By Brian P. Dunleavy

Daniel Bédard, OD, knows how to work an edger, the central piece of equipment used in lens finishing. He also knows that any piece of equipment an eyecare professional (ECP) brings into his optical store needs to work well with the lenses he dispenses. At Dr. Bédard’s practice, for example, 90 per cent of the lenses dispensed are treated with anti-reflective (AR) coating and a high percentage of patients opt for free-form lenses in both single-vision and progressives. Yet, the optometrist says the practice is still able to finish 99 per cent of the lenses it dispenses on-site.

“Finishing equipment has improved so significantly that we can do drill mounts, wrap sunglass lenses or lenses for frames with unique geometry fairly easily,” explains the partner at Kanata Bridgewood Optometric Centre in Kanata, ON. “The technology has enabled us to provide our patients with fast service, without compromising on quality.”

Finishing lenses is nothing new for ECPs – the technology has been around for more than 25 years – but the ever-expanding array of new lens designs (think free-form) and materials (high-index, mid-index) has presented new challenges when it comes to bringing service into the practice. However, thanks to new technology and software upgrades, optometrists and opticians who want to speed up eyewear turnaround time by installing a finishing lab don’t have to change the lenses they dispense to make the labs viable.

Today, most finishing systems – which include a tracer, a blocker and an edger (costs for all the equipment typically run in the $30,000 to $60,000 range) – run with on-board computers that can be programmed to work with almost any lens product and frame design available, and they can be operated with minimal training. Most optometry practices that finish in-office have an optician on staff run the lab (Dr. Bédard recommends cross-training all optical department staff in dispensing and lens processing, both to increase efficiency and develop a working knowledge of lens and lens finishing technology and processes). Opticians who run their own shops typically train multiple staff members as well.

Before he decided on his current finishing system, which he purchased last year, Dr. Bédard visited Vision Expo East in New York in March 2012 to try out the equipment himself. His practice has had its own finishing lab for more than 10 years but it was time for an upgrade. The equipment they had been using couldn’t provide them with the needed throughput, or capacity, and some new frame designs (with unique shapes) were giving them problems.

Given that a finishing lab is a significant investment, he wanted to make sure he was purchasing equipment that wouldn’t be outmoded with the release of a new lens design or material. For his practice, finishing on-site hasn’t meant a change in the lenses they dispense, only in the services they offer the patients who buy them, and that was key. In particular, he notes, he sells a premium free-form progressive design and wants to be able to finish these lenses in order to offer his presbyopic patients the same convenience as his single-vision patients.

“Today, time is money,” he says. “Finishing our lenses here has enabled us to speed up delivery to our patients. We can give lenses back to some of them the same day, which has meant a huge increase in patient satisfaction. I am very happy with my decision on the new equipment, and I think my patients are, too.”

By Brian P. Dunleavy

Brian Paul, OD, considers himself a “picky” patient. That’s why the optometrist at Brantford Medical Centre in Ontario believes in the enhanced vision offered by free-form lenses.

“I’ve been wearing them for years,” he says. “Recently, I had some lenses made from another material and when I looked through them, I felt like I was in a fishbowl. Now that I’ve been wearing free-form lenses for a while, I won’t go back to anything else.”

So-called free-form or digital lenses – sometimes referred to as wavefront or high-definition lenses – have been generating a buzz in the optical industry for several years. The technology incorporates multiple measurements – which, depending on the lens design, include pantoscopic tilt, vertex distance and near viewing distance, along with the patient’s prescription and pupillary distance – into the surfacing process to generate a customized visual field that reduces peripheral distortion and aims to recreate the “natural vision” of the wearer’s eyes.

Historically, those with high plus or high minus prescriptions have benefitted most from what optician Rosemary Coleman, owner of Rosemary’s Optical Shop in Brockville,ON, describes as “the bigger visual field” of free-form lenses. However, the potential wearer population for this still relatively new technology continues to expand to include patients across the Rx spectrum, according to David Watson, an instructor at the BC College of Optics in Surrey.

“I actually have had mine for about a year now – and I am a -2.50D,” he says.

