MAKING THE INVISIBLE VISIBLE – Demonstrating UV Protection to Patients

PRODUCT SPOTLIGHT: New screening technology instantly reveals effects of UV rays on eyes and skin

By Deborah Kotob, ABOM

Release Date: June 1, 2019

Expiration Date: December 31, 2022

Learning Objectives:

Upon completion of this program, the participant should:

  1. Learn how digital demonstration and screening tools enhance and inform the patient's purchasing decisions.
  2. Learn how practices increase patient confidence and loyalty when a digital demonstration tool is used.
  3. Learn how the patient can see and compare UV protection in lenses for the first time ever.

Faculty/Editorial Board:

Deborah Kotob Deborah Kotob, ABOM, is currently director of education for Jobson Medical Information LLC, has more than 20 years of experience as an optician. With over 10 years in lens manufacturing as a Sales Consultant, Trainer and LMS content developer. She lectures, trains and conducts webinars on a variety of optical and practice development topics.

Credit Statement:

This course is approved for one (1) hour of CE credit by the American Board of Opticianry (ABO). Technical Level 2 Course STHJHI007-2-NYSSO, STWJHI006-2-NYSSO

This course is approved for one 1 hour O.D. CE credit by NYSSO

THIS COURSE IS SUPPORTED BY AN EDUCATIONAL GRANT FROM ZEISS VISION CARE

The buzzword in consumer science is "experience," more precisely it's Customer Experience (CX). Although we refer to our customers as patients, we must come to terms with the fact that as purchasers of goods, they are also consumers. And as purveyors of optical products, we are retailers. Why does this distinction matter? Because the retail landscape is changing to adapt to the new consumer and their changing demands. The new CX revolves around the fact that today's consumer is digitally connected, tech savvy and demand more from their purchasing experience whether online or from brickand-mortar retailers. Today's consumer is seeking an interactive and engaging experience; our retail mentality has shifted away from buying "things" to purchasing products that improve our life experiences. So the question to answer for the patient for any product recommendation is "How will this product make their life better?" The next question to answer is "How can I make the shopping experience more fun and interactive? Perhaps something that consumers might even look forward to." The digital space we inhabit, more and more in our daily lives, is full of interaction and information at our fingertips. Just as our online shopping activities are elevated by interaction and engagement, so should our "Brick-and-Mortar" interactivity. In this course, we will explore a novel way to make the UV protection message resonate with your patient (aka optical consumer) by incorporating digital interactivity into the brick-and-mortar retail experience.

It is no longer enough in our digitally connected world to offer a traditional purchasing experience. We live in a world where everything from entertainment, education and shopping is a click away. In this world, an engaging digitally complemented shopping experience becomes the differentiator that helps us stand out in a noisy crowd. Whether we are purchasing the latest electronic device or eyeglasses, new digital tech tools now exist to assist with the shopping experience. In the eyewear and lens arena, successful practices use technology to sell technology. Tablet-based tools are becoming mainstream as they allow the patient to experience virtual try-on, so they can see how they look in different styles, sizes and colors. They love that they can see themselves in the glasses, and with just a click, share the photos with friends and family for instant feedback. Returns due to buyers' remorse sharply decline. We can now use tablet-based tools to show the benefits of a lens product feature(s). We can show the wider field of view in a progressive lens with a new optimized digital lens design versus old PAL technology. We can also see the difference in lens thickness by comparing side by side simulated images based on lens power, the lens index of refraction, and with and without aspheric design. We can demonstrate the reduction in glare with polarized lenses and better night driving with AR coatings.

Using a tablet-based tool to visually demonstrate product features and benefits increasingly informs our tech-savvy patient's purchasing decisions. Practices that use digital demonstration tools report an increase in retention rates and conversion rates. They report higher sales of higher ticket items, fewer returns and an overall increase in customer satisfaction.

Highly successful practices that integrate digital interactivity into the path to purchase understand the confidence and positive impression that the patient experiences when they see state-of-the-art equipment in use during an exam. Now digital tools can also be leveraged to enhance the eyewear purchase experience during dispensing as well. These tools range from centration devices and software that extrapolate as-worn metrics to the digital simulation of lens features and benefits. They can be used as tutorials to increase the patient's awareness of ways to protect their eyes from harm so that they can maintain good eye health and enjoy good vision into their golden years.

