Article Date: 10/1/2006

Practice pulse

Who Should Sell Contact Lenses? 2 Bills Give 2 Answers

Proposing a "proper balance of consumer choice and the health and safety of the American public," U.S. Rep. Ed Whitfield (R-Ken.) introduced the Contact Lens Consumer Health Protection Act (HR 6117) last month.

The proposed legislation would establish a "Patient Safety Hotline" for eyecare professionals (ECPs) who have patient health concerns related to a prescription verification requests. When the hotline receives a call, it would suspend the respective transaction until the vendor addressed the specific health concern.

The bill would also allow ECPs to specify how they would like to receive prescription verification requests from third-party vendors (fax, email or phone). Vendors would be required to try at least two of the three media. Failure could result in fines of up to $100,000 per violation.

Mr. Whitfield's office noted that the prescription verification requirements of the Fairness to Contact Lens Consumers Act "have been routinely ignored or abused by some third-party vendors." The American Optometric Association and the American Academy of Ophthalmology endorsed the legislation.

The introduction of HR 6117 follows Congressional hearings regarding the FCLCA. During these, Jonathan Coon, CEO of 1-800 CONTACTS, gave his support for HR 5762, a bill that would require contact lens manufacturers to make their lenses available to alternative distribution channels, such as mail order companies, Internet retailers, buying clubs and mass merchandise outlets. Mr. Coon said that 39 state attorneys general support HR 5762 "to ensure the consumer protection intended by the FCLCA." 

Greg Fryling, chief operating officer of Cooper Vision, questioned the benefits of HR 5762 and stated: "It is essential that contact lens manufacturers, like manufacturers in other industries, retain the ability to choose reputable distributors that have ethical, efficient and safe business practices."

America's Vision of Eyecare is not 20/20

A new survey of more than 3,700 adults shows that while 74% agree that eye care is as important as other health issues, 25% say it has been more than two years since their last eye exam, and 14% claim they do not have a regular eyecare professional (ECP). In addition, 35% of parents say their children have never seen an ECP.

The study, "Americans' Attitudes and Perceptions About Vision Care," which was conducted by Harris Interactive on behalf of The Vision Care Institute of Johnson & Johnson, notes that these statistics vary among ethnic groups. In this respect, the survey is "a cause for concern," says Derrick Artis, O.D., director, professional affairs, Vistakon, "because adults and children who are at greater risk for certain eye conditions and diseases are not receiving proper diagnosis and treatment."

Checking demographics

For example, while 72% of African Americans strongly agreed that maintaining proper vision is a priority and 50% strongly agreed that taking care of eyes is as important as other health issues, only 21% report that they have a regular ECP. Twenty-seven percent of Hispanic respondents strongly agreed that they are concerned with their vision getting worse (compared to 15% of all respondents), yet only 43% had seen an ECP in the last year.

The survey also reported the following information:

36% of Asian-Americans said they do not need an eye exam unless they are having a vision problem, yet 94% agreed maintaining vision is an important priority.

Caucasians were more likely to understand common vision problems, such as myopia or presbyopia, yet 25% had not seen an ECP in the past two years.

51% of women report being diagnosed and/or treated for nearsightedness, compared to 42% of men.

Only 53% of those 40 and older know that they are treatments available for presbyopia.

78% of adults wear some kind of vision correction: 67% prescription glasses, 16% contact lenses and 10% non-prescription glasses.

11% wear both prescription eyeglasses and contact lenses.

practice tip of the month
The Sign of the Times

By Neil B. Gailmard, O.D., M.B.A., F.A.A.O.

Many practices have had the same look for so long, they become invisible. That's why the physical appearance of an eye care office is so important to any practice's marketing plan. Maybe it's time to take an objective look at yours.

Times have changed in the health care professions. For example, while still maintaining a professional look, it's perfectly acceptable to have a large, self-illuminated sign. Provided it complies with local zoning codes and state board of practice rules, a great sign can create an upscale, progressive image. High-end signs are expensive, but they are actually very economical as a form of advertising. Break out of the mold and get noticed.

Take an objective and creative look at your office exterior and how a new sign could be installed. Get the opinions of friends. Look at other practices and businesses in newly developed areas for examples. Speak with your landlord if you rent and with city government officials if you own.

Consider where you might place a sign for best visibility. I personally like a free-standing, self-illuminated sign in front of the building, or individual, self-illuminated letters and graphics mounted to the wall of the building.

A common mistake on signs is having too much text. Resist the urge to put all kinds of information. A first class sign just says the name of the company.

