Archive for the ‘Private Practice Doctors’ Category

Helping out ForSight in York, PA

Jill N. is a member of VSP's Corporate Public Relations team.

Jill N. is a member of VSP's Corporate Public Relations team.

VSP network Dr. Dennis Delp of Shiloh Eye Care Center in York, PA, has been volunteering his time once a week for the last 20 years with ForSight Vision Center, a not-for-profit serving its community by providing quality, specialized services and opportunities designed to prevent, prepare for and manage loss of vision.

Dr. Delp volunteered with us during our fifth community event providing exams with the clinic back in November of 2007 and we were happy to partner with him again last month when he called to ask for our support of during this important inaugural event with ForSight. Listen to Dr. Delp as he speaks to the results of the event and the impact it had on the community.

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Do You See Floaters?

Joel Kestenbaum O.D. is a VSP provider in Long Island, NY.

Joel Kestenbaum O.D. is a VSP provider in Long Island, NY.

Today we welcome VSP provider Joel Kestenbaum, O.D. from Long Island N.Y. His guest blog gives an overview of those annoying floating spots we sometimes see …

Often patients either complain of or casually mention that they see little floating spots in front of their eyes.  They are described as worms, dust, feathers, spiders, mites, flies on a wall, or just plain floaters.  What makes these floaters and why do we see them?

Did you ever put your hand in front of a beam of light and see its projection on a screen? Lets think of the inside of the eye just like the inside of a movie theater.  If you stand up and get in the way of the projection, you are seen as a shadow on the screen.  In the same way, if something gets in the way of the beam of light coming into the eye, the image is projected onto the retina, the eyes’ movie screen, and seen as a floater with a particular shape.

Where do floaters come from?  This is a complicated question and there are two basic answers:

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Burning, itching & watery eyes? You may have Computer Vision Syndrome.

Joel Kestenbaum O.D. is a VSP provider in Long Island, NY.

Joel Kestenbaum O.D. is a VSP provider in Long Island, NY.

Today we welcome VSP provider Joel Kestenbaum, O.D. from Long Island N.Y. His guest blog gives an overview of Computer Vision Syndrome (CVS) and tips to resolve CVS symptoms.

Everyday patients complain of blurred vision and burning or itchy eyes. More often than not, these people are spending overwhelming amounts of time at the computer at work and at home.  They are developing Computer Vision Syndrome (CVS).

Practicing healthy computer vision hygiene is just as important as brushing your teeth and taking a shower … and its results can dramatically improve your comfort and productivity at work.

Here are a few simple steps to keep your vision healthy starting with the “20/20/20 Rule.What’s with all the 20′s?  It goes a little something like this.

  • 20 minutes using the computer- in which you focus intently upon the screen.
  • 20 second break – take a 20 second break after you have focused on the screen for 20 minutes
  • 20 feet away – focus your eyes upon something roughly 20 feet away for this 20-second break.

What happens if you use the computer for long periods of time without a break?

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    Photo courtesy of Indiana University.

  1. Headaches
  2. Neck and upper back aches
  3. Blurry vision during and after computer use
  4. Eye strain, possibly causing changes in vision
  5. Burning, itching and watery eyes
  6. Overall loss of short-term focus until eyes adjust.

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Rob Lynch discusses the importance of vision benefits on healthnewsdigest.com.

Rob Lynch

Rob Lynch

VSP Global CEO Rob Lynch co-authored an opinion piece for healthnewsdigest.com discussing how stand-alone ancillary benefits, such as vision and dental, provide an essential component of healthcare that should be included in any comprehensive healthcare reform efforts.

Here is an excerpt from the article:

“The current proposal could have significant cost consequences for the medical delivery system. Dental and vision benefits play a critical role in improving the health of Americans and reducing the overall cost of chronic disease. With chronic disease representing 75 percent of the total U.S. spending on health care, few know that optometrists and dentists have the ability to detect symptoms of diseases such as diabetes, hypertension and heart disease, much earlier than primary care providers. Moreover, it is well established that Americans with dental and vision coverage are more likely to go to the dentist and optometrist or ophthalmologist for regular preventive care and obtain needed early treatment related to dental or optical conditions, as well as other chronic diseases which can be detected through these regular visits.”

