The Reality of the DREAM Study

Plenty of misinformation is still being spread on the Internet regarding the DREAM (Dry Eye Assessment and Management) study that claimed fish oil is not good for dry eyes. Readers who found themselves poring over these click-bait headlines were misled, and their misunderstanding was further perpetuated by the omissive messaging by the New England Journal of Medicine regarding the findings from the National Eye Institute study.

Not only was the DREAM trial not well designed or controlled in its broad, inclusive subject selection, the researchers also permitted concurrent dry eye therapies. Additionally, the active Omega-3 supplement used was tested against a placebo, olive oil, which also happens to be a healthy oil.

The research concluded there was significant improvement in dry eye symptoms in both the placebo and in the fish oil supplement groups, but that there was no significant difference between the two groups. Wouldn’t that imply that an increase in healthy oils, such as that found in fish oil and olive oil, can significantly help dry eye symptoms? Yet, the lead researcher in the DREAM study, without noting that the placebo is also a healthy oil, said that fish oil is not effective in improving dry eye symptoms when his own research clearly indicates that it is. Fish oil and olive oil both help reduce dry eye symptoms.

“The Omega-3 used (in the study) was a fish oil concentrate in triglyceride form, rather than re-esterified triglyceride, which may help to shed light on the findings,” says Dr. Richard L. Maharaj from eyeLABS in Brampton, ON.

Although the study had many blemishes, the conclusions did illuminate other alternatives to consider in the treatment and management of dry eye disease (DED). “Interestingly, the name DREAM is appropriate, in that seeing the impact of the olive oil may point us to seek out other naturally existing oils and their impact on the ocular surface,” says Dr. Maharaj.

Before jumping into what healthy oils to consume, it is important to first know about Omega-3, -6 and -9 fatty acids. The body cannot produce the essential dietary fats Omega-3 and -6, and so these must be consumed. These fats are part of a family of polyunsaturated fatty acids called PUFAs, including DHA, EPA, DPA, and linoleic acid. Omega-3 helps balance pro-inflammatory Omega-6. Also, Omega-3 fish oils come in triglyceride or ethyl ester forms. Triglycerides are the natural form of Omega-3 in fish and do contain impurities. The more expensive, re-esterification process converts the artificially manufactured ethyl ester form without impurities back into the natural form of Omega-3. Omega-9 are monounsaturated and are not deemed essential because they are already produced by the body.

All EFAs treat cells as miniature cities with signaling systems between the cells. They make up part of the protective cell membrane, especially Omega-3 which allows nutrients and wastes to go in and out of the cell.

Not consuming enough healthy oils or consuming too much creates a traffic jam which won’t allow oxygen to pass through properly. This reduction in oxygen causes the normally paired oxygen molecules to gain electrons, thus turning them into unpaired molecules called free radicals. Cellular injury and damage occur when free radicals build up at the cellular level, and the communication system between the cells becomes erratic and causes inflammatory disease, such as cancer, heart disease and arthritis.

These inflammatory conditions can contribute to dry eyes, which in turn can cause more inflammatory reactions on the ocular surface. It is important to treat dry eyes as the symptom. Because eyedrops are for symptom-relief and don’t fix the problem, it makes sense to treat the inflammation within the body to help get rid of dry eye by consuming healthy oils. A shift in lifestyle diet, added to a body wellness regime will help with dry eyes.

Omega-3 and -6 fatty acids are the building blocks of healthy cell membranes and healthy cells in general. The recommended ratio of Omega-6 to Omega-3 is 2:1 or 4:1, not the 10:1 we often see in Western diet. The Mediterranean diet, which uses large amounts of olive oil, is excellent for those with dry eye. Eating healthy oils creates better traffic flow between cells, which prevents free radical build-up.  Healthy oils help to clean out the bad cells and sometimes even repair them.

“Certainly, the DREAM study adds to our new collective approach to managing DED using a comprehensive approach which includes nutrition counselling, ” says Dr. Maharaj.

