Binocular Vision Dysfunction: Why 20/20 is not good enough

By Dr. Patrick Quaid, OD, FCOVD, PhD

Binocular vision (BV) dysfunction, a term generally used to describe problems with teaming and co-ordination of one’s eyes, is often a significant challenge to detect and treat in the eyecare arena. BV disorders are more frequently encountered than glaucoma, macular degeneration and diabetic retinopathy combined. Surely a condition that occurs 8.5 – 9.7 times more often than all ocular disease in children aged six months to 18 years1 combined deserves greater attention.

Using U.S. Census Bureau estimates of the prevalence of amblyopia (2-3 percent) and strabismus (3-4 percent) in the general population, in 2010 there were approximately 9.3 million amblyopes and 18 million people with strabismus in the U.S.1 Indeed, published research has indicated that “correctable vision impairment” is the most common “treatable chronic condition in childhood”2,3. Building a Comprehensive Child Vision Care System, published by the National Commission on Vision and Health4, has useful statistics for interested readers.

There is also growing research indicating an association between academic performance and vision. One such study5 looked at 782 first- to fifth-graders and found an association between lower academic achievement and hyperopia of +1.25DS and higher. We looked at this issue in our practice recently and found that students with a reading-based IEP (Individual Educational Plan) had significantly greater hyperopia compared to controls, with the median value being close to +1.25DS. Cycloplegic refractive error was used (i.e. drops) as children often mask significant amounts of hyperopia by virtue of their accommodation. Indeed, over 80 percent of IEP children in this study saw 20/20 without glasses despite significantly greater levels of hyperopia. A worsening trend of reading speed is also observed using the Visagraph III system with increasing levels of uncorrected hyperopia (Figure 1).

binocularfeature

Figure 1Left: Reading speed (measured objectively with Visagraph III system, which uses infra-red photodetectors to track eye movements in real time) versus refractive error (no significant difference in astigmatism between IEPs and controls). Note the Y-axis shows reading speed below grade level. Thus, a higher number indicates worse performance. Right: Difference in refractive error (DS) between the IEP and controls (in submission, Quaid & Simpson, 2012).

If you don’t think +1.25DS is a big deal, try over-minusing yourself by 1.25 dioptres for a day and get back to me. While we do not doubt that other factors are involved in reading ability, +1.25DS or higher on cycloplegic should also prompt other BV specific tests, such as fusional and accommodative facility and reserve measurement.

Interestingly, published literature shows a three-times-higher incidence of convergence insufficiency (CI) in ADHD-diagnosed children compared to the general population6. Given that five of the nine DSM-IV criteria symptoms for ADHD overlap with CI, the authors advised that any child with suspected ADHD have CI specifically ruled out. CI is important to detect when we consider that the Convergence Insufficiency Treatment Trial7 (a randomized controlled trial) showed that CI can be effectively treated using vision therapy. Interestingly, patients with known BV issues also score significantly worse on behavioural test batteries (i.e. Connors scale)8, re-enforcing the need to detect BV conditions in “behaviourally challenged” children. In short, 20/20 really is “not good enough”.

We have developed an iPad-specific application (app) called “NuBV”, which is free to download from the App store. This app contains tools for all eyecare professionals to use. There is a BV questionnaire that is quick to administer (0-60 scale). If the patient scores over 20 they should be seen for an eye examination with attention to BV. For more information on BV, we recommend www.covd.org. A great resource for your patients is www.visionhelp.com.

The area of learning disabilities is multi-disciplinary. Collaborative care is the way forward, not just in eyecare. Thus, when dealing with learning disabilities as an ECP, it is important to build rapport with professionals in allied health fields such as psychology and occupational therapy.

Top 5 symptoms of BV dysfunction:

  1. Frontal headaches (forehead and/or around the eyes).
  2. Losing their place while reading or having to use their finger or ruler to track.
  3. Seeing text drifting in and out of focus when reading or writing.
  4. Easily distracted from reading/near point activities.
  5. Rubbing eyes when reading and general agitation/resistance to reading.

Dr. Quaid practiced in the UK hospital eyecare system, specifically dealing with glaucoma co-management and pre- and post-operative care of binocular vision patients (Bradford Royal Infirmary). He attained his PhD in 2005 from the University of Waterloo School of Optometry and started his practice in Guelph with IRIS The Visual Group (a collaborative care model) with specific emphasis on binocular vision. Dr. Quaid serves on the Editorial Board for Optometry & Vision Development, is Adjunct Clinic Faculty at UWSO and serves on the Quality Assurance Committee for the Ontario College of Optometrists. 

References:

  1. Maino, Dm (2010). The Binocular Vision Dysfuntional Pandemic (Ed). Optometry & Vision Development, 41(1), 6-13.
  2. Kemper et al (2004). Patterns of Vision Care Among Medicaid-Enrolled Children. Pediatrics, 113, 190-196.
  3. Kemper et al (2004). Prevalence and Distribution of Corrective Lenses Among School-Aged Children. Optometry & Vision Science, 81(1), 7-10.
  4. National Commission on Vision & Health (June 2009). Building a Comprehensive Child Vision Care System.Prepared by ABT Associated Inc.,55 Wheeler St.,Cambridge,MA.
    1. Rosner J & Rosner J (1997). The relationship between moderate hyperopia and Academic Achievement. How much plus is enough? Journal of the American Optometric Association, 68, 648-650.
    2. Granet et al. (2005). The Relationship Between Convergence Insufficiency and ADHD. Strabismus, 13, 163-168.
    3. CITT Study Group (2005). Convergence Insufficiency Treatment Trial.
    4. Borsting et al (2005). Measuring ADHD Behaviours in Children With Symptomatic Accommodative Dysfunction or Convergence Insufficiency: A Preliminary Study. Optometry, Vol. 76, Issue 10, 588 – 592

Kids Eyewear: Children Know Best

By JoAnne Sommers

featureWhen it comes to eyewear, today’s children are both seen and heard. Kids know what they want and they’re not shy about expressing it. And if they’re smart, parents and eyecare professionals (ECPs) are paying close attention.

“Children have much more influence on eyewear purchasing decisions than ever before,” says Beverly Suliteanu, creative director and vice president of product development for WestGroupe.

Durability used to be the primary focus of kids’ eyewear but fashion has become a much more important consideration in the past two years, she says.

“Children are adamant about wanting what their peers and idols have and if they dislike their glasses they simply won’t wear them.”

Kids are often the pickiest consumers because they’re highly trend-conscious and want to look like adults, especially their parents, says Josh Wyman, marketing coordinator with Ogi Eyewear.

“The Ogi Kid’s collection bridges the gap between fun and functional with frames that emulate those worn by adults. Today’s children are the fashion enthusiasts of tomorrow and Ogi is looking to give them a head start.”

Tastes have changed a lot in recent years. Gone are teddy bears, balloons and happy faces; in their place are cool, trendy-looking frames with an emphasis on fun colours and shapes.

V. Design’s Kids collection from Concept Eyewear has taken children’s eyewear to a whole new level with multi-dimensional frames that kids are excited to wear, says President Pille Annist. “They have the “cool” factor and the ability to express the child’s individuality,” she says.

The collection combines unexpected, unique shapes and extravagant temple details with bright, fun colours, such as white with bright purple and turquoise with orange.

“This assertive, upscale eyewear line mimics V.Design adult frames,” says Annist, who believes there’s a growing market for unique, non-mainstream children’s frames. “They’re perfect for a child or parents who are looking for something playful, fresh and stylish.”

The frames are also very sturdy, which is essential with children’s eyewear, she adds. “Quality is key because kids are so hard on their glasses.”

Children’s optical eyewear poses a major challenge for eyewear producers because the fit, weight and performance must be right to ensure that it fulfills its medical purpose while withstanding great stress. It must also look good to persuade children to wear it.

adidas kids’ eyewear offers visual appeal combined with convincing functional performance. Very light, yet robust, it adjusts to the wearer’s face thanks to soft nosepads that prevent pressure points and ensure a comfortable fit. Flexible temples always return to the correct starting position and a non-slip rubber coating on the inside of the temples ensures a secure grip.

Lafont pour les enfants from Lafont Co. offers glasses specifically designed for children’s faces, says Brand Manager Kristin Calimlim. That’s important because children’s faces are shaped differently than those of adults.

“Lafont frames enable the eyecare professional to fit each one to the specific morphology of the child,” she explains. “Our glasses are the most optically sound for kids because they’re designed for a child’s view of the world. The lens area is above the eyebrow because kids are always looking up.”

Thanks to growing awareness of the importance of protecting children’s eyes, kids’ eyewear is becoming an increasingly lucrative market, says Amanda Grant, communications director with Rudy Project.

