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Teleoptometry Tools Redefining the Meaning of ‘Phoning it In’

With about 200 different telehealth models being run today, ECPs have to decide which tools, if any, add value to their services.

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OCULAR TELEHEALTH, WHICH delivers eyecare remotely through medical equipment and telecommunications technology, is a hot-button issue right now. The question of whether it can offer a viable alternative to an in-person comprehensive exam is being intensely debated. What’s driving its progress are rising health care expenses as compared to the lower costs and added convenience it offers to patients.

There are about 200 different telehealth models being run these days in the U.S. and abroad, says Vitor Pamplona, founder of EyeNetra, which enables its customers to build their own telehealth models. And they are all different and generally protective of their own way of doing business. “The beauty of the state of vision care today is that anyone can build their own fully functioning telehealth system, using state-of-the-art tools like EHR-enabled AI-based voice assistants, blockchain storage and crypto vision benefits all the way down to the most basic one-on-one patient coaching approaches,” Pamplona explains. “Software is cheap. Technology is cheap. The field is booming but in a very diverse and decentralized way.”

While some states, such as Indiana and Connecticut, prohibit ocular telehealth, the majority allow it. One of the fastest growing entrants is 20/20NOW, which has completed 78 installations of its Ocular Telehealth Solution and expects to complete 125 by year-end. “Optical retail has always embraced ocular telehealth,” says Chuck Scott, CEO of 20/20NOW. “We are now seeing a trend within private optometry to utilize ocular telehealth within their practice, primarily for practice expansion, revenue improvement and better work/life balance.”

Given an abundance of options, the challenge now facing ECPs is to decide which tools, if any, add value to their services.

Smart Vision Labs

SV One, a handheld, smartphone-based autorefractor.

(212) 796-6124, smartvisionlabs.com

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Digital Optometrics

DigitalOptometrics’ Teleoptometry

Eye Exam (877) 506-0002, digitaloptometrics.com

D-EYE

D-EYE’s Smartphone-based Retinal Imaging System

(401) 473-6323, d-eyecare.com

20/20NOW

Ocular Telehealth Solution

(844) 843-2020, for2020now.com

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RightEye

Tests called Functional Vision EyeQ, Brain Health EyeQ, Reading EyeQ and Sports Vision EyeQ.

(301) 979-7970, righteye.com

EyeNetra

Digital Lensometer

(617) 684-5680, eyenetra.com

Smart Ways To Use Teleoptometry Tools

Joseph Ianni, Swift Eyewear, Massena, NY

The option to find doctors locally was limited so we purchased hardware from DigitalOptometrics to provide eye exams. We book a 30-minute complete eye exam and the system can accommodate walk-ins too. It has proved to be an amazing solution and we’ve carried out hundreds of exams since we went live in January. Our technician carries out pre-tests and then we videoconference in a doctor who looks at the results and can control the phoropter remotely and then sends us a prescription electronically. Our patients love the seamless experience and they’re happy they don’t have to travel to see a doctor.

Brian Chou, OD, Revision Optometry San Diego, CA

These are interesting times as technology impacts the evolution of optometry. Many new forms of teleoptometry are startups and like all startups some will succeed and some will fail and some could even get their technology acquired. The alternative distributors of online glasses and contact lenses are focused on giving prescription renewals online. More ambitious technologies offer digital retinal imaging using AI to diagnose diabetic retinopathy. We used to think autorefractors were a threat and now we see optometrists embracing them in their practices to improve efficiency. 20/20NOW is an enterprising outfit that helps clinics and opticals by giving non-dilated eye exams to patients so they can get a prescription when the doctor is not present. Stanton Optical allows patients in all its offices to videoconference with a remote doctor. So, looking to the future, I do believe there’s an opportunity for ODs to use online screenings to drive patients to use their services.

Ericson Quintanilla, Greenleaf Optical Compton, CA

We use the SV One from Smart Vision Labs to get a prescription for patients who don’t have access to a doctor or the fee to see a doctor. For $40 we give them an eye exam and free readers. Letters from the device are transferred to my laptop, where I add comments and send an email to some doctors in New York. I normally get a prescription back from them within 10 minutes. The patient then buys their glasses and single vision lenses from us. I also work with an online insurance company, Patch, that allows me to use their vision benefits.

 

 

Carol Gilhawley is a contributing writer for INVISION.

