The Elephant in the Room: CR-39

[Browman]

I brought this up in another thread, but as it was piggybacked onto another question, it was quickly batted down as conversation moved on to the topic at hand. I would like to have a thread dedicated to the discussion of one of the elephants in the room of today's dispensary: CR-39.

Office policy dictates that we give patients a "good scare" if they ask for CR-39 lenses as covered by their insurance (or if they're just trying to get an inexpensive pair OOP), outlining horror stories of people blinded and/or disfigured by flying lens shards during car accidents. This emphasis on frightening people in a sales environment has never sat very well with me, and I've long wondered if this "scare tactic" is just that-- a sales tactic to upgrade/steer towards poly. Occasionally the more logically minded or history-savvy glasses wearer will bring up that plastic and glass were all that was available for ages, coupled with "If it weren't safe, why are all the lenses in sunglasses made of plastic?" and/or "I've never heard of anyone blinded by their glasses/sunglasses in a car accident." The fact that some nurses and ER staff have said the latter is particularly troubling.

So, ladies and gentlemen, let's discuss. CR-39: Safe alternative, or insidious death-trap?

[optimensch]

how many eye injuries are caused by this dangerous CR39? Since 1986, when I began in this field, I have seen a total of zero.

[Johns]

I have seen the same. But wait...I could tell you many stories of MY customers that listened to my advice, purchased poly, and today, in spite of the many car accidents, golf mishaps, and collegiate food fights, STILL have both eyes intact.

I would hate to think of the thousands of prosthetic eyes I would have had to fit (oh, never mind, I can't do that), were it not for my ability to convince my customers to buy poly. (Not to mention the extra income it provided me)

In all honesty, I bought into it, but looking back, it was a "better safe than sorry" thing for me. And TBH, I could have probably made more selling CR-39 than poly, and gotten a lot more use out of my edger wheels/blades.

[Judy Canty]

Zero for me since 1973.

[optimensch]

cr39 is the best IMO for low powers, no drilling. great abbe, tintable in-store, superior optics to poly.

[fjpod]

Although I am sure they do exist, I have never known anyone blinded while being hit while wearing CR lenses...since 1978.

[Chris Ryser]

Optically CR39 is still the best material next to glass and most if the extras can be done right in the shop at a fraction of lab charges.

Not to forget you can also strip AR coatings that are defective and remove the scratches that are on the hard coat by removing it.

[cocoisland58]

It's definitely the elephant in my office. I have been chastised for selling "non-premium" lenses ie: CR39. IMO poly is for safety purposes so children, sports frames, industrial safety. I like CR39 for it's clarity and affordability so I will continue to sell it when the patient and I feel it's the better choice or simply when cost is an issue. Better to sell a pair of glasses completely covered by the patient's insurance than sell none at all.

[Judy Canty]

I have seen the same. But wait...I could tell you many stories of MY customers that listened to my advice, purchased poly, and today, in spite of the many car accidents, golf mishaps, and collegiate food fights, STILL have both eyes intact.

I would hate to think of the thousands of prosthetic eyes I would have had to fit (oh, never mind, I can't do that), were it not for my ability to convince my customers to buy poly. (Not to mention the extra income it provided me)

In all honesty, I bought into it, but looking back, it was a "better safe than sorry" thing for me. And TBH, I could have probably made more selling CR-39 than poly, and gotten a lot more use out of my edger wheels/blades.

I'd like to tell you about all my horror stories using poly as well, but alas, none come to mind.

[MikeAurelius]

"They" still use this story to scare people about glass lenses. At least be honest about this.

[MikeAurelius]

Additional thought: isn't this kind of "scare tactic" illegal? I seem to recall several FTC rulings against such practices, calling them product denigration and disparagement.

Federal and state laws prohibit advertisements that overstate the qualities of a product or that falsely disparage those of a competitor. This is true even if the competitor’s product is not expressly mentioned but the implication is obvious. For example, Nabisco could argue that the above "Marie’s cookies" tagline directly invokes an Oreo. If Nabisco uses real chocolate and cream in its celebrated cookies, then Marie will have some explaining to do.

Finally, even if the disparagement comes via a review by an author who has no commercial bias, you nevertheless may have recourse. The First Amendment provides a safe haven for some critical comments, but it does not create a legal right to cross the line into trade libel or defamation.

[Happylady]

We had a company that came in to help improve our business and they recommended that we not sell CR39. However, I still do and so do the other opticians. Nothing is said to me about it.

I use it for tinted sunglasses and low powers in full frames. My over the contact driving glasses are CR39. As for optics, personally I see fine in any lens material. And for all the concern about poor optics with poly, I can't remember the last time I have seen a problem with it with any patient.