The DREAM study, albeit flawed, shows that Omega-3 supplementation is beneficial while shining a bright light on the need to look more closely at other healthy oils as well.

By Shirley Ha HBSc, OD, FCOVD

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Wowing the World of Eyewear Design: Mary Iljazovic for ROLF Spectacles

Mary Iljazovic is one of a kind: strongly determined, wildly creative and technically obsessed. And, after only 10 years fashioning eyewear frames, she and her team at ROLF Spectacles may well lead the optical world in design awards.

Those awards keep piling up at ROLF Spectacles, headquartered in the village of Weissenbach, Austria. “I think there are about 45 awards now,” Iljazovic allows, “with the most important being the SILMO d’Or, which we won three times, the Red Dot Design award, which we won several times, and the iF (International Forum Design) design award.” Clearly not one to boast, Iljazovic is instead profoundly focused on the heart of the ROLF business philosophy: setting trends and making the impossible, possible.

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Rather than having to kowtow to the whims of a ‘boss’, Iljazovic always knew she wanted to be in business for herself. It suits her. “I have always lived from one day to the next, keeping things simple and having no grand plan,” she says. “I grew up in a very technically creative family and I always knew that one day I would be making things. I definitely did not want to be someone’s employee.”

ROLF began as a vision in the minds and hearts of Iljazovic and her then-romantic partner Roland Wolf. They met while teaching snowboarding in the Austrian Alps. Wolf was working as an optician and the two shared a passion for vintage automobiles. The path to eyewear design started to emerge at this point. They began by representing frame manufacturers in Austria and South Germany. Their own vision for frames started to emerge in 2006.

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In 2007, Iljazovic and Wolf teamed up with Christian Wolf (Roland’s brother) and Mary’s younger brother, Martin Iljazovic, to see if they could wow the world of eyewear. The four worked in the basement of Roland and Christian’s home. They wanted to make frames out of sustainable natural materials, starting with wood. “We tried to find a factory with the highly specialized technology needed to realize our vision, but it did not exist, so we had to invent our own machines and systems,” says Mary.

Iljazovic is entirely self-taught. Her role in the startup was production software design. “We decided to try out some ideas and within six months we had finished product. But everything takes much longer than expected. In 2009 we took a bad prototype to the trade show in Munich. Based on the feedback we received we went back to the drawing board to make the product better.”

With the goal of making the impossible, possible, Iljazovic and Wolf designed a wooden hinge right off the start. “I had an idea for the shape, and we did the technical aspects together,” says Iljazovic. They also developed a unique glazing system that inserted a variable thickness of nylon thread through tiny drilled holes on the eyepiece and then into a groove in the frame. “It’s not as easy to glaze wood as it is acetate and metal,” says Iljazovic.

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When they first showed their frames in Munich, people were fascinated by the hinge and glazing system. A second hinge, the FLEXLOCK, was created in 2017. An ingenious combination of densely compressed wood and natural rubber, the FLEXLOCK has multi-directional capabilities, is metal-free and able to absorb shocks.

Iljazovic was the first designer to combine wood and stone in frame design, as seen in models from ROLF’s Main, Evolved and Excellence collections. An exquisite and technically innovative collection made from buffalo horn, MONOCEROS, launched in 2017.

From the initial four owners working in a cellar to a team of 53 employees, ROLF Spectacles has come a very long way in just over 10 years. Still ardently true to their first objectives of sustainability, in-house production and turning the impossible into the possible, the company makes frames entirely in-house from locally sourced materials—except for the nylon thread used in glazing, which is imported from Germany and some of the wood, which is sourced from reputable suppliers.

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And Iljazovic lives exactly the lifestyle she prefers, in a small village, which is a ten-minute drive from company headquarters. Here she keeps four horses and a dog. She likes to snowboard occasionally and generally lives a quiet life. “I like visiting cities but only for a few days at a time,” she says.