Read the entire article—we’d love to hear what you think.

 

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Eyes bigger than your stomach? Maybe they've just been dilated.

David Kisling, O.D.

Dr. David Kisling is a VSP doctor practicing in Fort Collins, CO.

Dr. David Kisling, a VSP network doctor, returns for his second guest blog. Today’s post addresses one of the most challenging portions of an eye exam—dilation of your eyes.

Does an hour appointment with your optometrist turn into a full day of discomfort due to the pupil dilation? Have you wondered why you have to endure this glaring assault on your eyes? If you have ever tried looking through a peephole in your front door to see if it is a friend or foe knocking on the door, you have some idea of the difficulty of looking inside an eye. You have to get very close to the tiny peephole, squeeze one eye shut, and even then you have a very limited view. Think how much easier it the would be if there were holes for both eyes the size of a silver dollar! When examining the retina, the tissue lining the back of your eye, having the equivalent of a silver dollar size opening allows a much more thorough check of your eye health.

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What’s in a puff? The eye-puff test demystified.

We welcome Dr. David Kisling, a VSP network doctor and guest blogger, as he demystifies parts of an eye exam. Today’s post addresses the unsettling eye-puff test; stay tuned next week as he discusses dilation.

Non-Contact Tonometer aka the Eye Puff Test. Photo thanks to: http://www.university-eyecare.org.au.

Non-Contact Tonometer a.k.a the Eye-Puff Test.

Why do some people procrastinate on scheduling regular eye exams? That dreaded puff of air that makes you cringe in anticipation could be the reason. That little puff, (and it has become smaller and more gentle as technology has evolved) is measuring the fluid pressure inside the eye. There is fluid constantly being produced in your eye and a drainage system that ferries it back into the bloodstream. When the drainage system malfunctions, the pressure inside the eye starts to rise. We know from large-scale studies that keeping the eye pressure low enough helps prevent loss of sight. High pressure acts to dampen the circulation to the optic nerve and cause a slow, painless loss of vision. Over 50% of the nerve may be dead before you become aware of the loss of vision, so annual eye pressure checks are good, preventative medicine.

Instruments used to measure eye pressure are referred to as tonometers. The first tonometer was invented in 1861, but the introduction of the indentation tonometer in 1905  was the true beginning of measuring eye pressures. Patients who have had the experience of this type of tonometer pressing on their eye with small weights actually look forward to that puff of air. A new type of tonometer was introduced in 1951 that was much more accurate due to the lighter touch and lower tendency to alter the eye fluid’s normal distribution. This tonometer replaced the indentation tonometer and is still used today.

In the late 1950′s, Bernard Grolman, O.D., a member of the Research and Development Group at the American Optical Read more »

My Favorite Sights

Tamiko M. is a member of VSP's Provider Services team.

Tamiko M. is a member of VSP's Provider Services team.

Some memories are stored through sound. Saturday mornings as a child – Earth, Wind & Fire over the hum of my mother’s vacuum, Don Cornelius wishing me “love, peace and soul”. Other memories are tied to taste. Pittsburgh, PA – perfect pillows of pierogi or the surprising balance of tang and salt in a Primanti  Bros. sandwich.

Though all of my senses impact the way I experience the world, vision seals the deal. Most of my favorite moments were experienced overwhelmingly through vision.

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  • The first view of my children
  • Michelangelo’s David
  • The big smile from the cute stranger who would become my husband.
  • Exploring Mauna Kea – an elusive blooming silver sword, snow boarders, the sun setting behind the clouds, Saturn’s rings from a telescope!

A life this rich requires vision. For my best chance at new sights I have an annual comprehensive eye exam with my private practice VSP eye doctor. I also work to maintain my overall health to keep my risk for diabetes, a leading cause of blindness, low. I hope you will too.

I would love to hear about (and see) your favorite visual experiences. Do you have photos to share? E-mail us! You may see your photos here.

Are You an Andrea?

Tamiko M. is a member of VSP's Provider Services Team.

Tamiko M. is a member of VSP's Provider Services Team.

