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 By Neil B. Gailmard, OD, MBA, FAAO, Editor November 4, 2009 - Tip #404 
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Should you recommend new glasses even if the Rx did not change?


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Additional Information

The title above may seem like a trick question and I guess it is in a way. I wrote the title in a manner to cause you to think about all the valid reasons a person might benefit from new eyeglasses and to point out that a prescription change is only one such reason. I find most optometrists are so careful to avoid being construed as merchants by their patients that we tend to ignore eyeglasses and focus only on the refraction. Most of us approach our recommendation for the purchase of new glasses in an extremely narrow way; mostly basing the decision on if a lens prescription change is significant or not.

An analogy with contact lenses

I have found that most eye care providers (ECPs) have learned to handle contact lens recommendations in a more open minded way and we should try to carry that over to the spectacle patient. Proactive ECPs will discuss and recommend an upgrade in contact lens design or material during the annual eye exam even when there is no prescription change and no patient complaints. This is good eye care in my opinion, because there are new and better contact lens products available and it is the ECP's duty to provide the best. Even the patient who does not complain might be made more comfortable and might be shown how vision could be clearer at all distances. Sure, it's easy to just replace the same exact contacts, but I see offering new advancements as part of my job.

The same should be true with eyeglasses, but the age-old aversion that most ODs have to eyeglasses (ironic, isn't it?) stops most of us cold from going there. We are so worried that the patient will see us as just trying to sell a product for profit that we overcompensate and ignore an important aspect of our service. And we couldn't be more wrong. Patients think of us as experts in eyeglasses and ophthalmic lenses and I hope we still are! Many people still come to see us for that expertise. It's understandable that people seek an expert because technology is expanding rapidly in all aspects of optical dispensing and lenses are becoming increasingly complex. That should be good for our profession if we handle it right.

A new approach at chairside

The next time you examine a patient with no significant eyeglass Rx change, move all the instruments away and look the patient in the eye and say the following script. This is a good time to actually look at the patient's old glasses, which I venture many optometrists never do.

"Your prescription did not change much this year, Mrs. Jones, which is always good to see, but there are some other aspects of your eyeglasses I want to talk with you about. There have been some amazing advancements in lens technology in the past year or so which can improve your vision. Before I get into that, tell me more about how you use your eyes at work. Do you have any hobbies? Do you use a computer? Do you participate in any outdoor activities?"

The answer to these questions will obviously guide you straight to the best lens recommendations. This is simply practicing what has always been called lifestyle dispensing, but it probably needs to be revitalized in your practice. Optometrists have typically tried to delegate this procedure to staff members or to self-questionnaires (that no one looks at) but I'm advocating that the doctor take it over. There are two reasons this technique works and will help you sell more glasses: 1) Patients love to talk about themselves; it's their favorite subject. If someone would just ask! 2) The doctor has the most power of anyone in the office and his or her recommendations are always taken seriously.

At this point, look at the patient's old glasses and pick one or two lens features that are missing that you want to focus on. Don't list lots of options, but rather find a way to say "In your case I recommend..." Here are some possibilities:

  • Introduce a bifocal wearer to progressive lenses by explaining the multifocal aspect (not the cosmetic aspect).
  • Tell the progressive lens wearer about customized digitally surfaced progressive lenses and how distortion is minimized but field of view is maximized.
  • Discuss premium anti-reflective lenses with new anti-scratch, anti-static and easy-to-clean technology and describe the warranty that backs it up.
  • Explain the new generation of photochromic plastic lenses that are virtually clear indoors and very dark outdoors.
  • Tell patients the best sunglasses have Rx lenses that are polarized and how they reduce eye fatigue while driving, offer better vision on the water and may help a golfer to "read the green".
  • Educate the patient about high index plastics that make higher prescriptions thinner and lighter.
  • Be really daring and provide your opinion about the frame choice to achieve a better fit and more comfort while making the glasses look better. You might discuss new lightweight frame materials, smaller eye sizes, up-to-date styles or how to minimize the frame impact with rimless drill mounts.

Close the sale (pretend I didn't use that word)

While doing all this begin to prepare for your handoff to the optician (or see my previous articles about scribes).

  • Page your optician or walk the patient to the optical area.
  • Show an educational video clip on a computer that confirms your optical recommendation.
  • Demonstrate the recommended lenses by using demo products supplied by your lab or mock-up eyeglasses.
  • Ask the patient if they would like to order the new glasses.

Best wishes for continued success,

Read Past Tips Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week


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Send questions and comments to neil@gailmard.com.

Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com.

Please Note: The views expressed in Management Tip of the Week do not necessarily reflect those of the sponsor.

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