Who exactly is Mary Iljazovic? She describes herself as ‘an architectural draftswoman’ who loves animals and the countryside of her native Austria. The world is describing her as a preeminent designer of luxury frames who sets design trends and realizes new ideas: just witness the awards! It seems impossible for such a young company to rack up almost 50 awards for design, but Mary Iljazovic is proof positive that the impossible is within reach.

By Paddy Kamen

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When More is Less: The Too-Much-Choice Effect

Optical retailers recognize that customers crave choice, perhaps even abundance. Research from various sources, including marketers, economists and psychologists supports the belief that shoppers feel they benefit from having more choice. Online giants like Amazon have indeed built their business models on the ability to offer endless assortments in any product category.

But did you know there is a well-documented “too much choice” effect? It’s also known as “choice overload”, “the paradox of choice”, or “hyperchoice”. Further investigation has shown that having too much choice can be associated with less purchasing!

Offering consumers too many options makes them less keen to make a final choice. How many of us have been overwhelmed by our options when shopping online for cosmetics or electronics, for example, and have simply put off the decision and abandoned our carts? Perhaps even more surprisingly—and more importantly for ECPs—when there are too many options, customers have less post-purchase satisfaction with their choice.

What causes this lower satisfaction? Having to decline many alternatives. The more alternatives customers have, the more uncertain they may feel about whether they have made a good choice.

Three Tips to Avoid this Effect

  1. Reduce the Amount of Similarity between Alternatives

The most important thing is to make the range of choices seem less complicated to the consumer. When presenting frames start with options that are quite dissimilar. Present choices in a specific order, from the boldest to most subtle frame designs, from the most advanced design to entry-level options in lenses. Propose a frame or lens that you can describe as a standout option and offer one back-up option for easy comparison. Offering one choice that is clearly superior will help reduce the choice paralysis your customer may be feeling.

  1. Reduce the Range of Alternatives

The size of the assortment matters differently to two distinct types of customer. For customers who don’t arrive with something specific in mind, more IS less, whereas customers who walk in with strong preferences tend to be more satisfied if they choose from a larger assortment, expecting that a large selection will ensure they find the look or the product they have in mind. You can be successful with both types of customers if you merchandise your frame selection strategically. Place more of the “same” items together: multiple colours of the same frame, the same sunglass style with and without polarized lenses. This will avoid triggering the “too much choice” effect. Mirrors, false bottoms and simply presenting every product twice on a frame board can go a long way to creating the comfort of selection without the discomfort of choice paralysis.

  1. Chunk Technical Information into Categories

We owe our customers the necessary technical information, so they can participate actively in the selection process and make well-informed choices, but the difficulty of choosing will increase with the number of different pieces of information they need to evaluate. This is particularly true when consumers lack expertise and experience­­—particularly when they are first-time wearers of prescription glasses, progressive lenses or contact lenses. The secret to avoiding information overload is to simplify the choices by grouping them in categories. For example, if you tell customers, “we will walk through three decisions together with respect to your lens options—lens material, lens design and lens coatings”—it will be less overwhelming than if you had listed all the options one-by-one. Same for frame choices: saying, “let’s compare the benefits of the different materials, then choose a shape, then your colour preference,” helps reduce the complexity. This approach has proven to be even more effective with smaller rather than larger assortments.

Always keep in mind that your customer’s ultimate satisfaction is not directly associated with the number of choices you offer. The relationship between choice and satisfaction is complicated and sometimes too many choices can damage your overall effectiveness.

By Margaret Osborne, BSc MBA RO

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For Lenses, it’s Showtime!

Vision Expo West (VEW) in Las Vegas, scheduled for September 26 through 29, offers ECPs from all over the world an opportunity to learn, network and, okay, have a little fun.

However, meetings like the two annual Vision Expos also provide manufacturers and suppliers with a platform for introducing new products. Notably, some of the most important recent releases have been in the spectacle lens market.

