Meet the Growing Challenge: Treating Macular Degeneration

Our aging population is providing more cases of macular degeneration. Serve this growing need by discussing UV protection and lifestyle changes, and by providing early detection and early treatment. Technology is advancing; educate yourself on improved detection and treatment options.

With the Baby Boomer generation (those between 1946-1964) aging into senior citizens, macular degeneration is increasingly being diagnosed.  Taking steps to prevent and treat macular degeneration is the right thing to do, but it also is a great practice builder as you are providing services vital to the health of your community.

Institute Screening for all Patients

Patients who have a family history of macular degeneration are the most susceptible to this disease, but with the occurrence of it so common today, you should screen all patients. Take a baseline digital retinal photo and then review the image with patients letting them know if and where you see potential for disease inside their eyes. Point out details such as their optic nerve, the blood vessels and macula. Create a policy to photograph the retina at each annual exam (similar to a dentist requiring an x-ray annually), and, more frequently if they have diabetic or hypertensive retinopathy, AMD or a retinal hole, tear or degeneration that should be monitored more frequently. That way, everyone is screened and that creates an ideal opportunity to discuss prevention of potentially blinding eye diseases, like AMD and glaucoma with annual eye examinations, good nutrition and protecting the retina from UV damage. You can charge for the photo taken and advise the patient there will be a charge. You can participate with Medicare and Horizon BCBS for medically based eyecare. The billing code is 92250 and the diagnosis would be 362.57 (drusen) or 362.51 (dry AMD).

You shoulde explain the effect that ultra violet radiation has on this part of the eye and why it is important for patients to protect their eyes from the sun with quality sunwear.

Educate Nutrition and Personal Habits

In addition to explaining the importance of sun protection, you can point out how smoking triples the risk of developing AMD.  Explain the importance diet plays in prevention. For instance, according to the Mayo Clinic, eating kale, spinach, broccoli, peas and other vegetables, which have high levels of antioxidants, including lutein and zeaxanthin, may also reduce the risk of macular degeneration.

Talk Supplements

In addition to protecting eyes through the use of quality sunwear, a better diet and avoiding smoking, you should recommend that all patients, and especially those who are 50 and over, or those with a family history of macular degeneration, take MacuHealth, a macular degeneration-focused nutraceutical. The script has a toll-free number patients can call; it is $75 for a 90-day supply. Macuhealth is only available through a Doctor of Optometry or Ophthalmology or by dialing the toll-free number on the Rx pad. It is NOT available in drugstores or on other web sites.

Educate that in an Era of Electronic Screens, All Are At Risk

More research needs to be conducted in this area, but evidence is beginning to emerge that the blue light emitted from electronic devices like laptops and mobile devices, along with the light emitted from compact fluorescent (CFL) lightbulbs, increases macular degeneration risk. This is one more reason to take precautions regardless of your age or family history. Explaining the possible role these modern forms of light play in increasing macular degeneration risk, you can also emphasize the importance of annual comprehensive examinations in protecting eye health.


How Do You Price Free Form Progressive Lenses?

Freeform progressives are commanding top dollar at many optometric practices, according to The Vision Council November 2012 Eye Care Professional Report. The most expensive progressive lenses being dispensed were free form progressives which sold on average for $413.14. Free form progressives were less expensive at smaller practices. Practices with only one location sold free form progressives for an average of $402.93, while practices with more than five locations sold free forms for $436.82 on average–over $30 more per pair. Free forms were also more expensive in the Midwest region of the US than other regions ($431.60 in the Midwest vs. $382.39 in the Mountain-Pacific region.


How freeform progressive lenses are doing in your practice?

If you have an average practice, you are seeing 2,200 patients for exams with refractions per year per doctor. Approximately 60 percent are getting eyeglasses–that would be 1,320 people (eg: .6 x 2,200 = 1,320). Of the 1,320 people who get glasses, approximately 50 percent are single vision and 50 percent are multifocals. That means 660 potential pairs of freeform progressive lenses per year could be sold in your practice.

