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Thread: Customer asks you, is it a big change?

  1. #1
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    Customer asks you, is it a big change?

    Hello everyone,

    if a customer brings in a rx, the change isnít much, letís say the rx has gone up by -0.25 in the distance and/or +0.25 in the add. They want to know if itís worth spending the money for such a small change, we want to sell them lenses only or a complete set?

    Do you just say any change by the doctor should be updated and can make a difference or do you say itís a minuscule change and let the customer use their existing glasses and loose the sale?

  2. #2
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    I tell them it is a change that some notice and some do not and if they want their best vision possible and especially if the lenses are old and scratched now would be a good time to retire them to spare pair status and get a new pair.

    If they persist and ask is it a big change I tell them that's subjective and we cannot tell until we update them.

  3. #3
    OptiBoard Professional OptiBoard Silver Supporter Optical Roy's Avatar
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    I use trial lenses over their current RX to mimic the new RX versus the old. Have them look through all zones to see the difference, 95% of the time it's a sell.
    Roy W. Jackson, Sr. ABOC

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by Optical Roy View Post
    I use trial lenses over their current RX to mimic the new RX versus the old. Have them look through all zones to see the difference, 95% of the time it's a sell.
    They want to wait until after the refraction to see if anything changed but by then the OD has their pupils dilating.

  5. #5
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    I had a police officer & a friend who had a .25D change. The Dr. told him it was minor, I told him it was minor. His reply was that it was his money, his eyes and "damn it order the glasses". When he picked them up, his comment was that both the Dr. and I were idiots. He saw a huge difference. It turns out that he had his pistol qualification coming up, and the other cops were kidding him about failing because he was the oldest. He wanted to stack the deck in his favor with anything he could. Was it a placebo? Maybe. But he was happy. And if he's happy spending money with me, I'm happy.

  6. #6
    OptiBoard Professional OptiBoard Silver Supporter Optical Roy's Avatar
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    Quote Originally Posted by Uncle Fester View Post
    They want to wait until after the refraction to see if anything changed but by then the OD has their pupils dilating.
    Absolutely, if they are dilated I ask them to come back a day or so later if they really want to know the difference before purchasing.
    Roy W. Jackson, Sr. ABOC

  7. #7
    What's up? drk's Avatar
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    I wish prescribers would clarify. I try. And yet, maybe the patient wants a second opinion. Maybe the patient forgets.

    The high-end professional service would be to trial frame. But what a pain. Hopefully you get the 95% like Roy does, as a reward for your expertise.

  8. #8
    What's up? drk's Avatar
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    But as a rule of thumb (police officer notwithstanding, and knowing that -0.25 is conjugate to only 13ft!) I believe in the 1/2 diopter rule.

    That is, 1/2 D (sphere) is almost always significant. If you see that, it's a "significant change".

    1/4D is really the level of sensitivity for a clear-lensed, large-pupilled person. That's why we use it. If you have an adult (and I'll say that's 20-60), they'll probably be able to tell the difference, but it's a "small change", nevertheless. If the patient is as old as Martellaro, it's a drop in the bucket...lens opacification and pupil miosis and probably trace reduced acuity will make it pointless. And those are the patients that usually obsess about getting their good vision back.

    It's sad.

    Opticianry and optometry is quite tragic, actually.

    Try to carry on.

  9. #9
    OptiBoard Professional OptiBoard Silver Supporter Optical Roy's Avatar
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    Quote Originally Posted by drk View Post

    If the patient is as old as Martellaro, it's a drop in the bucket...lens opacification and pupil miosis and probably trace reduced acuity will make it pointless. And those are the patients that usually obsess about getting their good vision back.

    It's sad.

    Opticianry and optometry is quite tragic, actually.

    Try to carry on.
    It is sad, trying to explain their acuity is no longer 20/20, that 20/40 or worse, is the best that can be accomplished, then answering "why the hell did I even get these damn things" and asking if it's better than the previous, with a "yes, but I wanted to see the world again" is kinda heart wrenching. Have dodged many a flying frame due to this.
    Roy W. Jackson, Sr. ABOC

  10. #10
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    I had a patient yesterday that had a .25 change in one eye. She also had a significant cataract in that eye. The OD was recommending surgery but the patient didn't want it yet so the OD told the patient that she could get the new lens and try for a couple weeks. (Camber Trivex Trans AR in Drill Mount) When the patient came to see me, I was pretty blunt and said due to the cataract she wouldn't have clear vision and the change was the smallest you could make and that she probably won't see any difference. (I did have her trial it and she said she didn't see a big difference.) I pretty much told her that I could make her a new lens, but really I would just be taking her money. Nothing more frustrating than when you make a set of lenses and the patient gets angry that they can't see any better. I really try to stress that it is the smallest change you can make and most people won't notice it. Once they are educated, they can decide if they want to order. (and the cataract patient I had ended up making a consult apt with our ophthalmologist). I myself have had a .25 change and noticed it and had a .25 another time and didn't. I always try my best to inform the patient so that they can make the right decision for them. That's all we can do.

  11. #11
    One eye sees, the other feels. OptiBoard Gold Supporter
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    Quote Originally Posted by mervinek View Post
    I myself have had a .25 change and noticed it and had a .25 another time and didn't.
    I can live with a little under-minus (-3 myope) but over-minus leaves me cranky, somewhat like too weak/strong coffee.

    Robert
    Roberts Optical Ltd.
    Wauwatosa Wi.
    www.roberts-optical.com
    ~~~~~~~~~~~~~~~~~~
    Science is a way of trying not to fool yourself. - Richard P. Feynman

    Experience is the hardest teacher. She gives the test before the lesson.