While it’s true the new lens offerings that debuted at Vision Expo East (VEE) in the New York last spring lacked the fanfare of, say, the first freeform lenses or, going back a bit, the initial launches in progressives and photochromics, they were no less impactful in terms of increasing the options you can provide your patients and/or clients. And, more importantly, they also make significant inroads in enhancing how eyeglass wearers see, and their overall visual comfort.

Take for example Essilor’s decision to offer blue light protection on all of its lens products going forward, via a new coating (see cover story). The new treatment, called Essential Blue, filters three times as much harmful blue light as a conventional clear lens, the company reports. It meets the needs of today’s eyeglass wearers, and their growing use of digital devices (which emit blue light), by filtering out harmful rays (415 to 455 nanometers) while allowing in rays that are beneficial to eye health (465 to 495 nanometers).

Zeiss, meanwhile, used the New York show to launch UVProtect, a lens treatment it describes as the first-ever complete sunglass-level ultraviolet (UV) coating available for clear, organic eyeglass lens materials. The company will now be offering this UV protection (up to 400 nanometers) on all its lens designs and materials. This is notable because, according to Zeiss, most clear spectacle lenses protect against 380 nanometers (UV380) of UV, leaving eyeglass-wearers exposed to as much as 40 per cent of the most harmful rays. This exposure has been linked with photoaging, cancer and cataracts.

Staying on the theme of eye protection, Vision Ease and Younger both made significant additions to their polarized sun lens lines during VEE. Vision Ease has expanded its Coppertone Polarized Lenses line with new offerings in PPG’s Trivex material. Of note, Coppertone Trivex lenses block 100 per cent of UVA and UVB rays, and also filter blue light.

Younger’s launch in New York is called NuPolar ® Infinite GreyTM. According to the company, the new lens is designed to combine its “award-winning” NuPolar polarization technology with state-of-the-art photochromics, creating an “adaptable” corrective sun lens. The new product was developed in response to complaints from prescription eyeglass wearers that their sun lenses were, “either too light or too dark, typically at the wrong times,” according to Younger. In their lightest state, NuPolar® Infinite GreyTM lenses allow for 35 per cent light transmittance, compared to only nine per cent at their darkest state.

VEW in Las Vegas will likely see more new products brought to market. How these new innovations can and will be used in individual optical practices remains to be seen, but new technology generally brings with it new opportunities to meet the ever-increasing expectations of eyeglass wearers.

By Brian P. Dunleavy

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Did You Put that Fly in My Soup? The Service Recovery Paradox


Wait staff have long known that their tips will be higher if they go to great lengths to fix a mistake they made with your meal order. An urban legend suggests that some waiters make mistakes on purpose so they can wow you with an exceptional response to your concerns. They find their tips are higher with excellent service recovery than if there was no mix-up with your order at all!

This scenario is called the service recovery paradox. A customer will think more highly of an organization after it corrects a problem with its service, compared to how the customer would have perceived the organization if no service failure had happened. Needless to say, no ECP could ethically conceive of deliberately staging service failures. So how can this phenomenon be relevant to us?

What ECP’s can do with this knowledge is to manage our rare but inevitable service failures as effectively as possible. We can benefit from the same halo effect by converting glitches into golden opportunities. To be successful with service recovery we need to understand that consumer dissatisfaction styles fall into four distinct groups and respond to each group appropriately.