In the age of the experience economy, consumers are increasingly well informed and stay connected in their digital space. Brands— and yes, your practice is your "brand"—are using interactive technologies to interact with the patient to provide a fresh and fun experience. When we engage the patient with digital technology to show them how their vision can be improved and protected, we create a positive customer experience that raises their confidence in the product and the practice and bonds them with you—your brand. Remember that you are competing not just with other local practices but especially with digital/online alternatives that appeal to a younger demographic. How can you offer something truly unique and experiential that an online rival simply cannot match?

A brand new interactive technology from ZEISS has just entered the optical retail arena. It's called the ZEISS C-UVProtect screening technology. The truism "a picture is worth a thousand words" supports the effectiveness of a visual demonstration that produces a shareable image to deliver the "UV damages skin and eyes" message! But before we learn about this new screening device, let's review the effects of UVR on our eyes and our skin, and why it is such an important eye health conversation to have with patients.

WHAT'S THE HARM OF EXCESS UV EXPOSURE?

UVR is an undisputed threat to eye health. Scientific and international regulatory bodies all agree: UV is harmful to the human eye and its surrounding tissues. UVR is EM radiation that can cause ocular oxidative photodegradation due to photochemical damage, which can result in severe and permanent damage to the eyes and the surrounding skin. UV contributes almost nothing to actual human vision, but interacts strongly with skin and ocular cells' molecules. The effects of UV damage accumulate over a lifetime, and damage is irreversible; early and frequent retinal exposure may contribute to age-related macular degeneration later on in life. Other known effects of UV exposure include:

  • Photo-aging of the eyelids and surrounding skin.
  • Skin cancers of the same regions. UV photo-damage thickens the skin, resulting in deep premature wrinkles. While eyelids only account for 1 percent of total skin surface, eyelid cancers represent up to 10 percent of all skin cancers and metastasize or spread quickly.
  • Degenerative and unsightly growths on the conjunctiva (pterygium and pinguecula).
  • Acute and painful inflammation of the cornea (photokeratitis).
  • Melanoma of the iris, a potentially deadly type of cancer.
  • Nuclear sclerosis (hardening) of the lens, leading to reduced vision and ultimately to cataracts, which require surgery to replace the crystalline lens with an intraocular implant (IOL).
  • UVR exposure results in photo-aging of the eyelids and surrounding skin. UVR damage to sebaceous glands can lead to xerosis (dry skin).
  • Actinic keratosis is an advanced type of damage to the skin characterized by dry red patches; it is considered pre-cancerous.
  • UVR causes pre-cataractous changes to the crystalline lens by causing proteins to clump together. As the eye ages, protective pigments in the lens convert to pigments that react to UVR, further damaging the outer layer of the lens and lens proteins. When enough damage has accumulated, cataracts develop. Both UV-A and UV-B induce cataract formation. In "Biology of the Human Lens," Joan E. Roberts states: "The removal of these wavelengths from ocular exposure will greatly reduce the risk of early cataract formation. If you prevent light from exciting endogenous or exogenous chromophores in the lens, or you block the damage of reactive oxygen species with antioxidants, you may prevent or retard cataracts from forming. (Roberts 2008 photobiology.info/roberts.html)
  • In young eyes, a significantly higher amount of UVR reaches the retina, because their crystalline lens has not yet developed the proteins that absorb UVR and shield the retina from this high energy light exposure. Consequently, they are at a higher risk of photochemical damage occurring in their young vulnerable retinal cells. The retina is susceptible to photochemical damage, which occurs because of chemical (oxidative) reactions induced by absorption of high energy photons. The highest energy photons that reach the retina are from ultraviolet radiation. UV transmission reduces with age, but those in their teens, 20s and 30s still have significant amounts of UV reaching their retinas.

DAMAGE AND DISEASE CAUSED BY UVR

The damage caused by UVR can be acute or chronic. Acute damage occurs with short but intense exposure. Most acute damage is painful and temporary and will heal. Chronic damage is phototoxic and photo-aging. It accumulates over a lifetime, involves lower exposure levels, and there is no cure; the harm is irreversible. Chronic conditions are insidious, and because they happen gradually, they go undetected until significant irreparable damage is present.

THE CONSUMER AND UV HAZARD

Most of us have been warned about the danger that UVR poses to our skin, either by our dermatologist, our GP or through national consumer health campaigns or national advertising campaigns by sunscreen manufacturers. We are warned of premature aging, wrinkles and the increased risk of skin cancers due to excess UVR exposure. We are generally well informed that ultraviolet radiation is harmful. Even still, nothing brings this message home like seeing it with our own eyes. The ZEISS C-UVProtect makes the invisible UVR and its effects on the skin visible. Although we are well-versed in the risk posed by UVR exposure to the skin, we are woefully uninformed about the hazard that UVR poses to our eyes.