This "Tip of the Month" is excerpted from the article "Is it time for an image makeover?" which was originally published in the Optometric Management Tip of the Week e-newsletter. Both a free subscription to the newsletter and an unabridged version of this tip are available at

Santinelli and CIBA Join IDOC

IDOC, a practice development group, has announced that Santinelli International and CIBA Vision have become preferred vendor partners. Both companies will now provide exclusive benefits and services to the 500 independent optometrist members of IDOC. IDOC now has over 40 vendor partners. IDOC members receive a complete set of benefits that deliver savings and information to facilitate both patient care and practice management. IDOC delivers buyer services, continuing education activities, practice management guidance and topical communications specifically geared toward the independent optometrist. In addition, IDOC also conducts CE-accredited conferences that emphasize practice management. For more information contact Brian Kleinberg, president, IDOC, at (973) 377-7400.


Essilor International has acquired Vision Star (lab management software), Prio (corrective lenses to treat computer vision syndrome), Sunstar (prescription lens lab) and Tec Optik, an Australian-based lab.

At Vision Expo West, Younger Optics unveiled Drivewear polarized eyeglass lenses. These photochromic lenses are the first that darken behind the windshield of a car.

Also at Vision Expo, Ophthonix, makers of iZon high resolution eyewear, announced it has partnered with Le Mans racing series driver Liz Halliday.

Topcon Medical Systems acquired Anka Systems, a Web-based, software solutions company known for EyeRoute, which integrates information from various ophthalmic instruments into a single digital environment.

Transitions and the Vision Council of America joined with Scholastic Publishing to create "Our Amazing Eyes," a teaching guide sent to 166,000 educators. The guide is available in three versions — grades 1-3, 4-6, 7-8.

Ed Greene has become CEO of the Vision Council of America, replacing William C. Thomas. Mr. Greene who retired as president and CEO of Carl Zeiss Optical in 2006.

Reaping the Benefits of a VT Specialty
By René Luthe, Senior Associate Editor

heresa J. Ruggiero, O.D., F.C.O.V.D., of Northampton, Mass., received international acclaim for her "miracle" patient, Susan Barry, Ph.D., a professor of neuroscience who achieved stereoscopy almost 50 years after surgery to correct crossed eyes. The case garnered attention because it broke the rule — that is, the belief that the human brain only has a brief window of time, during infancy, to "rewire" and repair itself.

Dr. Ruggiero says that Dr. Barry's recovery is not so rare; the brain's plasticity makes such recoveries possible at any age. She says optometrists are particularly suited to recognize and treat binocular visual dysfunction. Further, a practice can distinguish itself by incorporating vision therapy (VT).

Dr. Ruggiero says the biggest challenge in vision therapy is the diagnosis of binocular visual dysfunction.

The challenge

Perhaps the biggest challenge in VT is diagnosing binocular visual dysfunction. A patient, 58-year-old "Red" Greene, had an amblyopic right eye all his life. When he suffered an ischemic event in his left eye, leaving him with 20/100 visual acuity, his amblyopic right eye improved to 20/20. This change caused a significant disruption.

Things presenting on his left side bothered Mr. Greene (he jumped when people approached on his left). He constantly shut his left eye and resorted to wearing a patch. It compromised all aspects of his life including his work and personal relationships. Yet a number of doctors, including those at Massachusetts Eye and Ear Infirmary, said, "Why are you complaining? You see clearly in your bad eye."

The problem is that many doctors look at vision as "an eyeball thing," rather than a brain process. The brain's compensatory mechanisms may also mask a patient's dysfunction. When patients reach their 40s, though, these mechanisms often break down. At this point many present to their eye doctors.

Use your ears

"Optometrists can help by really listening to what patients tell them about their symptoms and struggles even if they see 20/20," Dr. Ruggiero says.

Patience can be a virtue with VT. Compensating mechanisms are more deeply embedded in older patients so successful outcomes may take longer, but they will come. In the case of Mr. Greene, Dr. Ruggiero prescribed lenses that stabilized his vision. He now functions with comfort and ease.

Vision therapy in practice

Vision therapy for adults typically lasts from three to nine months depending on the condition. Total fees range from a few hundred dollars to several thousand. The treatment is not usually covered by insurance. The costs of adding VT to a practice are minimal and much of the test administration and hands-on treatment can be delegated. The net income is usually greater than 50%.

Dr. Ruggiero recommends O.D.s go online to the College of Optom-etrists in Vision Development ( and the Optometric Extension Program ( for resources.

An O.D. with a general practice for 19 years, Dr. Ruggiero receives approximately 200 referrals each year from a network of health and education professionals, including occupational and physical therapists, neuropsychologists, teachers and physicians. (She doesn't market her specialty directly to patients.)

"There's a tremendous number of people who need treatment for binocular dysfunction," says Dr. Ruggiero. "The treatment isn't hard and the results are so rewarding!"

Optometric Management, Issue: October 2006