So are we in the business to fit someone with the best pair of glasses they ever had or are we here to do that, ALONG with a song and dance for them while we hand them warm fuzzy's so that they feel good about themselves?
Frankly I got in the business to be a Optician. If we wanted to do entertainment we would be in Hollywood handing out champagne and wine with the glasses.
It's all well and good to trash these devices, but the level of competence here on this forum is far above the level of skill that I have encountered in my travels and I have traveled through a lot of states and visited a lot of practices. Anything, ANYTHING that helps to provide accurate measurements saves time, money and aggravation at every step of the fitting and dispensing process.
Look down with distain if you will, but until there are uniform standards of education and training and until those who are charged with hiring demand those competencies, the majority of "opticians" need all the help they can get.
Reread my post. I'm really making fun of all the new tech stuff. I'm definitely old school. However I do own a pupilometer that I recheck the measurements the old fashion way using a mm ruler.Originally Posted by CCGREEN
+1
It depends on how successful you wish to be in the future.
p.s. What's wrong with warm fuzzy's?
Correct. And if patients wanted to be entertained, most of them would not go to an optician (some exceptions may apply).
Warm fuzzies are superfluous, for one. The amount of $ spent on these digital measuring devices could be capital better spent. If the price of the device flows through to the patient ordering a digital lens (when none is really needed), then they paid for admission to the show.
What I'm butthurt about is that opticians (and optometrists) are taken in by the lens manufacturers. All this POW and digital and DMD and blather and smoke and mirrors.
If you spend time cluttering your head with fluff/lies/marketing, then you have less space to focus on what really matters: the fundamentals.
Interestingly, the best free form, digitally processed PALs I've worn, and are currently wearing, didn't require any measurements other than my PD and a seg ht. That being said, one of the aspects that I talk to ECPs about when demo-ing my iPad app is providing a uniform message when discussing lens options. It is much easier to stay on point with the patient education features that are currently available, most especially when they're generic and not vendor-specific.
Digital measuring devices have their purpose, just like any other digital device available in any healthcare related field.
I guess it helps to be a lab tech and be able to adjust things to my liking, even after the measurement has been taken.
I will say this though, I would rather use a DMD, then spot up the demo lenses to double verify(and adjust accordingly), rather than do it the old fashion way.
At least the DMD gives you a place to start. I also normally take at least 3 images, and split the differences.
you don't have to invest the time actually teaching your staff ......................
Would that not mean that you are playing into the hands of the on line-opticals ? Is that not a solution they have been waiting for ?
Optical measuring stations in shopping centers..........put $ 5.00 in slot or a credit card and it will print out all the measurements needed to fill a Rx ?
Thank you all SO much for your feedback. I was looking for honest opinions or reviews and I definitely got them.
probably more along the lines of, have a lot of employees that only know how to use a DMD, so you dont have to train them to do it the old fashion way.
Pay them less, and they dont have leverage to work somewhere else or compete with you unless they make the DMD investment.
Please, please, please, don't use DMDs. And please keep saying widespread old school terms like a twelfth when it's actually twelve one-hundredths. The less of you that change, the more business there is for the rest of us that progress with the rest of the world.
I have a follow up question to my original post. For those of you who HAVE used DMDs, has it improved your redo rate? Or is it close to the same as without using DMDs?
haha, it's actually just hundredth, no "one" according to my calculus professor. Got quite a lecture about that one.
Slight improvement for those who are too lazy to take a manual measurement.
Gives a lot of problems with skewed panto and making the PD skewed as well.
Really high OC heights are always a problem as well.
Use and trust your tools, that is a good idea.. but know when to adapt them to your patient needs. as a 'seasoned' tech, take the advice and adapt it to your needs or ignore it as you choose... there are still some excellent seasoned techs out there who don't mistrust new equipment. I just know when they are wrong in individual cases. did you misunderstand my comment?
I do wonder if you wear PALs... VIP vs. Definity 3? NO CONTEST in practical use.
My personal redo rate due to misaligned measures... in the last 20 years less than 1%. in the 30 years before that? considerably higher. reason? Started wearing PALS.
Understanding that the best tool in the Optician's tool box is on either side of your head, priceless. allow yourself to become a Valued seasoned tech. by the way, I never trust anyone else's measures either, unless I taught them myself.
Yes, it has improved redos due to optician error. And if segs are consistently high using a DMD that's not handheld, the opticians are not checking posture. If it's with a handheld, they're not being held at the proper angle.
I'd normally go after this post, but your picture is really awesome.
You can go after it:) Had to have a sunglass pic on National Sunglasses Day. Lots of room in the world for people to disagree and do stuff differently. What works for me may not work for everyone else!
This +1
From my experience DMDs, just like traditional measuring systems, are only as good as the people using them. It took me a bit of working with them to get them to be consistent but once I got it down I find the measurements to be very accurate.
The downside of the devices I have used however is that you have to be a detail-oriented person to achieve consistently accurate results, as I've trained a number of people with the devices I can tell that where they may be very detail-oriented with a PD stick, they seem to think they can rush through the process with a digital device and it will make up for the errors for them. Lo and behold, they usually get inaccurate results.
I would also say that we are still seeing the first couple generations of these products and I would feel safe in guessing that in the next couple years they will become both incredibly accurate and efficient as the technology continues to improve. If you don't feel comfortable with technology that may be lacking now, do not make the mistake of assuming that it will continue to be bad just because of your current experiences. I would relate it to transitions, I don't know how many "seasoned" opticians I've talked to who wont promote transitions at all because of the horrible tint they had to them years and years ago.
Last edited by D_Zab; 06-27-2014 at 05:03 PM. Reason: grammar!
It doesn't matter what method you use as long as you know how to use it. Having to learn Accufit at the LC was pretty lame at first, because I thought I was above the "gimmickyness" of it. However I've tested and retested and it's very accurate, as long as you know how to use it. Those of us optical nerds who after working a long day come here to optiboard are more than likely going to be using whatever technology they have to the best of their ability. Those who don't, work with me and I have to check their measurements made with the billion dollar equipment that's 5x more accurate except when they aren't noticing their patient is suddenly a flounder or appears to have the same measurements as Sloth from the Goonies but doesn't look like him. I mean really, how many patients have monocular pd's of 37/30?
They are a good tool, but they don't replace competent opticianry. IMO the measurements may be super-accurate, but are they actually measuring the correct thing? Is the posture correct and natural, the pt in correct position without an artificial head turn, the frame properly adjusted? It takes skill to get all that right and interpret the results correctly. Anyone who thinks that a Visi-office operated by a shaved monkey in a smart shirt replaces the need for a decent optician is kidding themselves, in my view. But in that competent optician's hands, it's a useful tool.
Just a quick off-shoot: do most people here take their machines readings as gospel? Like a poster above, I like to take a couple of digital readings, but then I also take pupillometer and manual height readings. I tend to fudge the ordered parameters using both sets of data as I see fit. Maybe I just haven't had access to a digital measuring device for long enough to completely trust it. Interested to know what others do/think.
And I'll say this: optometrists are in no short supply of gizmos.
Some add to our ability to do our job correctly. Some are rather fluffy.
Docs chalk up the "fluffy" technology to "practice building" or "high tech image" or "wow factor".
BUT! If they don't know what they're doing in the first place (practicing sound optometry), all those machines are a waste of capital. A big waste. And that sinks ships.
Could not agree more.
I would agree with a caveat, "fluffy" technology can quickly turn into useful technology. Don't just ignore what is coming out because you already do your job well, make sure you are paying attention to when technology becomes reliable enough to be used for your practice's advantage.
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