An article about expensive glasses; truths and myths

I recently read an article about why glasses are so expensive.   While I do agree, at times, glasses can be expensive.  There is a lot more that goes into it and I wanted to clear up some truths vs myths in the article.

Let’s look at the first section I read.

Why are these things so damn expensive?The answer: Because no one is doing anything to prevent a near-monopolistic, $100-billion industry from shamelessly abusing its market power.

As you read further, you will learn the author is referring to Luxottica, or as some know now as EssilorLuxottica.  While EssilorLuxottica is a large player in the optical industry, they do not monopolize the industry.  In addition, Essilor works very hard to keep up with the needs of our eyes, which are changing every day as technology changes.  I’ll talk a little more about that later in the blog.

The true cost of a pair of acetate frames — three pieces of plastic and some bits of metal — is as low as $10, according to some estimates. Check out the prices of Chinese designer knockoffs available online.

Here is another myth.  While there are some frames that may only cost $10 to make, not all plastic or acetate frames fall in the same category.  There is a difference of exactly HOW they are made.  Are they hand-made, where the colors are fused together to give them a unique, quality look?  Did the designer have to design 20 different versions before they found the design that did the proper balance of beauty over optical quality.  Not everyone can design a frame to hold as many different variables of lenses as we ask it to.  It takes design, work, and rework.  Do you pay more for a known celebrity’s name to be on it?  Sometimes yes.  Sometimes no.  Does a brand name up the price?  Again, the answer is no.  Take Ray-Ban frames.  This is a brand known all over the world.  I have had patients come in and say, “Oh, those are Ray-Bans, we can’t afford those” Well Ray-Ban, like so many other brands, have multi level styles of frames.  We have some retailing at $150 and we have some retailing for over $300.  They are all Ray-Bans so why the price difference?  Quality of materials, intricacies of the designs; from the type of hinge to hold everything together to the decals used.  Everything on the frame, even the trim work, the Ray-Ban logo, can affect what price category a particular frame is in.

Lenses require precision work, but they are almost entirely made of plastic and almost all production is automated.

This could be said about almost everything we purchase.  A car is made mostly out of metal and plastic and is automated, why are they expensive?  It amazes me how someone can take something they know NOTHING about and put thoughts like this together to come up with this reasoning.  It doesn’t make sense.

The bottom line: You’re paying a markup on glasses that would make a luxury car dealer blush, with retail costs from start to finish bearing no relation to reality.

This is ABSOLUTELY untrue.  Many optical places put in fair mark ups for products.  While, like every company, you have some who go extravagant and try to make as much money as possible on every little sale there are also those companies who make a fair margin of profit.  Everyone has to make a profit of some kind or they won’t stay in business.  The lights have to stay on.  The 1000 frames you enjoy choosing from in the display all have to be paid for with the hope someone will buy them.  If the buyer makes some bad decisions then the product may be sitting there for a while or might have to be marked down, minimizing the amount of profit the company is making on that frame.  As a consumer, you have every right to go to more than one location to get price quotes, just remember to make sure you are having them price exactly what it is you are getting and you are comparing apples to apples.  For example, I recently quoted a patient a price for Varilux X lenses with Crizal Sapphire 360.  The patient went to a retail establishment and was told their “top of the line” lenses were just as good as the Varilux X.  Their “top of the line” lenses came out for sale back in 2007.  Varilux X lenses came out in 2017.  Tell me how they could POSSIBLY be just as good?  Would you want to go from your brand new, HD television back to watching a television that came out for sale in 2007?  The image will be different.  It comes down to what type of quality you want.

She said soaring eyeglass costs should be a part of the country’s overall healthcare debate in light of the fact that many people simply couldn’t function without corrective lenses.

“At the very least,” Balber said, “there needs to be some transparency about how much things really cost.”

The question I have to this quote is WHY?  Why does there have to be transparency?  Some of the responsibility is on the patient to also educate themselves on what it is they want or need.  I have said all along more money needs to go into the quality of the lenses, not the frame, but so many patients spend more time and money on the frame.  I often ask my patients, what is more important, the pills or the pill bottle?  I do agree  overall healthcare costs are crazy.  When a hospital can bill a patient $6 for a regular bandage with a cost to the hospital of $.10 there is a problem.  In most cases, the optical industry does not have crazy mark-ups like that.   Again, you will find some offices that do.  For example, I worked in a private office that marked frames up 3+ times the cost to them to purchase it.  Did I think it was high?  Yes!  Did I try to discount the frame for the patient?  Yes, I did.  Did I get yelled at for it?  Yes, I did.  How did I get around this problem?  I listened to the owner yell at me, smiled, nodded, and looked for another job.

And because it represents so many different manufacturers and brands, she said, it’s difficult for the association “to make any comments on pricing.”

