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Monthly Newsletter - Tips & Reviews. Volume 1. June 2005

Business Tip: Staff
This month we will focus on what staff want and what we as proprietors can do to enthuse and inspire them.  What is key to this process, is that our valuable staff have expectations, that if not met will demoralise them. The challenge for us is to provide something extra that they were not expecting.The positive energy this can create will lead straight into your bottom line. Read on for more.




O2Optix Website

CIBA Vision's unique O2OPTIX material, lotrafilcon B, contains 33% water, with a permanent surface treatment to assure wettability for for comfort and a surface that is resistant to deposits. It is the healthy choice for daily or occasional over-night wear.

Therapeutic Review: Allergies
With the coming change of season, it is more common for our patients to encounter the "itchy, burnies".  This is usually attributable to seasonal hayfever and allergies.  Often our patients seek treatment via the GP and are placed on oral antihistamines.  This sometimes fixes one problem and creates another: dry eye.

Our product of choice is Systane. This product is unique because it bonds to the tear film requiring less instillations.  It is more convenient that the single dose minims.More Detail.


Product Review: Customised Multifocals
Rodenstock has released its latest generation multifocal the Impression ILT (Intelligent Lens Technology).  It has now become our premium lens of choice
Read on and find out why.


Business Tips: Staff

Time and time again, Nicole and I hear the same comment:

"Why do I feel that my staff do not support me? If only I had better staff my business would thrive!"

This is probably true, but maybe we already have the appropriate staff. Should we not be asking ourselves this question:

"Why should they support us? What is in it for them?"

The following are things to think about when feeling let down by your staff.

  • Do you respect them and their skills?
  • Do you recognize their efforts frequently?
  • Are you equally fair to all employees?
  • Are you paying them at least the average salary? Believe it or not the salary, as long as it is average, is not the highest of priorities.
  • Do you delegate responsibilities?
  • Do you involve them in the consultation process? We have found that one of the most satisfying activities of their day is the preliminary testing process. We delegate IOP, auto-refractor, visual fields, digital images of the retina, corneal topography and insertion and removal of contact lenses to our optical dispensers. They absolutely love it!
  • Think about what the most boring part of your day is. Probably the refraction. It's the other stuff that is interesting. Variety is the spice of life.  Involve your staff in everything. Your life will be a lot easier and the staff will appreciate it.

Because staff issues are so important we will expand further on this in next months newsletter.  It is something we need to get right so that your staff create synergy and do no create an energy drain.  Stay tuned.

Register for Business 2005.(coming soon)

We will concentrate on staff and take home business tips that are bound to increase your efficiency and your bottom line.



Recognise your staffs effort!



Therapeutic Review: Allergies

Seasonal allergies are very common. Especially with the change of season in Autumn and of course Spring. The classic symptoms are bilateral itching, watery/mucoid discharge, venous congestion and papillae. Often it is associated with nasal hayfever.

  • Where possible I tend to avoid over-the-counter medications. This is because I feel it tends to undervalue my input. Product of choice is Patanol. It is an antihistamine with mast cell stabilising properties.  It is used twice a day but requires a prescription.
  • For the non-therapeutic states, you will find your local GP will be more than happy to see your patient and write them the Rx.
  • Often I also prescribe cold compresses in combination with the drops. What I have found best are the hot/cold packs, which are also used for sporting injuries. These are kept in the freezer, so they are ready to go.
  • Remember to wrap them once in a tea-towel as the extreme cold can burn the tender skin around the eyes.
  • In severe cases I also kick-start treatment with a mild steroid like Flarex or FML.
  • For the non-therapeutic states you will find your local GP will possibly be reluctant to prescribe topical steroids.
  • Over the years I have been successful in getting the GP's to trust my judgement.  It has not been easy, as it takes a comprehensive referral letter, with a diagnosis and the whole treatment plan. You then need to assure the doctor that you will diligently follow-up the patient with measuring their IOP to rule out steroid induced glaucoma.

