Author Archive

Computer Spectacles Escape Distraught Owner!

Patt S. is a member of VSP's Ophthalmic Services team.

Patti S. is a member of VSP's Ophthalmic Services team.

My morning ritual was interrupted in such a way that the remainder of my day will suffer.  I was thrilled to discover that all my meetings were canceled, which means that I can envelope myself in small project that must be completed in a couple of days.  Settling into my chair, I reached for my work glasses glazed with a pair of Near Variable Focus [NVF] lenses, but much to my horror, they were gone, as if they had sprouted wee little legs and scampered off to the place all lost eyewear longs to be.

I love these specs because they provide crisp, clear vision when I work on my computer and they let me position my head comfortably when doing so.  It’s not that I can’t see out of my progressives when working, it’s just that the NVF lenses are considerably more comfortable.  They’ll never replace my regular eyeglasses because the lenses lack any distance correction; they only correct near and intermediate vision. Read more »

Cheaters: Their Name and Their Nature

Patti S. is a member of VSP's Ophthalmic Services team.

Patti S. is a member of VSP's Ophthalmic Services team.

It’s difficult to wander down the aisles of almost any store without encountering racks of “high-fashion” frames bearing the answer to your presbyopic woes. Those drug-store readers beckon to many an unwary baby-boomer with promises of visual youth regained behind suave, yet sprightly, frames bejeweled with little glittery things all over. They may alleviate the frustration of small print and short arms, but do you really know what you’re not getting when you opt for this quickie fix to a problem that you’ll have to contend with for many years?

You don’t need a doctor’s prescription because you can just experiment until you find a pair that suits your elegant tastes and helps you see better. This might be OK when you’ve forgotten your prescription glasses at home and need something to get by with on vacation. If you’re foregoing regular eye exams, though, you’re cheating yourself out of something that has the potential to identify diseases such as diabetes, glaucoma, brain tumors, and high cholesterol, to name a few. Read more »

Word of the Day

Patti S. is a member of VSP's Ophthalmic Services team.

Patti S. is a member of VSP's Ophthalmic Services team.

I had a friend tell me once that she found eyeglasses egodystonic .  “That’s unfortunate,” I thought, “because, you’re getting old and we all know that like hairy ears and sagging buttocks,   presbyopia is but one harbinger of our gradual physical decline.”  I didn’t say it out loud because a tendency for over-emotionalism also often accompanies the plight of the aging.  At any rate, I put on my optician’s hat and advised her of her options: mono-vision contact lenses or laser surgery, a secret stash of reading glasses, refraining from anything requiring near vision, or sucking it up and getting a pair of specs.

With long teeth, she saw her eye doctor and then embarked upon a tear-laden journey to find frames that would not disrupt her lens-free self-image.  Naturally, I assumed she’d find something nearly invisible, like a pair of drilled rimless mountings that would perch imperceptibly on her petite little snout.  That was not to happen.  Miss Egodystonic found the haute couture equivalent of the optical world and availed herself of their exotic wares.  Not only was she old, but she was bold as well.  As an added bonus, she could read again.

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The Perfect Pair-Part 2

Patti S. is a member of VSP's Ophthalmic Services team.

Patti S. is a member of VSP's Ophthalmic Services team.

I believe you should really consider the addition of an anti-reflective [AR] coating when filling your child’s lens prescription. A lot of people may cringe at this suggestion because we all know the little buggers can be hard on their lenses. Anyone who’s purchased a pair of glasses with an AR coating knows that they usually come with a special little cloth and cleaning instructions designed to encourage proper care and the preservation of your investment. The instructions should apply to any lens, regardless of material, and the little microfiber cloth, or similarly soft material, should be used to clean any lens—coated or not. Lenses are expensive and require appropriate care. If your kid wears spectacles, he or she needs to be taught what that care is, because if coated lenses can’t be treated with respect, then uncoated ones will suffer at least as badly. I say “at least” because the world of anti-reflective coatings has evolved. Read more »

The Perfect Pair for Kids-Part 1

Patti S. is a member of VSP's Ophthalmic Services team

Patti S. is a member of VSP's Ophthalmic Services team

This is not a treatise on the benefits of the natural feeding of human infants, but rather the first installment of a two-part post containing my ideas of what constitutes optical nirvana when filling your child’s ophthalmic lens prescription. Well, maybe only fools like me achieve anything close to nirvana when considering the composition of the ultimate pair of lenses given the needs of the recipient. Having children of my own and obviously working in this esteemed industry, I have developed a vast array of opinions over the years. I am about to share a few more with you.