“Consumers understand that eyewear is not just for looks,” she notes. “It provides protection against cataracts and growths on the eye, including cancer, which is why it’s so important to start protecting the eyes with sunglasses early in life. Rudy Project understands this and we’ve designed our ROB sunglass specifically to fit the faces of children and smaller-faced adults.”

The ROB is a very lightweight sunglass designed to fit small faces, making it ideal for children and smaller women. “Comfort is key with sunwear – whether for children or adults,” says Grant. And weighing in weighing at less than 0.78 oz., “the ROB is so comfortable you barely know it’s there.”

It is also fully Rx-able and comes in a variety of bright, fun colours that appeal to even the most discerning young customer.

Tips for ECPs

Here are some suggestions for ECPs who want to grow their children’s eyewear practices:

• Don’t talk down to kids, says WestGroupe’s Bev Suliteanu. Involve them in the buying process by asking about their favorite colours and find out what they like or dislike about particular frames. Be guided by their answers.

• Create a kid-friendly environment. Roberts & Brown recently renovated, adding a large, colourful, interactive kids’ rug, rainbow-coloured frame bars and vanity mirrors shaped like giant pairs of kids’ glasses.

• Take time to explain things to parents and answer their questions, says Sheena Taff, manager of Roberts & Brown Opticians in Vancouver. “They’re often worried and overwhelmed when they come in so we want to reassure them by answering all their questions and providing support.”

• Good warranties are essential with kids’ frames because they undergo so much wear and tear. Make sure the frames you sell are covered by solid warranties and instruct staff not to ask what happened to a pair of broken glasses if they’re returned. You don’t want to make either kids or parents feel bad about it.

• Discuss the importance of proper sunwear and sports goggles with parents. “Some kids lose their vision due to injuries,” Taff warns. “That’s why it’s important to educate parents about the benefits of protective eyewear.”

• Ask your adult patients whether they have children and if so, ask if their child’s eyes have been examined within the last year. Children should have their first eye examination by six months of age and every year thereafter.

WHAT’S NEW IN KIDS EYEWEAR:

Canadian Optical Supply (COS)

Collection: Lite Fit from adidas eyewear

Ages: children and teens

Features: Colourful, sporty, full-rim models; very light and robust; adjust perfectly to the wearer’s face. Flexible soft nosepads prevent pressure points and ensure comfortable fit. Flexible temples always return to correct starting position. Non-slip rubber coating on the inside of temples ensures a secure grip.

Key Models: Youth metal models a001 and a002 in brown, grey mat/black, cherry, blue jeans.

Warranty: guaranteed against manufacturer’s defects for 2 years from date of purchase.

Concept Eyewear Inc.

Collection: V. Design Kids

Ages: from 4 up; also suitable for smaller adults

Colours: white with bright purple, turquoise with bright orange, lime green

Materials: 22 stainless steel models, 2 acetate models with metal temples

Shapes: multi-dimensional with different layers; unique temple details

Special features: adjustable nosepads, durable construction

Warranty: 1 year on manufacturer’s defects.

J.F. REY

Collection: J.F. Rey Kids & Teens

Ages: 6-15

Materials: Irwin, Ibizza, Indy, Izza and Idol: acetate on the front with stainless steel on temples. Icone and Ideal: stainless steel. Impala & Iguane: nylor, with rich, refined work on the temples. Highly coloured resins on girls’ models adopt mirror effects.

Shapes: Indy, Izza and Idol: fresh, flowery designs, round or butterfly shapes.

Irwin andIbiza: modern shapes with a double bridge for boys. A wide range of colours and two-tone colours.

Warranty: 1 year from date of purchase on manufacturer’s defects.

Lafont

Collection: Lafont pour les enfants

Ages: babies to tweens

Features: babies-only styles have silicon inside, very soft and non-allergenic.

Material: acetate and silicon for babies, combination acetate and stainless steel for kids 2-12.

Features: end tips are customizable; temples have 5 mm increments and can be shortened up to 15 mm.

Silicon-based nosepads; most models have spring hinges.

Colours: bright pinks, purples, blue, green, red, tortoise, black.

Shapes: cat eyes for girls, rectangular for boys. All have a higher lens area above the eye for a children’s view of the world.

Warranty: 1 year on manufacturer’s defects.

Modo Eyewear

Collection: Eco Kids

Ages: 7-12

Features: non-toxic and hypoallergenic, featuring round temple tips and spring hinges. All made of 95 percent recycled material.

Key Models:

515: narrow retro rectangle in plastic; in brown, navy.

514: subtle, sculpted look in plastic featuring complimentary interior and exterior colours. In red, tortoise.

513: Potter-like specs with complimentary coloured rims made of stainless steel and temples in plastic. In brown, navy.

512: butterfly frames; front is stainless steel, temples are plastic and come in super-chic patterns. Topped off with the Eco icon inlaid at the temple. In brown, purple.

Warranty: 2 years from purchase date against defects in workmanship or materials.

Ogi Eyewear

Collection: Ogi Kids

Ages: 3-12

Key Models:

OK300: perfectly resembles a scaled-down version of the adult 3101. A playful cat-eye with delicate feminine flair made from Italian acetate; unique colour palette of blue, purple, red, or amber marble.

OK301: scaled-down version of adult model 9606. The keyhole bridge and neutral colour palette reflect conservative fashion. Italian acetate unites with spring hinges for long-lasting durability.

Colour: crystal/grey demi, blue demi/blue, amber demi/brown, green demi/green.

Warranty: 1 year

Optik Innovision Canada

Collection: Allegro Junior

Ages: 12-16

Shapes: square to classic ovals.

Materials: most are metal, 2 acetate.

Key Models:

474: unisex plastic frame with some texture on the front. In black and candy pink; deep purple and tangerine; evergreen and blue; navy blue and bright yellow; teal and bright purple.

473: metal with fun embellishments on the temple. In two tones of purple; black and white; chocolate and pink; dark burgundy and turquoise.

Warranty: 2-year warranty from purchase date.

Rudy Project

Collection: children’s sunwear collection consists of five models.

Ages: from 5 and up

Key model: weighing just under 0.78 oz., ROB 2.0 is the newest addition to the casual line. For those with vision correction needs, ROB 2.0 offers a highly refined RX option and broad parameters.

Warranty: Lifetime replacement lens guarantee and 3-year frame warranty.

Sunoptic

Collection: Zoobug sunwear

Ages: 4-12

Features: 100 percent UV protection.

Key Models:

DaisyChain: features a flexible temple design and robust but soft side, integrated into the temple for excellent comfort and ease-of-wear. In pink, pink/white, dark pink or lilac.

SUPER A: new interpretation of the classic Aviator in six colours: pink or purple for girls, transparent or black for boys. Slightly oversized at the front, features classic double bridge. They offer a snug fit on the sides and around the ears. In lilac/flower, pink/flower, red/flower, blue/stripe, clear/stripe or black/stripe.

BUZZBLING: in purple, pink, black and transparent. Decorated with crystals on either side of the front. Has Zoobug’s ultra-comfortable flexible temple joint.

ZB 9 WAYFARER: in lilac, black, red, red/white, pink, dark blue or lilac.

Warranty: 24-month full replacement.

Tekā Eyewear

Collection: Huveli Milano

Ages: 10-16, also fit smaller women.

Material: newest, most popular models are full plastic, adjustable, durable and lightweight.

Shapes: round, square and rectangular.

Mainly unisex, some exclusively for boys or girls.

Warranty: 1 year

Viva International

Collection: SKECHERS

Ages: 5-10, 11-16

Key Models:

SK 1030 and SK 1031: boys’ styles; SK 1030 has a metal rectangular front; SK 1031 an acetate rectangular front.

Both feature recessed horizontal detail; the raised metal SKECHERS “SKX” logo is etched on each temple.

Colours:

SK 1030: matte black/blue, satin brown, satin gunmetal/green

SK 1031: black/blue stripes, brown on orange, grey on black

Girls/Tweens

Colours: pink, magenta, purple

Material: rubber

Shapes: stars, hearts and flowers with glitter and sparkle

Boys/Tweens

Colours: black, gunmetal, blue

Shapes: Metal in half rimless shapes

Warranty: 1 year

Westgroupe

Collection: Superflex Kids

Ages: 5-12

Materials: stainless steel and acetate.

Styling direction: fun, funky and bold.

Colours: two-toned fronts and temples. Boys: navy, grey, brown, black. Girls: fuschia, teal, turquoise, red, purple, citrus.

Shapes: for boys softened rectangles and sporty ovals; for girls softened rectangles, cat eyes, modified ovals.

Features: spring hinges and lightweight material.

Warranty: 2 years for manufacturer’s defects.