Of course it is!  Every office has the right to charge what they want.  If you want a small, private office to be in your neighborhood and your average rent for a business space is 10 times greater than going 5 miles in another direction, the cost of the rent has to be paid for somewhere.  Since there is hardly any money made for the optometrists because of how little insurances reimburse them for a comprehensive healthy eye exam, then a lot of private offices have to rely on the profit made with the frames and lenses.  Can a big box retailer sell a single vision pair of glasses cheaper?  Yes, they can because they are buying 1000 sets of lenses a month vs only 100 sets a month or in some cases, 10 sets a month.  Online locations can sell even cheaper yet because they don’t have to pay for an optician, rent, lights, but they also can get away with not worrying about quality because people just assume they may or may not be correct because they were cheap.  I wrote a blog about my experience with an online purchase.

“We often see low-ball retailers promise price savings but fail to deliver the quality patients expect in terms of fit, comfort, durability and, of critical importance, precision in vision, over one or two years of daily wear,” he said.

This is a very good point.  The expectation from patients is to have an amazing pair of glasses at the best price possible.  Sometimes the expectation doesn’t match reality.  I’ve had patients come in expecting to pay $200 for top of the line quality.  Again, not to continue to focus on electronics, but when the phone they are carrying costs $1100 and they only expect to use it 1-3 years, why is there an expectation of GREAT VISION costing only $200.

“Today’s glasses aren’t the glasses of 20 years ago, and the price can reflect these technological advances.”

Fair enough. But with about 126 million American adults wearing prescription glasses, and many replacing those glasses every few years, you have to assume it doesn’t take long for frame and lens makers to recover any R&D costs.

Again, there is some truth to this but just like everything, some of the money you are paying for an item is helping the manufacturers to make an even better product.  When I first started as an optician, the progressive lenses (no line multifocal) were HORRIBLE.  They were a hard design meaning the minute you moved one way or another outside of the correction, you wouldn’t be able to see anything.  The amount of intermediate vision was very minimal.  As computers and tablets became an everyday thing, the demand for more digital friendly lenses increased.  Even with some of the best we have now, patients still want something better.  The something better is coming from the design and testing being done all over the world in order to make an even better progressive lens.  Every time a quality progressive lens is purchased, I can guarantee a fraction of the cost for the optical location to purchase those lenses is going towards the men and women working behind the scenes to make them even better than what we already have.

It won’t. And the more than 1,000% markup for most vision products proves that.

If there is a 1000% mark-up, I can guarantee is isn’t at most of the optical places you are visiting.  I don’t think it is right to throw a number out like it is a fact when there are no basis of truth to it.  Where did the author get that number?  I prefer to deal with facts and this author does not have his facts straight.

Why do glasses cost so damn much?

Because this industry has been getting away with fleecing people for decades.

Again, an opinion of one person with no merit to base it on.

Now, I want to share some true, behind the scenes scenarios we face each and every day in this industry.

Patient A comes in for an eye exam.  Feels it isn’t necessary to fill out all of the medical questions on the form because it’s “just an eye exam”.  The optometrist does a thorough eye exam, writes the prescription.  The patient takes it to a quality optician who fills it correctly.  Patient picks up the glasses and a week or so later, comes back and says, “I can’t see out of these”  The optician double checks to make sure he or she didn’t make a mistake.  Does some other checks and everything is coming out exactly as it should.  They schedule an appointment with the optometrist and learns the patient is on a new medication known to affect vision.  They had only been on it for a week when they came in for the eye exam but now, a month later, has an entirely new prescription.  The patient expects the optical office to remake them at no charge since it’s a new prescription.  The optical shop re-orders the lenses.  The lab makes the new lenses at no charge.  Who should really have to pay for those lenses?  The patient because he or she couldn’t be bothered to indicate all of the medication they are taking?  No, the lab has to eat the cost of those lenses even though they did nothing wrong.  I know you want to say, well that doesn’t happen very often, but it does.  It happens more than you think it would.  So now, not only does the lab have to have enough of a markup to absorb their cost of doing business but also those occasions where they will have to remake lenses at no charge for the office.

Patient B comes in for a pair of eyeglasses with a prescription over 6 months old.  The prescription was written by an outside doctor.  The optician recommends a new eye exam but since it is still technically not expired, they fill it documenting they had recommended a new eye exam since it had been more than 6 months.  (Yes, your eyes can change in 6 months, while rare, it can happen)  The patient picks up the glasses and then three months later they go in for their annual comprehensive eye examination.  The prescription is slightly different because it had been over a year.  They bring the new prescription back to the optical office they purchased from and demand they remake the lenses because “they made them wrong” when, in fact, they did not make them wrong.  The patient’s eye changed.  So the optical department has two choices.  Make a patient mad and refuse to remake them (which they would have the right to do) or remake them for the patient at no charge to keep the patient happy.  Some offices may opt to remake them.  Now, just because they aren’t charging the patient doesn’t mean they aren’t being charged for the lenses from the lab.  They still have to pay the lab for the new lenses.  Again, you would think these are rare incidences, but they are not.  Everyday optical locations have to make a decision between trying to keep a patient happy vs not losing money on a remake.