According to Dr. Paul, approximately 60 per cent of the eyeglass prescriptions he dispenses in his practice feature free-form lenses, including as many as half of the single-vision eyeglass wearers. “I see free-form as the future of single-vision lenses,” he says. “I know not everyone sells them and that a lot of people are concerned about the cost, but the edge-to-edge clarity really makes a difference.”

In addition to providing all eyeglass wearers with increased clarity, free-form lenses can offer unique function to single-vision wearers with specific needs. Recently, Coleman fit a long-time client and avid hunter with free-form single-vision distance lenses that he could wear while engaging in his weekend hobby.

“He was super-impressed with the free-form progressives that he wore day-to-day,” she recalls. “We gave him a free-form single-vision lens at +7.00D safety thickness that he could use for shooting. He came back and told us they were perfect. He could see well throughout the lens, even on the periphery.”

This enhanced performance has led lens manufacturers and optical laboratories across Canada to expand their free-form product offerings in clear and photochromic – in both progressives and single-vision; a leading manufacturer offers performance sunwear in the technology as well. However, not all free-form or digital designs are alike. Some feature an atoric front surface while others are fully optimized using position of wear and/or biometric data. Thus, eyecare professionals should try out free-form lens designs themselves before they start dispensing them. Drs. Paul and Coleman both emphasize this point, and Watson, who has studied the technology in order to pass along insights and dispensing suggestions to his students, says his own wearing experience gave him the most information.

And, as with any premium product, it is up to the eyecare professional to sell patients on what sets the product apart – both in terms of quality and price. Coleman says patients may not grasp all the aspects of the lens design; they just need to understand that the technology offers the closest thing to customized lenses available in spectacles.

“I always say to patients, ‘If you were buying tires, would you want tires from Michelin or tires from Wal-Mart?” notes Coleman. “It’s an easy choice. The quality of the product is there with free-form lenses. Now it’s about educating patients as to the benefits of the technology.”

By Brian P. Dunleavy

Making prescription eyewear that effectively meets the vision needs of clients involves a mixture of art and science. The issue of refractive power tolerance is definitely part of the science. And, like most such issues, there are multiple schools of thought with regard to tolerances, creating some confusion for optical staff and laboratories across Canada.

“Tolerance charts vary, depending on the store,” notes Madelaine Petrin, R.O., B.Sc., professor of opticianry at Seneca College in Toronto. “But for labs, it would be convenient if we all agreed to use one set.”

Indeed, opticians and optometrists use tolerance standards to assess the quality of prescription lenses delivered by their labs. If the axis, cylinder and sphere powers on the lenses are within tolerance – or the “wiggle room” lens processors have in grinding powers before the visual acuity of the lens is adversely affected – then they are distributed to the patient; if not, they are sent back to the labs as “redos ” at the labs’ expense. At present, because Canada does not have a national tolerance standard, optical professionals have developed their own standards, with most based on the specifications established by the U.S. American National Standards Institute’s (ANSI) Z80 standard. But, as some lab executives point out, if all optical shops and optometry practices use different tolerance standards – “Most [charts] tend to be more stringent than ANSI, not less,” Petrin says – then labs have to constantly refine their own standards to keep costly “redos” to a minimum.

For example, some eyecare professionals use the ANSI standard for sphere tolerance (for example (+/- 0.13D), while others insist on tolerances within ranges more stringent than ANSI (say, +/- 0.06D). In and of itself, this is fine; however, problems arise when optical shops or optometry practices adopt more stringent standards without telling their labs. Of course, ideally there would be zero prism errors in all lenses processed, but this is not only unrealistic, it’s arguably impossible as individual focimeters read lenses differently.

Interestingly, rather than reinventing the wheel and developing a “Canadian standard”, some professional groups, including the National Association of Canadian Optician Regulators (NACOR), have either formally or informally endorsed the use of the ANSI Z80 guidelines; however, the industry as a whole has yet to adopt them universally. It has taken some time for that to happen in the U.S. as well. Though the Z80 standard was originally developed in the 1950s (it has been revised several times since, most recently in 2010), industry observers south of the border say that it was largely ignored until the 1990s, when Lenscrafters developed its own, more stringent guidelines based on it. Only then did lens manufacturers wanting to do business with the powerful chain begin adhering to the standard; independent opticians and optometrists in the U.S. who work with wholesale labs have since benefitted as well because they, too, receive higher-quality eyewear as a result.