Game On: Performance Sunwear Offers Incremental Growth Opportunities

Game On: Performance Sunwear Offers Incremental Growth Opportunities
ByJoAnne Sommers

North America’s sports-performance sunwear market has undergone a shift in recent years. Gone is the one-size-fits-all, mass market approach; in its place is a highly differentiated approach designed to meet the demands of people involved in specific sporting activities. These people want sunwear that improves their athletic performance by delivering better vision combined with solid protection and good looks. And manufacturers are stepping up to the plate with an exciting range of new products that deliver all three.

“Sports sunwear was originally designed to be protective but it has since become performance-enhancing and fashionable as well,” says Rob Begg, president, 20/20 Accessory Source.

He cites 20/20’s GK™ Ghost and ProGear as examples, noting that both models combine their best features into products that look good and outperform the competition.

“The GK Ghost has a sporty look and is durable and flexible with its ultra-light polycarbonate frame, combined with A/R back coat and flash mirror finish to reduce reflection. The ProGear Eyeguard line has evolved traditional, goggle-like athletic eyewear into more stylish frames without compromising safety.”

GK Ghost and GK Helium are ideal for bicycling or motorcycling, says Begg. “The wrap-style lens and frame provide protection from side winds and TPR temple tip inserts are remarkably durable, yet soft and flexible for optimal comfort.”

Interchangeable lenses increase versatility by enabling the wearer to suit the tint to the activity. Dark, UV-protected lenses are good for baseball and other outdoor sports, while golfers can benefit from gray or brown-coloured lenses that make it easier to outline the course.

20/20’s GK Helium comes with brown, grey and clear polycarbonate UV400 interchangeable lenses, while GK Personal offers a range of customization options.

Bollé’s portfolio includes sunglasses and goggles designed for everything from alpine skiing to water sports. The French company has always had a sports orientation but its marketing approach has changed, says René Gerber, marketing coordinator, eyewear, Bushnell Outdoor Products, which distributes Bollé inCanada.

“We used to sell fashionable, sporty, all-purpose sunwear that appealed to the masses,” says Gerber. “But Bollé’s marketing has gone more vertical and our products are now designed for distinct market segments.”

She points to the Competitor line (including Bolt, Tempest, Helix, Draft, Vortex), which is designed for running and cycling as well as water sports. Interchangeable lenses in different colours enable wearers to match lenses to changing light conditions, she notes.

The Alpine Sun collection (Diablo,Rainier, Ouray) provides an alternative to ski goggles for snow sports enthusiasts. The wrap on the collection is severe, providing greater protection at high altitudes. Lens choices include standard, photochromic and polarized, all of which feature hydro-oleophobic and anti-fog coatings.

The Liberty Sport line from Alternative Eyewear is designed for everything from golf to scuba diving and motorcycling, says PresidentPaul Storace.

“This is a comprehensive, fully-customizable product. We offer 15 lens options and five different sizes and colours. The lenses are five times stronger than standard polycarbonate and everything is Rx-able.”

Storace calls sports sunwear, “the most interesting segment of the optical marketplace because it presents opportunities for incremental growth (growth separate from sales of ophthalmic glasses and purchases driven by vanity alone). This is real organic growth that doesn’t compromise the primary sale and savvy eyecare professionals will recognize and capitalize on the opportunity to maximize sales.”

The process starts by talking about sports while conducting the eye exam, says Storace. “Ask about the patient’s lifestyle and sports interests. Bring up the benefits of wearing eyewear designed specifically to suit their activity needs.”

Alternative Eyewear can help with the process of patient education, he adds. “We offer several options, from six- to 48-piece displays, that help create an independent profit centre inside the dispensary. By having the display in what we call a Sport Centre, the ECP can demonstrate the features of different products and their accompanying benefits. The end result is a better fit and a better-informed patient.”

The practitioner can combine the display with sports equipment such as soccer balls, baseballs, etc., which reminds patients that they should at least consider performance sunwear as part of their overall purchase that day.

Vision Ease, which manufactures Coppertone™ and SunRx lenses, offers a wide range of educational tools for ECPs, including a polarized demonstrator that allows customers to view a glared-out scene through polarized lenses. By demonstrating how the lenses work, customers can experience their benefits, which increases the likelihood that they will choose this option, says Marketing and Communications Manager Jay Lusignan.

Hilco, which sells Leader Rx sunglasses, has developed a complete merchandising system, featuring protective eyewear for work and play. It hangs on the ECP’s frame board to promote vision protection.

“Eye protection is good for patients and good for business,” says Debbie Fitzgibbons, director, marketing communications. “Anyone can carry sunglasses but we give ECPs a merchandising vehicle that helps consumers think about protection in a different way.”

Another shift in the sunwear market reflects the greying of the baby boom generation.

“This is the first generation of presbyopes that doesn’t want to get old,” says 20/20’s Rob Begg. “They need a correction but don’t want to buy sunwear at the drug store.”

To meet that need, 20/20 has introduced Hidden Suns, the first bifocal golf sunglass. “Hidden Suns are a treat for those who require bifocals but don’t want to be seen wearing them. The add or segment borders are on the back instead of the front like traditional bifocals. With the tinted colour and mirror coat on the front, and the add on the back, the result is a sleek, stylish look with no evidence of a bifocal.”

And with seniors expected to comprise almost one-quarter of the population by 2036, this is one marketing trend we can expect to see a lot more of in the years ahead.

Here’s what’s new in performance sunwear this year:

20/20 Accessory Source

GK™ Marlin

An excellent choice for fishing enthusiasts, with ultra-light TR-90 frame, polarized polycarbonate lenses with flash mirror and oleo phobic coatings on the front, and an A/R purple backcoat.

GK™ Max

The ultimate in comfort and protection with side shields, rubber comfort temples, and nosepads for extra cushioning and grip. Customize fit with adjustable pantoscopic tilt temples.

GK™ Sport

Ultra-light, rimless, non-polarized, unisex bifocal sunglasses with flash mirror-coated polycarbonate lenses.

adidas eyewear

(distributed by Canadian Optical Supply Co. Ltd.)

Adizero Tempo

Designed for runners, the aerodynamic lens shape creates an extremely wide field of view, providing sun and wind protection. Adizero Tempo features a rimless design and lightweight temple material (XPX).

Features:

• Polycarbonate lenses;

• Innovations Flex Zones™ for better fit;

• ClimaCool™ ventilation system;

• Vision Advantage™ Basic 9 PC lenses decentered;

• Ergonomic temples with Traction Grip™ do not slide;

• Double Snap Nose Bridge™;

• Available in 9-base lenses or 7.5;
• Quick-Change Lens System™;

• Performance Insert™ available for Rx;

• Quick-Release Hinge™.

Terrex™ FAST – a393

Can be used as a regular sunglass or for activities such as biking, running and cross-country skiing. Polycarbonate lenses equipped with Vision Advantage™ PC filters that provide 100 per cent UVA/UVB/UVC protection.

Features:

• 8-base decentered;

• Vision Advantage™ PC lenses: Space Lens, LST Bluefilter, LST Active, LST

  Bright;

•TRI.FITTemple;

• Double Snap Nose Bridge™;

• Quick-Change Lens System™;

• Quick-Release Hinge™;

• ClimaCool™ ventilation system.

Alternative Eyewear

Liberty Sport consists of two lines: Sports Protective and Sun Performance.

Sun Performance

Fully customizable, in five sizes and colours. Fifteen lens options for use-specific situations, including biking, hiking and swimming. Available with a range of lens tints and coating options.

Features:

• Sport-specific, optical quality poycarbonate lenses that pass ASTM Z80.3 standards and provide UV400 protection;

• Fully Rx-able;

• All full-rim sunglasses designed with a Safety Back Lip to ensure lens retention in the frame.

Sport Protective

The most comprehensive collection of sports safety eyewear, designed for basketball, handball, soccer, etc. All have polycarbonate lenses and meet ASTM F803 standard.

Liberty Sport offers Plan “B” Eyewear’s Switch™, the world’s first magnetic interchange lens system®, enabling you to change lenses to manage light in different situations. Lenses eliminate UV light and glare, and rebalance light to improve vision. All Switch Vision lenses are made with zero-distortion, optically correct, shatter-proof polycarbonate.

Bollé

(from Bushnell Outdoor Products, distributed by Centennial Optical)

Competitor Series (Bolt, Tempest, Helix, Draft, Vortex)

The series features B Clear Anti-fog lenses with Trivex® (lighter than polycarbonate), that offer the best impact resistance and provide maximum UV protection.

All models are all half-rim and feature adjustable nosepads, and the moisture-absorbing hydrophilic properties of Thermogrip® that keeps frames comfortably in place during extreme exertion. Interchangeable lenses offer the flexibility to change lenses to match conditions.

Vortex can be paired with an RX adapter while Helix and Tempest can be customized through eyecare professionals and the Bollé National Sun RX Program.

Alpine Collection (Diablo,Rainier, Ouray)

Alpine features B Clear Anti-fog lenses with Trivex® and comes with interior anti-fog coating and hydrophobic coating.

