Anti-Fatigue Dispensing

[Perry Papilary]

Is it common to push Anti-Fatigue lenses when the prescription lists no ADD power?

I am having a hard time pushing a lens without ADD on the RX, unless the optometrist specifically notes it after their exam.

[Brea]

Would the person you're hypothetically recommending the lens to genuinely benefit from it? Are they spending large amounts of time at a computer, reading, or focusing on a near zone task? I recommend anti-fatigue lenses to quite a few people in our office, I wear them as well since as an optician I do a lot of close up work and staring at a computer, but really only have a distance Rx. Ask the patients questions about their daily life, what their hobbies include, and if they experience any eye strain or fatigue, then if they seem like a likely candidate talk them through how the lens works and the benefits. I wouldn't say I "push" them but I do recommend them when they would be beneficial to the patient

[drk]

I have nothing against anti-fatigue lenses, like I have nothing against photochromics.

I, too, have a problem finding how AF lenses "fit in".

Rarely are they medically necessary for accommodative disorders (including presbyopia).

I think the best concept around these lenses would be as "value added" lenses (like photochromics) that would be recommended to any non-presbyope that uses their phone a lot.

Notice how close we hold our phones...one hand, upper arm pressed against torso, relatively small screen so needing a 33cm working distance...that's a load.

(It's really not in the field of view for desktop computers and probably not laptops.)

[chamilun]

are we talking about eyezen like lenses? if so, they are fantastic

[SergeTrigger]

Typically, the only time I ever fitted a lens with a boost power at the bottom (i.e. Eyezen+ 1-4) was because the Dr wrote an RX for a PAL with a low add power (typically +1.00 or under) because it seemed like a more economical choice and there were less adaptation issues. The eyezen start, Essilor's "anti-fatigue" lens with no boost power I would fit usually just for self-pay patients because the place I worked at offered it as part of a package that including crizal AR. I tried an older eyezen with a think a +0.3 boost at the bottom and never really noticed it being all that helpful, not did I feel less fatigued after wearing it. Same with the eyezen start.

[NAICITPO]

Is it common to push Anti-Fatigue lenses when the prescription lists no ADD power?

I am having a hard time pushing a lens without ADD on the RX, unless the optometrist specifically notes it after their exam.

I don't like the term "push" when referring to any lens options. If you have a customer who is getting tired eyes at the end of the day from too much close up work and they are 45 and under and not ready for a bifocal they would be a good option for accommodative lenses. But why would you push a customer into this if they don't have a need for it? If the customer might be a good fit for this kind of lens and they are interested, I would tell them that I will talk to the doc about the exact power needs that would make life more comfortable for them.

[Perry Papilary]

That is exactly my question NAICITPO. I am seeing anti-fatigue being given to people with no ADD power on the RX, which results in them returning in two weeks dissatisfied with their glasses.

My first inclination is to explain the design and how to use the boost of power to their advantage for near tasks, after confirming the frame is adjusted correctly. Even setting up an environment like their own gaming/office area, to support the lens feature.

I'm trying to find a balance between sales staff which are not licenced opticians, but are told to offer this lens even without an ADD power, and the percentage of lens returns/changes that are the result of this.

Then put into play the factor of not discussing with the customer what to expect BEFORE they put the new glasses on....the whole anti-fatigue issue keeps snowballing.

I'm in the process of licensing after passing exam, and I just feel that I have seen situations that need to be examined so our customers can feel we are providing services they require.

Thanks for replying everyone, your input is so valuable!

[drk]

Well, I think the idea with anti-fatigue lenses is to make a general recommendation for it, like one would for adjustable tint lenses. The idea is that "anyone" would benefit from it, and if you ask the right question "do you use your phone a lot?" it could be a good choice. (Especially for pre-presbyopes i.e. 30-somethings.)

FWIW, I would never go with higher than about +0.62 D, and never much less. More and you run into adaptation issues, which blows up the whole premise, and less and you get no discernable benefit.

(I will say, though, that even Eyezen 0 is useful as a FFSV lens, which can often be very helpful with ansio or cylinder patients.)

[NAICITPO]

That is exactly my question NAICITPO. I am seeing anti-fatigue being given to people with no ADD power on the RX, which results in them returning in two weeks dissatisfied with their glasses.

My first inclination is to explain the design and how to use the boost of power to their advantage for near tasks, after confirming the frame is adjusted correctly. Even setting up an environment like their own gaming/office area, to support the lens feature.

I'm trying to find a balance between sales staff which are not licenced opticians, but are told to offer this lens even without an ADD power, and the percentage of lens returns/changes that are the result of this.

Then put into play the factor of not discussing with the customer what to expect BEFORE they put the new glasses on....the whole anti-fatigue issue keeps snowballing.

I'm in the process of licensing after passing exam, and I just feel that I have seen situations that need to be examined so our customers can feel we are providing services they require.

Thanks for replying everyone, your input is so valuable!

Yeah it sounds like maybe some of the people who are selling lenses could use some more training on how the lenses work and how to explain that to the customers. Since you are selling Essilor products do you have a rep you can partner with to help? It may be easier coming from a third party then coming from you.

(I will say, though, that even Eyezen 0 is useful as a FFSV lens, which can often be very helpful with ansio or cylinder patients.)

Not only is it useful for these situations, if you want the best single vision lens go digital. The two biggest reasons my office doesn't sell a ton of Eyezen 0 or other FFSV lenses is the fact we have a finishing lab and can get finished blanks at a much better price, and that most with minimal Rxs won't notice the difference so they get turned off by having to pay more for similar vision. But if someone has a higher Rx and/or is concerned with needing the best vision possible FFSV is a great option.

[chamilun]

I prescribe it when needed. patients with acommodative dysfunction love the eyezen lenses. But definitely only prescribed when needed.

[AndyOptom]

Optometrist here, have been dispensing anti fatigue lenses by all major manufacturers and also various generics since 2014 or so.

Can't speak for all optometrists, but for my prescriptions, if I believe a low Add is helpful and/or an anti fatigue lens, I note it as such on my prescriptions + records (including the specific Add, especially if the patient goes to someone else for the dispense). I only ever do so for symptomatic patients, or in the case of cases where they have heavy duty indoor work, and their distance minus is increasing with the new prescription.

Several times, if the distance minus was already reduced compared to the old glasses in my prescription, an outside dispense of anti fatigue lenses for the patient actually led to discomfort with near work... which normally resolved with a switch back to SV lenses (in those cases, the outside dispenser dealt with the remake costs).

So I would suggest clarifying with the prescriber if no Add was included on the prescription. Might have been noted that way for a reason.

Although having said that, I think there is no harm in an optometrist doing that one or two extra tests, and noting relevant findings + possible lens suggestions even for outside dispense. In fact, I think with the advance of technology, more options, etc, it's only fair play if an optometrist does as such where possible... it's maybe an extra 2-3 minutes of chair time, for most cases I've handled.

So your mileage may vary if our opinions are different there itself.