How Satisfied Are Patients With Exams at Independent OD vs. Chains?

Independent ODs are leaving a more favorable impression with patients than corporate-owned optometry chains, according to Jobson Optical Research’s 2012 Adult Consumer Eye Exam Experience. Fewer consumers who had an exam at a chain in the last six months strongly agreed with the statement that overall they were satisfied with the eye exam experience compared to those who had an exam at an independent in the last six months (45.3% and 58.1% respectfully). Indeed, just under half of those consumers who had an eye exam at a chain in the last six months (46%) said the exam was thorough, compared to 58.9% of those consumers who had an eye exam at an independent in the last six months.

Among consumers who had their eye exam at a chain in the last six months, 53.4% said they were extremely likely to return to the same place for their next eye exam. By comparison, 70.7% of those who had their eye exam at an independent in the last six months said they were extremely likely to return to the same place for their next exam.

Of the respondents who had their exam at an independent in the last six months, 63.5% reported that they are currently covered by a type of managed vision care or vision insurance plan. This is greater than the 53.9% who have a vision plan and chose to have their eye exam at a chain in the last six months.

iMatrix Launches Web Marketing Services for ODs and Dentists

Internet Matrix, Inc., (iMatrix) announced its expansion into online marketing for optometrists and dentists. iMatrix, based in San Diego’s Sorrento Valley, revealed that it will now offer optometric and dental web marketing solutions that include professionally designed web sites, social media management, video marketing, PPC advertising, and their advanced search engine optimization service called Dominator. According to a company spokesperson, the new online marketing services are designed to equip optometrists and dentists with the tools needed to reach a broader audience of potential patients online and increase local market share.

Optometrists now have a new resource for online marketing services. Optometry web marketing services are now being offered by iMatrix and are tailored to meet the needs of the optometry industry. The new services provided by iMatrix are Starter, Social, Media, Velocity and Dominator.

According to iMatrix, the Starter Service includes a professionally designed web site with a structure that is optimized for search engine crawlers. In the Social Service, social media for dentists or optometrists is included with the professional web site. The next service level up from Social is the Media Service, which includes the customizable web site and social media management, as well as video marketing for optometrists and dentists. The top two levels of web marketing services provided for dentists and optometrists are Velocity and Dominator. Velocity builds on all the features of Starter, Social and Media, adding pay-per-click (PPC) advertising and re-targeting campaigns. The premier-level service offered by iMatrix is Dominator, which encompasses an optimized web site, social media management, video and video advertising, PPC and custom SEO management.

Optometric practices that are interested in these new services can view demonstrations of the services or live chat with an internet consultant through the company’s web site:

Who Does Better Financially? Solo ODs or ODs in Partnerships?

Optometrists who practice alone are up against greater financial odds than those in partnerships. Annual income for solo doctors averaged $144,125 last year. But ODs in partnership or group practices averaged $191,195—a difference of nearly 33%. Like other doctors, the report surmises, optometrists are under an ever-growing pressure to invest more in technological and practice costs; group practices can share these expenses and take advantage of efficiencies of scale. That can translate to more profit.

Net is an interesting topic in the optometry world. There are actually two different “nets” we should discuss.

The Optometric Net is calculated by adding together all dollars paid to all optometrists (both employed optometrists and owner optometrists) for working in the practice plus any money left over after paying all other expenses. This is the number that is traditionally referred to as the “Net” in optometry. This practice is unique to optometrists.

A True Net is calculated by subtracting all expenses including what it costs to have optometrists in the practice from all money collected. This is the number that all other businesses in the world (except optometric practices) use to judge fiscal health.


Money collected-Cost of Goods-Payroll-Occupancy-Marketing-Overhead=Optometric Net-Optometric Payroll=True Net

You need to know both numbers, the Optometric Net and the True Net. There are a two major reasons: tax consequences and future consequences.

It matters, from a tax perspective, how you remove income from a practice. This is a discussion you should have with your tax planner as soon as possible. It is your responsibility to pay any taxes that are appropriate, but if you have not had the discussion of how best to remove money from the practice with your tax planner, then that conversation needs to be scheduled now.