Available with Element (all-purpose), Eclipse (photochromic) and Horizon (polarized) lenses.

Most of the Bollé line is Rx-able, except shields.

 Hilco

Leader Rx sunglasses combine wrap styling, affordable frame pricing, superior optics and low-cost standard lens processing. Ideal for outdoor, non-contact sports, including motorcycling, fishing and skiing.

Features:

• 8-base wrap styling with the processing ease, affordability and optics of standard Rx lens mounting;

• Optical performance superior to 8-base Rx sunglasses and eyewear with “fit behind” optical inserts;

• Pre-edged, 8-baseplanopolarized polycarbonate lenses (optional) convert any style to performanceplanosunglasses.

Collection features 11 styles with:

•planopolycarbonate sun lenses in standard Rx adapters;

• over-molded temples for added comfort.

Kaenon Polarized

Kaenon presents three sport-specific pieces from its Kore Performance series of polarized sunglasses: Hard Kore Blue G12, Hard Kore Red G12 and Soft Kore Aqua Marine G12. All are unisex.

All Kaenon polarized sunglasses come with patented SR-91® polarized lenses that provide the optical clarity of glass and the light weight and durability of polycarbonate, without compression and distortion issues.

All SR91 lenses available in grey, copper and yellow tints that allow users to “tune their vision”, depending on the sport or lighting. Frames built with lightweight TR-90. Rubber nosepads and temple tips keep things anchored in place.

All available in Rx in single vision and free-style progressive.

Nike Vision/Transitions Optical

Nike Vision and Transitions Optical have launched Nike® MAX Transitions® adaptive sunglasses.

Lenses combine Transitions Optical’s advanced photochromic lens technology and Nike Vision’s patented Nike MAX Optics. Patented tints engineered precisely to enhance the visual details of the natural environment.

Available in:

• Nike MAX Transitions/Golf Tint – a violet colour, designed to improve contour recognition on the greens and increase ball pop;

• Nike MAX Transitions/Outdoor Tint – a green colour that brightens shadows, increases contrast and enhances the visual spectrum in natural environments.

Nike MAX Transitions lenses are polycarbonate and block 100 per cent of UV rays.

NikeMAX Transitionssunglasses available in the Show X2 style (ideal for golf, tennis and cycling). SQ frames designed for golf and training.

Oakley

Oakley’s full spectrum of lens colours helps match optics to the environment. The perfect balance of light transmission with lens tints improves depth perception and colour recognition, with the option of polarized, photochromic or gradient tinting.

This spring Oakley offers two new additions:

RADAR LOCK™

Lets athletes take advantage of Oakley’s wide array of performance lenses, thanks to Switchlock™ technology that makes lens changing fast and easy. Switchlock lets you adapt your vision for any environment and keep up with changing light. All lenses are optimized with the clarity and impact resistance of High Definition Optics®.

TRUE DIGITAL

Most Oakley sunglass frames available with Oakley True Digital (OTD) prescription lenses. OTD utilizes its own custom frame database to digitally tailor the prescription lens to the specific frame and Rx, creating the ultimate in Rx performance eyewear. Oakley developed Dual Peripheral technology to optimize peripheral vision in the mid and far ranges, ensuring sharper peripheral imaging and motion detection.

Rudy Project North America

Best-selling models Noyz and Rydon are a favorite of many triathletes because of their eye-candy colours, lightweight design and aerodynamic lenses. Ideal for cycling, tennis and other sports because of adjustable nosepads and temple tips to ensure sunglasses stay comfortably in place.

Hypermask and Hypermask Performance are mask-styles, ideal for cycling, triathlon and running.

Lenses:

Rudy Project offers technically advanced specialty lenses with high visual quality tailored to meet your needs. Rudy Project Polycarbonate RP Optics lenses provide 100 per cent UVA/UVB protection. Contrast lenses are best to enhance depth perception and colour, while neutral lenses provide the darkest coverage possible.

The styles mentioned feature award-winning photochromic and polarized photochromic lenses (available in Rx and non-Rx).

Sundog Eyewear

Sundog Eyewear continues the evolution of sunglasses for golfers with 12 new models featuring industry-leading Mela-Lens™ technology for ultimate protection and clarity with no colour distortion.

In partnership with BNL Sun Lenses, Sundog Eyewear created the Mela-Lens lines, utilizing synthetic melanin to produce state-of-the-art melanin lens technology. It absorbs light seamlessly over a broad spectral range, providing superior blue light filtration with minimal colour distortion, and 100 per cent UVA/UVB protection. Mela-Lens features Eternity Hard Coat for superior abrasion resistance.

Among the new models – including Bent, Pursuit, Chop, Blast, and Fluid – Laser offers a sleek suspended lens open frame design in three choices of MaxFlex Rilsan frames, Megol temple tips and nosepads, and smoke or brown lens. Laser available in Mela-Lens, Mela-Lens Polarized, and Mela-Lens photochromic models.

(distributed by Importlux inCanada)

TAG Heuer sunwear features avant-garde materials, including hypoallergenic titanium and composite material, that provide lightweight strength and ensure streamlined comfort. Special elastomers, such as those on Reflex’s titanium temples, provide great grip. Reflex also features a patented hingeless closing mechanism.

Polycarbonate lenses, some polarized, feature oleo and hydrophobic coatings. In case of physical shock lenses are designed to pop out. Some models are Rx-able, depending on base and Rx; all lenses provide optimum protection from UV and infrared rays.

TAG Heuer offers a range of lenses for various activities:

Blue tint for water sports, brown for high mountains, orange for golf, and Night Drive Vision – yellow lenses designed for night driving; they are also very efficient for driving in foggy weather.

Men’s Frames: Who’s Zoomin’ Who?

By Paddy Kamen

As we move into 2012, the men’s eyewear market is hot and getting hotter.

What do men want in eyewear? While it’s true that some men still want to blend into the woodwork, a growing segment of this market actually wants to use frames as a signal of distinction, if not panache. Amin Mamdani, buyer and vice president of Josephson Opticians in Toronto, has noticed that men expect more from their eyewear.

“Men collect watches, shoes and hats but they don’t accessorize with the face, so frames are ideal for them. Being men, they still look for functionality, which is a plus because the same form will not necessarily fit different functions. For example, the urban look for weekdays won’t suit weekend cottage activities. And this is especially true for sunwear: rollerblading and sailing require different sun frames and this presents an opportunity to the optical retailer.”

Mamdani sees a slow but sure increase in the number of men who consciously chose their eyewear to make a statement. “I’d say it’s close to 50 per cent now, compared with over five years ago when it was about 30 per cent.”

Michael Bohbot, president of Bo Optik, agrees. “Men today are very different and much more diverse than they were a generation ago. Men represent half the population but often have far less choice in frames than women. This was due to a lack of product and a bias towards men being boring. Now men are catching up to women in terms of spending on fashion, be it in clothing or eyewear. They have always spent on watches and suits, but now they want better choices for eyewear and more distinctiveness and diversity. If you don’t have a great selection, you may be missing out on selling multiple frames to a significant market. 

Nada Vuksic is an optician and proprietor of Bruce Eyewear in Vancouver’s trendy Gastown district. She finds men more willing to purchase multiple frames for different lifestyle needs and in order to prepare for that, she works hard to have a wide variety of frames available. “We have an equal opportunity shop for men and women, which means we have to back that up with a wide range of product for both genders. As a woman, I easily know what I like for my female customers. But at the end of the day I have to exert more effort in making an amazing selection for men. I spend more time and care when selecting for men when I’m at a trade show or with sales reps.”

Several companies have launched men-only collections — including Wescan, Tura, Bo Optik, Alternative Eyewear, Plan B and Optiq. Others are speaking to men with distinctive stylings within collections that also address the needs of women. But how different are the needs of men and women? Mehran Baghaie, designer for Spectacle Eyeworks, created a collection for men and daringly offered them in pink! “They sold out very quickly,” he notes, explaining that “women are wearing very large men’s frames but they want them in beautiful colours they can relate to: wine, red, pink. This blurring of the gender edges gives my retro line wide appeal, although ironically, they were originally designed 100 per cent for men.”

Mamdani’s opinion is that gender differences in frame design are indeed widening. “For women I am definitely seeing more of the cat eye and upsweep as the biggest trend. Women frames will be much more feminine, while men’s frames are becoming squared or very round.”

Vuksic agrees. “I’m seeing more gender-specific styling. While it is true that women can wear men’s clothing and even eyeglass frames, I find them happy to have more feminine options.”

Bo Optik is one company that has responded to the market with a strong showing of brands just for men.