John Young, founder and CEO of COLTS Laboratories, an eyewear product testing facility in the U.S., notes that years ago he and his staff often found lenses that didn’t meet ANSI tolerance standards in their testing work; now, that’s changed. “We used to mark them with red print on our audit sheets,” he explains. “But in the past three years, we’ve had very little red print.”

Young believes Canada will eventually reach this point as well, if the industry here continues to use the ANSI guidelines. Eyecare labs must also work closely with their lens-processing labs to develop specifications (either ANSI or more stringent guidelines based on ANSI) that work for their respective businesses.

Petrin agrees. “I make sure my students know the ANSI standards by rote,” she says, “but I also explain what patients might be able to tolerate. Yes, they’ll have to reject some orders [from labs] but they also need to know when not to reject them.”

And that’s music to the ears of lab executives across the country.

By Brian P. Dunleavy

Trisha Beal, O.D., started wearing photochromics when she was eight years old and she remains a big believer in the product today.

“As an optometrist, I started wearing and recommending [photochromics] in 1996,” says Dr. Beal, adding that her young children now wear them as well. “My husband and I agree that for activities such as travelling, golfing, and day-to-day activities that involve varied and changing light conditions, it is extremely convenient to have lenses that automatically respond to our needs.”

Dr. Beal’s personal history with the product may be unusual, but her support of it as an eyecare professional is not. Photochromic lenses are arguably the optical industry’s best-known spectacle lens product, thanks in large part to the consumer advertising efforts of Transitions Optical, the category’s leading manufacturer (in terms of sales). The lenses have been lauded for their eye health benefits (they are effective at protecting the eyes from harmful UV light) and convenience (clear indoors and dark outdoors), but they are not without their detractors. In the past, the category – particularly its plastic product lines – was plagued with questions about darkening performance and lens durability.

“If you don’t educate patients properly about how photochromic lenses are designed to perform – they do not replace sunwear – you are not selling them honestly,” notes Trina Menoria, optician and owner of Artsee Eyewear in Victoria. Traditionally, it should be noted, manufacturers such as Transitions have marketed photochromics as an “everyday” lens and not as a sunlens. Other vendors in the category include Rodenstock (with its ColorMatic IQ photochromic lens line) and Corning (with SunSensors+ in plastic and Photogray and Photobrown in glass).

However, improvements in photochromic technology have rendered many of these performance issues a thing of the distant past – and thus expanded the potential wearer population of the category significantly. According to Dr. Beal, a partner at Brant/Paris Family Eye Care, a two-location practice in southern Ontario, nearly half of the patients visiting her practice are fitted with photochromics, including children. In fact, in 2011, Dr. Beal was recognized for her work in fitting photochromics on younger patients when she received Transitions’ “Eyecare Professional of the Year” award for Canada.

But increased sales aren’t the only change for changing lenses. Rodenstock, for example, continues to improve the “speed” of its ColorMatic IQ photochromic line, which it claims is already the fastest in the industry in terms of response to changing light conditions. At the company’s new web site (launched last spring) – called “House of Better Vision” – patients and eyecare professionals can see the product’s performance for themselves. Rodenstock’s ColorMatic IQ line is available in a wide array of lens designs and materials, in both progressive and single-vision.

And Transitions has introduced a new performance sunwear line, which features photochromic lenses that effectively change from “dark to darker”, depending on UV light exposure. Many manufacturers, including Essilor, Nikon and Carl Zeiss Vision, market a full array of single-vision and progressive plastic lenses using Transitions “everyday lens” technology.

“There are so many possible solutions for patients – from the convenience factors of photochromic lenses to superior light management control,” notes Dr. Beal. “The lenses adapt well to many lifestyles and activities. Although we don’t believe in blanket ‘one-size-fits-all’ solutions, most often, for those who require prescription lenses, we find ourselves recommending [photochromics].”

And that’s quite a change for the lenses that change.

By Brian P. Dunleavy

Dennis Wong sells a lot of anti-reflective (AR) coating. “99.9 per cent of the lenses we sell have it,” says the Vancouver-based optician and owner of EyeCity Optical.