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Better Vision

Golf Lenses Guaranteed to Be a Hole in One

8 options that address the three factors patients want in their golf glasses.

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THREE FACTORS USUALLY come into play when patients are looking to buy golf glasses: “Their lenses to make a difference on the tee, to see their scorecard, and to track their ball down the fairway,” says Rob Curry at True Focus Eye Care in Port Richey, FL. As a result, lens makers provide ECPs with a number of options.

Liberty Sport

Switch H-wall Frames that come with interchangeable lenses in a two lens kit with a specific golf tint.

(800) 444-5010, libertysport.com

Oakley

The Oakley Prizm Dark Golf lens

(800) 403-7449, oakley.com

ImageWear

Callaway frame with fully Rx-able lens.

(800) 414-7656, walman.com

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Under Armour

The UA Tuned Golf lens features a proprietary tint formula for heightened contrast in bright conditions.

(516) 576-9100, eyeking.com

Scheyden Eyewear

Golf-specific CIA (Confidence in Action) sunglasses with fixed gear titanium frame and high definition dye-infused LT16 polyamide lens.

(800) 851-2758, scheyden.com

Maui Jim

Golf line with PolarizedPlus2 lenses, Guardrails polarized aviator sunglasses (shown).

(888) 666-5905, mauijim.com

Tifosi Optics

Swick sunglasses with Enliven Golf lens or an Rx option of golf/tennis tint.

(877) 530-0815, tifosioptics.com

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Shamir

Shamir Golf lens

(877) 514-8330, shamirlens.com

Smart Ways To Sell Golf Lenses

Tom Harrigan, J.C. Reiss Optician, Morristown, NJ

Our go-to golf lens is a Maui Jim sunglass lens. We’re a small independent optical that opened 127 years ago and I find Maui Jim helps level the playing field by doing everything for us. Being a golfer myself, I like certain lens colors for golf so I recommend a brown or a rose-colored lens which helps read the greens better than a flat, gray lens. Generally, sunglasses double as the patient’s golf lenses unless they want to buy a second pair, say, a dark gray lens for fishing. When patients come in we ask them about their hobbies. This opens the conversation to talking about golf and, since I know the game myself, I discuss my recommendations with them. In addition to selling Maui Jim for golf, we also sell some Liberty Sport Switch frames with golf-tinted lenses.

Rob Curry, True Focus Eye Care, Port Richey, FL

Our two doctors are golfers and have photos of themselves playing in their exam rooms, so golf often comes up in conversation with our patients. Most of our golfers want to be able to track the ball from the tee to where it lands on the green so they will buy a distance prescription and/or bifocal lens. We use the Tifosi frame and lens package more than any other. Its new Enliven Golf lens comes standard in the frame (in plano) and if the patient wants an RX they can get it in the GT tint (golf/tennis). We personally tested it on the course and the results were overwhelming. It’s a non-polarized, color enhancing, green lens that allows you to read the cut of the greens more clearly and vividly than any other golf lens.

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Ways to Protect Kids’ Eyes While Playing Sports

And smart ways to get their parents on board.

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IT’S ESTIMATED THAT 80 percent of eye damage occurs before 18 from exposure to solar UV radiation. As children play games, it’s necessary to protect their eyes from the sun and sport injuries. ECPs need to educate parents about the importance of protective eyewear for kids when participating in sports. For maximum protection and performance, Rx lenses ­— polycarbonate is preferred — can be inserted into a variety of sport-specific styles in a variety of youth sizes.

Wiley X

The Wiley X Youth Force line offers Rx-able eyewear for all types of sports.

(800) 776-7842, wileyx.com

Puma

Puma Junior Eyewear line.

(844) 790-9165, kering.com

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Oakley

The Rx Frogskins XS is especially engineered for young faces.

(800) 403-7449, oakley.com

Julbo

Little Heroes children’s line of Rx-able polarized lenses.

(800) 651-0833, julbousa.com

Nike Vision

The Nike Legend S, an 8-base sport wrap sunglass made with Max Optics.

(800) 645-1300, nikevision.com

Liberty Sport

The Sport Shift frame or goggle in the Patriot Collection has an RS 2.0 lens with FogBlok coating.

(800) 444-5010, libertysport.com

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Polaroid

Polaroid Kids sunglasses with polarized lenses for ages 4-12.

(800) 631-1188, safilo.com

Hilco

Rx-able swim goggle.