“Since the fall of 2011, we have launched KHI Eyewear, Lunettes L’AMY and Penguin to complement Jhane Barnes and Safari. These five lines give us the broad range required to satisfy both dispensers and consumers,” says Michael Bohbot. “Penguin is our newest launch and has a very retro look that fashion-forward men crave. Lunettes L’AMY has the French European flair and style. KHI Eyewear is for the entry-level professional, Jhane Barnes is our high-end product offering, and Safari has been our go-to product for the large man since 2001. Each of these brands is strictly for men, with the exception of L’AMY.”

Jhane Barnes and Penguin are brands heavily involved in clothing. The other three are optical only. “All are built on excellence in quality and design and with 75 styles over 400 SKUs (stock keeping units) across the spectrum, we are positioned to satisfy this important market that represents a big percentage of frame revenues,” says Bohbot.

Spectacle Eyeworks’ Mehran Baghaie has created a stunning collection of acetates in retro styles for men. In addition to the bold, feminine colours previously mentioned, Baghaie explains that most of this collection is offered in beautifully subtle, natural colours that are very tactile, just begging to be touched.

While still offering a pure wood collection, Baghaie’s new pieces look and feel like wood, “which opens a new avenue for everyone,” he explains. “They have a grainy, natural look, with a rough polish. The green one looks like horn and the brown model looks like wood. I wanted to continue with very clean retro shapes.”

Baghaie has named the pieces after his two sons, Thomas and Shayan, in addition to one with his own first name, Mehran. The family grouping is complemented by Penn, after his favourite actor, Sean Penn. “We’ve made Sean Penn part of the family,” he quips. Banking on retro to stick around for another four to five years, Baghaie’s approach is to take the genre sideways. “Retro is very specific. These new styles are definitely in the genre but have their own distinct character,” he notes.

Mizyake Couture offers men an opportunity to make a fashion statement with expressive designs that aren’t outrageous, says Richard Allen, vice president of sales for distributor Optika Eyewear. “Men are very focused on quality when selecting frames and Mizyake has superior quality in hinges, plating and materials. They’re made of super-lightweight stainless steel for comfort and durability in high-end designs.”

Allen notes that the Mizyake Couture collection appeals to all age groups. “We offer bold acetates for the younger market, along with frames that give excellent lens depth for progressive wearers.”

J.F. Rey has always spoken strongly to the men’s market, especially those men who favour an emphasis on technical and design elements. Two techno collections, Fibres and Airnet, are the latest word from this renowned manufacturer.

The Fibres collection found the design team turning fiberglass and carbon into an elegant weave. “Featherweight, industrial and elegant,” are perfect descriptors for this subtle collection, where industrial design is reinforced by muted colours in tobacco, navy blue and silver. The frames are definitely masculine.  

Airnet is the first J.F. Rey collection to use ultra-thin stainless steel, providing outstanding lightness. Tiny holes on the temples bring integration with the wearer’s skin tone.

J.F. Rey models JF 2410, JF 1217, and JF 1213 are Canadian bestsellers, available at J.F. Rey Eyewear Canada.

Paul Storace, president of Alternative Eyewear and Plan B has two collections for men: one a conservative, football-themed collection, Gridiron, and the other an edgy, metrosexual collection, Headlines™. “Headlines represents the very wearable side of edgy, for men from their mid-20s up to middle age and up.  The older guy who knows he is still young will choose this brand, which is a mix of really cool plastics along with pure titanium. This collection speaks to a sweet spot in the marketplace because it is definitely not slumming for the man who buys high-end, while the quality is there for the young man who wants to look like a million bucks,” notes Storace. “Plus we have eye sizes deep enough for progressives.”

The Gridiron collection suits the older gentleman who needs a larger fit (with 58-60 eye sizes) in a high-quality frame priced in the low-mid range. “Everyone needs a 58 eye size titanium semi-rimless on the boards,” notes Storace. “This collection offers many solutions to fitting problems and for those who are allergic to nickel. When comfort, fit and price take precedence over fashion, Gridiron is there and does extremely well.”

You may remember Parasite as the company that, a few years back, launched strange-looking futuristic frames with temples that cling to the side of the head. Parasite continues to lead in a ‘techno-organic spirit’, with cyber-punk frames known as Sidero. While still uber-cool, Sidero will appeal to a wider audience, with new models featuring a glossy polyamide front and metal temples. These elegant and edgy frames for men come in sophisticated colour blends and will soon be available with bored lens mountings.

Eyecare professionals will be pleased to know that hard-to-fit men are wellserved by the Michael Ryen collection from Cenoco. With a wide range of sizes, the collection offers plenty of choice in both trend-setting and traditional styles. Each frame is made of quality materials, including titanium and Mazzucchelli acetate fromItaly. Spring hinges ensure comfort. MR-176 boasts a square Mazzucchelli acetate front with the trendy geek look now so popular with men, while MR-171 sports a laser-cut, semi-rimless front. A small section of the temple is bent over the hinge and inset with openwork chrome metal, which serves to lighten the look on the face.

Prisme Optical Group offers some of the most stylish brands – Orgreen, Cogan, Façonnable – with strong styles for men. They also represent Bellinger, the Danish tour de force, led by the husband and wife design team, Claus and Malene Bellinger Diederichsen. Within the Bellinger collections is Blac, said to be the first frames made totally of carbon fibre. This collection is specifically for men. The design element is very strong, uber-masculine and fascinatingly sophisticated. A must-see.

Designed in Switzerland by optical professionals, the Götti collection offers strong masculine models within a mixed-gender collection. “The design of Götti glasses always has a harmonic and coherent look,” says design director Thomas Frischknecht. “We dispense with fancy details while maintaining distinctive accents on each frame, which makes it an unmistakable Götti. All models are extremely wearable,” he adds.

The two-man Götti operation that began in Switzerlandin 1993 has grown into a company of 48 employees with an American presence in Winter Park, FL. Product is available at high-end optical shops in 37 countries. Götti SWITZERLAND won a 2012 iF product design award (a Danish award established in 1953) for its Fons sunglass style.

Henry Jullien launched Equinoxe at Mido 2011, marking the arrival of the first model in the collection known as Les Urbaines. This acetate and metal frame for younger men is designed and manufactured completely in the Jura region ofFrance, where Henry Jullien has been making fine eyewear for over 90 years. A second collection, Les Signatures speaks to the impressive history of the brand. Here, gold-filled frames in classic styles are made with the finest materials.

Joe Nadler, president of Optik Frames, offers the bold and contemporary Respec Collection to men with a self-assured fashion sense. “These are men who care about their appearance and understand that eyewear is a statement of one’s personality and style,” notes Nadler. “I see men’s eyewear evolving as men become more aware of fashion trends and consciously turn to eyewear as an accessory that will enhance their image. This the perfect time to present the Respec collection, with styles that will appeal to men from 25 and up.”

The Eyefunc collection from Optique Levy features 40 different models for men. PresidentGeorges Levy describes his collection as, “fierce, edgy and hot.” These are manly shapes with trendy urban temples and funky styling, as the name suggests. EF276 is a current bestseller, as is EF307P. “The colours have really helped to make this collection a big success,” says Levy.

Also look for elegant men’s frames in the Borsalino collection, which is just now being introduced toNorth Americaby Levy. “There are 20 men’s styles in this luxurious line, handmade inItalywith 100 per cent Italian material,” says Levy. “Each frame has its own serial number.”

Optik Innovision brings some striking designs forward for the fashion-conscious man. Allegro Plus 4139 has a retro vibe, mixing new with older elements to great effect in acetate and metal. Allegro Plus 7063, with angular cut-outs on the temple, gives an edgy masculine look in four colour combinations. And half-eye frames such as Allegro 5318 convey a confident charm in a rectangular shape with subtle temple designs.

While also carrying the German-designed TITANflex for the upscale male shopper, Tura has a 20-year history with one of the first memory metal products: TuraFlex. James Ahola, sales manager forCanada, says, “The lightweight titanium alloy with its unique flexible properties struck a chord with the typical male buyer. And while the memory metal offers great advantages it also has some inherent design limitations, the main one being that it does not allow for great detail work or embellishments as desired in typical feminine frames. Because of this TuraFlex quickly evolved into a strictly men’s line for the average male who could not care less for embellishments or funky colours.”

Two best-selling TuraFlex models are M861 and M868. These are both generous frames with a comfortable vertical measurement. The M868 is a lightweight  semi-rimless with simple design cues of rolled metal. The M861 is a heavier frame with wider temples and a pinstripe design cue. “These sell well because they are lightweight, have some style without being over the top, and are affordable,” notes Ahola.

Le Groupe Optique Plus fromHolland brings the De Stijl collection across the pond with great aplomb. These are architectural pieces inspired by the aviation industry and made without screws or welded hinges. Stainless steel is the material of choice for all metal components and comfort is taken for granted. Extremely durable colours are an outcome of the manufacturing technology and four colours are offered on each of 11 models for men.