Unlike UVR skin hazards, in eyecare we lack a large-scale national consumer campaign to alert us to the dangers of UVR to our eyes. And in eyecare, the UVR hazard to the eye often goes unmentioned during the eye exam or the dispense. Part of the reason for this is that ECPs are under the mistaken impression that all lens materials, particularly polycarbonate, already block 100 percent of UVR from reaching the eye. ZEISS has launched a campaign to raise awareness of the UV protection gap that exists in 4 out 5 of the most-sold clear ophthalmic lenses in the market. They raise awareness and provide a solution with their ZEISS UVProtect lenses that deliver 100 percent UVR protection up to UV400 nm. Current industry standards for UV protection only require blocking up to 380 nanometers to claim "100 percent UV protection." Although the 20 nm difference appears small and insignificant, it actually accounts for 40 percent of total solar radiation at sea level. The World Health Organization, along with numerous international scientific and public health associations, has defined 400 nanometers (UV400) as the true upper boundary of ultraviolet light. In fact, UV400 is the global standard used in premium sunglasses and for most cosmetics. Innovations such as the ZEISS C-UVProtect and ZEISS UVProtect Lens Technology are setting a new benchmark for ocular UV protection.

ZEISS C-UVPROTECT TECHNOLOGY – REVEALING UVR

Until the ZEISS C-UVProtect screening tool, it was impossible for the ECP to show the amount of UV exposure and its effects. Now, for the first time, you can make the invisible visible and reveal UV exposure through standard lens materials versus through UVProtect lenses. And you can also show the impact on the skin, especially the delicate skin surrounding the eyes. Because patients are already well-informed about the risk of UV to the skin, showing them the threat posed to the eye will empower their decision about eye protection in their everyday clear pair of eyewear and the need for full UV protection up to 400 nm. The added value you bring to your patient experience, through interactive technology that demonstrates the threat and the solution visibly, elevates you as their eyecare provider, in the eyes of your patient. It also sets you apart from other practices, be they brick and mortar or online.

The ZEISS C-UVProtect UV screening technology for eyeglass lenses is a tool that ZEISS developed in a joint venture with Voxelight, LLC, a manufacturer of Sunscreenr UV Camera technology (patent pending), to demonstrate the complete blocking of UV in clear UVProtect lenses. And in contrast, it also displays the absence of full UV protection that is so common in today's standard lens materials. The ZEISS C-UVProtect screening device is a specially designed handheld tablet demonstration tool that lets the patient discover for themselves how much protection their current lenses are providing from ultraviolet (UV) rays. ZEISS uncovered the UV protection gap present in polycarbonate lenses (typically UV 380 nm) and standard plastic lenses (around UV 360 nm). Knowing that this gap equates to an increased risk of UV exposure in patients using these lenses, they developed a solution to protect up to 400 nm with UVProtect Technology. ZEISS UVProtect Technology makes full UV protection up to 400 nm standard in all clear ZEISS lenses. To help the ECP convey the importance of having full UV protection up to 400 nm, ZEISS was driven to find a way to visibly demonstrate the patient's susceptibility to unnecessary UV exposure when wearing UV380 lens technology versus UV 400 protection. C-UVProtect technology captures images that help eyecare professionals evaluate and improve UV protection for their patients' eyes, eyelids and delicate skin surrounding the eye. Think of all the Millennial 20-something single vision eyeglass wearers who routinely settle for low-quality plastic lenses from low-cost retailers, completely unaware of the UV protection their eyes are simply not getting… Now they can see for themselves what they have been missing. Think of children, whose retinas are exposed to higher levels of UV because their crystalline lens hasn't yet developed the protective qualities of an adult lens, from UV exposure. What impact will this visual demonstration with the C-UVProtect have on parents? They will be shocked by the lack of protection in standard lens materials while breathing a sigh of relief that they can rest assured that their child's eyes are fully protected with UVProtect lenses.

