Apart from limited spending capacity or tendancy of patients, what are the considerations to suggest that its Not For You to a willing to pay case ?
Apart from limited spending capacity or tendancy of patients, what are the considerations to suggest that its Not For You to a willing to pay case ?
children
Bart Smith, continuing to be awesome since 1982 so that you don't have to.
Love is a duet, each voice complementing each other and making them sound better than they would alone, each voice at times stepping back and letting the other shine. We've got a pretty good duet going Tina.
On April 28th, I'll be marrying my best friend. I can't wait!
Extreme motion sickness.
I never liked trying to talk Bifocal wearers into them. Same with trifocal. If they are happy with what they have, leave them in it. If they come in looking for the specific advantages of a PAL, then educate them and then move forward.
What For-Life said; trying to "force" Bif/Trif wearers into them especially if they have an ADD power above +2.00.
I re-fit a PAL wearer into a FT 35 after he had an ADD increase from a +1.50 to +2.25. He would look ridiculous in a large frame, so we kept him in a 30 B and he could not tolerate the higher power increase ratio within the corridor.
Clinton Tower
The intellect to live free is in short supply
ALT248=°
A: when the patient is under 40 years of age.
B: When the patient reads with the head in a fixed position and uses eye movement alone for lateral vision.
C: When the patient wants the most precise vision possible at each viewing distance.
D: Patient has any retinal disturbances at all causing less than optimal vision.
You may now expect replies from other optiboarders telling you about all the subnormal acuity patients they sold progressives. Those higher fees and commissions motivate a lot of improper applications. So do words like new and technology.
Chip:cheers:
Relatives and close friends.;):DOriginally Posted by sandeepgoodbole
I have encountered all the above patients and after some education on progressive lenses, they still insist on getting a PAL. In situations like this, you just have to give them what they want.
however, optiboarders should be ethical enough to tell them what suits them best rather recommend something based on higher fees and commisions.
Everything Chip said.
I can't tell you how many times I've heard an acquaintance of mine sell 1.67's in -1.00 to -2.50 to a former CR39 wearer, pronouncing the higher index lenses as employing the "best technology available". JEEZ!!! I cringe every time.
...and Win C, one would hope this to be true but do understand that not all Optiboarders were created equal which is why this forum is so potentially useful for some. I'll respectfully offer that the person in my example is NOT an avid Optiboarder, if one at all.
If they are happy with their lined bifocal or tifocal, DON"T SWITCH
Monocular patients are also tough. Including those with suppression. I have had better success with the newer designs.
Also, if a patient has ambliopia. Probably not a good candidate for a progressive ... but a good candidate for a FT-35.
A -1.25 44 year old office worker
Anyone with a relatively low distance rx, coming from SV readers... or at least make sure you council a LOT.
Re: progressives:
There is far less "subnormal" acuity with a properly-fitted, measured and POW compensated mild-wrap ( 7-9 degree face form) progressive, in my experience.
If you think your client will balk at the price, do what I do...consider lowering your normal mark up, and get them into this terrific new technology.
Sure, goin' about it this way means I'm bringin' home less bacon lately. But it's my way of ensuring succees in the future.
Hey, the internet and insurance are putting downward pressure on your margins anyway. Why not use this situation to get an unexpected (and unsurpassed) result?
Being able to exceed people's expectations in optical is becoming increasingly harder. Client's are jaded by the woo and lure of discount prices from whereever.
The easy path, IMHO, is in this latest lens FF technology (including SV and FT 28)
One of my equations for success:
Exceed your client's expectation = building client trust.
And trust functions like an annuity toward future business success.
One man's opinion...
Barry
I think the simpliest advice I've ever gotten to this question (which is a summary of a lot of these posts), if the patient is wearing a multifocal and you don't have to change lens design/material (due to the fact that either the lens is no longer made, or in the case of a progressive you've fallen under the MFH) don't make any changes. Especially if it means you're keeping a person in glass. And yes so far this year I've dispensed 3 patients in glass progressive lenses, because that's what they were wearing.
