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This is far behind the foreign market rate of 50% to 99% penetration. Why is this? Common reasons may be the ECP is wary of the new coats due to past failure rates of AR coatings, an incomplete understanding of the way AR works and the benefits it provides, or they are unsure how to present the product to the patient in an effective way.

What is Anti-Reflective Coating? 
Anti-Reflective (AR) coating is a series of layers that is adhered to the back and front surface of a lens, or just the back if the lens is polarized, to help reduce the amount of reflections on the lens. Consisting of metal oxides, each layer is a thin film that is designed to block a specific wavelength of light. The more layers of film, the more wavelengths that are blocked. Working by the destructive interference, AR causes the light that reflects from the inner and outer surfaces of each film layer to become equal, thereby canceling each other out. 

Coatings of Today
Gone are the days of single layer AR coatings that craze, scratch or smudge easily. Today’s premium AR coatings have extra hard coatings that increase its scratch resistance, as well as oleophobic, hydrophobic and anti-static layers that help repel oil, water, and dust. Not only do these layers decrease the amount of debris and dirt that stick to the lens, but they also make the lenses easier to clean and thereby reduce surface scratches from excessive cleaning. 

• Oleophobic layers are especially important with the multilayer coatings because the more effective the coating, the more likely it is to show smudges.
  

• Hydrophobic layers are thin layers of silicone that is placed on top of the AR. It provides a smooth surface that decreases the wetting angle of the lens. The result is that liquids form small beads that can be easily removed from the lens. 
  

• When oleophobic and hydrophobic layers are used together, they create a seal that acts as a secondary scratch coat. 
  

• Anti-static or Electro Magnetic Interference (EMI) layers are place on the lens to prevent static build up. By reducing static on the lens, airborne particles are a lot less likely to be attracted to the lens and adhere to it.
  

• Premium AR coatings are actually bonded to the lens surface, becoming one with the lens. This decreases the likelihood of crazing that was a problem with earlier AR coats.

Reaping the Benefits
Now, how does all this scientific data actually help the patient? Well, AR allows 8% more light to enter the eye. The result is clearer, sharper vision and reduced eyestrain, which would benefit everyone, however in some situations, the benefits are more noticeable.

• Occupational - Fluorescent lighting, computers, cash registers, etc, all cause an increase of reflections in the workplace. This increase in reflections causes eyestrain, headaches, fatigue and a decrease in work productivity. 
  

• Night driving - External reflections are a major problem when it comes to driving safely at night. The reflections from oncoming headlights, streetlamps, and the road can cause distractions and discomfort to the driver. Internal reflections can cause ghost images and result in a decrease in reaction time.
  

• Sunwear - Backside AR can eliminate a couple of problems related to sunwear. First is the annoying image of the eye that is reflected in the center of the lens and can be very distracting. The second is the glare hazard that is caused by the mirror effect of a dark lens. With sun lenses, light from behind the wearer can be reflected directly into the eye from the back of the lens surface causing discomfort. Be sure not to place AR on the front surface of a polarized lens because it affects the polarization process and can reduce the darkness of the polarized lens by as much as 8%.
  

• Cosmetic - Shakespeare once said, “The eyes are the window to the soul.” If reflections are inhibiting eye contact and eye visibility, much can be lost. AR coating enhances not only the appearance of the patient but can increase the effectiveness of communication by enabling better eye contact.

Premium AR coatings on the Market
Getting premium AR coatings are easier than ever. Several manufacturers have developed AR coatings that work best with their lens substrates. Some of the most common manufacturers and their AR coatings are:

Hoya and HiVision has developed a process that matches the index of the coating to the individual lens substrate and sandwiches it between a super hard scratch resistant coating and a hydrophobic top layer.
Essilor has a family of AR coatings under the Crizal name. The newest member of that family is Crizal Avance with Scotch Guard. Crizal coatings go through an eight step process that combines super scratch resistance with hydrophobic, oleophobic and antistatic topcoats to the AR coat.

Seiko has a patented AR coating called Super Clean AR. It has a super hyprophobic top coat, a high index non-tintable hard coat, and a high index shock absorbent primer. The result is an AR that repels dust, dirt and grime and is easier than ever to clean. It is found on the Seiko 1.74 and 1.67 hi index lenses. In their Pentax family of lenses, Seiko has developed the Surpass ECP AR coating. Surpass combines hydrophobic and oleophobic layers to create a super top coat that prevent AR deterioration from temperature fluctuations, UV, and humidity. 

Carl Zeiss has a wide range of AR coatings available. In the Sola line, the AR is Teflon with clear coat. In the Zeiss line, AR coat is available with either the Carat family of AR coats or the ET family of AR coats. The newest member of the Carat family, Carat Advantage has a new super hydrophobic coating.

Recommending AR to the Patient
Although some surveys show that 60% of patients would purchase AR coated lenses, only about 25% of them do. It is up to the ECP to bridge this gap. The easiest way to prove the benefit of AR coating is to demonstrate it. 

With this in mind, everyone in the dispensary should be wearing the product. It is hard to tell a patient that the product will benefit them if the ECP doesn’t believe in the product enough to wear it. 
Also, seeing is believing when it comes to a product, so be sure that there are multiple types of AR displays available in the practice. These displays should show a specific benefit of the product. Very effective types of displays include:

• The doughnut. The doughnut is a plano lens with AR coating applied just to the center. When placed against a dark background, it is very easy to see the difference in the amount of light reflected between the coated and uncoated portions.
  

• Glasses with a coated lens and a non coated lens. This display is very effective for the fashion conscious consumer because it really highlights the cosmetic benefits to the patient, so be sure to place it in a stylish frame. With this display, the patient can see how the coating will actually look when being worn.
  

• An oleophobic/hydrophobic lens and a permanent marker. Patients are familiar with permanent markers so they are impressed when the ink of the marker beads up on the coating and is easily wiped off without leaving a mark.

A word of caution, although everyone can benefit from AR coated lenses, AR coating does not work well under certain environmental conditions. If a patient works in an extremely dusty environment, it would probably benefit them to buy a second pair of occupational glasses without AR coating applied to the lenses. Also, be sure to explain proper care and cleaning - as detailed by the manufacturer - so that the patient can get the longest possible life out of the lenses.

AR coatings are the icing on the cake when it comes to lenses. They enable the wearer to see things clearer, reduce eyestrain, increase productivity as well as participate in activities more safely. With all these benefits, it is important to recommend AR to every patient. By believing in the product and showing the benefit, the ECP can provide their patient with the care they deserve.

Carrie Wilson
BS, LDO, ABOAC, NCLEC