The Passives, Voicers, Irates and Activists

  1. Passives are the non-complainers. You won’t hear anything from them. You won’t even know they had a problem. And they won’t be back. We’ve all met people who bought glasses two years ago ‘somewhere else’ and never wore them because they felt something wasn’t quite right. Over 70 percent of consumers who experience a service failure never complain directly to the manufacturer or seller. It’s common to underestimate how many of our own patients are in this category. Routine follow-up calls asking them to rate the main aspects of your products and services are the best way to reach this group. You may offer them immediate low-cost remedies for any dissatisfaction you uncover but they are unlikely to return. Use this feedback to improve your service and the customer’s perception of your business.
  2. Voicers complain directly to you and expect you to fix the problem. These consumers don’t want to switch to another ECP, nor do they want to spread bad reviews. They definitely won’t ‘go public’. You will benefit the most from the service recovery paradox if you make the voicer style the most attractive choice for your patients. Do this by working to convince everyone who interacts with your practice that you welcome complaints and that they will be handled seriously. Easy-to-use non-confrontational methods of eliciting feedback like anonymous checklists in-store or on social media are essential to encourage voicers. Handled graciously, this group will become your most vocal advocates.
  3. Irates are the angry consumers who not only complain to you but will spread negative word of mouth to friends and relatives. They will, however, stop short of complaining publicly to regulators or other third parties. You’ll need to roll out a well-planned, comprehensive complaint management system to manage service recovery with this group both in person and on social media. It is best to be prepared with ‘over and above’ compensation for their perceived aggravation before their complaints go viral.
  4. Activists are dissatisfied consumers who use all available channels for complaining (the Better Business Bureau, traditional and social media, regulatory bodies). They believe they should not only look after their own issue but take care of all the other customers who might possibly have had issues with your service— perhaps even with your inability to overcome the laws of optics! Proceed swiftly with the same response as with the previous group, however, be prepared to raise the stakes with appropriate mediation and/or legal representation.

Remember that it is essential to keep an open mind towards complaining customers instead of regarding them as costly, difficult, or a psychological strain. Hug your haters: they offer insights for improvement and will be extremely loyal if you deal with service issues promptly and fairly.

By Margaret Osborne, BSc MBA RO

Leadership Changes at Transitions Optical

PrintTransitions Optical announced a number of key executive changes following a PPG Industries statement that after nearly 40 years of service, including almost 24 with Transitions Optical, Richard C. Elias, senior vice president, optical and specialty materials, and chief executive officer, Transitions Optical, would be retiring, effective April 1, 2014.

The announcement also came on the heels of Essilor International’s report that it had finalized the acquisition of PPG Industries’ 51 per cent ownership stake in Transitions Optical.

Dave Cole, Transitions Optical president, has accepted the promotion to vice president for PPG’s packaging coatings business following nearly 24 years with Transitions Optical. Cole joined PPG in 1981 and held a variety of sales and marketing roles in the chemicals organization prior to joining the Transitions Optical organization. He participated in the start-up of Transitions Optical in 1990 as manager, sales and business development and later progressed through several positions of increasing responsibility before being named its chief operating officer in 2010. He was appointed president, Transitions Optical in 2011.

Paddy McDermott has been appointed president, Transitions Optical, effective immediately. He will report directly to Bertrand Roy, senior vice president, strategic partnerships, Essilor. McDermott originally joined Transitions Optical in 1993 and has previously held several key positions in the company’s EMEA region and globally. He was responsible for the start up of Transitions Optical’s Ireland facility and subsequently worked as director of operations and customer service for Europe, global supply chain director, and information technology leader globally. Subsequent positions included director, lenscaster sales, EMEA; director, operational excellence and global engineering; and his most recent role as global director, strategic initiatives.

Bertrand Roy, senior vice president, strategic partnerships, Essilor, will lead the Transitions Optical business for the Essilor Group. Roy has been with Essilor International for nearly 27 years and was instrumental in the foundation of the Transitions Optical joint venture. He has served Transitions Optical in many capacities including executive director and board member.

Congratulating Elias on his retirement and Cole on his promotion, Roy shared his appreciation saying, “For me, it has been both a professional and personal honour to work with Rick and Dave for nearly two decades. They are gentlemen of the highest caliber of integrity and professionalism. Their leadership has been integral to creating Transitions Optical’s unique culture and driving its continued strong performance since its inception. Their dedication has positioned Transitions Optical for continued success well into the future.”

A Thorough Revamping for is happy to announce the collaboration with Opal Group France, the Ponts d’Or gold winner in the POS Material category and silver winner in the Children category. This new association allows to offer a wider range and meet the needs of the company’s clients. 