THE C-UVPROTECT DEMO

With the dramatic results displayed on an 8-inch tablet, ZEISS C-UVProtect incorporates Sunscreenr's patent-pending UV camera, visibly demonstrating how much a person's eyeglasses are protecting their eyes and skin around the eyes from harmful UV rays. Using a specially designed indoor UV light technology, the

C-UVProtect can show whether glasses are protecting against UV rays up to 400 nm. Clear lenses with UV 400 protection will look like sunglasses, dark and with no eyes visible. Lenses that allow UVR to transmit through the lens will be either completely clear or only slightly dark with eyes perfectly visible. The Sunscreenr technology in the C-UVProtect incorporates unique AI facial analysis algorithms and a new indoor light technology to recognize if a person's eyeglasses are not adequately protecting their eyes and skin from all UV. The ECP can have the patient try on demo frames with clear lenses and one lens with ZEISS UVProtect technology (UV400), and the other with a lens with the current industry standard for UV protection (UV380), for a striking side-byside comparison often referred to as the "pirate" look: One lens is totally dark while the other is clear.

Now with the ZEISS C-UVProtect tabletbased tool, we can show the patient the dangerous levels of UVR to which they are exposing their eyes and their children's eyes when wearing a standard clear lens material. We could simply tell them that 4 out of 5 of the most sold lens materials do not provide full UV protection up to 400 nm, but when we show them, the message resonates loud and clear. After all, seeing really is believing. By contrast, we can "wow" them by showing them how ZEISS UVProtect lenses block 100 percent of UVR up to UV400 nm providing sunglass level UVR protection in a clear lens. It is also a valuable tool to ensure that a pair of sunglasses also provides full protection up to 400 nm. In fact, by some estimates as much as 20 percent of sunglasses do not offer UV protection up to 400 nm. Even some premium sunglass brands occasionally fall short of this important threshold. A 2010 Australian study found that over 20 percent of the sunglasses made in Europe were falsely labeled, not meeting stated levels of protection for UV, polarization or other requirements for the Australian market. Another study from Brazil tested around 800 pairs of sunglasses and also found that approximately 20 percent failed to offer full UV protection up to 400 nm.

Meanwhile, many consumers erroneously equate dark tinted lenses with full UV protection. This isn't always true and—counterintuitive as it may sound—can in fact result in higher UV exposure. According to ophthalmologist Marc Werner, MD, of Stahl Eye Care Experts, "Dark sunglasses that don't protect from UV rays are even more dangerous, because the dark lenses cause the pupil to enlarge, allowing even more UV light to enter the eye where it can lead to significant problems, such as macular degeneration."

BRIDGING THE UV PROTECTION GAP

C-UVProtect visually demonstrates the benefits of ZEISS UVProtect lenses, the only clear lens collection currently that makes full UV protection up to 400 nm standard in all lens material offerings. These lenses bridge the UV protection gap inherent in approximately 80 percent of today's clear lens materials. Traditional lens materials such as polycarbonate typically adhere to the industry standard and only protect up to UV380. Materials such as standard plastic only block UV up to 355 nm. Many patients and ECPs are unaware of this protection gap and likewise do not know that 4 out of 5 eyeglass wearers are being exposed unnecessarily to a 20-nanometer gap in protection that represents approximately 40 percent of total UV radiation reaching the earth at sea level. With ZEISS C-UVProtect, you will be able to show patients that you only dispense glasses with new UV protection technology that provides sunglass-level UV400 protection— regardless of the lens material selected. You can visibly demonstrate the shortfall of UV protection in their current lenses. By presenting new technology to your patient, using tech adds credibility and facilitates upselling to higher quality lens materials and designs. This digital demonstration and transparency will improve the capture rate and prevent the patient from taking the prescription and walking out the door, since they know the glasses they get from you, their trusted ECP, will have full protection.

Such innovation comes from a 100 percent foundation-owned company that has 25 research and development centers globally and has been innovating optical science for over 170 years. As a recognized global technology leader, operating in the fields of optics and optoelectronics, the company continually advances the world of optics and helps shape technological progress. ZEISS technology in optics ranges far beyond optical lenses for eyewear; they are developers, producers and distributors of measuring technology, microscopes, medical technology, eyeglass lenses, camera and cinema lenses, binoculars, telescopes and semiconductor manufacturing equipment. As a 100 percent foundationowned company, ZEISS is not subject to the vagaries of being a publicly traded company or to wealthy shareholders/investors; instead, they direct all profits back into science, research, education and corporate social responsibility. Talk about truly being independent and devoted to the advancement of the field of optics and society! As a longtime optician, I appreciate any opportunity to learn about a company's historical and current contributions to the advancement of our field.

WHY IS IT SO IMPORTANT TO REVEAL THE UV PROTECTION GAP TO THE PATIENT?

UVR is actinic light, and actinic light is high energy light that can cause harm to biological tissue. In humans, it is the skin and the eyes that absorb UVR and are therefore susceptible to UV injury. The type of damage from UV radiation is known as photochemical damage because its light-induced chemical reactions can result in cell damage and cell death.