Topical steroids deserve a whole days seminar.

Register for the Anterior Segment 2005 or for Ocular Therapeutics 2006 (coming soon), which will devote a number of hours each to the diligent use of topical steroids. Stay tuned to future newsletters, as topical steroids will often be recommended.

Learn about steroid induced glaucoma and the latest in glaucoma technology by: Registering for Glaucoma 2005 (Sunday 21st August)






Porsche frames position our practice to the business professional.
Get your patients to test drive this premium product.  It's success in our practice has amazed us


Aquify with its unique antibacterial case now is our solution of choice.  Stay tuned for a review on this great product soon.



Product Review: Impression ILT (Multifocal by Rodenstock)

For the last few years when we have had a difficult prescription, or a difficult patient, our lens of choice was the Rodenstock Multigressive.  In comparison to other multifocals it was streets ahead.  We had it reserved as a premium lens and would only consider it if we had a patient with high astigmatism.  What an ignorant decision!

We were ignorant because we did not understand how much better this lens was.  It was only when one of the Rodenstock reps presented to our practice staff, that we finally understood the unique properties of this technology.  A number of assumptions were made in regard to the pantoscopic tilt, vertex distance and face form.  The practitioner would supply mono pds etc and the disadvantages of regular multifocals were eliminated by an atoric prescription surface individually optimised for every power combination.  This created over one million possible options.

Once we understood what this lens had to offer we gradually increased its usage but it wasn't until the release of the Impression ILT and Impression ILT XS that we were really amazed.  Now there were literally an infinite number of possiblities.

What ultimately won me over were two different prescriptions.  One was for an unsuccessful keratoconic patient, whose Rx was:

R/ +1.00 -5.00 x65

L/ +4.00 -5.50 x 127

Add: +2.00

This gentleman had tried multifocals a few times unsuccessully.  The distortions were unbearable.  I had to talk him into the product, as he was convinced he would fail.  He was so amazed that he then came back and bought a second clear pair and a separate pair of multifocal sunglasses.

The other was for my mother-in-law:

R/ plano -1.00 x 80

L/ -0.25 -1.00 x 160

Add: +2.25

She could not even wear SV distance glasses to walk around with, due to the anisekonia induced by the astigmatism being nearly 90 degrees apart between the eyes.  I have been having grief with her prescription for over 15 years and here was the first pair of glasses that she could walk around in!

This lens technology requires measurement of:

  1. Mono PDs - with conventional multifocals most reading areas are decentred 2.5mm.  This assumes that every patient converges by 5mm from distance to near.  We all know this is incorrect and many of us would fudge the distance PD to make sure the near PD was roughly right.
  2. Vertex Distance
  3. Pantoscopic Tilt
  4. Face Form Angle

These extra measurements even though might seem a nuisance, add tremendous value to the patients perception.  The analogy we use, is that we are tailor making these spectacles like an expert tailor.  We can prescribe and dispense an off the rack product, or we can tailor make it specifically for them.  When presented in this way, most patients choose the custom made product.

One disadvantage that supressed our usage of this product to begin with was that it takes about 10 days to deliver, as it is manufacturered in Germany.  Our perception was wrong though.  Most patients felt that was a great delivery time considering the product was being specifically manufacturered for them.  Again the tailor made suit analogy helps.  Normally when I make a suit I will attend two fittings and the process takes a minimum of 3 weeks, so why should the glasses be any quicker.

Do patients and yourself a favour.  Start prescribing this great technology immediately.  It is guaranteed to give your practice the edge over the competition.  Once your patients have experienced distortion and restriction free vision for the first time, they will thank you and never put up with conventional multifocals again.

Apparently Rodenstock are releasing custom made SV lenses and an even better multifocal after ODMA.  I find this hard to believe, but the way this lens has improved over the Multigressive I guess anything is possible.











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