This is why some locations have such strict remake, refund policies.  Eyeglasses are custom-made to the individual as well as to the frame selected.  Every change done, every prescription change, every measurement change often results in a cost to someone other than the patient.

Insurances do not help the fact.  Here is another example.  Patient has VSP.  They purchase a frame covered in full by their insurance and purchase just the basic lens covered by their insurance.  They have a co-pay of $25.  In reality, even though the frame allowance on VSP is $150, the location may not even make enough to pay for the cost of the frame plus shipping….or make JUST that amount.  VSP isn’t paying the location $150.  They are paying a very small portion of that.  Now, the lenses…….since they are covered in full by the insurance, you would assume the location was receiving the amount the optical location charged for the lenses, right?  WRONG.  They are receiving exactly $25.  VSP will pay the lab for the lenses.  So the office made maybe $35 if they made a $10 profit on the frame, and that is very unlikely.  So $35 for the optician to take the time to help them select a frame, within a certain price range, and do all of the measurements necessary as well as go over any options the patient should consider to help them see better. A good optician won’t compromise quality of care just because the office isn’t making as much money on the sale.  All of this can take up to 30 – 45 minutes depending on the patient.  If every patient was like this, how could an office afford to stay in business.  I’m not picking on VSP, I just want to break down some real truths behind it.  I actually like VSP insurance.  It helps our patients afford the items they want and need to have the best optics available.  I just want everyone to understand your insurance may not pay for everything you need for the best visual outcome.  Sometimes you still have to pay some additional money for a great pair of eyeglasses.

All of this affects the markup of lenses and frames at both the optical shop level as well as the lab level.

Another truth, I work at a location where we don’t focus on heavy markups.  We like to try to keep the products our patients need at an affordable price.  With that being said, there are some product where, if you were to go to locations around us and price out the exact same items, you would find we were cheaper, but we still have patients asking us for a discount.  Our society has become so ingrained in getting discounts where, even when the discounted amount is more than it would cost from some place else, we can’t see the value.

So, David Lazarus….the next time you want to bash an industry without trying to get your facts straight, please leave optical alone.

If you would like to read the original article written in the LA Times by David Lazarus, please click the link below

If you like my blog and want to  learn more about the optical industry as it pertains to you, the patient please subscribe here or follow me on Facebook  @PaulaTheOptician


Ultimate Lens Package Promotion Ending January 31, 2019

I try to be brand neutral for the most part on my site.  I may tell you what brands I like and why, but I also respect there are a lot of different options and what is good for one optician or patient may not be as good for another patient.  I started to share this information just on my Facebook page but decided to put something on here as well.

If you are needing new glasses and can get to a location over the next week to take advantage of this, I highly recommend you do.

The Ultimate Lens Package promotion is ending January 31st. This promotion has been really good for us in the sense that it has helped a lot of our patients be able to purchase two pairs of glasses for an affordable price. It hasn’t been great from a business perspective, which may be why some locations didn’t really like it. It created more work for the opticians, as well as more time spent with the patient without a real fiscal gain. I loved it though because it truly benefited the patient.
Here’s how it worked……if you bought the qualifying items in your first set of glasses, you would get the second set of lenses completely free, you just had to pay for the frame. To help our patients out, we would still give them the second pair discount and give them 20% off their frame. 
There is a single vision option; Eyezen as well as a progressive (no line multifocal) option; Varilux X. It can be combined with insurance. Our VSP patients often took advantage of the promotion.
You do have to get Transitions lenses in the first pair. If you haven’t been a fan of transitions in the past, I would highly recommend the Graphite Green color.  Another option for single vision lens wearer is to go with a fun new color like Sapphire, just pick one that matches your frame colors. If you give the transitions a whirl for 30 days and determine you just don’t like them, because the promotion is sponsored by Essilor, you can have them remade in a clear pair as long as you let the office know in a reasonable amount of time. We generally said between 30-60 days to let us know.
The second pair can be another regular everyday pair with or without transitions, it can be an occupational pair, or a great sunglass complete with polarized lenses, including fun colors like Xperio UV lenses.  Occupational lenses, for those who don’t know, are designed for someone who spends a lot of time focused on the intermediate portion such as reading music or sitting at a desktop computer for long periods of time.  If you are doing that, make sure your optician does a modified version of the Varilux x for your occupational lens, not just do a single vision or even the Essilor computer.  We have the modified Varilux X is more comfortable, especially for those patients who sit and use multiple monitors at work.
It is ending soon so if you’re in the Kansas City Area you can come see me.  You’re also welcome to go see any essilor provider.  To locate an office near you, feel free to use the location finder to find a location this next week to help you.
Please note, while this may seem like an Essilor advertisement, it is not.  I am not getting any compensation for posting this post.  I’m doing it because I feel like it was a great promotion and it’s ending in a week so I wanted to make sure it was known it was ending.   If you are reading this AFTER the promotion ended, I know they have another promotion starting February 1st but it isn’t as great of a deal for the patient.  Always remember to ask your optician if there are any promotions you can take advantage of, especially if you are purchasing multiple pairs.
If you want to stay up on different optical solutions for the consumer / patient, follow me here or like my Facebook page:  @PaulaTheOptician