Wong may be exaggerating but only slightly. Older patients who had bad experiences with AR in the past or those who balk at the cost are the only ones who leave his shop without it. Wong takes pride in the amount of AR he sells, and rightfully so: his numbers dwarf the national average, which, according to industry estimates, is slightly higher than 50 per cent.

Even though this number is likely to increase as the use of free-form lenses (which must be treated with AR) continues to grow, Canadian opticians have a lot of work to do to catch up to their colleagues overseas. In Europe, according to industry reports, roughly 75 per cent of all spectacle lens pairs sold are treated with AR; in Japan, this number is a stunning 99 per cent.

Given the obvious benefits of AR, both optical (reduced glare improves visual acuity and reduces eye fatigue) and cosmetic (the coating cuts down on glare reflecting off the front of the lenses), Canadian eyecare professionals should be pushing to increase the numbers of AR coated spectacle lenses they dispense, experts say. AR is a must for myopes, for example, as well as those opting for polycarbonate lenses (because of increased chromatic aberration). Thankfully, some recent changes in the coating marketplace should spur growth in AR sales.

First, as Madelaine Petrin, RO, B.Sc., notes, the quality of AR coatings available in Canada has improved significantly in recent years, making the peeling and scratching issues associated with the product largely a thing of the past. Still, the professor of opticianry at Toronto’s Seneca College emphasizes that even with the improvements, opticians must caution patients when dispensing glasses to care for their AR coated lenses properly.

“[AR coated lenses] still must be handled with care,” she says. “And not all coatings are equal.” She advises opticians to research coating products carefully and to avoid using them on certain lenses, such as some safety glasses (depending upon the conditions in which they will be used) and lenses for hyperopes (some say AR highlights wrinkles around their eyes), unless they are also fitted with aspheric lenses. Wong tried a number of coatings before working with a lab that imports its AR from Germany, where quality has traditionally not been an issue. Even so, fitting patients the right way is crucial in dispensing AR, he says.

Another factor affecting AR sales that’s unlikely to change is that provincial health care plans do not currently cover the coating, meaning patients must pay for it out of pocket. This can mean an extra charge of $20 to $30, if not more. However, all is not lost: to mitigate this extra cost, Wong suggests offering AR as part of a “package” with other premium lens features.

In the end, avoiding some of the barriers to AR sales and taking advantage of the opportunities comes down to educating patients. Wong believes strongly that education begins in the optometrist’s exam chair. If your optical shop is part of an optometry practice, encourage doctors to “prescribe” products such as AR coating by touting its optical and cosmetic benefits; if you’re an independent optical shop, partner with optometrists in your local area, if possible, and develop a patient education program.

“Education is key,” Wong says. “In my shop, I’ve made AR mandatory and I’ve found that when I explain the benefits – and the concerns – patients will try it and be happy with the results.”

Winter Sun Promotion Winners

As snow has been replaced by the summer sun, Vision-Ease Lens announces the grand prize winners of the Winter Sun Promotion offered in partnership with Riverside Opticalab in Ottawa, Superlab in Montreal, and AN Optical in Waterloo. More than 50 eyecare professionals (ECPs) participated in the promotion that ran from Jan. 1 through March 31, which introduced ECPs to Coppertone^® polarized lenses and encouraged patient education in year-round eye protection.

The grand prize winners are:

1^st prize – iPad II: Ottawa Optometry Clinic, Ottawa, ON

2^nd prize – Kindle Fire: Lenz and Trenz, Uxbridge, ON

3^rd prize – iPod Nano: Harding Optical, Calgary, AB

ECPs were automatically entered to win monthly prizes by registering for the promotion, which required watching a brief educational video about the dangers of solar radiation to the eyes, and the benefits of Coppertone polarized lenses. Each pair of Coppertone lenses sold earned ECPs a chance in the drawing to win a grand prize.

By Brian P. Dunleavy

For Trina Mendria, high-index plastic lenses simply make sense – both from a business standpoint and with regard to the benefits they bring her clients.

“We sell a lot of semi-rimless and rimless frames,” notes the optician and owner of Artsee Eyewear, which has locations in Saanich and Victoria, B.C. “High-index plastic makes up more than 70 per cent of the lenses we sell.”

