Tag: opd

Automated Refraction System Was “Practice-Changing” – An Article From Women in Optometry

Original Article Published in Women in Optometry
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Of her three exam lanes at Vision Source of Brandon, in Brandon, Florida, owner Laura Vizzari, OD, avoided one. It was the only one of the three that didn’t have a Marco TRS automated refraction system in it. “I was embarrassed to bring patients into it because they were used to advanced technology. It would have felt like a less-than experience for them,” she says.

But using it as a dilation-only room or for consultations made her realize that was ineffective. “I realized I couldn’t avoid the room anymore,” so she added the TRS to it and now has three fully functional exam spaces that she and her associate can use.

Her focus on improving the patient experience and capabilities of this practice has been at the top of her list since she acquired it in 2004, when it was an optical shop. “There was nothing else to it, so I completely rebuilt it with a focus on high-end frames and high-tech instruments,” she says.

Components of the TRS automated refraction system - a table and automated phoropter
The TRS automated refraction system

She moved to a larger location in 2007, but she continued to work with a manual phoropter until 2012, when she added the TRS and the OPD-Scan III. Five years later, she added a second TRS system in a second lane.

“Even though we’ve been using this system for more than a decade, patients continue to be impressed with it,” she says. “I’m surprised at how often people say, ‘Remember when you used to have all those dials?’ It’s almost ancient history, but they remember that. The wow factor stays strong with this technology,” she says.

“HERE’S YOUR CHANGE”

One of the most helpful aspects of the TRS system in terms of patient flow is how easy it is to show patients the difference between their old prescription and the one from that day’s exam. “Patients want to know if there’s a change, so I can show them what the difference is. Now I can tell them, ‘If you can see a difference, then you can benefit from new eyeglasses.’ It’s amazing how much a 0.25D change can make for some people,” she says.

She knows that from personal experience. She just tweaked her own prescription for a 0.25 degree of astigmatism. “I’m really surprised by the impact. I can see so much more clearly, even with such a small numerical change,” she says.

By doing phoria testing and binocular balance with all patients, she can arrive at a more customized prescription, too. “All I do is hit one button and the chart changes. Overall, it takes less time to get to a precise prescription,” she says. It’s very helpful, she says, because “I’m ruling something out, or I’ll find new information because I chose that extra test. Patients routinely tell me they’ve never had such a thorough exam.”

These features helped increase her sales of eyewear, and it also helps get patients out of the exam lane more quickly and into the optical. If patients set aside a certain amount of time for their annual exam, the more quickly she can achieve an accurate prescription, the more time they can shift to picking out their new eyewear.

A GREAT STARTING POINT

OPD-Scan III instrument
Marco OPD-Scan III

As a part of every exam, patients stop at the Marco OPD-Scan III Visual System, a combination autorefractor, keratometer, corneal topographer, pupillometer and wavefront aberrometer. “I look at that data first,” Dr. Vizzari says. “Before I start the exam, I want to see data on their eyeglasses, their vision and their OPD. It helps me know whether I’m expecting a big change or if there’s something unusual and the data doesn’t match. It allows me to start thinking about keratoconus or know what other questions to ask,” she says.

This data is also very useful as a patient education tool. “I can show them a picture and say, ‘This is why I cannot make your vision perfect.’ Or it’s an opening to talk about specialty contact lenses,” for example, she says.

Dr. Vizzari says the amount of time that she saves with each patient compared to the days of using a manual phoropter are significant. For now, the doctors are doing the refractions, but she sees the opportunity for training a licensed optician to do the testing. “As I’m trying to expand the practice, that may be one way of increasing efficiency,” she says.

But she says she cannot imagine why some doctors are hesitant about adding the technology. “I’m surprised when I talk with a colleague who doesn’t have it. I tell them, ‘Just do it. It’s practice-changing.”

As someone who has changed the nature of an eye care business, from a generic optical shop to a full-service, high-tech primary eye care practice, she knows how much difference the right equipment can make.

Read other WO stories from Marco here.

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Fast, Efficient Refractions Allow Doctor Time for Deeper Discussions

One of the first investments that Michelle McReynolds, OD, made when she opened cold was with the Marco OPD Scan III Wavefront Aberrometer and TRS automated refraction system. “I was looking for anything that would make my work faster because I didn’t have a technician when I first opened. It was just me doing everything,” she recalls. She opened West County Vision Center in St. Louis, Missouri, in 2011.

Being able to have a system that could streamline everything from keratometry and refraction and transfer the data to her Revolution electronic health records system made everything easier. “In fact, I’m still using the same TRS and OPD that I purchased then. I’ve not had any issues with that equipment,” she says.

However, she has expanded the usage of it. As she got busier and equipped a second exam lane, she installed a second TRS system. “Once you have it, it would be hard to go back to a manual phoropter,” she says. “I knew that if I didn’t add the TRS to the second exam room, I wouldn’t want to use that room.”

Being streamlined is just as important now as it was in the beginning. When she opened, her mother worked her front desk, and she had an optician. Now she has two full-time front staff, a technician and optician, and she is looking to expand. “We’re busier than we’ve ever been, and I’m booking two months out,” she says.