Look no further than Scandinavian Eyewear for men’s frames with a rich tradition of craftsmanship blended with materials and technology that are very on-trend. Skaga is the brand and Skaga Originals, designed by Sighsten Herrgård, are attracting a lot of attention. Models for early 2012 are inspired by glowing skies and crystal formations. “We have been making men’s styles in the Skaga collection since 1948 and release 48 new styles every year,” says Nils Fredriksson, sales manager forNorth America.

Wescan Optical is releasing Evatik Sunwear this February as an encore to their highly successful Evatik ophthalmic collection for the stylish urban male. Eighteen models in stainless steel and acetate feature diverse eye shapes from rectangular to aviator and beyond. “Masculine elegance” is a term used to describe this collection, which is inspired by both fashion and performance. “Men’s eyewear can traditionally be divided into two distinct categories: fashion and technical,” explains Beverly Suliteanu, creative director and vice president of product development. “By marrying cutting-edge technology with fashion-forward styling, Evatik Sunwear defies convention and offers today’s urban male the ultimate accessory to express and enhance his personal style.”

Swiss fashion design house Strellson comes to Canadian men via Mark Altow and optician Karen Tarshis. Strellson Eyewear Canada brings this Euro-style optical and sunglass collection forward, presenting warm masculine colours in the finest metals and high-end acetates. Real wood components are found in the patented ‘switch it inside’ segment. “The products have a cool, modern, retro “60”s vibe yet stay grounded in Strellson’s overall Euro look and feel,” says Altow. “The eyewear is a natural extension of the Strellson brand and we’re very excited to bring it to Canadian retailers.” 

Are today’s men getting what they want in eyeglass frames? Are more of them confident enough to let their frames do the talking? Let’s see how they see themselves in the new frame offerings for 2012.

Multifocal and Monovision Contact Lenses: Much Success, Many Challenges

By Paddy Kamen

featureJosh Josephson has a bee in his proverbial bonnet: “The question of whether to fit monovision or multifocal contact lenses is very important and in my opinion most practitioners don’t understand the issues involved.”

As the chairman of the ophthalmic devices section of the Standards Council of Canada and a founding member of the International Society for Contact Lens Research, Josephson knows whereof he speaks.

Monovision is a method of correcting presbyopia by using a contact lens corrected for distance in one eye (usually the dominant one) and another lens corrected for near vision in the other eye. Monovision works for the patient because the brain’s visual cortex chooses the focused image and ignores the blurred image. So when the patient looks into the distance the dominant eye does the lion’s share of the work and when focused at near, the corrected, non-dominant eye is focused and does the job.

Sounds good, but, according to Josephson, “Monovision wearers who « perceive » that they see well, do not realize how monovision can, under certain conditions such as low light and particularly in adds 1.5 D or greater, adversely affect their lives.”

As just one example, Josephson recounts the case of a woman who called him in distress. She had been prescribed monovision contact lenses and thought she was doing well with them — until she had to drive at night. “She had driven during the day from Toronto to New York Cit ybut when she started to drive home at night she simply couldn’t do it and had to pull off the road,” notes Josephson. “In low light environments, contrast sensitivity is reduced significantly and patients do not appreciate colours as they should be perceived. Further, when driving at night on a poorly lit road and moving into a curve in the road, if a car approaches from the opposite direction with their brights on, monovision wearers may be subjected to a shift of dominance in which the near-corrected (and distance vision blurred) non-dominant eye takes over for a brief period of time.”

According to Josephson, no active person with an add of 1.5 D or greater should be wearing monovision lenses unless they have compensatory eyeglasses for night driving.

Keith Harrison agrees. This contact lens specialist at Harrison Optical Services, located at the Toronto Western Hospital, would go Josephson one better and take the threshold for wearing monovision down to 1 D. “All too often I see patients who have been prescribed monovision contact lenses which don’t meet their needs. Sometimes they believe they are wearing multifocal lenses when they are not.”

“The biggest problem for those wearing monovision lenses is with binocular vision,” explains Harrison. “They have issues with depth perception and for those prone to migraine headaches or vertigo they are definitely not a good choice.”

In Harrison’s opinion, many practitioners simply don’t want to take the time to learn how to fit multifocal contact lenses properly. “For the practitioner it may seem easier at the start to prescribe monovision but you get diminishing returns. As time goes by you’re giving up too much distance vision or too much near vision. Certainly, monovision won’t meet the patient’s needs as they age and then they have to adjust to something new.”

How Much Chair Time is Enough?

Harrison has a professional dispute with the concept that contact lens fitters should always be aiming for less chair time in their dealings with patients. “I believe we have driven people into refractive surgery and the problems attendant on that, simply because we haven’t taken the time to fit them properly with contact lenses. There is so much emphasis from manufacturers on reducing chair time and I think it does the practitioner and the patient a disservice.”

Harrison advises practitioners to figure out what it actually costs them to maintain the office, take their professional training into account, determine how much money they feel they should be making and charge accordingly. “The most important thing is to determine the real wants and needs of the patient and that takes time. We’re getting paid to fit them so let’s charge what it takes to make a profit and do the best job possible for the patient.”

“It does take time for a patient to learn how to use multifocal lenses,” adds Harrison. “The practitioner can’t just say, ‘here they are, go and try them’. You have to have them back for a follow-up appointment in order to refine all aspects of the lenses for the patient to the best possible level of performance. When you dispense, everything may look fine, including the positioning and alignment on the cornea, but that’s only after 30-60 minutes. It’s a whole other thing when the patient has been wearing those lenses for a full day. By checking the patient after a week or two of wear, with the lenses being on for six-to-eight hours, you can really tell how the adaptation is going and you may have to make adjustments to fit, material or design.”

Harrison is a big fan of multifocal contact lenses. “I can help most people see as well as they did 15 years ago. That’s a big turning back of the clock.”

The Inherent Limitations

The limitation of all bifocal/multifocal lenses is that they are pupil-sharing lenses, says Josh Josephson. “They all work on the principle of simultaneous imagery. Light from both distance and near areas of the lens enters the eye simultaneously. If you’re looking into the distance, you have some light focused on the Rx for distance and when looking at intermediate or near, a certain amount of light is present for those areas. The amount of light devoted to each image is restricted to about 50 per cent of what it might be (depending on zone diameters) with a single vision lens. The brightness of the retinal image affects a person’s perception of how « clear » the image appears to be. The impact of this situation can vary somewhat from patient to patient. With alternating image bifocals, when they work as designed, this isn’t significant. However, even with those designs there is a small amount of pupil-sharing that typically occurs when looking down and reading, so they may have less of an impact than with distance viewing.”

Randy Kojima, director of technical affairs for Precision Technology Services, and instructor at Pacific University College of Optometry, notes that compared with ophthalmic glasses, multifocal contact lens designs are, “trying to pack all the power the patient needs into a tiny zone. For example, an average pupil for a 55-year-old presbyope in normal illumination is 3-3.5 mm, which means you need all the power packed into this small zone. It appears that early presbyopes do quite well in multifocal contact lenses but above +2.00 D one needs more magnification within a tinier zone and it becomes a bigger challenge to provide the extremes of far, near and intermediate vision. It’s like ophthalmic in that the bigger the add, the tougher it is to adapt. Having said that, multifocals are helping many patients with their presbyopia,” notes Kojima.

“Materials and designs for delivering the optics have improved over the past five years. Lenses with more oxygen and wetability are improved over older-generation materials. And the design options have given us improved distance and near vision. Some of them have really amazing outcomes while others achieve only near or distance but not both. And most are in between.”

More Research Needed

Kojima is of the opinion that neither rigid gas permeable (RGP) nor soft contacts are perfect — yet. “We want multifocal contacts to be more predictive and consistent. For instance, are certain pupil sizes less than ideal for this modality? Are certain Rxs contra-indicated? Are certain corneal shapes less likely to achieve ideal outcomes? More research needs to be done by true scientists in multifocal lenses. In the contact lens industry, there is a lot of trial and error, rather than research-based advancement. The more research that goes into optimizing these designs, the better we can advance this option.”

Harrison agrees with Kojima and adds, “We also need more practitioners who are willing to invest the time in their patients and practices to determine what can truly be a success for each individual.”

Your Dirty Patients: Contact Lenses Need Rescuing!

Your Dirty Patients: Contact Lenses Need Rescuing!
ByPaddy Kamen

Sticking harmful microbes in the eye is no one’s idea of a good time. Yet it happens frequently with contact lens wearers. Why? Because they aren’t careful enough.

Two surveys by Johnson & Johnson Vision Care, published in May 2011 in Contact Lens & Anterior Eye, the journal of the British Contact Lens Association, found that astonishing numbers of users are not compliant in every major area of contact lens care.

