Give Me Your Tired, Your Poor... Your Eyes, That Is

By Mark Mattison-Shupnick, ABOM

In today's high-tech world, the eyes are constantly focusing on PDAs, laptops, e-readers, tablets and cell phone text messages. Focusing on close and mid-range objects or small letters and images on small screens is an effort for the eyes. Especially when combined with long work hours, this prolonged accommodative effort often leads to tiredness, tearing, headache and blurry vision. Why?

Human eyes are at the peak of their accommodative capabilities around the age of 9, after which there is a gradual decline with the passing years. During ages 18 to 27, many are spending countless hours reading, researching and writing for college. By ages 28 to 38, accommodation can have a noticeable lag and can be difficult to sustain for long hours of intermediate and close vision tasks. Even if visual correction for close viewing is not required, the eyes need a solution for the eyestrain created by tasks at this everyday range of mid and near vision. For the pre-presbyope, consider the new versions of lenses with a small plus boost in the lower portion like HOYA Sync, Shamir Relax or Essilor Visual Fatigue. For presbyopes, the variety of office-type lenses (Zeiss RD, SOLA Access, HOYA Tact, Shamir Office to name a few) provide every higher add wearer a solution.

WHAT RANGE TO CHOOSE?

Knowing which range is often the real question. You can talk to your lab; they are great at helping to create the right patient experience. However, understanding the results yourself is better. Here are two illustrations of how a SOLA Access lens in an 075 and 125 range work for a +1.50 add and a +2.00 add wearer. In each case, look at the visible range that is available with each range of power that allows the computer monitor and more of the desk to be in clear view.

PEARLS: START THE PATIENT CONVERSATION WITH THE FOLLOWING

• Would you like more comfort when reading, at the computer, etc...
• Can I get rid of those neck and backaches...
• One pair of glasses can't do everything, especially when we wear multifocals...
• Haven't you noticed that reading...
• Haven't you noticed that vision at the computer...
• Our office offers...

RANGE, DEGRESSION, POWER CHANGE—WHAT DOES IT MEAN?

By Mark Mattison-Shupnick, ABOM

I'll call them computer glasses but they are really also scrapbooking, drafting, illustrating and woodworking (when in polycarbonate) glasses so consider calling them just that. Whenever the patient has a need for:

• Wide, clear mid-range vision
• Sits at a computer or hobby two or more hours a day
• Has an add of +1.75D or more
• Large reading area
• Tries to use general-purpose progressive lenses for the task

This kind of lens is indicated.

There are two general categories of designs—lenses that have reading to mid-range vision or those with reading to distance. The design is actually progressive but the design significantly increases the size of the mid-range and reading power zone, and removes or significantly reduces the size of any distance zone. They are reading glasses that lose plus power as the eye looks through the lenses from the lower to the upper portion. The power that they lose is called a "range" or "degression."

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LIFESTYLE DISPENSING AIDS MULTIPLE PAIR SALES

The benefits of asking lifestyle questions don't end with only first pair options. The answers can be a guide to suggesting additional "first pairs" too. Isn't a pair of Rx sunglasses just as essential for comfort and protection as that first pair of Rx eyewear?

Since the typical vision plan allows the member to receive an exam and just one pair of glasses or a supply of contact lenses each year, additional pairs at near retail pricing should be attractive given the savings already realized. Second pairs are also without any restrictions on materials or in-house edging that may be present with the pair made through the plan.

Many plans state in the member's plan summary that the provider will offer a discount on additional services (often around 20 percent). Many offices already offer discounts on multiple pairs to their private pay patients. A courtesy reduction in eyewear that is purchased at the same time as either the first pair was ordered or the day they were dispensed maximizes the opportunity for the patient. It is typically more difficult to get the patient back into the office. In fact, some offices make the reduction on multiple pair discounts available for eyewear purchased within 30 days of dispensing. Once patients understand the advantages of multiple pairs, they will always be more open to having a variety of eyewear.

—Brandie Shaw