and readers.

Madonna teams up with the über-chic Italian duo Dolce and Gabbana to collaborate on a stylish sunwear collection. MDG (which is Madonna + Dolce and Gabbana) launches six seductive styles this month. This is the pop-diva’s first foray into the world of eyewear and will be manufactured by Luxottica. (Article reprinted with permission from Jobson Publishing at 20/20 Lenses & Technology. By Patrisha Zabrycki) “Designing an eyewear line with Madonna was a new experience for us,” say Domenico Dolce and Stefano Gabbana. “The oversized and wraparound designs are sexy and very feminine, like our clothes. Madonna’s creative contribution and unique point-of-view were key, even in designing the MDG logo.” Madonna will also lend her face to the MDG ad campaign. The campaign features the singer as the sensual femme fatale of a noir film caught on camera in the company of an intriguing man. The voyeuristic images metaphorically evoke the essence of a star: admired, spied, adored, pursued and desired, but never fully revealed, shrouded in dark glasses and mystery.