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    OptiBoard Professional KrystleClear's Avatar
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    I second what others have said - people expect opticians to always want to sell sell sell, and they appreciate the honesty and free education. Some won't notice the change, and then some patients seem to notice even the slightest axis change.

    I work with one doctor who tells a lot of the patients that the script hasn't changed much and to not bother ordering glasses - and while he is right, some of these patients are wearing ancient frames with scratched, crazed, and/or yellowed lenses. It's my personal feeling that everyone paying for a refraction should leave with a copy of their script, but this doctor only prints it if he thinks the change is significant enough or the patient requests it. Patients take the doctor's word as gospel so they will just keep on wearing the same pair until they break or get lost. Be honest and let the patient decide with that information whether they wish to invest in new glasses.
    Krystle

  13. #13
    Ghost in the OptiMachine Quince's Avatar
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    Agreed. A quarter is hit or miss for a noticeable difference.

    Recently did 3 Rx changes for a lady that had gone back to her glasses from 2019 because none of the newer RXs were as good... then she tells me she has cataracts forming but not ready for surgery. Thanks doctor who apparently was like 'yeah I'll just keep sending adjusted RXs to wherever she is going and not inform her that her vision just won't be what it was until post surgery.'

    I know you guys are better about setting up proper expectation but in this case, I was not impressed with her doctor. True, maybe she just didn't want to listen, but at some point you think they'd try and talk her out of another recheck.



    Different patient came in recently and wanted me to duplicate their lenses to set them up with a new pair but then proceeded to tell me they couldn't see that well out of them anymore. Needless to say, I suggested they get a new exam before purchasing lenses they already knew they weren't seeing well out of...

    Isn't that Einstein's definition of insanity??
    Have I told you today how much I hate poly?

  14. #14
    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    I keep a kaleidoscope at each desk to aid in determining eye dominance, which further impacts advice on Rx change.

    Also one must not forget changing, improving or upsetting binocular balance: I advise if your eyes don’t feel they’re playing on the same team, then a small, unilateral change might be advisable.

    B

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Tested after eating special mushrooms???

    "I keep a kaleidoscope at each desk to aid in determining eye dominance, which further impacts advice on Rx change."

    Please expand Barry.

  16. #16
    One eye sees, the other feels. OptiBoard Gold Supporter
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    Quote Originally Posted by Uncle Fester View Post
    "I keep a kaleidoscope at each desk to aid in determining eye dominance, which further impacts advice on Rx change."

    Please expand Barry.
    Most of us instruct our clients look through a circle formed by their extended forefinger and thumb.

    Discount opticals use empty toilet paper rolls.

    Barry serves la haute sociťtť, so they get a light show and probably a nice red.

    Robert
    Roberts Optical Ltd.
    Wauwatosa Wi.
    www.roberts-optical.com
    ~~~~~~~~~~~~~~~~~~
    Science is a way of trying not to fool yourself. - Richard P. Feynman

    Experience is the hardest teacher. She gives the test before the lesson.



  17. #17
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    I hate when I dispense a pair of glasses and they say my doctor told me that my Rx didn't change that much. Doctors don't usually look at a customer when they are putting the glasses on for the first time. A small change for one person may be a bigger change for someone else, especially if you are working with an engineer. Remember this doctors!

    And I'm all for honesty and telling the customer what changed, but I do agree with Uncle Fester that there's usually a reason that they need to be buying glasses. A change is a change is a change, or their glasses are scratched, or you've uncovered a need for sunglasses, or maybe they need a new task specific glasses. In this zoom era I can't tell you how many more NVF pairs we have sold this year over 2 years ago.

    If a customer asks you if something changed and you say no not much and that's the end of the conversation, you are doing it wrong.

  18. #18
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    Quote Originally Posted by Quince View Post
    ...I know you guys are better about setting up proper expectation but in this case, I was not impressed with her doctor. True, maybe she just didn't want to listen, but at some point you think they'd try and talk her out of another recheck...
    Patients are the literal worst. In the clinical portion of my education, I would have patients tell me that without security physically dragging them out of the building they wouldn't leave without an antibiotic Rx for what was absolutely a viral illness with no secondary infection.

    Patients feel they are absolutely entitled to a cure or treatment by the end of the appointment even if doing so is borderline malpractice.

    They never did honor my request for a huge bottle of Placebo™ that I could use to fill amber vials for patients... At a certain point a Placebo™ is actually a more medically and ethically appropriate therapy to give a patient than a treatment that is completely ineffective and inappropriate for a given condition.
    Last edited by Lelarep; 06-30-2021 at 09:04 PM.

  19. #19
    One eye sees, the other feels. OptiBoard Gold Supporter
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    Quote Originally Posted by drk View Post
    If the patient is as old as Martellaro...
    Have a drink. Itíll make me look younger.
    Roberts Optical Ltd.
    Wauwatosa Wi.
    www.roberts-optical.com
    ~~~~~~~~~~~~~~~~~~
    Science is a way of trying not to fool yourself. - Richard P. Feynman

    Experience is the hardest teacher. She gives the test before the lesson.



  20. #20
    Master OptiBoarder optical24/7's Avatar
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    Quote Originally Posted by drk View Post

    ….If the patient is as old as Martellaro, it's a drop in the bucket...

    Pot calling kettle black…

  21. #21
    One eye sees, the other feels. OptiBoard Gold Supporter
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    Quote Originally Posted by optical24/7 View Post
    Pot calling kettle blackÖ
    Projection? I can take it. Most folks are finished after age 25 anyways.
    Roberts Optical Ltd.
    Wauwatosa Wi.
    www.roberts-optical.com
    ~~~~~~~~~~~~~~~~~~
    Science is a way of trying not to fool yourself. - Richard P. Feynman

    Experience is the hardest teacher. She gives the test before the lesson.



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