Ultraviolet rays are invisible. Ultra means beyond, so ultraviolet is light electromagnetic (EM) radiation that is beyond the visible part of the EM spectrum (beyond visible violet light): Violet is the highest energy visible light that borders UVA on the electromagnetic spectrum. Just as UVR is invisible to the naked eye, so is the insidious nature of the damage occurring inside our retina. Only two parts of our bodies absorb and are vulnerable to actinic light damage, the skin and the eyes. Making the damage and exposure levels visible provides the impetus to the consumer to take action.

HOW ZEISS C-UVPROTECT SCREENING TOOL HELPS ELUCIDATE THE UV HAZARD STORY FOR YOUR PATIENT

By its nature, UV radiation is invisible to the naked eye so we can't see its presence. We can't see that in addition to outdoor UV exposure, a surprising amount of UV radiation transmits indoors as well. Think that windows in cars, offices, homes, trains, buses and planes block out all UV? Think again. Most people are under the impression that UV is just an outdoor phenomenon. Meanwhile, indoor UV is far more prevalent than people realize. The wavelengths that get through windows (usually UV rays above 350 nm) are not likely to cause visible sunburns. Instead, they are more likely to have a deeper penetrating effect into the eye and especially the skin (think photo-aging). This is another important reason why a visible demonstration of UV exposure is so important when telling the UV hazard story, it's even reaching us inside our homes, cars and workplaces.

With the ZEISS C-UVProtect screening tool, the dramatic demonstration of UV transmitting through standard lens materials, and the apparent sun damage to the skin that the tablet makes visible is a startling reminder to the patient that UV is ever present, invisible and insidious. ZEISS C-UVProtect is a tabletbased tool that shows the patient the amount of UV radiation being blocked by a lens. The dramatic UV protection gap between standard clear lens materials that block up to 380 nm versus ZEISS UVProtect with sunglass level UV400 protection becomes visible with this tool. The patient will witness this startling difference for themselves. As their trusted eyecare professional, you will augment the demonstration by raising their awareness that just as their skin is damaged by invisible solar ultraviolet radiation, so are their eyes! They will understand, perhaps for the first time that this damage is cumulative and irreversible in the eyes, and that preventing exposure is essential for long-term eye health. They will come away armed with new knowledge that up to 10 percent of skin cancers occur on the delicate eyelids and skin surrounding the eye.

Telling the patients of the dangers posed by UV is an important health service you can provide, but an explanation is always more effective when augmented with an engaging digital visual demonstration of the amount of UV incident upon their eye when wearing standard UV 380 lenses. The contrast between the level of protection with traditional clear lenses and the protection available in UVProtect lenses is dramatic and impactful. Both UVProtect lenses and photochromic lenses with UV400 sunglass level protection will be demonstrably better, which will increase sales in the true UV protection lens category.

Use the technological appeal of C-UVProtect tablet-based UV screening technology to provide your patients with an engaging, informative experience that fosters confidence and loyalty. There has been a buzz over the last year about UV400 nm protection in a clear lens. You've read other CE courses such as "Closing the UV Protection Gap" and more recently,

"UV Before Blue" at 2020mag.com/ce. UVProtect technology goes above accepted standards to a higher level of UV protection to block harmful UV rays up to 400 nm; the same standard of UV protection provided by premium sunglasses. There are no good reasons why clear lenses can't offer the same level of UV protection as sunglasses. UV blocking efficacy is not a function of tinting. And now you can demonstrate this added protection with ZEISS C-UVProtect. Give your patients the advantage of sunglass level protection from UVR in their clear lenses. Help save them from the inferior UV protection in plastic lens materials and give them the opportunity to opt for sunglass level UV protection for the prevention of UV damage to their eyes.

UV protection for the skin and the eyes is one of the most important health and wellbeing messages that patients need to hear. As their trusted eyecare professional, it falls on you to ensure that every patient is aware of the hazard posed by UV radiation exposure, and that damage begins in childhood and is both cumulative and irreversible. It also falls on you to be aware of the UV protection gap in standard clear lens materials that claim 100 percent UV protection based on the industry standard that only requires UV protection to 380 nm. Based on this 380 nm standard for UV protection in lenses, up to 40 percent of UV radiation incident on the earth's surface is allowed to reach our eyes. Ensure that every patient leaves armed with the knowledge that reducing UV exposure to the skin and the eyes is the most effective way to prevent UV damage to the eyes and protect their eye health.