Before approaching your optician, bear in mind that lens material is the first consideration you must think about. I was going to say “should,” but I think “must” fits the bill far more accurately in this case. You want to provide an impact resistant (note the italics) material. There are no ophthalmic lens materials, of which I am aware, that are impact proof, just resistant, and that is a relative term. Two readily available materials spring to mind and will do so for nearly anyone concerned with children’s vision and eyewear. These are polycarbonate and Trivex. Both of these materials will not only provide your child with safer lenses than standard plastic (don’t even think about glass), but they will be lighter in weight and possibly thinner, depending on the correction. So, poly (in optical nerd jargon) and Trivex are a done deal. Consider this bit of advice indispensable law.

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Electric Lenses?

Patti S. is a member of VSP's Ophthalmic Services team.

Patti S. is a member of VSP's Ophthalmic Services team.

Conventional ophthalmic lenses might be described in many ways, depending on a person’s point of reference.  Many years ago, while working as a sales representative for a progressive lens company, it was not uncommon to hear people refer to my wares in terms suggesting they were not of the “conventional” variety.  Progressive lens designs, after all, employed sophisticated engineering techniques to create a lens with a gradual increase in plus power so that my lifeblood, the presbyopic population, could enjoy distance to near vision (and everything in between) without lines.  This was still considered cutting edge then, but now generally regarded as “conventional.”

In spite of the fact that progressive addition lenses have been commercially available since the 1950s, with the first patents appearing in the early decades of the 20th century, they were just gaining noticeable use in the 1980s and 90s.  At this time, the technology used in their design rendered this category of lens a genuine visual benefit versus a mere cosmetic enhancement.  Nevertheless, the model on which progressive designs were created was based on a molded blank containing the aspheric surfaces that induce power change with a back surface traditionally ground to create the actual prescription.  Researchers developed better ways to manipulate the front surfaces through the years through refinements and advancements in engineering technology, but the basic model remained the same.

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Polarizing Priority

Patti S. is a member of VSP's Ophthalmic Services division.

Patti S. is a member of VSP's Ophthalmic Services division.

Real sunglasses are more than just darkly tinted lenses in a cool frame. Although these types of glasses may serve a function in terms of fashion and diminished light transmission, they are not sufficient, in my opinion, to act as genuine protective sunwear.

Truly protective sunwear should, at a minimum, include a tint with ultra-violet [UV] protection. Many materials, (e.g., polycarbonate), naturally absorb harmful UV rays and don’t require an additional coating. Tinted lenses, however, don’t reduce the disturbing affects of glare—they just reduce light transmission.

Polarized lenses do decrease glare and are an indispensable feature I want when buying my own sunglasses. Glare is created when light bounces off a surface. The more reflective a surface, the more glare is produced. A wet road produces more distracting and interfering glare than a dry one, but both surfaces do reflect light. Glare actually interferes with your vision and can obscure images, like children playing in the street or the rear bumper of the car you’re following.SusanandJim

Polarized lenses can be likened to microscopic venetian blinds for your eyes. They actually contain a filter that’s embedded with iodine crystals stretched so that they are oriented in one direction. When rotated correctly prior to insertion into your frame, they reduce visual interference from glare created from light bouncing off horizontal surfaces by preventing those scattered rays from reaching your eyes. Fishermen love them because they allow them to see into the water, not merely the bright reflection off the water.

There are many lens options you can add to polarized lenses, including anti-reflective coatings, variable tints, and a variety of colors. They are also available in almost any multi-focal or single vision design. Polarized lenses are more expensive than simple tinted lenses, but they serve a vital function in terms of your health and comfort as well as your own and others’ safety.

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Glancing Backward Through the Light

Patti S. is a member of VSP's Ophthalmic Operations Team

Patti S. is a member of VSP's Ophthalmic Operations Team

Perhaps the only things we really see instantaneously are the little blobs and flakes of loose matter that float in the chambers in our eyes. Unless something is right on top of your eyes, you are gazing into the past every time you peer out at your world and beyond.