For new patients the one question that you need to ask is if they get vertigo/dizzy spells. Depending how bad it is, then no multifocal may be the correct answer. The best example I can think of for this case, is our office once had a patient that when they sat at a stop sign and turned their head to look at it, they got dizzy (this was using a DVO prescription). A patient like that needs 2 pairs of SV lenses, 1 for NVO and 1 for DVO.
Now concidering the above post...
If we don't want to dispense these to people who already have a tendancy toward motion sickness and the like...
Could we be inducing motion sickness to those who don't have same but might if things were just a little worse visually...?
Could we be inducing a little motion sickness in everyone we dispense them to....?
What are we doing to the pilot who hits a little barely controlable turbulance...?
Chip
One caution:
*Every* Bifocal, SV, Porgressive or RX change requires "getting used to".
If you shy away from new lens types, just because you fear that they'll "have an adjustment to make" visually, posturally or perceptually, I think you may short-change a particular client from enjoying the benefits of what they may have enjoyed.
How do you know? You don't.
Try, and try again!
Barry
Last edited by Barry Santini; 09-24-2009 at 09:18 AM.
I was going to say the same thing as Barry Santini!! :D
One thing I tell all my patients is there is not one lens that will serve all purposes for all people. There are lots of different designs for different tasks, and we just have to find out together what is best for the patient's lifestyle. With any lens, though, there will be something in the vision that is compromised.
If a patient is happy in his BF/TF, by all means they can stay in it. If a patient is going from SVNO to full-time wear, we definitely will talk about progressives, and their versatility, but I do my best to let them know what to expect. And yeah, you'll never know untill you try.
It's nice to be important, but it's more important to be nice.
If people are happy, why to change? = Pro inccumbency. Why not try for some thing which will creat more happiness ? = Anti incummbency.
i sell a lot of Progressives.. about 97% of my multifocals are Progressives. Including many children with convergence disorders with the Drs permission.
But I warn and screen the following more...
1) patients with Vertigo
2) muscular disorders of the eye that result in abnormal converngence (I have done it successfully)
3) any neurological condition that causes shaking (again, I have done it, but I warn the patient that they could be better off in a lined lens)
4) self corrected mono-vision patients (OD: -1.25 OS: Plano Add: +1.25)
5) low power latent presbyopes who still have good visual acuity w/o glasses and are not motivated to wear glasses yet.
6) engineers who look at blue prints and hate not seeing a straight line
i average about 3 progressive non-adapts per year, and most of those are solved by switching to different brand of progressive lens.
I would disagree... I believe quality of life is greatly improved with Progressive lenses.
I put a 96 year old woman in her first progressives a few years ago... and she was really mad... not at me... but at all the Opticians over the previous 20 years who never even told her about progressive lenses. She said it gave her a new lease on life and she could see better and more naturally than she had in years. Hobbies were more pleasant, everything in her life better, and she loved how they looked on her. She was very very happy with progressives...
I just wonder whay kind of hobbies a 98 year old still enjoys, and how valid such a comment would be to further sales of Pals. You could probably sell PALS to everyone in an old age nursing home.
good Morning
First I want to ask Chris why do you hate progressives? It seems like everytime this type of conversation comes up you go on and on about don't use them, don't switch them...
I have guidelines I use for my patients too. common sense stuff that is already listed here, however I do recommend progressives for most other wearers. I don't get paid commission or bonus. I have no incentive to "sell"something to patient. In today's life, so many people could use the benefits of progressives. That 98 year woman might be facebooking or twittering, and listening to her Ipod. Would a ft 28 work for her, no since now she alot of focal lengths to look at. Why if she ask would I tell her no.
Also most people come in knowing what they want. With proper education patients do fine with progressives. Take the time to talk to patients get to know them and what they need/what, and then make decisions with them.
I just tired of the negative remarks. No Chris I don't just "sell" to my patients, and I don't think most good opticians do
Christina
She enjoys baking, canning, jigsaw puzzles, and gardening.
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