The studies were done independently of the sponsor and participants were blind to who the sponsor was. In the first study, 645 frequent replacement contact lens wearers answered questions about lens replacement frequency. In the second survey, 787 frequent replacement wearers answered questions about lens disinfection, hygiene and storage case replacement. All respondents wore hydrogel and silicone hydrogel lenses prescribed for two-week or monthly replacement.

Survey results demonstrated that vast numbers of contact lens users simply do not take lens care instructions seriously enough to comply.

Almost half (44 per cent) of respondents never washed their hands with soap prior to lens insertion or removal. Forty-six per cent did not fill their empty cases with fresh disinfecting solution every day and 33 per cent cleaned their contact lens cases monthly or less often.

What Are They Thinking?

How might a consumer be thinking about the importance of proper hygiene with respect to their lenses? One imagines that they push the envelope, experience no repercussions and then assume that the instructions are too rigid.

Sheila Hickson-Curran, director of medical affairs with VISTAKON®, says the relationship between contact lens wear and care and complications is well documented. She believes that experiences of non-compliance with no ill effects do reinforce poor behaviour. “However, by not following instructions on proper wear and care, contact lens wearers are more likely to experience discomfort and may put themselves at greater risk for infection or other serious complications, such as microbial keratitis.”

The ‘rub’ or ‘no rub’ debate appears to have been put to rest. This fall, Bausch + Lomb launched a global initiative instructing consumers on a ‘rub-and-rinse’ regimen for use with their multi-purpose contact lens solution, replacing the former ‘no-rub’ instructions on all packaging for renu® fresh™ in Canada.

The Canadian Association of Optometrists applauds the move because the mechanical step of rubbing lenses helps to remove microbial organisms that may cause microbial keratitis. “Moving towards a rub-and-rinse routine is consistent with recommendations made by eye care organizations, regulatory agencies and eye care professionals,” said Glenn Campbell, executive director of the Canadian Association of Optometrists.

The new cleaning instructions include these steps:

1. Using three drops of multi-purpose solution on each side of the contact lens, gently rub for 20 seconds;

2. Thoroughly rinse each side of the lens for five seconds with multi-purpose solution;

3. Place cleaned lenses in a lens case, fill with fresh solution and soak for at least four hours.

Bausch + Lomb also advises against reusing solution and recommends replacing lens cases monthly.

Keith Harrison is an optician who specializes in contact lens fitting at Harrison Optical Services at theTorontoWesternHospital. He stresses the importance of educating patients from day one and continually reinforcing the importance of good hygiene at each opportunity. “I tell patients that their planned replacement soft lenses should feel as good on the last day of wear as it did on the first. The point is not to see how long it takes before you have a complication. In my experience problems develop as a result of people topping up solution (rather than replacing it entirely), not changing solution, not doing a rub and rinse, not changing their cases routinely, and not maintaining good case hygiene.”

The Johnson & Johnson research agrees on every point. According to their news release: “Failure to empty and replace the full volume of contact lens disinfecting solution was one of the few significant behavioral factors found in the U.S. Center for Disease Control and Prevention investigation of the Fusarium outbreak of 2005.”

Josh Josephson, O.D., chairman of the ophthalmic devices section of the Standards Council of Canada and a founding member of the International Society for Contact Lens Research, says that case hygiene is just as important as personal hygiene when it comes to preventing eye infection in contact lens wearers.

“The internal walls of cases build up a biofilm of microorganisms that are released into the solution in planktonic form. So if patients are in the habit of ‘topping up’, rather than placing fresh solution in a new case, the antibacterial agents that remain in the partially used solution can be overwhelmed by the destructive microorganisms. This happens when the case has been used for a minimum of four weeks.”

Clearly patient compliance comes down to the patient fully realizing the importance of infection prevention. Change will take a concerted effort on the part of contact lens fitters and the industry. It’s good to see this happening. Short of having ‘contact lens police’ visiting people’s washrooms, education seems to be the only way forward.

Seeing and Selling Your Way to WOW: New Lens Technologies Make it Happen

By Paddy Kamen

featureAfter years of the same old, same old, optical lenses have recently enjoyed a paradigm shift, making it easier than ever to wow your customers.

Anyone who has worked in an optical dispensary knows that people wearing really dirty glasses are usually completely oblivious to the murky view before their eyes. Something as simple as a squirt of cleaning solution and a quick rub with a high-quality cloth can make a huge difference. Educating the consumer about what a difference new lens technology can make is akin to the cleaning ritual. True, it can be a challenge to convince people to buy something they cannot fully appreciate until they have actually spent the money. But here’s where stories about others who have enjoyed the benefits come in handy.

Every salesperson knows the routine: “My best friend just bought it and she can’t stop talking about how wonderful it is,” or, “my parents never thought it would make a difference but now they send all their friends in for free-form lenses.”

Demonstration tools help, too, notes Maria Petruccelli, marketing and professional services manager for HOYA Vision CareCanada. “Some dispensers are really comfortable with the topic of free-form lenses but others require guidance. Education empowers the dispenser, giving her the confidence to embrace the technology and correctly inform the customer. But if the office isn’t comfortable with it, they won’t sell it and the patient won’t benefit.”

Price no longer needs to be a barrier to experiencing the benefits of new lens technology. While cost is often associated with quality, even the least expensive free-form lens is superior to conventional products, according to Paul Faibish, president of Plastic Plus. And premium high-tech lenses are coming down in price, too, as equipment costs decline.

Let’s take a look at some of the new lenses, coatings and equipment that will make your life easier as you create the wow factor for your customers.

HOYA is one company that has gone above and beyond to make it easy for eyecare professionals (ECPs) to excel at selling the latest lenses. For example, the MyStyle Identifier is an easy-to-use online patient consultation and ordering system designed for the new HOYALUX iD MyStyle progressive lens.

“The beauty of the MyStyle Identifier is that it takes more factors into consideration than previously possible,” notes Petruccelli. “We often hear that ECPs don’t want to take a patient out of a design the person is familiar with. One of the influencers in the MyStyle Identifier algorithm is previous wearing history. We have mapped our previous Hoya and competitor designs, helping us create a superior lens design that is compatible with the patient’s current PAL. It also customizes for lifestyle activities, taking into account what the patient will be doing when wearing this particular lens.”

HOYA has two new high index polarized lenses, 1.67 NuPolar single vision and polycarbonate IMAGE polarized progressive. Both are available in AR packages. The company also added 1.50 polarized brown as a colour option for its Hoyalux iQ Summit ecp and Summit ecp PALs.

C & C Optical Laboratories recently released the latest in their Vista Plus house brand series: theVista PLUS 3G Digital Progressive Lens. “This digital lens is the optimum in vision correction,” says President Tony Civello. “It is produced on our top-of-the-line equipment specifically for the individual patient’s frame and prescription. We can customize to every frame, from 14 to 30 mm. We’re getting terrific feedback on customer satisfaction and can barely keep up with orders.”

C & C has two additional fully integrated digital lenses ready for release, pending final testing results from ECPs.

Civello adds that all lens products — conventional lenses and digital — and all lens treatments are available from C & C. As an optician, he prides himself on amazing service and the fact that he lends his personal technical support to ECPs who call with questions. With over 35 successful years in the lens business, Civello has the personal touch along with great pricing, warranties, and fast delivery.

The INNOVA lens edging division offers new features in the award-winning Nidek ME-1200 multifunctional edger. Smaller than its predecessor, this machine measures lens thickness to ensure correct placement of the bevel or groove, as well as the diameter of the existing lens to determine where and how much pressure to exert for optimal results. With features too numerous to mention, this Silmo d’Or award-winning system is truly impressive: “Powerful but silent,” according to Business Development Manager Wayne Metelsky.

Another innovation from INNOVA is their environmentally friendly LFU-220 lens dust filtration unit. Metelsky says that total water usage is reduced to less than 10 per cent of that used in a standard pump and tank system, and over 500 per cent less than direct water connections to an edger for each lens processed. “It’s an incredible water savings and eliminates residues going down the drain into the water system.”

April 2011 saw the introduction of the latest digital progressive lens from Nikon Optical — the SEEMAX Power AP, within the SeeSeries category. Marketing and Communications Supervisor Lora Discenza notes that, “Not all digitally manufactured lenses are the same. Nikon manufactures back-sided and double-sided progressive lenses. Double-sided technology is used for Nikon’s premium lenses. By offering back-sided and double-sided lenses to patients, we offer dispensers the possibility of deciding which lens is most suitable according to the patient’s profile and requirements. So there are good, better, and best options for consumers.”

SEEMAX Power AP is a personalized, double-sided digital progressive lens using the advanced Nikon calculation system. Each patient’s data is sent to Japan for personalized design (using parameters such as wrap angle, pantascopic tilt, and vertex distance) and then transferred back to Canada where it is manufactured.