The images you see are the result of light bouncing off objects and connecting with your consciousness (or possibly sub-consciousness). It travels through your eyes to your retinas, through your optic nerves, and ultimately to the visual center of your brain, where vision is achieved. Light is reflected off the surfaces of tress, stars, babies, rocks, water, and all the matter that composes our tangible realities. As with sound, it behaves like waves and moves and outward from its point of origin in all directions, where it is potentially perceived by a sentient being or absorbed into dark matter. Light is reflected, refracted, absorbed, and manipulated.

When light reflects off the surface of a body or when emanated from a source, it bounds forth at an incredible seyepeed. At 186,000 mps through space, it takes about 8.5 minutes for images of the sun to reach earth. Because it travels so fast, it is nearly impossible to discern its journey when objects are close, like across a room or on the surface of the moon. When you look deep into the night sky, you are experiencing visions from the distant past. Many of the celestial objects painting the heavens died out during one of the many eons preceding our flash in time.

Powerful telescopes peering into space may be able to collect the light and radio waves created during the origin of the universe. This glimpse into nascent existence may explain the mysteries of universal origin or reveal vastly more complicated webs of an ethereal and ineffable beginning.

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Suitable for Framing

Sophie_GlassesIt wasn’t too long ago that our choices in lenses were as narrow as “plastic or glass.” This was the predominant question posed to patients in the 1980s and even into the 90s, (even though relatively modern technological options were available at that time). During most of the 20th century, glass was the only material and the selection in lens designs presented to patients was usually limited to basic single vision, bifocal, and trifocal configurations.

The question of frames often centered on plastic or metal, black or brown, and silver or gold. It’s been a fairly recent development that people don’t routinely regard their eyewear in varying degrees of ugly and the catalyst to adolescent social annihilation, not to mention the weight induced crevices gouged into many overburdened noses. Heavy lenses and cumbersome frames didn’t seem to be a great motivator for innovation in the optical industry during those dark, yet not so long ago, ages.

Today we see a plethora of materials, designs, and treatments that offer an exponential array of choices when combined with the multitude of available frames on the market. It is no longer necessary to cast our children into infinite nerd-dom or liken ourselves to the portraits of unsmiling ancestors, wizened beyond their years by unsightly eyewear. Frame and lens choices abound that enhance our appearance and vision well beyond the limitations of yesteryear’s trends.

While the frame purchase may be regarded as any other fashion accessory by many, it’s function is to hold lenses in front of the eyes. When those lenses contain a prescription, the frame need only be of ophthalmic quality and manufactured suitably for your correction. It can run anywhere from $20.00 to thousands, depending on designer labels, gold content, and the number of embedded diamonds sparkling on the temples. Aside from the obvious expense of bejeweled frames in precious metals, there are other factors that determine cost and some would justifiably argue that quality is among those considerations. Nevertheless, it is not necessary to go broke buying a good quality, attractive frame.

Lenses, on the other hand, are generally functional and don’t usually bear visible or commonly recognizable markings. There are, of course, exceptions to this, but they are typically in the form of sunglass/lens combinations and most often don’t include a prescription. The lens portion of your prescription eyewear should be your first concern; they provide the fundamental purpose for the frame. Furthermore, your prescription, facial measurements, and lens choice affect which frames are appropriate for you. If your budget doesn’t permit both the optimum lenses for your correction and a designer frame, it’s always best to compromise on your frame selection—not your lenses. The aesthetic charm of your eyewear is admittedly very important, but it shouldn’t dominate and supersede the part that helps you see better.

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Fire the Optician, My Glasses are Late

Patti S. is a member of the Ophthalmic Operations division at VSP.

Patti S. is a member of the Ophthalmic Operations division at VSP.

The advent of the one-hour optical shops announced to the spectacle-buying world that a complete pair of eyeglasses can be churned out in an hour. Anyone visiting a mall or with access to advertising media will be able to attest to the fact that these purveyors exist and do make good on their promise most of the time. So why, you might ask, is it that you are asked to wait 7-10 business days for your order when visiting an independent eye doctor? A bigger “why” might be posed when something unforeseen happens and that 7-10 day estimate turns into an unfulfilled dream and you are left waiting even longer, lamenting your poor vision and cursing the beings responsible for the delay.