“Thank you for calling Dr.’s Keddington and Kalra. This is Andrea. I’m so glad you called; how can I help you?”. That’s how I’m greeted by Andrea when calling a San Diego area optometric practice. So happy I called – really? What a way to set the stage. I can hear her smile through the phone. And she walks the talk. I’ve visited the practice, met with the staff, interacted with a doctor – everyone follows through on the expectation that Andrea sets. The doctors and staff don’t take their patients and business partners for granted.

Andrea from Drs. Keddington and Kalra.

Andrea from Drs. Keddington and Kalra.

At VSP we take service seriously. In my work in Provider Relations I meet with doctors and their staff members regularly. The most common feedback? “You guys provide great customer service!” (or some similar comment). The service that our providers receive from our Customer Service Representatives sets the bar high for me. Customer Service is my Andrea – they frame the expectations that providers have of me. In these difficult economic times, more than ever, I know that I can’t afford to take the loyalty and hard work of our providers for granted.

I’m glad there are “Andreas” on my team. Does your business have an Andrea? Tell us about her (or him!).

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VSP Global + VSP Doctors = Success

VSP Global launched today at the American Optometric Association annual meeting. Steve Baker, Chief Technology Officer of Eyefinity/OfficeMate provides a guest blog post on the positive impacts.

Steve B. is Chief Technology Officer for Eyefinity/OfficeMate.

Steve B. is Chief Technology Officer for Eyefinity/OfficeMate.

I love cycling. It’s a great sport that also affords an opportunity to get away from television and media in general. It seems that ever day I’m pelted with new brands. Products. Companies; Services. You name it. I can hardly keep up with it but every now and then something exciting and unique comes along that grabs my attention. Well, I’d like to share with you something that I hope grabs you like it did me … The VSP Global brand.

We recently announced a new brand that ties together all of our diverse companies. Pulling together industry leading companies like Marchon and Eyefinity/OfficeMate enables our companies to be much much more than just the sum of our individual parts. We can offer integrated products in benefit programs, the latest in frame fashion, advanced optical lab services, and technically superior business management solutions. The best part? Working together we can create fantastic and unique programs that you will benefit from. Here’s two quick examples:

EyeHealthCheck+: Want to increase patient satisfaction and grow your revenue? VSP doctors can jump into this program that gives them access to Optos‘ retinal imaging technology at great pricing. New optomap installations also come with a free ExamWRITER equipment integration software license for OfficeMate users.

Healthcare Technology Program: VSP doctors who are looking to update their old software but are unsure of the price can take advantage of this risk-free offer from VSP Global through Eyefinity/OfficeMate which gives current OfficeMate users ExamWRITER electronic medical records at no initial software license fee, and gives first time users the whole package: OfficeMate Suite or OfficeMate Enterprise with ExamWRITER at no initial software license fee. This offer will prepare VSP doctors to take advantage of federal stimulus money which will become available to eyecare professionals who use electronic medical records. How great is that?

We’re hard at work developing new programs that leverage all of the companies under the VSP Global brand. Check out the latest video

Drop me a line on your feedback. I’d love to hear from you, especially if you love cycling!

~Steve


Fire the Optician, My Glasses are Late

Patti S. is a member of the Ophthalmic Operations division at VSP.

Patti S. is a member of the Ophthalmic Operations division at VSP.

The advent of the one-hour optical shops announced to the spectacle-buying world that a complete pair of eyeglasses can be churned out in an hour. Anyone visiting a mall or with access to advertising media will be able to attest to the fact that these purveyors exist and do make good on their promise most of the time. So why, you might ask, is it that you are asked to wait 7-10 business days for your order when visiting an independent eye doctor? A bigger “why” might be posed when something unforeseen happens and that 7-10 day estimate turns into an unfulfilled dream and you are left waiting even longer, lamenting your poor vision and cursing the beings responsible for the delay.