Purchasing glasses online, missing a key ingredient

I am a bargain shopper. I appreciate a great deal just like any other person. I understand wanting to get the best price for anything. The problem is, sometimes a great deal isn’t what you think it is. Buying glasses online is like baking a chocolate cake without any chocolate. You’re missing a key ingredient; the optician!

Just yesterday I had a patient tell me he never understood how important the optician was in his seeing clearly. He came in to see me about a month ago because he could never see as sharp as he would like to. The optometrist did a complete comprehensive exam, corrected his vision to 20/20 with a new prescription, and referred him to me specifically. He told the patient to tell me what was going on. After talking to the patient for about 10 minutes, we came up with a plan for him. It would ultimately be 3 – 4 pairs of glasses (same amount as he currently had) but he wanted to start with one pair to see if he noticed a difference. When we talked yesterday, he openly said ” I know it’s a different prescription and that helps, but whatever you did….that’s the remarkable difference. I had no clue it was that important to see the right person for my glasses”

Of course I was appreciative of his words. I’m always happy when I can help someone see the best they can. I would like to believe every optician has the same goal.

Back to purchasing online, the optician is taken out of the equation. Let’s first talk about single vision lenses. I decided to purchase a pair of glasses on-line. I really wanted a pair of lime green frames big enough to fit my head. Not an easy task. I had been looking at the lines we carried but none of them had exactly what I was looking for. I finally found a pair and looked to see where I could get them. I saw they could be purchased online from Daniel Waters Eyewear. I won’t include a link because I don’t recommend purchasing glasses online. Now, if you want to take a chance and purchase a frame online because it is the frame you want, and take it to an optician for lenses, I have no issue with it. You are never guaranteed a good fit though so you may end up wasting your money. I know enough about frame sizing and shapes to know this frame was going to fit me.

The frame I chose was by Geek Eyewear

Geek Rad 09 Lime Green
Geek Rad 09 Lime Green Photo courtesy of Geek Rad Eyewear


Now, I ordered my lenses with a simple +.75 in both lenses. I knew I wasn’t going to be using the lenses, I had other plans for these beauties, but I wanted to see just how accurate everything was, so I treated it as if I was going to be wearing them.

The first question asked is for a PD (pupil distance) This measurement is the distance from one pupil to the other pupil. Now, a good optician will always measure this in relation to the center of your bridge because the distance from your bridge to your right pupil and from your bridge to your left pupil may be slightly different. Most of us are not perfectly symmetrical. In my case, I am more than a mm different.

When I put in my PD, I put in 62 which is my PD from pupil to pupil, but remember, I am not symmetrical so my PD for each eye is not 31. I selected single vision distance and regular plastic lenses. All of their lenses come with AR (Anti Reflective) coating. We will talk more about coatings at a different time. As an optician, I would normally take another measurement, an optical center measurement, for a single vision distance order, but it is not possible to do with online orders because you have to be wearing the frame in order to take it.  In theory, when a pair of glasses are complete, the optical center of the eyeglass lens should be directly over your pupil, especially in a single vision, distance only lens.

I placed my order. I received an email asking me which color I wanted. I found that a little odd since I had clicked on the lime green frame when I selected it. I did not see the email right away so it was a day or two more before I responded.

The glasses shipped out the day after I responded. When they arrived, I will admit the presentation was nice. They arrived in a case, a bottle of cleaner, and a lens cleaning cloth. The AR coating was visibly on the lenses.

Daniel Walters Online Purchase
Everything I received with my Daniel Walters order

So the optician in me immediately got to work checking the quality of the glasses.  To make sure the technical aspects are easy to understand, I will give you a little information.  A “B” measurement is the number of millimeters from the top of the lens to the bottom of the lens.  An OC (Optical Center) height should be specified when ordering distance glasses.  When it is not specified, the lab should cut the lenses with the pupil distance horizontally and to the middle of the frame vertically.  The vertical heights should be the same on both sides unless different heights are requested by the optician (again, it can not be done with an online order).   In looking at the picture below, you will see a couple of things.  First, you will see one set of three dots on the right lens (left side of the picture) and two sets of three dots on the left lens (right side of the picture).  As you can clearly see, the dots are not centered vertically in the frame.  They are extremely low.  I will explain how this could affect the wearer a little bit later in this post.  On the left lens, I first marked them up evenly with the right and then I moved the lens to mark it up to where the true actual optical center is.