A pair of lenses can quite easily be cut to fit a frame and mounted within minutes if your prescription is simple and you order single vision lenses. The mechanics of this process are fairly straightforward, especially with newer, more technologically advanced equipment. This is not to suggest that skill isn’t necessary, just that newer equipment improves accuracy and speeds up the process. The majority of prescriptions, however, require that the power is ground into the lens through a step called “surfacing.” Surfacing doesn’t take very long either. Most independent doctors with onsite labs have the equipment to finish (cut and fit lenses to a frame) lenses but have to send orders to a wholesale lab when surfacing is required. One-hour optical retailers have surfacing equipment in-house, if they provide this service on all prescription types.

Manufacturers produce many types of “finished” single vision lenses in stripped down versions as well as those with premium options, such as anti-reflective coatings. A finished lens is one that is molded with all powers intact—not to be confused with the act of finishing, which cuts lenses to fit a frame. Doctors who finish lenses in their office will stock the single-vision products with which they are most confident and fit most frequently. They also maintain relationships with labs able to provide the full spectrum of lenses they favor. Lenses that require surfacing come in all materials, colors, and with virtually any treatment. Retailers specializing in expedited service keep an inventory of what they anticipate they will sell and have the ability to control what patients are offered because of their integrated model. They also know the frame models available through their dispensary, lending a degree of familiarity to their technicians, which contributes to the ability to offer such quick turn-around times.

Wholesale labs produce lenses for many customers and by necessity must be able to accommodate the varied product preferences and visual impairments of the doctors, opticians, and patients they serve. Consequently, they stock a broader range of lenses and accept almost any frame model. Although they can reasonably forecast what will be ordered, there are no guarantees. The benefit is that doctors and opticians can offer patients a full array of lens designs, materials, and treatments available, knowing that full-service wholesale labs will likely be able to fill their request. If the lens is not in stock, most can be ordered and received quickly, often the next day. These labs also have access to a network of sub-contract facilities able to produce specialty coatings and treatments.

The delivery estimates presented by independent practitioners differ from location to location, but it is fairly safe to say many still quote 7 to 10 business days. Most orders will be returned within this period, many sooner, and others later—sometimes much later. It is important to note that delayed orders are the exception. Wholesale labs wouldn’t stay in business very long if they couldn’t turn orders out, on average, within a few days. It is also worthwhile to understand that as technology advances, finer and more specialized products become available. Most often, this means slightly longer processing times, but it is well worth the wait. Still, the increase in turn-around time required for your highly personalized premium pair of lenses doesn’t always explain what sometimes appears to be an excessive delay, especially if you didn’t order something that necessitates subcontracting to a distant galaxy.

If lens surfacing and finishing processes are relatively simple and access to facilities able to apply treatments so convenient, why should there ever be any extended delays? There are a plethora of answers to that question. Nevertheless, a basic understanding of what typically goes wrong will address the most common issues and hopefully convey to you how unique your order is and why lens fabrication is an art in spite of the refined technology that enables precision surfacing and finishing.

Lens prescriptions have multiple components and typically can include one to many of the following elements: sphere, cylinder, axis, add, prism, and prism direction. The power of your prescription is measured in diopters, which occur in 1/8 diopter steps. There really is no limit to power, but most are less than +/-10.00, which is a pretty hefty correction but can go much higher. Sphere, cylinder, and add are measured this way (adds usually top out at about +4.00 and are only in plus powers). There are 180° of axis and prism (measured in prism diopters) is really not capped, but usually runs less than 4 or 5. Some conditions also affect factors like lens thickness, attachments, and whether lenses will be transparent or frosted, among other things. Then there are specific measurements, such as how far apart your pupils are and where in the frame an optical center or multi-focal height measurement will be located. A conservative idea as to the number of possibilities is 4.6 million, based only on what is really a limited assortment of prescription possibilities (no prism, add, or anything funky) and considering only one eye. Add prism power up to 5 diopters and 12 add powers and there are 612 million possibilities.

Your prescription and other measurements influence how your lenses will fit into a frame. One of the reasons delays occur is because the unique elements of your order, alone or in combination, affect how lenses work with a mounting. Not all frames are equal and certainly not all frames are suitable for all corrections. When a lab receives an order, they may be able to identify a problem job immediately and notify the doctor, who will in turn let you know that you should pick another frame. If this happens, you should do it, even if it’s the only chartreuse striped frame with an attached elephant nose in the western United States. Just do it and cry your bitter tears in silence.

