Pterygium

Long touted for their revenue enhancing benefits, premium lenses aren't just about aesthetics.

Premium spectacle lenses have been promoted so long for their revenue-boosting potential that it's sometimes easy to forget that they offer significant benefits to eye health as well. Yet many eyecare practitioners are enthusiastic about them for just that reason - which makes their recommendation that much easier. Read on for a reminder as to just how much your patients may need these lenses.

Bridge the gap

"Understanding the need for premium lenses for certain pathologies is the perfect way to bridge the current gap between the 'medical' exam room and the 'retail' dispensary," says Gary Gerber, who's president of The Power Practice consulting group, based in Hawthorne, N.J. As a consultant, he instructs clients to explain the need for these lenses just as they would explain the need for a medication. "Present the lenses for the preventive benefits they bring to the patient," he advises.

Give them protection

Prevention is especially needed, given the hazards of ultra-violet (UV) light. Linked to cataracts and age-related macular degeneration (AMD), UV light is reason enough to recommend premium lenses to patients. "Prescribing UV-protected lenses is religion in our office," says Alan Glazier, O.D., F.A.A.O., of Rockville, Md. "I believe that you're performing a disservice to patients by not offering the best lens possible, specifically with protection from UV, even more so when they don't have cataracts or AMD. You may even be harming them by not offering a preventive option. By the time they get cataracts or AMD, it's too late."

Once cataracts have developed, though, the AR coating featured with premium lenses still offers a benefit. Janice Jurkus, O.D., M.B.A., of Chicago, reports that AR coatings make vision clearer, especially at night, for her early-stage cataract patients.

Milton Horn, O.D., F.A.A.O., of Azusa, Calif., prescribes UV-protected lenses for conditions such as pterygium and pingecula. "One of the main goals of pterygia management is to keep it from advancing," he says. "I find that pterygium essentially goes through two cyclical growth stages: active and quiescent. Pterygium and pingecula growth occurs during the active stage when the pterygium spews out inflammatory factors and appears red and angry. One key is to keep the pterygium in the quiescent stage and out of the active stage by eliminating triggers such as UV light."

Dr. Glazier also recommends premium lenses for patients who have contrast sensitivity problems. These include decreased contrast sensitivity on visual field tests, photophobia or photosensitivity, retinal degenerations and age-related ocular problems. He does not, however, recommend premium features such as colored overlays to pediatric patients with learning disabilities.

For healthy eyes too

Of course, patients don't need a medical condition to benefit from premium lenses. Eyecare practitioners are enthusiastic about the ability of these lenses to enhance patient lifestyles, visually speaking. Patients who lead active, outdoor-oriented lives were first on O.D.s' lists as premium-perfect candidates. Polarized lenses, and the newest materials offer superior performance for these patients. Polarized lenses are particularly helpful for those those who spend time on the water.

Dr. Gerber instructs his clients to recommend safety glasses/ polycarbonate lenses "for anyone doing anything remotely dangerous - be it work or leisure," he says. And the particularly time-crunched will appreciate another feature of premium lenses, Dr. Jurkus says: New coatings stay cleaner longer, minimizing cleaning time.

Don't overlook this group

Located between patients who have medical conditions that premium lenses could help and those whose hobbies would benefit by them, are the heavy-duty computer users. Despite the media attention given to computer vision syndrome, patients who spend a lot of time working on computers remain "a huge underserved segment," says Dr. Gerber.

Eyecare practitioners may find that patients need some convincing in the type of prescription they need, however. "I always tell my patients who work the majority of hours up close that their primary prescription should be one for near, not far," Dr. Glazier says. "The old paradigm of prescribing for 20/20 for all instances for non-presbyopes is gone. Why wear a pair of glasses that allow you to see two football field distances comfortably if you're working at 25 inches in front of your face for six to eight hours each day, five days each week, and prescriptions exist for 25 inches and outward that can reduce eyestrain, fatigue, headache, increase concentration and decrease frustration caused within near visual space? Prescribe patients for what they do most, and every other distance concern should be secondary."

Now for the pitch

Practices experienced with selling premium lenses claim that the right approach is crucial. "It's a team effort that everyone in the office must understand," says Dr. Gerber. Doctors should insist that their staffs know about various premium lens offerings and their benefits; and to be really credible, he says that doctors and staff should wear the lenses themselves.

The O.D. first recommends the premium lens to the patient and the staff follows up. An experienced optician has a good feel for the lenses and is very helpful. Paul Cimos, an independent optician in Winchester, Mass., says that while manufacturers provide promotional materials, he mostly walks the patient through the lens selection process verbally. He starts with the most expensive premium lenses and demonstrates the differences between a premium and standard spectacle lens with samples. He estimates that more than 75 % of his patients go with the premium lenses.

If someone presents the lenses correctly to patients who will truly benefit from them, Dr. Gerber says, they generally will spend the extra money. "We counsel our clients to prescribe from the heart and to do what's best for every patient every time - no exceptions. We teach them not to focus on how much a recommendation costs, but on how it will enhance the patient's life."

Should patients be reluctant to purchase premium lenses, however, avoid the "hard sell." Bob Levoy, O.D., author of 201 Secrets of High Performance Practice, cautions that patients who require a lot of persuading are likely to experience "buyer's remorse" later and resent spending extra money for something they don't believe they need and can't afford. "Don't sacrifice long-term relationships for shortterm profits," he advises.

BY RENE LUTHE

Senior Associate Editor

Copyright Boucher Communications, Inc. May 2005
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