Information GAP
Members of The Vision Council’s Optical Lab Division weigh in on ways to decrease redos and remakes
Alex Yoho, ABOM
According to The Vision Council, 12.6 percent of eyewear purchases were returned for problems, redos, or remakes during the 12-month period ending September 2012.
There are a number of reasons for this high number. One of them is knowledge shortfall on the technical side of dispensing.
To offer suggestions, Eyecare Business spoke with several members of The Vision Council’s Optical Lab Division. Thanks to the following: Kevin Bargman, Duffens-Hawkins Optical; Mike Estes, Pech Optical Corp.; Drake McLean, Dietz-McLean Optical; Jonathan Schwartz, PFO Global; Mike Sutherlin, Sutherlin Optical; and Jeff Szymanski, Toledo Optical.
ANSI TOLERANCES
Q Is a lack of understanding ANSI tolerances causing unnecessary returns, and what do ECPs need to know to prevent them?
BARGMAN: I don’t find too many returns because of this unless an entry-level optician has just begun to check in work coming to the office. He wants to ensure every job is exactly correct on his watch, and that is commendable. But without a thorough understanding of tolerances, he sometimes returns a job that is within ANSI tolerances.
This inconveniences the patient and could cause an unfair patient perception of the office and the lab they use.
SZYMANSKI: For years, the technicians and opticians who worked for ECPs came from the lab side and, therefore, had more in-depth understanding of lenses and optics. As career paths have changed, many folks who now work on the front line lack the formal training of the past.
With this comes an increase in possible remakes and, in certain segments, an uncertainty about current ANSI standards.
When an ECP teams up with a quality laboratory, training and educational initiatives can be put in place to help staff understand lens options better, thus eliminating unnecessary remakes.
ESTES: Some of the biggest issues causing unnecessary returns are not understanding prism as it relates to PD and compensated Rx’s, and where to check progressive lenses.
Many offices are not aware that prism should be ignored when checking power through the circle above the fitting cross and that prism is to be verified at the prism reference point.
We also get jobs returned because they are trying to verify the prescribed Rx instead of the compensated Rx.
SCHWARTZ: Communication between the ANSI Committee and ECPs and schools has never been very good. Updates to the documents have never been well publicized. Practicing skills in obtaining consistent measurements, reviewing the basic document, and allowing lab personnel to assist in the process will all help.
SUTHERLIN: We receive less than two percent of work back because of optical quality. And, of that, the biggest reason is scratches. The best thing ECPs can do is post a list of ANSI standards (available on our website) in their offices.
MEASUREMENT POINTERS
Q How would you explain the best way for eyecare professionals to measure fitting height and pupilary distance in order to prevent remakes?
BARGMAN: Having the frame adjusted properly before making those measurements is just as important, if not more so. There are many new devices being introduced to aid in addressing the measurements, but the staff needs to be trained on how to properly use them.
SZYMANSKI: Lens technology has evolved to the point where few remakes or non-adapts are actually caused by defective lenses. As such, we see many remakes as a result of measurement mistakes.
While seemingly simple to take, good measurements can be a true art, and experience will provide the best training.
In addition, we are now seeing more and more sophisticated measurement devices enter the market that deliver a significantly more impressive patient experience while adding far greater precision to measurements.
MCLEAN: Fitting heights need to be tested prior to confirming. Masking the lens with tape helps confirm both near and far vision as it relates to fitting height. Test both standing and sitting positions.
PDs should be taken with no less than a pupilometer. Take this measurement several times to confirm your result. Labs can help their customers select the best method and assist with training.
SCHWARTZ: Some people do not get the measurements done consistently in the correct patient posture with no parallax and a pre-adjusted frame. Heights tend to be too low.
| Making Measurements Count |
|---|
|
Measuring can be a lost art, but it’s one of the most important factors in proper functioning eyewear. Notes Mike Estes from Pech Optical Corp., “Incorrect measurements can result in prism problems such as double vision or feeling that eyes are pulling. It can also result in bifocal segments being too high or low.” “Probably the biggest problem comes with progressive lens corridors being misaligned with the pupil,” he adds. “It is very important to use a pupilometer to take an accurate monocular PD and to have your eyes at the same level as the patient’s. It is also important to observe how patients carry themselves and hold their head. These are all important factors in getting accurate measurements.” |
SUTHERLIN: Measuring problems are an unfortunate cause of many remakes. There are new devices that can virtually eliminate the problem. For offices that do not have an automated device for measuring, a digital pupilometer will give you accurate PDs every time if used correctly.
Also, seg heights can be measured the old fashioned way by marking on the demo lenses, but be sure the frame is pre-adjusted and the head is in the natural viewing position before taking this particular measurement.
BASE CURVES
Q What knowledge can you share that would help an office better understand base curves?
BARGMAN: Conventional lenses can still accommodate corrective curve technology. However, some of the new digital lenses do not work as intended when the complete algorithms are not incorporated into the design or the lens.
SZYMANSKI: Base curves are often cited as a problem necessitating a redo, but keeping base curves the same is not always a good idea. Manufacturers and laboratory management systems have done an incredible job of electing the optimized base curve depending on the specific Rx parameters.
Because of this, we strongly encourage ECPs to limit selecting a specific base curve to gain a certain result. A discussion with a quality laboratory is always the best way to get the desired results.
| Base Curve Transitions |
|---|
|
Measuring base curves works best when based not only on the current Rx, but also on the previous Rx, notes Mike Sutherlin of Sutherlin Optical. “I recommend measuring the base curves of the patient’s old glasses. I usually advise keeping the lenses on the same or similar front curve, but not always,” Sutherlin says. It seems simple; so, what’s the challenge? He notes: “The problem arises when the prescription changes a great deal or if the Rx was previously right on the border between bases, and the new prescription throws it into a different base category.” He adds, “Patients who have the base changed may notice a slight difference but are getting used to it even before they leave the office. Some people, however, are so sensitive that the change almost makes them sick and will require a remake to go back to the original curve. Unless told otherwise, we will always use the base curve recommended by the manufacturer, so it’s a good idea to measure the old glasses.” |
ESTES: Unless there is a very specific reason to request a special base curve, the lab is best equipped to make the base curve determination. The lab will process the Rx according to the manufacturer’s design criteria.
SCHWARTZ: Patients are more sensitive to the inside curves.When I was 10, I was a -0.50. I’m now -6.00. Should I still be on the same base curve? No. Most labs have excellent software to choose the best base curve by lens, material, and design.
Well, there you have a lab perspective on how to curb some of the problems that cause returns.
If you need help in understanding what your lab can do, just give them a call. They are there to help! EB
![]({"src":"/media/l10do1md/32013.jpg","focalPoint":null,"crops":[{"alias":"thumbnail","width":1110,"height":700,"coordinates":null}]})