Sometimes a lab will attempt the order and end up breaking the lenses or possibly the frame. In the latter situation, they have to reorder the frame and wait. If they break lenses that were ordered specifically for the job, they will need to reorder and wait, otherwise a new pair will be pulled from inventory. Depending on the lab and their relationship with the doctor, they may continue to try. If the frame is an unfamiliar model, there may be unforeseen pitfalls and you are the lucky trendsetter whose selection provides the education. Rest contentedly knowing that you helped the next patient selecting this frame get his or her spectacles back in a couple of days. Most unfortunate are the times, when after several attempts, it becomes apparent that either the frame is not suitable for ophthalmic use or that there is no acceptable way to mount your prescription in it.

There are any number of other causes for breakage, which will all add extra time to the delivery date. Higher-powered lenses are more prone to breakage. Equipment failures cause breakages and slippery coatings can allow lenses to slip during processing. A coating may not adhere correctly or in some other way your order fails quality control. The excuse nobody ever wants to hear is that someone made a MISTAKE! Yes, it happens to the best of us. Labs employ people and from time to time, they goof up. The most skilled technician will break lenses on occasion.

Frame and/or lens backorders are another factor contributing to longer waits. Labs have no control over this, but can and do offer alternatives. If your chartreuse striped frame with an attached elephant nose is on backorder, you might want to opt for the one with mouse-ears instead if you have an imminent job interview and want to look your best. If a lens is backordered, the lab will notify the doctor. Alternatives will be suggested, so if you’re not the sort of person who freaks out at the slightest change in lens design, you should consider going with the lab and doctor’s recommendation. If you are the super-sensitive type, remember that although designs do differ, many have similar characteristics and your doctor or optician can probably identify something comparable or the same design in another material.

The advantages of seeing a private practice doctor are many, among which is the golden opportunity to have access to the latest and greatest in coatings. Anti-reflection [AR] coatings are a must to those of us who make our living in this industry. Many of us actually turn away in embarrassment if caught in a pair of old beaters without AR. We also know that many of the premium coatings are more expensive, but well worth every penny and require 2 additional days to process—if the coating chamber is onsite. If not, add a day to get to the subcontract lab and one to return to the originating lab, thus bumping your wait time up 4 days. Other premium services and some unusual prescriptions require orders to be subcontracted. This is true regardless of whether you patronize a one-hour retail establishment or a private doctor.

The accuracy of the information about your spectacle lens order is imperative, so when there is any doubt about your measurements, prescription, materials ordered, or frame, the lab will call your doctor. If anything prevents contact with your doctor’s office, such as holidays, weekends, vacations, or simply an inability to connect, the job will be on hold until your information is confirmed. Again, we are dealing with the human element and wherever people and handwriting are at play, the need for confirmation is bound to arise from time to time.

Are these potential problems reason not to order glasses from a private practice doctor? No. All the potential delay-inducing circumstances that can frustrate you when your glasses don’t come in on time can happen at the one-hour place. The difference is that they usually promote the products carried onsite. If the materials for your order are not stocked in the store, your glasses won’t be on your face in 60 minutes. If any of the other problems mentioned above plague your spectacles, you probably won’t get them in that time either. Will they get most out on time? Yes. That is their business model and like the wholesale lab, they must perform according to the reasonable expectations their customers have.

Private practice doctors’ patients must have reasonable expectations as well. It’s a trade off much like buying ice-cream from a convenience store versus hitting the major supermarket. I can run into my local 7/11 and pick up a carton of chocolate, vanilla, or maybe choose from a few other flavors and be home in five minutes. I might have a limited selection and pay a little more, but in addition to ice-cream, I was shopping for instant gratification. On the other hand, I could go to the full-service grocery store and wander down the frozen confections aisle for hours locating the perfect combination of flavor, fat content, and price before heading home. It will take longer, but I will get what I want (even if I don’t know what it is when I embark upon this self-gratifying journey), and if lamb and banana is the hot new flavor, that will be my indulgence. I could run into lines or encounter other delays at either location, but my experience will usually be consistent with my expectations.

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