Daniel Walters Eyewear marked up with optical centers located
Daniel Walters Eyewear marked up with optical centers located

As you can see from the next picture, there is a 4mm difference.  I would actually be ok with the difference (in theory) if it was centered vertically in the frame because then I would just assume they made the right lens wrong, but it isn’t so clearly they just have no care as to where they put the optical center.  Now, to be fair, the distance between one optical center to the other is 63 mm.  Yes, I ordered 62 mm, but the lab is allowed a 1mm variance, so it would be considered good.


Glasses not cut evenly
Optical centers not evenly placed on both lenses – Daniel Walters Online Orders

Next I put the frame on.  As you can see, my actual pupil is above the center of the frame.  This is the case with most frames today because it allows a better fit for progressive (no line bifocal) wearers, which a majority of eyeglass wearers are.  What my pupil is not, is it is not anywhere near the optical center!  If I chose to wear them, I could be causing some issues with my eye called induced prism.

Center of my pupil in comparison to optical centers Online purchase
Center of my pupil in comparison to optical centers – Daniel Walters Eyewear online purchase

Induced prism is complicated.  I don’t want to get too technical on this post because I want everyone to be able to understand it.  Prism bends the light.  Sometimes patients have a need for prism such as a lazy eye or double vision.  Prism moves the optical center of the lens in a way that it forces those muscles to work more so the patient sees evenly (no double vision).  Induced prism occurs when eyeglasses are measured or made wrong, resulting in prism being in the lenses when it wasn’t wanted.  If you are a technical person and want to know more, click here for an interesting article on induced prism.  The amount of prism induced can be calculated by a formula called Prentice Rule.

Center of my pupil in comparison to actual optical center marked up
Center of my pupil in comparison to actual optical center marked up

Prentice’s Rule is something all licensed, certified, or good opticians know and understand.  Prentice’s rule was named after an optician; Charles Prentice.  It is a formula to determine the amount of induced prism in an optical lens.  The formula is simple.  P(prism) = cf/ 100  c is decentration (the distance between the pupil center and the lens’s optical center, in millimetres  f is the lens power.  So taking all of this into account.   P = 5 x .75/100  P = .0375  So, in this pair, it is not even quite half a diopter of prism (prism is discussed in diopters)  That isn’t a lot but imagine if my prescription was a -3.00 instead.  The amount of prism would be quite a bit more.

bad online eyeglass purchase with mark ups
Noticable difference between eyeglass lenses cut and center of pupil – online eyeglass purchase

So, how does all of this affect you?  Prism affects the muscles in your eyes.  First, you have to understand, you may pick up a pair of glasses and have induced prism and you wouldn’t even realize it.  Now some patients can tell right away, they may have a slight double image, they may feel a little dizzy, but depending on the amount of induced prism, you may not even know it’s there.  If you don’t know it’s there, then it’s not a problem, right?  WRONG!!!  The best way I can explain it is, imagine you go to the gym and you’re working out your triceps.  You start out lifting 10 pounds with your left arm only.  You don’t do anything with your right arm.  Then you eventually add 10 pounds to your right arm but whatever you lift with your right, you add 10 more pounds to your left.  You get to 80 pounds with your right so you’re lifting 90 pounds with your left.  Now, you go to lift a 100 pound object and you start out doing great, but your right arm isn’t quite as strong as your left so you feel it inching lower and lower until you are forced to put it down.  The left muscle just got worked differently than your right for too long.

Now, imagine you go to the optometrist for a comprehensive eye exam.  You walk away with a prescription and you take it to an optician who fits you with a great pair of SV distance only lenses, digital, with a smart blue filter because you spend a lot of time on your cell phone and tablet.  They are measured perfectly, you come in to pick them up and you can’t see clearly.  You’re seeing a slight double image.  The optician tries to figure out what’s going on, recheck their measurements, everything is correct.  You make an appointment for a recheck and the double vision isn’t making sense.  Then they have to begin a series of tests to rule out any medical issues because double vision when you don’t have a history or double vision can be caused for a medical alarm.  Your old glasses are rechecked a little more in-depth and it is discovered you’ve been wearing a pair of glasses which have caused induced prism for the last year  / year and a half.  You then have two choices, work with the doctor and the optician to begin the slow process of reversing it, which could end up costing you a little more because you may have to buy a couple sets of lenses over the course of 12 – 18 months OR you have the doctor now prescribe some prism in your new glasses and you will have to always make sure your glasses have prism in them going forward, which means you will have to always go to an optician who is skilled at fitting prism.  All of this time and energy could have been avoided if you would have just had your glasses done by a skilled, professional optician in the first place and not taken the “cheap” route.