For Michelle Skinner, optician and owner at Cowan Optical in St. John’s, the situation is much different.

“We sell maybe three or four pairs [of high-index plastic lenses] per week,” she says. “At most, it’s maybe 15 per cent of the lenses we sell.”

So which shop has it right? How much should your eyeglass dispensary use high-index plastic? The answer is simple: both shops have it right because they have based their recommendations of the material on the needs of their patients/clients.

Unlike other premium lens products, which have always had a more defined role in the eyecare professional’s toolkit, dispensing high-index plastic lenses has changed significantly in recent years due to changes in the product category. The category of high-index plastic – which is loosely defined as plastic lenses with indices of refraction of 1.54 or above (in other words, anything higher than CR-39) – has arguably seen more change than any other spectacle lens product over the past 20 years. In the late 1990s and early 2000s, lens manufacturers began introducing more product options in the high-index arena, with the idea of making these lenses more durable and, in some cases, more affordable for eyeglass wearers. As a result, new products in the mid-index range (1.55 to 1.60) and, of course, Trivex^® were introduced.

While most of these products are still around, several mainstays have separated themselves from the herd: polycarbonate and Trivex for their impact resistance, and 1.60, 1.67 and 1.74 index plastics for their aesthetics. Historically, these latter products have been seen as options for patients with high-powered prescriptions because they are thin and lightweight. However, as Mendria notes, they have also become a go-to option for patients who want smaller frames. She finds that 1.60 index plastic lenses are perfect for semi-rimless and rimless frames because they are “more durable and won’t chip.

“We know our patients in semi-rimless and rimless will be handling their glasses a lot, just like all eyeglass wearers do,” she says. “So our choice for them is also very pragmatic. I know the 1.60 index will hold up well and there won’t be that much of a sacrifice in Abbe value. Of course, we could put them in an even higher-index product, but we also have to be realistic. Is it worth them looking through a lens with compromised optics just to save a half millimeter in thickness?”

When it comes to high-index, Skinner is pragmatic as well. In her local area, she explains, “most of the high-minus, single-vision eyeglass wearers are getting LASIK.” As a result, most of her clientele, she says, are 45 to 50 years old and are entering or well into presbyopia. Given the advances in progressives with digital or free-form technology, she has been able to fit these patients in 1.67 index plastic lenses with excellent optics, compared to their older-line, high-index progressive lens predecessors. For patients with really high prescriptions, 1.74 index plastic free-form progressive lenses are also an option.

“We don’t see a lot of those,” she says. “But it’s nice to have them there if we need them. All patients want their eyeglasses to look good, and they want thinner and lightweight lenses.”

Two different optical shops in two different communities: two different uses for high-index plastic lenses. Optical shops seem to have discovered how this important product fills the needs of both their businesses and their patients.

By Brian Dunleavy

Tracey MacLeod believes in free-form lenses – for certain patients, anyway.

“Once you have witnessed the digital surfacing process, it is hard to imagine dispensing anything but free-form,” says the optician and owner of Wizard Optical in Halifax.

But while free-form technology (also known as digital technology, Wavefront technology or high-definition technology) has been the buzz in the eyeglass lens arena in recent years, it’s not for everyone – at least not yet. Most experts agree that the technology – which incorporates multiple measures (including pantoscopic tilt, vertex distance, near viewing distance and panoramic angle), in addition to the patient’s prescription and pupillary distance (PD), into the surfacing process – has greatly improved the optics in progressive lenses, and thus expanded the options for presbyopic patients. Single-vision, however, is a different story – for now.

“The bulk of our patients are 45 to 50 or older; most younger people are having LASIK done now,” notes Michelle Skinner, optician and owner at Cowan Optical in St. John’s. “Our presbyope patients love free-form progressives. With older progressives, you had to remind patients to look through the center of the lens because of the peripheral distortion. With free-form progressives, there’s no peripheral distortion. It’s almost like looking through a single-vision lens.”

Still, although opticians like Skinner and MacLeod agree that free-form progressives are a no-brainer for their presbyopic patients, they are not always an easy sell – particularly if opticians haven’t taken the time to educate themselves on the new technology. The higher price tag associated with these lenses means that opticians must be able to explain the visual benefits to patients who may have a difficult time understanding the technology.