[Judy Canty]

These are the kinds of things that happen when we buy into the marketing and lose sight of the reality. Marketing is not inherently bad. It just needs to be taken with a healthy dose of experience.

[vcom]

Just as long as customers don't find out about the BPA content of Polycarbonate. Since that has quickly become the 'Poison Plastic', I can just imagine hearing a patient claim the BPA leeched into there eyes and made them get catarcts or something.

[Judy Canty]

Hey, we're all gonna die of something.

[optimensch]

between say -2 and +2 in a full-rimmed frame, i think Cr39 IS the premium choice, especially with a hi quality a/r + hard coating.

[coupe]

I have seen straight from the baseball bat to the pitchers eye, glass chemical hardened lens....no damage. I have seen 400 volt electrcal box spark, directly to the face, Rx poly safety eyeglasses... full face poxed by sparks...no eye damage and I have seen countless cases of rough housing damage to CR-39 but no eye damage. The only lens that seems to be aproblem is the ultra - thin ones. I actually have a DRP BAL TESTER that I use and the only ones that break constanly are the 1.6. CR-39 is the work horse of the optical industry. It is tintable , comes in all diameters, is shatterproof certified, cuts easy, meets the needs of most clients and has great clarity. t is agreat procuct.

[Uilleann]

The original question is flawed on several levels. Remember that poly - the perennial scapegoat of these boards for everything from silly claims about it's "horrible" optics to causing the plague - is thinner, lighter, UV protective, comes stock on flatter base curves than CR and also more impact protective with all else being equal. I don't know of ANY office that has ever gotten rich selling poly because of it's massive mark-up...most likely because there generally isn't one.

As for what the insurance covers (and this is a whole other can of worms) if you think you're doing your patients a favor by "saving" them from a miniscule co-pay for "upgrading" to poly, I'm sure the Ins co CEO's are laughing all the way to the bank. Their reimbursements will never allow most practices to remain viable on their own. But then, that's the great dilemma with managed care - you get to let them dictate what is "best" for your patients based strictly on their bottom line. If you like to dispense a majority of CR, for your managed care patients...don't plan on staying in business long, unless you're operating on a Walmart mentality of sheer quantity vs any form of quality or detail oriented dispensing to meet patient/lifestyle needs.

[Judy Canty]

We had a company that came in to help improve our business and they recommended that we not sell CR39.

That's not improving your business. That's just raising your prices. I you didn't pay a lot for that advice.

[SeaU2020]

I think the issue is more with where you work and the "sales goals" you are being given.

[Johns]

A google search of lawsuits regarding eyewear turns up nothing but America's Best and Lenscrafters customer complaints...

[Robert Martellaro]

Food for thought.

Among a group of 452 patients treated for eye injuries between 1979 and 1983, there were 66 with injuries due to broken spectacle lenses.

http://www.ncbi.nlm.nih.gov/pubmed/3682689

Please note that 36.4% of the injuries were due to the patient falling.

Each year more than 2.5 million eye injuries occur and 50,000 people permanently lose part or all of their vision. Nearly half (44.1 percent) of the injuries occur at home.

http://www.hcup-us.ahrq.gov/reports/...iefs/sb112.pdf

Please note that 37.6% of the home eye injuries patients were age 65 or older.

[NCspecs]

I keep seeing the phrase "it's tintable" in all of the arguements for CR-39. I have nothing against CR-39; I use it in many applications, but who the heck tints anything anymore? I don't even have samples in my office.

Sorry for the segue Browman. :)

[Tallboy]

The office I run the finishing lab in now sells more CR-39 than I have ever worked with in my 9 year career. We even have patients who request it in grooved, knowing full well that their old ones chipped because of the material and having been offered both trivex and poly.

I'd say 80% of the CR-39 we sell is free-form sv/ft28s or backside progressives, and they are the clearest least distorted lenses I have ever seen. We don't present CR-39 as a lesser material, we just say what its properties are.

We also sell a lot of poly and some trivex/1.67/1.60/1.70 almost no 1.74 for us unless it is a VERY high RX (over -10.00). Almost all of it is edged in house.

I love CR-39, not so much for stock lenses... I think they mostly turn out ugly from stock. I wear almost only poly myself because I am cheap and a -5.75sph -.75 cyl OU.

on a side note: I also have just as many material non-adapts for Trivex as I do for poly, and in my humble opinion it has more to do with their inherently flatter base curves in stock lenses. When freeform surfaced I never have poly non-adapts.

[fjpod]

We still do a few tints...sometimes an older person with cataracts doesn't do well with a dark polarized lens...sometimes people want funky colors. Not as much as we used to, but we do it where appropriate, and I think that is the whole conversation here. Doing what is appropriate for the patient.