In addition, a lot of offices are starting to charge patients a discovery / troubleshooting fee when you purchase your glasses online and you can not see out of them.  Most optometrists will do a prescription recheck on a patient who purchases glasses from another optical location if they did the original exam but some optometrists are saying no, they won’t do it for free if you purchased online because it is resulting in too many patients coming back in and they are finding it isn’t the prescription that is the problem, but it is the way the glasses were made.

This next picture shows an actual pair of glasses purchased by one of my patients (before he was my patient).  He came in because he was struggling to see out of his new glasses.  I marked them up to double-check all measurements and as you can see from the picture, where the center of his pupil sits is not where the center of the lens is and his prescription is a lot higher than +0.75 so he was noticing the difference.

Bad online glasses
Patient’s online purchase indicating his pupil and optical center of lens.

As I said at the beginning, I understand wanting to save a few dollars here and there, but when it comes to your eyes, sometimes it’s a little better to spend a little more on the front side so you’re not dealing with issues later.  Don’t leave the chocolate out of the chocolate cake.  Find a great optician who understand his or her profession really well and trust them to take care of you and your eyes.  As I often say, a prescription is only half the solution, your optician is the other half!  When you purchase online, you take away that key ingredient, the optician!

Have a great day everyone and see the world as clearly as you can! 🤓



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After Cataract Surgery; You have choices and benefits – PaulaTheOptician

Has your optometrist said you need to see an ophthalmologist for a cataract consult? I want to take a minute to break down your options as well Your eyeglass benefits.

Let’s start with the referral   Many times an optometrist refers you to a particular surgeon (Opthalmologist) for a reason, but it’s not always the best reason

Here are a few of the reasons….

1. They are friends with the surgeon.  While it’s not uncommon to recommend people to friends or family in many businesses, sometimes the friend isn’t the best option or might not be a great surgeon in general.  I know an optometrist who referred all of their cataract and lasik candidates to a friend who, in my opinion, had a lot of unhappy patients.

2.  The optometrist is getting a “kickback” from the surgeon for their referrals.  Again, doesn’t mean the surgeon is bad or the optometrist is just out to make extra money.  It’s a concern only if it’s the ONLY reason they are referring to the surgeon.

3.  The optometrist has looked at your individual situation and, after considering the many surgeons they refer to, feel there is one in particular best for you.  This is obviously the best reason a particular surgeon is recommended.

At the end of the day, I still suggest doing some homework on your end as well.  Ask your friends who have already had cataract surgery.  Look at the reviews (if there are any) online.  Understanding you have a choice in the ophthalmologist you see for any surgical needs, not just cataract surgery, is the first step to finding the right one for you.

About a month after your cataract surgery, either your ophthalmologist (or your optometrists) will do a final refraction to determine if you need any eyeglass correction or not.  There are a variety of options when you have cataract surgery now and depending on the options you choose, you may, or may not, need eyeglasses.  If you have Medicare, they will cover the cost of one pair of glasses following cataract surgery.

Here is how that breaks down.  They will cover $65 towards a frame.  Any optical location who bills Medicare for post cataract surgery glasses have to have some frames priced to be covered in full.  This doesn’t mean you will like the selection and you have the right to choose any frame you want, just be aware you will be responsible for any cost of the frame over $65.00.  Medicare will also cover the cost of single vision or lined bi-focal / tri-focal lenses.  Anything above and beyond the basic lens is at your cost.

Post cataract surgery will almost always leave you a little more sensitive to glare and sun so make sure you talk to your optician about a good quality anti reflective coating (no glare) and either a second pair of polarized sunglasses or a custom clip on so you have proper protection. They will cost you a little out of your pocket but your eyes will thank you.

Not everyone will bill Medicare for glasses after cataract surgery. Some places will only bill Medicare if they are your prescribing optometrist or the surgeon who performed the cataract surgery. If your optometrist does NOT bill Medicare for your eyeglass benefit, you are welcome to ask other optical locations. You do not have to fill your prescription at your optometrists office. You can even ask other private offices if they will accept your insurance. There are a lot of reasons offices won’t bill Medicare so don’t feel frustrated. If your surgeon’s office has an optical attached to it, ask them if they bill.

One thing to know is Medicare does not allow for any discounting of any additional items not covered by them. The office isn’t trying to charge you more. This is 100% a Medicare thing. You are always welcome to see if the office offers discounts and would you save more money using their discounts instead of billing Medicare. I know I’m always willing to calculate it both ways for a patient.

The most important thing to remember is you have options. Don’t be afraid to ask!