“Manufacturers have spent lots of time and money on information to help the dispenser, and we all need to take advantage of this,” explains David Watson, an instructor at the BC College of Optics in Surrey. “These designs are exceptional products, but opticians need to be educated and skilled in producing the measurements needed. No longer are we merely taking PDs and segment heights with pen and ruler. We now need to measure segment heights, PDs, pantoscopic tilt, face-form or wrap and vertex distance of the frame for patients to receive full custom-lens benefits.”

At Wizard Optical, MacLeod and her staff initiated a formalized free-form education process two years ago in order to get their heads around the new product line. By taking advantage of educational programs offered by lens manufacturers and their wholesale laboratory and doing some research on their own, each member of the staff attempted to immerse themselves in all things free-form. Then, they held regular “think tanks” during staff meetings to share what they had learned.

“We prepared a one-page simplified graphic that depicts a lap and a grinding pad used for ‘conventional’ lenses,” MacLeod explains. “It compares that to the computer-controlled free-form cutting process, where those personal factors can be introduced. I found [the grinding lap] to be the most effective sales tool. It’s bulky appearance and old-fashioned look enhance the concept of the new technology used in free-form lenses.”

But while resourceful sales approaches such as these have made free-form lenses a must for MacLeod’s presbyopic patients – she says 100 percent of her progressive lens sales are now in free-form – she has not taken the same hard-sell approach for single-vision wearers. Skinner agrees. It seems that although free-form technology has revolutionized progressive lenses, it remains a work in progress on the single-vision side, except perhaps for patients with high prescriptions.

“I’m a -4.50 and I tried free-form lenses in single-vision and didn’t see a difference over other single-vision lenses,” notes Skinner. “Believe me, if we tried them and thought, ‘wow!’ we’d be selling them, but we can’t sell something we don’t believe in one hundred percent, especially given the cost. My sense is the technology will only get better, and we will soon see free-form take off in single-vision too.”

Which will mean better vision for patients and higher profits for dispensers.

By Brian Dunleavy

When it comes to exploring new products, optician Garry Oleksyn treats frames and lenses differently. 

“I’m always looking for new frame styles,” says the owner of Point Optical, which has two locations in the Saskatoon area. “But when it comes to lenses, I’ve really stuck with just three companies.” 

Make no mistake: Oleksyn does everything he can to make sure his shops dispense the latest and greatest lens designs. However, he has established relationships with certain vendors and believes in the quality of their products. He is willing to listen when it comes to discussing new lens designs from new vendors, but waits until they have a proven track record of providing quality vision before dispensing them in his shops. Oleksyn has taken the same approach in working with his lens-processing laboratory: he has been with the same one since he opened in the mid-1980s. 

And he is not alone. It seems many of Canada’s opticians and optometrists are much more conservative when it comes to the spectacle lenses they dispense – and the labs that process them – than they are with frames. That makes sense because while patients often want fashionable frames they ultimately wear eyeglasses to see properly. 

“Some of the new digital lenses designs may be great,” notes Oleksyn. “But I’ve had a number of patients who have worn them and experienced problems. I want people leaving my shop with the best vision possible.” 

Madelaine Petrin, R.O. Bc., professor of opticianry at Seneca College, says she understands the cautious approach but warns against taking it too far. “The number one thing is you have to provide what the client asks for,” she says. “Advertising directly to the public and to opticians drives the market. The client is more educated and knows what he or she wants.” 

So how do you know when changing vendors is right for you? And what criteria should you use for selecting new vendors? Consider the following: 

• Quality rather than price. “I want more than low prices from the vendors I do business with,” Oleksyn notes. Indeed, don’t just ask about price. If you are unfamiliar with a company’s product offerings, ask around among people you trust to see how the lenses perform “in the field.” 
• Support. Dr. Alan R. Boyco, OD, owner of Image Optometry, a 14-location chain of optometry clinics in B.C., says he focuses a lot on price because his patients do. “But given the competitive nature of our industry, the level of customer service must meet our expectations as well,” he adds. Ask potential new vendors about technical and sales support – and whether or not they will be available to assist if patients have problems with their lenses.
• Sales assistance. According to Petrin, one of the keys to selling spectacle lenses is, “having something to show [patients]” about the quality of vision offered by the product. Ask vendors – both lens manufacturers and labs – what sort of marketing materials they have for their products, and make sure they work for your optical shop/dispensary. 
• The process. As Petrin notes, not all lens processing laboratories process all lens designs. Ask any lab seeking your business what lenses they process and recommend. Product selection—from both labs and lens manufacturers – that matches the needs of your patient base is vital. 

