By the time you read this month's installment, we will have a new President. I hope your guy won! If your candidate was the loser, you can comfort yourself in the knowledge that the other candidate will end up screwing things up just as bad as your guy would have. Don't worry though, you are in a somewhat recession proof profession. To quote an instructor that I had while going through the US Army School of Opticianry, "There are two things that everyone needs, an Optician and a Mortician, and most people will want to see before they die!" 

There are several ways to further recession proof yourself. In my opinion, one of the best ways is to be able to educate the patients that you deal with every day. The point that I'm getting at is that the patients you come in contact with every day - will at times - ask more questions of you than the doctor. For whatever reason, many of the patients will feel more comfortable talking to you, especially if they are unsure of what the doctor meant by a term or diagnosis. That being said, you need to be able to answer their questions, by doing so you will build trust with the patients and become an indispensable part of their eye care experience.

Cataract in Human Eye

Understanding and being able to explain (in laymen terms) some of the more common eye diseases and disorders can be very useful. I have had the great fortune of being able to work for an Ophthalmologist over the last 5 years and have encountered things that I would have never seen working in a retail environment. Because of this experience, I am better able to serve my patient's needs, even if those needs are just a simple explanation and some reassurance. Over the next couple of months I hope to introduce you to some of these diseases and disorders so that you can pass this information along to your patients. The first one I am covering is cataracts. 

A cataract is a clouding that develops in the crystalline lens of the eye or in its envelope, varying in degree from slight to complete opacity and obstructing the passage of light. Early in the development of age-related cataract, the power of the lens may be increased, causing near-sightedness (myopia) and the gradual yellowing and opacification of the lens may reduce the perception of blue colors. Cataracts typically progress slowly to cause vision loss and are potentially blinding if untreated.

Cataracts develop from a variety of reasons, including long-term ultraviolet exposure, exposure to radiation, secondary effects of diseases such as diabetes, hypertension and advanced age; they are usually a result of denaturation of lens proteins. Genetic factors are often a cause of congenital cataracts and positive family history may also play a role in predisposing someone to cataracts at an earlier age, a phenomenon of "anticipation" in pre-senile cataracts. 

Cataracts may also be produced by eye injury or physical trauma. A study among air pilots in Iceland showed that commercial airline pilots are three times more likely to develop cataracts as people with non-flying jobs. This is thought to be caused by excessive exposure to radiation coming from outer space. Cataracts are also unusually common in persons exposed to infrared radiation, such as glassblowers who suffer from "exfoliation syndrome." Exposure to microwave radiation can also cause cataracts.
There are various types of cataract, e.g. nuclear, cortical, mature, hypermature. Cataracts are also classified by their location, e.g. posterior (classically due to steroid use) and anterior (common cataract related to aging).When a cataract is sufficiently developed to be removed by surgery, the most effective and common treatment is to make an incision (capsulotomy) into the capsule of the cloudy lens in order to surgically remove the lens. There are two types of eye surgery that can be used to remove cataracts: extra-capsular (extracapsular cataract extraction or ECCE) and intra-capsular (intracapsular cataract extraction, or ICCE).

Some of the things that you may want to let the patients know are that colors will be much more vivid, lights will appear brighter, and the glare that they have been experiencing at night should be lessened to some extent. Because of the perception of the light being brighter, you may want to advise you patients to purchase a pair of prescription polarized sun wear. Also, this is a great time to introduce your patients to anti-reflective coatings. I can't count the number of times that I have had a patient elect not to get an anti-reflective coating on their glasses after cataract surgery, only to bring them back because they can't see as well with their glasses as they should. The prescription would be accurate, but they have gotten used to life without the glare from the cataract. 

One of the newest things that you may get some questions about is the new multifocal IOL (intra-ocular lens). With the traditional lens, the patient's distance vision is corrected (to a large extent), but they still need a pair of multifocal spectacles as their near vision is uncorrected. With the multifocal IOL, the patient has their distance as well as near vision corrected. That being said, not all multifocal IOLs are made the same. Some correct the near vision better (14-16 inches), and some correct the midrange better (18-24 inches). 

It is great to be able to talk to your patients about their concerns and options, but make sure you have the patient talk to their Doctor about these and any other questions they may have. You should go one step further and inform the Doctor about the conversation and the things that you have told the patient.

If you have any questions or comments, just drop me a line. As always, take care of your patients and send the customers to the other guy!

Paul R. King, ABOC/NCLEC LDO is an independent consultant specializing retail optical laboratory
and sales training and also works as an opti­cian for Tri-State Vision in Cincinnati, Ohio  asktheking@ECPmag.com