Five new collections are introduced: Pola, Lapö, Owlet, Owlet Plus and Proximo, as well as new Rx lab edging and mounting services for frames, lenses and treatments.’s coolaboration with Opal Group France has allowed them to offer online purchasing exclusive for eyecare professionals who register on the site. Professionals may order per unit or in quantity.

Blanchard Laboratories Unveils Onefit Lenses

Blanchard Laboratories introduces Onefit Series lenses as the new standard for GP and soft lens wearers. This line of mini scleral lenses is designed to completely vault the irregular or ectatic cornea, as well as normal prolate cornea with astigmatism. Onefit lenses boast the crisp visual acuity and high DK of a GP lens, and the comfort previously only available in a soft lens.

“Our goal was a large-diameter RGP lens that is easy to fit and as comfortable as a soft lens. It had to be better than my own soft lenses before we would introduce it,” says Jean Blanchard, president of Blanchard Laboratories. “I wear these lenses comfortably during all of my waking hours.”

The Onefit Cone is designed to accommodate highly irregular corneas such as keratoconus (Oval, Nipple) and ectasias. Available in diameters ranging from 13.7 mm to 14.6 mm, the lens always centers well on the eye and provides the patient with visual clarity and stability never before possible with smaller GP lenses.

The Onefit P+A is designed to vault over corneas with normal prolate profile or astigmatism. Available in diameters of 13.8 mm up to 14.9 mm, the lens rivals the comfort of a soft lens and is ideal for those who cannot adapt to, or have developed an intolerance to smaller GP lenses or soft toric lenses.

A simple three-step, inside-out fitting approach, combined with a 14-lens trial set, makes Onefit the easiest mini scleral lens to fit and trouble shoot.

Joe Voros with Concept Eyewear

Joe Voros with Concept Eyewear

Concept Eyewear has appointed Joe Voros as an independent optical sales representative for V. Design and V. Design Kids eyewear brands in theOntarioterritory. He has been in the optical industry for many years and is looking forward to working with his existing, as well as new, accounts to introduce this exclusive eyewear line.

The V. Design’s assertive, upscale ophthalmic frames are unique, colourful and extravagant, corresponding to the wearer’s individuality and personality.

Inauguration of a Chair in Coatings and Surface Engineering

Inauguration of a Chair in Coatings and Surface Engineering

As of Oct. 1 Polytechnique Montréal, the Natural Sciences and Engineering Research Council of Canada (NSERC) and seven industry partners have inaugurated the NSERC Multisectorial Industrial Research Chair in Coatings and Surface Engineering (MIC-CSE).

As the country’s second-largest industrial research chair awarded by the NSERC, all fields combined, the MIC-CSE will have a budget of $5.35 million over five years: $2.6 million from NSERC and a total of $2.75 million from its seven partners: Essilor, Hydro-Québec, Guardian Industries Corp., Pratt & WhitneyCanada, Velan, JDS Uniphase and the Canadian Space Agency.

Research will focus on developing a new generation of non-polluting manufacturing technologies for nanostructured coating materials. These processes make it possible to add successive layers of nanometre-thick films and thicker coating architectures, using various materials (metals, ceramics, polymers, nanoparticles, or others) on flat surfaces as well as on three-dimensional objects. These “molecular millefeuilles” aim to confer a wide range of functional characteristics to the surfaces: anti-glare, anti-erosion and anti-fog as well as self-controlled (or “smart”) optical reflectivity or emissivity, luminescence, sterility and more.

“The possible functionalities are limited only by our imagination,” said Ludvik Martinu, MIC-CSE Chairholder and Professor in the Department of Engineering Physics at Polytechnique Montréal.

The scope of collaborations within the MIC-CSE Chair reflects the immense range of industry fields in which multi-layer coating technologies can be applied. The research carried out at Polytechnique will improve the sustainability and effectiveness of materials in sectors as varied as aerospace, energy and manufacturing, as well as optics, photonics and space exploration.