A pair of lenses can quite easily be cut to fit a frame and mounted within minutes if your prescription is simple and you order single vision lenses. The mechanics of this process are fairly straightforward, especially with newer, more technologically advanced equipment. This is not to suggest that skill isn’t necessary, just that newer equipment improves accuracy and speeds up the process. The majority of prescriptions, however, require that the power is ground into the lens through a step called “surfacing.” Surfacing doesn’t take very long either. Most independent doctors with onsite labs have the equipment to finish (cut and fit lenses to a frame) lenses but have to send orders to a wholesale lab when surfacing is required. One-hour optical retailers have surfacing equipment in-house, if they provide this service on all prescription types.

Manufacturers produce many types of “finished” single vision lenses in stripped down versions as well as those with premium options, such as anti-reflective coatings. A finished lens is one that is molded with all powers intact—not to be confused with the act of finishing, which cuts lenses to fit a frame. Doctors who finish lenses in their office will stock the single-vision products with which they are most confident and fit most frequently. They also maintain relationships with labs able to provide the full spectrum of lenses they favor. Lenses that require surfacing come in all materials, colors, and with virtually any treatment. Retailers specializing in expedited service keep an inventory of what they anticipate they will sell and have the ability to control what patients are offered because of their integrated model. They also know the frame models available through their dispensary, lending a degree of familiarity to their technicians, which contributes to the ability to offer such quick turn-around times.

Wholesale labs produce lenses for many customers and by necessity must be able to accommodate the varied product preferences and visual impairments of the doctors, opticians, and patients they serve. Consequently, they stock a broader range of lenses and accept almost any frame model. Although they can reasonably forecast what will be ordered, there are no guarantees. The benefit is that doctors and opticians can offer patients a full array of lens designs, materials, and treatments available, knowing that full-service wholesale labs will likely be able to fill their request. If the lens is not in stock, most can be ordered and received quickly, often the next day. These labs also have access to a network of sub-contract facilities able to produce specialty coatings and treatments.

The delivery estimates presented by independent practitioners differ from location to location, but it is fairly safe to say many still quote 7 to 10 business days. Most orders will be returned within this period, many sooner, and others later—sometimes much later. It is important to note that delayed orders are the exception. Wholesale labs wouldn’t stay in business very long if they couldn’t turn orders out, on average, within a few days. It is also worthwhile to understand that as technology advances, finer and more specialized products become available. Most often, this means slightly longer processing times, but it is well worth the wait. Still, the increase in turn-around time required for your highly personalized premium pair of lenses doesn’t always explain what sometimes appears to be an excessive delay, especially if you didn’t order something that necessitates subcontracting to a distant galaxy.

If lens surfacing and finishing processes are relatively simple and access to facilities able to apply treatments so convenient, why should there ever be any extended delays? There are a plethora of answers to that question. Nevertheless, a basic understanding of what typically goes wrong will address the most common issues and hopefully convey to you how unique your order is and why lens fabrication is an art in spite of the refined technology that enables precision surfacing and finishing.

Lens prescriptions have multiple components and typically can include one to many of the following elements: sphere, cylinder, axis, add, prism, and prism direction. The power of your prescription is measured in diopters, which occur in 1/8 diopter steps. There really is no limit to power, but most are less than +/-10.00, which is a pretty hefty correction but can go much higher. Sphere, cylinder, and add are measured this way (adds usually top out at about +4.00 and are only in plus powers). There are 180° of axis and prism (measured in prism diopters) is really not capped, but usually runs less than 4 or 5. Some conditions also affect factors like lens thickness, attachments, and whether lenses will be transparent or frosted, among other things. Then there are specific measurements, such as how far apart your pupils are and where in the frame an optical center or multi-focal height measurement will be located. A conservative idea as to the number of possibilities is 4.6 million, based only on what is really a limited assortment of prescription possibilities (no prism, add, or anything funky) and considering only one eye. Add prism power up to 5 diopters and 12 add powers and there are 612 million possibilities.

Your prescription and other measurements influence how your lenses will fit into a frame. One of the reasons delays occur is because the unique elements of your order, alone or in combination, affect how lenses work with a mounting. Not all frames are equal and certainly not all frames are suitable for all corrections. When a lab receives an order, they may be able to identify a problem job immediately and notify the doctor, who will in turn let you know that you should pick another frame. If this happens, you should do it, even if it’s the only chartreuse striped frame with an attached elephant nose in the western United States. Just do it and cry your bitter tears in silence.

