As one 80-year-old woman from Florida tells it, her optician is the only person who gave her any hope. "My eye doctor told me there was nothing more that could be done. And I couldn't get an appointment for months with our local organization for the blind. Finally, my daughter talked to her optician about me."

The result of that conversation? With the help of a stand magnifier she can now once again do her favorite thing, needlework, but with larger yarns and needles than before.

She is like a lot of patients, suggests optician Joe Bianchi, of Bianchi's Hemet Optical in California. "When a patient hears 'There's nothing more I can do for you,' they assume that means nothing more can be done. Period. But that's often not the case. It's just that the doctor may, for whatever reasons, not want to get involved with solutions like magnifiers."

That, say the opticians we interviewed for this article, is where opticianry can stand to benefit by providing the low vision aids and services that many doctors do not. While some of the opticians work in traditional dispensing settings, several others we've spoken with have combined their skills in less traveled venues. One gentleman from New Jersey, for example, sells magnifiers and other aids through a website. Some work in labs. Several others have become reps for suppliers of low vision products, while a handful are involved in retail stores selling low vision and senior-living aids.

What else? Two opticians we know of have added low vision aids to their mobile, home-service optical businesses. And, yet another is working with ophthalmologists to create "low vision corners" in their offices.

The opportunities are numerous. And, at a time when independent opticianry is finding many other doors closed -- managed care, to name just one -- low vision provides a welcome and much needed opportunity.

Following are interviews with just four of the opticians we've spoken with recently.

Joe Bianchi
Bianchi's Hemet Optical, Hemet, Calif.

Bianchi has been at the same location for 20 years, and as the population there has grown in age, so has the need for low vision aids. "I started out dealing with people who had cataracts and glaucoma," says Bianchi, "and it's just grown from there."

Like many opticians who work in low vision, Bianchi says most of the business is word of mouth as opposed to referrals. He agrees that too many doctors tell patients nothing can be done when, in fact, many tasks can be accomplished with a combination of devices and training. "That's where the optician is really strong," adds Bianchi. "Sure, I show them something a doctor didn't. But patients tell me many doctors won't take the time to explain how one magnifier works better for a task than another, or to talk about consequences of their selections, but we do take the time.

So, how does he build business without doctor's referrals? Bianchi's answer is he gets even more important referrals -- those from grateful patients and their families. "Even a little help is appreciated. We can't give them back the ideal way they want to see, but we can give them back some quality of life. When a relative brings in grandma, and you help her function better, that's the referral that's most important."

What about profits? "You have to make a profit. But the real reward is when, as one woman did, someone who couldn't see looks at your tie and describes the color."

Bruce Linder
Linder Opticians, Bel Air, Md.

Bruce Linder is a third generation optician who opted to forgo the family-owned business in Philadelphia and started up his own, Linder Opticians, in Maryland 23 years ago. "I first got involved in low vision through surgical loops," recalls Linder.

Now, he adds, "I have a large low vision business. I have sent out letters saying we have sophisticated devices not available elsewhere in Baltimore, and I do low vision by appointment only."

How does he build the business -- in an area with some 17 competitors in a radius of less than five miles? "I do local advertising -- not promotional advertising though. I'm a believer in institutional advertising. But my best form of advertising is from customer-to-customer via word of mouth."

Are opticians well suited to low vision? "Yes." explains Linder, "if you spend the time with them and offer the best technology -- I use Zeiss, for example -- it makes low vision one of the most gratifying forms of opticianry. It's time consuming, but in what other area of opticianry can you actually transform a person's life? Sure, it's profitable, but it's also a wonderful boost to the ego to help someone. And that is worth a lot more than money."

So, how does he recommend other opticians get started in low vision? "You can't sit back. You have to read constantly, talk to your labs, your manufacturers, and go to the better trade shows. If people will study, explore, and investigate, low vision does indeed represent a great opportunity for opticianry. But if they don't do the work to understand the technological difference between products, then they won't succeed. And they won't be able to transfer that critical information to the customer."

Mike Myers
Myers Opticians, Las Vegas

"For me," recalls Myers, "it started with a patient who was referred to us. I was able to help her and then told her about the services of the organization for the blind here. She called me up crying she was so appreciative. That prompted me to attend a low vision seminar at Vision Expo."

Myers promotes the availability of magnifiers and CCTVs (closed circuit televisions) at his two locations through Yellow Page ads and mailing information packets to doctors. The result? "Ten years ago, we saw one patient a month with macular degeneration. Now, it's every day."

What about profits? "You can't mark them up like eyeglasses," says Myers. "We usually keystone them. And sure, seniors can be reluctant to spend on magnifiers until you show them the reading card and they see for themselves they can now read an extra four or five lines."

Are there other benefits to carrying magnifiers? Yes, says Myers, who also sells products to geologists and mining experts. Even a nearby baseball and trading card store is interested in some specialized products. And for the prospective purchaser of general-purpose magnifiers, says Myers, "we carry small magnifiers that come in leather pouches. You have to seek out buyers for these products, and that's hard for some opticians. But if you're going to succeed, you have to evolve on a different level. It is," agrees Myers, "about pushing the envelope."

Alex Yoho
Hawkins Optical, Topeka, Kan.

Wholesale lab Hawkins Optical made a commitment to low vision early on. "Bud and Kevin Bargman looked at the demographics and felt this was a place we should be. We've been an Eschelbach distributor for five years, but initially I started with doctors asking me to mount telescopes on glasses. Basically, I'm self taught, which is the best way to go for many opticians."

"Now," continues Yoho, "some of our doctors who haven't been trained in low vision prefer having their patients come here to look at magnifiers. That gave me an opportunity to learn how to work with them. And I found the joy in doing it. It really brings life back to people."

But, is it profitable? "it's important for a dispensing operation to get involved with a low vision practice, but low vision is profitable. And with a little training, opticians are the best people to do this -- it's still filling prescriptions, just as with eyeglasses. And, opticians are used to taking a little extra time, and that can really pay off."

The doctor, for example, may prescribe a magnifier for reading. If, explains Yoho, "the optician discusses other tasks the patient wants to accomplish -- and recommends the appropriate powered product -- then it becomes lifestyle dispensing, but with low vision aids instead of eyeglasses."

And the inventory doesn't need to be huge, he adds. "Much of low vision is easy to address with low power magnifiers, and don't forget that if you get the parent or grandparent and guide them, then you get the family."

Yoho also suggests getting to know occupational therapists and mobility specialists. "They work with patients, but teaching them how to use products can be ignored. That's where the optician can come in."

What about the future? "Low vision is an incredible opportunity," concludes Yoho. "Anyone who isn't at least formulating a strategy is really missing out." EB