Have a great day everyone! 🤓

What’s more important? The pills or the pill bottle? Spending your eyeglass dollars correctly – PaulaTheOptician

Selecting the right frame for someone is fun for the most part. There are so many factors I take into consideration, including cost if the patient has expressed a concern about their budget. As an optician, it is my responsibility to make sure the patient can see out of their glasses first and foremost. Sometimes it appears the patient confuses cost of the frame with the quality of their lenses. All too often I have someone come in to see me saying they can’t see and they spent a fortune on their glasses. “The frames alone were $800!” If the frames alone were $800 and you only spent $1000 on your glasses, you probably didn’t get a great pair of glasses. You purchased a beautiful pill bottle.

What is more important? The pills or the pill bottle?

I use this example often with my patients so they can understand the importance of filling their eyeglass prescription with a quality set of lenses first and then, if they don’t have a budget and can spend what they want on the frame, great. If they have a budget then let me help them find a frame within their budget which will also look great and fit well.

Sadly, from experience, I can tell you, not every optician feels this way. Some opticians are not really opticians, they are sales people. They sell you a more expensive frame, tell you you’re getting the best lenses, and then put a progressive lens from 2003 in your frame. You might have trouble seeing but you’ll look amazing!

Imagine going to a pharmacy and the pharmacist saying, I’ll fill your prescription but let’s take a look at these amazing pill bottles you can choose. They range from free to $1000+. I know this is a little over the top because pills only last 30-90 days but I’m trying to stress the importance of focusing Your budgeted dollars in the right direction when cost is a factor.

Don’t get me wrong, anyone who knows me knows how much I LOVE finding the perfect frame and how much I love the unique and whimsical frames. Unique and whimsical in a lower cost isn’t always as easy to find but as the frame buyer at my office, I do try to find them so I can offer them to the patients wanting unique on a budget.

Frames costs range from low to high for a variety of reasons. Sometimes it’s the difference in material, sometimes it is where the parts used in it come from; for example, if a frame has hinges made in Germany vs hinges made in China, the cost may be slightly higher, where the frame is designed, as well as where or how the frame is manufactured. I am not saying NOT to purchase a nice frame. I just want to stress the importance of making sure you are putting the right lenses and features into the frame you selected.

If you have vision benefits such as VSP (Vision Service Plan) or Eyemed, it is important you utilize your benefits as fiscally wise as you can. If you wear contact lenses as well, have the optician price out both ways. It is almost always better to use your benefits for eyeglasses and pay for the contacts.

For progressive lenses, make sure your optician is selecting a lens suited for how you are going to use them. If you are someone who ALWAYS takes their glasses off to drive or watch TV, then talk about an occupational pair of glasses instead of a normal progressive. If you are on a laptop a lot, make sure the progressive lens has a wide intermediate area as well as some type of blue light protection.

It is important to have confidence in your optician. He or she is a crucial part of you seeing the world as clear as possible!

Have a great frame you love? Share a picture of yourself wearing them! I’d love to see them.

Have a great day everyone! 🤓

Photo courtesy of Gabriel

If you like the pill bottles in the picture, please visit the site I found them in by clicking here

Frame Friday – June 22 – Dilli Dalli Collection

Today’s Frame Friday is going to be a little different.  I wanted to stay with the theme of sun protection for your eyes with next Wednesday being National Sunglasses Day.  One of the most forgotten ages for sun protection for the eyes is in infants and toddlers.  On a hot summer day, I see parent’s putting suntan lotion all over the skin, but then, when it comes to protecting their child’s eyes, most don’t even give any thought to it.  I understand it’s a lot easier to put suntan lotion on than it is to get the infant or toddler to keep a pair of sunglasses on, but I want to talk about the importance of it as well as talk about another obstacle faced, getting a pair that fits!

When my friend’s son was born, I wanted to get him a good pair of sunglasses.  I ordered “infant” size ready-made sunglasses and they were horrible.  When he was in his car seat, the pressure from the seat pushed them off his head.  I ordered another pair from a different company and while they were better in the car seat, they still slid off him when we picked him up.

Pre-made ones falling off at the dog park, I'm sporting MyMaui Maui Jim's with Neutral Grey bi-gradient lenses
Pre-made ones falling off at the dog park, I’m sporting MyMaui Maui Jim’s with Neutral Grey bi-gradient lenses

I had worked with Dilli Dalli frames for young children who needed prescription glasses, so I decided to custom make a pair of sunglasses.  We ordered the frame in and then I sent them to the lab to have plano (no prescription) polarized lenses made in them.  I added the scratch coating to give them a two-year warranty but, to be honest, I probably wouldn’t recommend it for an infant because he / she is going to grow out of them before they can scratch them unless you plan on having more children and want to use them for the other infants, I would just do the plano polarized lenses.

First Pair Already too Small - he looks like a little professor!
First Pair Already too Small – he looks like a little professor!

I will admit, I have already had to order a second, larger pair for him and I did put the scratch coat on them because I figured he would be able to wear them a little bit longer.

Dilli Dalli frames come in a variety of sizes from infant to their newly expanded sizing which extends to some 3 and 4 year olds.