Sometimes a lab will attempt the order and end up breaking the lenses or possibly the frame. In the latter situation, they have to reorder the frame and wait. If they break lenses that were ordered specifically for the job, they will need to reorder and wait, otherwise a new pair will be pulled from inventory. Depending on the lab and their relationship with the doctor, they may continue to try. If the frame is an unfamiliar model, there may be unforeseen pitfalls and you are the lucky trendsetter whose selection provides the education. Rest contentedly knowing that you helped the next patient selecting this frame get his or her spectacles back in a couple of days. Most unfortunate are the times, when after several attempts, it becomes apparent that either the frame is not suitable for ophthalmic use or that there is no acceptable way to mount your prescription in it.

There are any number of other causes for breakage, which will all add extra time to the delivery date. Higher-powered lenses are more prone to breakage. Equipment failures cause breakages and slippery coatings can allow lenses to slip during processing. A coating may not adhere correctly or in some other way your order fails quality control. The excuse nobody ever wants to hear is that someone made a MISTAKE! Yes, it happens to the best of us. Labs employ people and from time to time, they goof up. The most skilled technician will break lenses on occasion.

Frame and/or lens backorders are another factor contributing to longer waits. Labs have no control over this, but can and do offer alternatives. If your chartreuse striped frame with an attached elephant nose is on backorder, you might want to opt for the one with mouse-ears instead if you have an imminent job interview and want to look your best. If a lens is backordered, the lab will notify the doctor. Alternatives will be suggested, so if you’re not the sort of person who freaks out at the slightest change in lens design, you should consider going with the lab and doctor’s recommendation. If you are the super-sensitive type, remember that although designs do differ, many have similar characteristics and your doctor or optician can probably identify something comparable or the same design in another material.

The advantages of seeing a private practice doctor are many, among which is the golden opportunity to have access to the latest and greatest in coatings. Anti-reflection [AR] coatings are a must to those of us who make our living in this industry. Many of us actually turn away in embarrassment if caught in a pair of old beaters without AR. We also know that many of the premium coatings are more expensive, but well worth every penny and require 2 additional days to process—if the coating chamber is onsite. If not, add a day to get to the subcontract lab and one to return to the originating lab, thus bumping your wait time up 4 days. Other premium services and some unusual prescriptions require orders to be subcontracted. This is true regardless of whether you patronize a one-hour retail establishment or a private doctor.

The accuracy of the information about your spectacle lens order is imperative, so when there is any doubt about your measurements, prescription, materials ordered, or frame, the lab will call your doctor. If anything prevents contact with your doctor’s office, such as holidays, weekends, vacations, or simply an inability to connect, the job will be on hold until your information is confirmed. Again, we are dealing with the human element and wherever people and handwriting are at play, the need for confirmation is bound to arise from time to time.

Are these potential problems reason not to order glasses from a private practice doctor? No. All the potential delay-inducing circumstances that can frustrate you when your glasses don’t come in on time can happen at the one-hour place. The difference is that they usually promote the products carried onsite. If the materials for your order are not stocked in the store, your glasses won’t be on your face in 60 minutes. If any of the other problems mentioned above plague your spectacles, you probably won’t get them in that time either. Will they get most out on time? Yes. That is their business model and like the wholesale lab, they must perform according to the reasonable expectations their customers have.

Private practice doctors’ patients must have reasonable expectations as well. It’s a trade off much like buying ice-cream from a convenience store versus hitting the major supermarket. I can run into my local 7/11 and pick up a carton of chocolate, vanilla, or maybe choose from a few other flavors and be home in five minutes. I might have a limited selection and pay a little more, but in addition to ice-cream, I was shopping for instant gratification. On the other hand, I could go to the full-service grocery store and wander down the frozen confections aisle for hours locating the perfect combination of flavor, fat content, and price before heading home. It will take longer, but I will get what I want (even if I don’t know what it is when I embark upon this self-gratifying journey), and if lamb and banana is the hot new flavor, that will be my indulgence. I could run into lines or encounter other delays at either location, but my experience will usually be consistent with my expectations.

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