(800) 955-6544, hilcovision.com

Under Armour

The UA youth sunglasses with sport-specific Tuned technology designed specifically for baseball and golf.

(516) 576-9100, underarmour.com

Smart Ways To Sell Sports Eyewear to Kids

Audrey Nelson, VisionQuest Eyecare, Greenwood & Indianapolis, IN

We offer a range of sports sunglasses from Oakley’s youth line, sports goggles from Rec Specs and prescription swim goggles from Hilco. The most important thing our doctors discuss with patients is safety. For those kids needing active sunwear with or without prescription, the Oakley Prizm lenses are great. Only about 10 percent of kids who come into our practices wear a sport-specific goggle or eyewear so I think more education is needed for parents to understand that their children should have safety eyewear when playing sports. It also protects their children’s eyes from the sun.

Dr. Samuel Teske, The Eye Doctors New Tampa, Tampa, FL

We’re based in an area that is growing rapidly with a lot of young families moving in and getting their children involved in sports. I first make sure parents understand the importance of eye protection, especially in sports. The mother is generally the decision maker so I talk to her first to ensure she’s on board. I ask her “What sports are your kids playing?” “How active is the sport?” Depending on how aggressive the sport is, I determine if the child will need protective eyewear. Baseball, for example, is an active sport with a high rate of injury. I usually concentrate on those children who already have a prescription and choose ideal safety eyewear that can help prevent injury. I usually prescribe Rec Specs from Liberty Sport, which have an in-built shock absorber. I always pair them with a polycarbonate lens due to its shatter resistance and I like to prescribe Transitions lenses too.

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Better Vision

Retinal Cameras Are More Efficient, More Effective and Less Expensive Than Ever Before

The latest models available and smart ways to use the latest technology.

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TRADITIONALLY, RETINAL CAMERAS were a large expense and pupils needed to be dilated to capture detailed images of the retina. However, in the past five years, high quality, non-mydriatic cameras that do not require dilation have come on the market costing a fraction of the price. There are also hand-held, wireless options and technology continues to improve. For example, D-EYE is building an artificial intelligence platform to help assess if a patient has a specific disease. Its goal is to provide a mass screening platform using their system and access to an approved database, to deliver an “assessment” (not a diagnosis) of the exam results for specific diseases so the patient can progress to the next level of care.

Hill-Rom Welch Allyn

Hill-Rom Welch Allyn RetinaVue 100 Imager

(800) 535-6663, welchallyn.com

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Topcon Medical Systems

TRC-NW400 fully automated, non-mydriatic retinal camera

(800) 223-1130, topconmedical.com

Coburn Technologies

SK-650 Retinal Camera

(800) 262-8761, coburntechnologies.com

Marco

Marco’s AFC-330 Automated Fundus Camera, SK-650 Retinal Camera

(800) 874-5274, marco.com

Canon USA

Canon CR-2 PLUS AF Digital Non-Mydriatic Retinal Camera

(800) 652-2666, usa.canon.com

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D-EYE

D-EYE Retinal Imaging System

(401) 473-6323, d-eyecare.com

Smart Ways To Use Retinal Cameras

Dr. William Goldstein, Laser Eye Care Center, Shelby Township, MI

I use D-EYE’s fundus camera to document the optic nerve in patients who have glaucoma or suspected glaucoma. I started to use D-EYE three years ago. It’s an attachment for the iPhone that has a lens you pop on when you need it. I used to have a camera mounted to a slit lamp in one exam room. Now I travel from room to room to take pictures and this has improved efficiency. I add the picture to the patient’s record and bill insurance for the office visit in addition to the procedure code for taking the picture. The only disadvantage to the D-EYE system is that its field of view of the retina is small.

Dr. Edward Chaum, Vanderbilt Eye Institute, Nashville, TN

This country needs to make it a scalable paradigm to effectively and efficiently screen patients for evidence of vision threatening eye disease in a primary care setting. There are 30 million diabetics in this country but only about half of them are seen by an eyecare professional. It is estimated that the number of diabetics will grow to 100 million within the next 20 years. Finding people and treating them early is critical. Most get seen by a primary care physician or endocrinologist but many need a second level of care and they’re falling through the cracks. Since the cost of a retinal camera has come down, spending about $5,000 to buy one is not a significant burden. Welch-Allyn’s RetinaVue device helps with eye care compliance among diabetic patients who might not otherwise get a retinal exam with a specialist in a timely manner.

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