Nikon strongly believes that eyecare professionals must be involved in the fitting and ordering of lens products. Discenza emphasizes that Nikon has made a conscious decision not to offer their products to optical web retailers.

Over 75 years ago Carl Zeiss Vision invented AR coatings. Now they are defining the category once again with PureCoat™. Available on finished lenses from Carl Zeiss Vision and Centennial Optical, the ultra-tough hard coat provides up to 50 per cent more scratch resistance than other leading AR coatings, based on tests conducted by COLTS Laboratories.

PureCoat 1.74 super high index lenses have also been recently added to the PureCoat offering, while the 1.50 index, polycarbonate, 1.60 index and 1.67 index lenses were introduced at the beginning of 2011. The 1.74 is a double-side aspheric that corrects power errors and marginal astigmatism in peripheral areas. With a 1.0 mm center thickness, the lens offers a 32 Abbe and 100 per cent UVA/UVB protection.

Centennial and Carl Zeiss Vision are also proud to be the distributors of NXT technology sun lenses. Using Trivex® lens material, NXT® options include fixed tint, photochromic and polarized lenses. With a 45 Abbe value for clarity and great chemical resistance for long lasting quality, these lenses are perfect for golfing, biking, driving or skiing.

Younger Optics has won numerous awards for its lenses from the Optical Laboratories Association. In 2002, Trilogy was named  ‘Best in Lens Materials’   and in 2003, Trilogy in Transitions was named  ‘Best in Lens Treatments.’  In 2010, Younger’s NuPolar® Trilogy – Visual Armor® was named  ‘Best in Lens Materials.’

Building on their innovative track record, Younger has improved its Trilogy® semi-finished lens blank, making it thicker in the lower base curves (0.50 to 4.25, only) in order to ease processing for both digital and conventional surfacing methods. Made with Trivex® material for excellent optics and impact resistance, Trilogy has superior resistance to small fractures at the drill points. “Trilogy lenses continue to receive great interest in the marketplace as the rimless frame category grows through all channels of the industry,” says David Rips, CEO of Younger Optics. “Laboratories can offer eyecare professionals a product with premium features with the assurance of a lifetime warranty against lens cracking.”

Coburn Technologies makes in-house lens processing easy, whether your practice is large or small. Just released this year is the Coburn CTL85 DP, a compact, dry-cut lens generator that uses no water or water management system. Designed to work with the CTL85 DP, Coburn’s LaunchPad™ is another innovative, patent-pending disposable free-form processing technology that allows for easier and more cost-effective polishing of free-form lenses. The proprietary material configuration of LaunchPad, combined with Coburn’s patented disposable foam lap allows for free-form polishing on a traditional cylinder machine (such as the Coburn CMX50 and/or Acuity Plus), thus eliminating the need for larger, more costly free-form polishers. Together, the Coburn CTL85 DP and LaunchPad eliminate the need for an industrial polisher. Free-form lenses can be polished on an as-needed basis, using smaller polishing machines that most small labs already have on hand.

Optical practices with limited lab space can bring their free-form lens production in-house, thanks to Coburn.

Plastic Plus, the first independent lab to process free-form lenses is, “At the point where over 98 per cent of all our progressive lenses are back-side free form,” says President Paul Faibish. “Now that we have a combination of branded and non-branded designs we are actively challenging our accounts to go 100 per cent digital. With a range of price options it’s a no-brainer.”

Faibish claims that within 36 months conventional lens technology will be a thing of the past. The one area where he finds ECPs slow to pick up on the benefits of free-form is in single vision lenses. As he points out, “There’s a huge market here. Patients love them as much as they do the free-form progressives, and the added cost for a second pair is minimal.” Plastic Plus is offering a sweet deal of only $10 extra per pair for single vision back-side free-form lenses.

An advanced digital lens optimized for wrap frames is now available from Essilor. Even presbyopes can enjoy wide fields of vision without sacrificing optical quality. The Essilor Wrap DS lenses fit most wrap-around frames. Available in six and eight base curves, they are adapted to each wearer’s needs via Essilor’s patented calculation process that takes vertex distance, pantoscopic tilt and wrap angle all into account to optimally refine the lens. And starting this October, the new Varilux Computer DS will replace the previous version of the product. This lens effectively addresses the needs of eight out of 10 eyeglass wearers who suffer from visual fatigue when using a computer, according to an Essilor news release. Designed to reduce visual discomfort, the Computer DS provides a wide intermediate zone for a natural head position when working at the computer. PhysioBrown 15 has been added, which filters out harmful blue light and improves contrast while maintaining colour perception.

Rodenstock has released several lenses this year including an improved version of their highly successful Colormatic photochromic treatment, which is available in 1.6 and 1.67 plastic lenses. “This is the fastest lightening photochromic plastic lens on the market,” says National Sales and Marketing Manager Martin Bell.

He is also excited about the new MyView Aveo, a free-form single vision lens in 1.6 and 1.67. “Its main feature is the accommodation assistance in the lower half of the lens, which gives the wearer +0.50D help in accommodating for near vision. We all lead busy lifestyles with visual demands for reading across different screen sizes and working distances,”Bellpoints out. “This lens will help wearers tremendously.”

Rodenstock has an app for the iPad that allows the dispenser to show the customer the difference between conventional progressive lenses and high-tech digital free-form lenses in a very graphic way. They also have a promotion that allows dispensers to earn an iPad with their lens purchases.

Lensnetclub is a buying club for independent ECPs who want rock bottom prices and don’t care about paying extra for a warranty. President Daniel Beaulieu is striving to bring Canadian ECPs better-quality lenses at lower prices. They offer two customized free-form house brands: Cleari and Innovative. His other company, Direct-Lens.com, is a full-service business with the house brands Precision and MyWorld. All products represent the best quality-to-price ratios in the industry, according to Beaulieu. “It’s so easy now to provide every patient with what they need. We offer up to 18 materials in all the major brand names and indexes in any fitting height. We can do any major brand name in a customized lens for a better price.”

Beaulieu’s companies are served by labs across the country. “It’s a new way to purchase lenses for the independent ECP,” notes Beaulieu. “We make it easy to order, manage and trace orders, all while enjoying significant savings.”

Vision-Ease Lens recently introduced a new VELA Poly FSV AR lens to their FSV line. The new lens offers outstanding clarity, low reflectivity and high abrasion resistance with an excellent Bayer rating for superior scratch resistance. Those seeking a healthy profit margin would do well to look at this offering, according to Senior Product Manager John Bator. Vision-Ease has also released LifeRx FSV lenses in grey. The new LifeRx FSV lenses and their SFSV counterparts are 100 per cent interchangeable due to matching front curves on both lines. Interestingly, LifeRx lenses are manufactured with 100 per cent renewable energy. They also deliver superior photochromic abilities with rapid darkening, industry-leading fade-back speed and excellent indoor clarity. LifeRx lenses are available in a power range of +2.00 to -6.00, to a -2.00 cylinder.

Signet Armorlite is well-positioned with both its Digital Design Technology™ and public confidence in the KODAK Lens brand. Digital Design Technology creates a complex, precise, three-dimensional back surface, which improves the optical performance of the front-surface progressive designs for the KODAK Precise® Digital Lenses, along with the KODAK Precise Short and KODAK Concise® Digital Lenses, both of which are designed specifically for small frames. This technology also allows flatter base curves, giving lenses a more appealing cosmetic appearance without sacrificing optical performance. According to Signet Armorlite, this technology provides more consistent optical performance, based on typical wearing conditions, over the range of prescription powers. With the reduction in wavefront errors, wearers can expect sharper vision in the principal viewing areas of the lens as well.

Signet Armorlite has another propriety lens design technology. Vision First Design™ directly controls the surface power at virtually every point on the lens.  The result is a smooth power increase across the entire lens, top to bottom.  Vision First Design is used to create KODAK Precise PB and Precise Short PB Progressives, which are digitally created full backside progressives with a wide field of view.

Transitions® XTRActive™ lenses are the ideal choice for those who spend a lot of time outdoors in bright, sunny conditions, and who value an everyday, adaptive lens that offers superior outdoor darkness in all temperatures. As with Transitions® lenses, Transitions XTRActive lenses are known for visual comfort both indoors and out, while offering automatic UV and glare protection. Where they differ is in the fact that they were developed with photochromic dyes that activate in the lower spectrum of visible light, in addition to UV light. Because of this, Transitions XTRActive lenses also provide moderate activation behind the car windshield and are designed to have a light tint indoors. The latest Transitions XTRActive lenses include 1.50 index and FT-28 bifocal designs. Sports enthusiasts can benefit from Transitions XTRActive lenses as can those who are in and outdoors in all kinds of weather, such as delivery and home service providers.

As we move toward 2012 there’s a fabulous array of exciting lens products to help ECPs make a great impression. “Wow” is a word you should be hearing from your clients more often than not, especially with today’s digital free form lenses.