As the owner of the practice, how do you know how much you are going to be paid?  If you are just waiting to see how much money is left over and that becomes your “payroll” amount, then you are not treating your practice as a business. Hiring an optometrist to work in your practice is a business expense. If you are working in the practice, then you need to be hired by the practice to do that work. Every business needs to know its true expenses. You need to know yours.

Management & Business Academy Staff Management Survey 2012 Now Available

The Management & Business Academy, sponsored by Alcon and Essilor, have released the Staff Management Survey: 2012. This resource features findings regarding staff hiring, compensation and management practices and OD desires for staff improvements.


Here are several of the survey’s key findings:


•Employment of non-OD staff by independent practice ODs increased 6 percent during the year ending June 2012, a rebound from a sluggish hiring environment during 2010, when optometric staffs increased by just 2 percent. Thirty-nine percent of practices added one or more staff members during the past year, while just 11 percent decreased their staff.
• Larger practices (nine or more staff members with an estimated $1 million+ annual gross revenue) account for 72 percent of current non-OD staff employment and were more likely to add staff during the past year. Larger practices accounted for 78 percent of the new hires for the year ending June, 2012.
• Average staff turnover in optometric practices was 14 percent over the past year, a decline from the 17 percent turnover ratio experienced in 2010 and the 20 percent ratio in the pre-recession 2007-2008 period. Presumably, in a high unemployment economy staff is less likely to seek new positions. Turnover is lower in larger practices, in which average staff turnover is 12 percent annually. Sixty-five percent of practices experienced some turnover during the past year. Thirty percent currently have one or more open positions. Thirty-six percent of staff members leaving optometric practices during the past year were terminated.
• Personal referrals are the leading source of new hires for optometric practices, accounting for 43 percent of people hired. Internet listings are the second largest source, accounting for 26 percent of new hires. Use of newspaper ads to attract candidates continued to decline in 2012. Larger and smaller practices acquire new employees in similar ways.

Vision Loans Program Receives Additional $10 Million in Funding from Essilor and VSP Vision Care

Essilor of America, Inc., and VSP Vision Care announced that they each have committed an additional $5 million in funding to the Vision Loans Program, which supports independent eyecare professionals (ECPs) by providing loans to optometrists looking to finance first-time practice purchases, partnership buy-ins and refinancing options.

The Vision Loans Program is a joint effort between Vision One Credit Union, Essilor and VSP. Since its launch in 2003, the program has distributed nearly $58 million in financial support to optometrists who want to enter private practice and those who want to successfully transition out. All loan payments are reinvested back into the program to ensure the continued success and growth of private practice optometry. “Supporting the Vision Loans Program is an important way for us to help optometrists remain independent and competitive in this changing marketplace,” says Howard Purcell, OD, vice-president of Customer Development at Essilor.

“The dynamics of the optometric practice today present some unique challenges to graduating ECPs.This added commitment will help thousands more enter private practice, and we are glad to provide that support.” Vision Loans provide funds for first-time buyers interested in:

Partnership Buy-ins: To purchase an ownership interest in an existing practice.

Practice Purchases: In conjunction with existing Vision One loan programs to purchase 100 percent of a private practice.

Down Payments: In conjunction with seller financing when purchasing up to 100 percent of a private practice.

Practice Refinance: Available for debt used as initial start-up or purchase of a private practice. “Innovative offerings like the Vision Loans Program help make certain that independent optometry can grow and renew itself year after year,” says VSP Global’s Chairman of the Board Stuart Thomas, OD. “We’re committed to exploring and supporting initiatives that keep independent ECPs thriving.”

Despite an uncertain economic outlook, Vision One says that demand for the program remains strong due to the unique capital loan access it provides, which can be difficult to obtain through traditional bank lenders. In fact, since the beginning of the recession, over $37 million in practice purchase loans have been funded.

For more information about Vision Loans, contact Vision One Credit Union’s lending division at 800-327-2628 or