DILLI DALLI MUD SLIDE – a new extended size version Photo Credit: Clearvision Optical

You can see the variety of frames, the shapes, and the sizes by clicking here.  The Dilli Dalli frames are soft and comfortable.  When you first put them on the infant or toddler, they won’t like them.  They will pull them off, they will want to play with them.  The best advice I can give any parent or grandparent is to put them on OUTSIDE so the world doesn’t look too dark for the child and then immediately distract them with something to keep their hands busy.  The more they wear them, the better they will get used to them, to the point they will know, if the sunglasses are going on, then they are going outside!  Parent’s of children who have to wear glasses for vision correction go through it all of the time, having to teach their child to leave their glasses on.  It is possible, it just takes some time and some patience.

Now let’s talk about WHY  a good quality pair of sunglasses are so important.  Let’s start with suntan lotion.  WHY do you put suntan lotion on your child(ren)?  Why do you put it on yourself?  Most people say it’s because they know it’s not healthy for the skin to burn.  They want to try to minimize their exposure to the sun.  They want to minimize their chances of getting skin cancer.  The sun damages the eyes AND the skin around the eyes.  Plain and simple.  The same UV damaging your arms and legs is doing the same amount of damage, if not more, to your eyes.  The difference is you don’t always feel the sunburn on your eyes the way you do on your skin and it is not reversible.  It is the beginning of long term damage to the eyes.

YourSightMatters breaks down some of the harmful effects of the sun

  • Photokeratitis— Also known as sunburn of the eye or “snow blindness.” Photokeratitis can cause loss of vision for up to 48 hours.
  • Cataracts— This progressive clouding of the lens of the eye can cause slow vision loss.
  • Pterygium— Commonly known as “surfer’s eye,” this condition causes a growth (not cancerous) on the eye’s surface that can itch, swell and be bothersome. Surgery may be necessary to remove it, but the growth can return.
  • Age-related macular degeneration— UV rays can damage the macula of the eye, which can blur vision and dull colors.
  • Cancer— UV rays can cause cancer of the eye, eyelid or skin

Children with blue eyes, or lighter color eyes, are more susceptible to the sun’s UV than a child with darker eyes, but all eyes can be affected.

Another thing to take into consideration is children spend a lot more time looking up into the sun as they talk to adults or older children than adults do.  Studies have shown half of the lifetime sun exposure occurs in the first twenty years of life. Children are generally outdoors much more than adults.  Many times parents think hats solve the problem of the sun and it doesn’t.  While it may protect somewhat from directly above, it doesn’t take into count the time looking up, as well as the reflected UV from water, sand or concrete.

In the end, it is important for everyone to wear quality polarized lenses when outside.  Just like our skin, the sun doesn’t always have to be completely visible to cause damage.  Teaching a child the importance of sun protection in all factors at a young age will help protect them throughout their lives.

Have a great weekend everyone and stay sun safe! 🤓

Frame Friday – Maui Jim Lava Tube – June 15th

Hey everyone, I think Spring and Summer had a meeting and decided to merge their seasons because it has been HOT!!! While I’m not one to only talk about outdoor lenses (aka sunglasses) when it’s hot, I figured today would be a good day to showcase a new Maui Jim sunglass I am falling in love with. It is the Maui Jim Lava Tube. The one I’m wearing in the video is the Satin Sepia with Maui Sunrise lenses.

I’ve been a fan of Maui Jim sunglasses for years. The clarity is amazing. Colors are sharp. While I’ve tried all of the lenses, my favorite has always been the neutral grey bi-gradient lenses. Today, while I was doing the video I looked around for the first time with the Maui Sunrise lenses and I was pleasantly surprised. The clarity is similar to my grey lenses. They are pretty. The colors were vibrant. I will definitely have to get a pair of the Maui Sunrise lenses!

Maui Jim sunglasses are available in prescription, non- prescription, readers (meaning no prescription on top, just a reading segment on the bottom), and customized. For example, if you wanted a Satin Sepia Lava Tube frame with HCL bronze lenses in them, you could do it. I am always customizing Maui Jims for patients.

Lava Tube Satin Dark Gunmetal
Lava Tube Satin Dark Gunmetal with Blue Hawaii Lenses Photo Credit: Maui Jim

If you like aviator style frames but they just don’t look right on you, the Lava Tube is a nice alternative option. As a modified aviator, it will look good on multiple face shapes. Overall, the new Lava Tube is sharp looking, lightweight, and fits a variety of people, from a larger head, like mine, to a smaller head.

Lava Tube Gold Matte
Lava Tube Gold Matte with HCL Bronze Lenses Photo Credit: Maui Jim
Lava Tube Black Matte
Lava Tube Black Matte with Neutral Gray Lenses Photo Credit: Maui Jim

I hope you liked today’s Frame Friday and have a great weekend! 🤓