Salespeople representing both labs and lens manufacturers will come calling. While it makes sound business sense to listen to their offers, being selective is important. Dr. Boyco, for example, insists on written introductions – usually by email – before meeting with sales representatives in person. For a partnership between vendors and eyecare professionals to work, he adds, both parties must share the same ultimate goal; providing quality vision care. 

Oleksyn agrees. “I want quality, service and backing and that’s what I get from my vendors,” he says. “If they want to stay in business with me, they have to give me that. I want to be looked after.” 

By Brian P. Dunleavy

Optician and educator David Wilson can find a “teachable moment” anywhere. Just ask his aunt.

Watson, a long-time optician and an instructor at the BC College of Optics, welcomed his aunt from out of province just as she was having “some difficulty” with her new progressive lenses. Rather than let her suffer, he decided to use her as an example for his students of what not to do as a professional optician.

“She explained that when she picked up her eyewear, the optician simply gave her the glasses in the case and told her if she had any problems to come back,” Watson recalls. “That was it – no adjustments to the glasses or instructions on how to use them.”

But eyeglasses aren’t that simple anymore, as Watson’s aunt learned the hard way. Today’s lens designs are not “plug-and-play,” to use a term commonly associated with high-tech gadgets, which is exactly what eyeglass lenses have become. With new technology incorporated into designs to help them conform to the unique visual needs of individual wearers, contemporary spectacles lenses offer many new and exciting benefits to wearers – but they can also present new challenges to eyecare professionals in the fitting process.

“Free-form or digital technology in both single-vision and progressives is a wonderful innovation,” notes Steven Levy, owner of LF Optical/LF Warehouse inToronto. “But how effective lenses that use it are for the wearer ultimately comes down to the fit.”

“One of the key messages I tell students is that most progressive non-adapts are usually not patient problems or Rx problems but the dispenser’s problem,” Watson adds. “In other words, a poor or incorrect fit or choice of frame.”

So how can you avoid fitting failures?

Distance relationships
Pupillary distance (PD) remains the most important measurement in lens fitting. Take monocular PDs and use a pupillometer for the most accurate measurement.

Measure up
Ocular centre (OC) and prism reference point (PRP) heights are often overlooked measurements that can make or break a fitting, particularly with free-form progressives, which take multiple measurements into account. “There is much more than just correct PDs in the fitting of progressive lenses and the digitally surfaced lenses of today,” Watson explains.

Take a position
Be sure to measure pantoscopic tilt, fitting height, vertex distance and faceform or frame wrap (the distance the frame “wraps around” the face). Some excellent high-tech devices are available to assist opticians in the collection of these measurements; however, Watson still emphasizes the importance of maintaining a mastery of old-school techniques.

“Know how to take measurements without fancy gadgets,” he says. “Pupillometers and computers break down or are easily put out of calibration. The basics will never let you down. We have a computerized system at the school that takes all the basic measurements. It’s fun to use and the students are always wowed by it. But every good optician I know can measure two or three patients in the same time it takes to use the computer system.”

Make adjustments
Once the patient selects their frame, adjust it before taking any measurements and note its “base curve” (the curve of the eyewire). Again, this is particularly important with free-form progressives. “I was talking to a lab manager at one of the largest labs in Canada and we agreed that this is an industry problem,” notes Watson. “Most non-adapts to progressives come down to the adjustment of the frame.”

Just like Watson’s aunt. How did things turn out for her?

“In class, I helped the students analyze her difficulties and solve the problem. First we inked up the glasses, adjusted them for her head, gave her some more faceform and pantoscopic tilt. She said it was like we replaced her lenses with something better! Her vision also improved two lines on the Snellen chart.”

How fitting.