Good data from the start

So she is grateful for the technology that helps her save time and provide excellent data on each patient. Patients interact with the Marco technology right at the start of their experience. In the pretest room, they sit at the OPD Scan III, which serves as a combination autorefractor, keratometer and topographer. “So many patients comment that they haven’t seen technology like this before,” she says.

Based on the data that Dr. McReynolds gains from the OPD, she can make decisions about the patient’s care plan. “I have detected a lot of early keratoconus, since we do a topography on every patient. The OPD obtains a topography automatically,” she says, noting that she can recommend crosslinking to help slow down the progression of keratoconus.

After those patients have been referred out for crosslinking treatment, she can fit them with scleral lenses if necessary. “I also love that I can show patients their cataracts with the retro illumination image. I can point to the dark opacities on the image and explain that I might not be able to correct their vision to 20/20 due to the opacities in the cataract,” for example, she says.

Refractions made easier

As patients move into the exam room, they continue to be impressed by the technology she has brought in. “Patients make comments about how high-tech everything is. I love being able to say to patients at the end of the exam, ‘This is the prescription you had, and this is what I’m getting today.’ Showing them is so much better than me trying to explain what a half diopter increase or decrease means.”

Toggling between the old and new prescription, patients can decide for themselves whether they want to purchase new eyewear. She can even use it to add validity to a complaint by a patient who says night driving is more challenging. The OPD will indicate if the patient needs a stronger prescription for night verses during the day.

Dr. McReynolds says that she enjoys the refractions process. “Optometry was founded on doing refractions, and I get a lot of satisfaction knowing that I am getting the best possible results for my patients. Plus, patients feel the refraction is an extremely important part of the exam.”

But because she relies on the technology to support her findings, she can also use that time to talk with patients about other concerns or conditions. “I’m talking to them throughout the refraction and listening to how they respond,” she says.

iON boosts education

More recently, Dr. McReynolds added the iON imaging system from Marco and has found that it helps her with her rigid gas permeable (RGP) fits and patient education. She can capture video of the RGP lens on the eye and upload it to her specialty lens consultant. “That helps a lot,” she says.

For patients with foreign bodies or oil gland dysfunction, she has also found that the video image helps them understand their condition better. “If they can see what I am looking at, they are more motivated to follow my treatment recommendations. Patients tell me, ‘No one has ever explained that to me.’”

The value of that comprehensive exam and customized solution is as important to her today as it was on the day she first opened.

Article originally published in Vision Source OD magazine. Learn more about Vision Source here.

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More Data, More Quickly

With the Marco OPD-Scan III wavefront aberrometer and the VisuALL virtual reality visual field perimeter, Rachel Tellez, OD, of San Antonio, Texas, captures more information on each patient. The systems talk to each other, so staff members don’t have to load data manually. And Dr. Tellez has all the topography and perimetry data right on her screen.

Since the VisuALL system is portable and allows the user to perform several tests without having to move the patient from one machine to another, that system has also sped up the data-gathering process. “Within a minute or less, the refraction, keratometry and topography are all on one screen, showing both eyes, much faster than compared to performing these tests with three separate instruments,” Dr. Tellez says.

Article originally published in Vision Source OD magazine. Learn more about Vision Source here.

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The Power of the Current and New Prescription Toggle Switch

After about nine years of having an automated refraction system in the practice, Heavin Maier, OD, of Eyes for Life in Spokane, Washington, couldn’t imagine practicing without it. When she added another lane of equipment, the Marco TRS Refraction System was part of that. “It’s part of our standard operating protocol now. The flow works well,” she says. She has other Marco technology in her practice, and it adds to the overall efficiency when the equipment “speaks” through the card system that moves patient data from the lensmeter and OPD Scan III Wavefront Aberrometer to the TRS system.

Patients as decision-makers

What she loves about the process is the ease with which patients can make the decision on whether new eyewear will benefit them. “I hated having to dial in the prescription manually and show patients what the difference was between their current and new prescriptions. Keeping track of axis and cylinder and sphere shift was mind-boggling,” she says.

With the Marco equipment, it’s a simple toggle switch. “I can show them each eye individually, or I can show it as two eyes together,” she says.

She appreciates that it’s not up to her to make a judgment call or try to convince a patient that a prescription change is “big enough” to warrant new eyewear. “There have even been patients where I think they cannot possibly notice this change, but they immediately say, ‘Oh, that’s so much better.’”

When patients are assured that the new prescription will help them see more clearly or more comfortably, they’re happy to make the purchase.

The patient experience

It’s important, too, that patients see that the practice invests in the patient experience. Since nearly all patients engage with the OPD and TRS systems, new patients have the immediate perception that the practice isn’t outdated or old-fashioned with its technology.

Goodbye, shoulder pain

Dr. Maier has been in practice for 19 years. “Within the first year of practicing, my shoulder was killing me,” she recalls. She began wondering whether the cost of doing manual refractions was going to involve her own comfort and shoulder mobility. “After switching to the TRS system, I realized that I was no longer in pain at the end of the day, so that’s priceless. I cannot imagine why there are doctors wrecking their shoulders,” she says.

She has gotten good support from her Marco team, and she credits Marco President Jocelyn Hamilton as a true professional committed to helping doctors succeed.

Dr. Maier says that she would have a very difficult time going back to a manual system. The Marco equipment she has provides her with a solid starting point for her prescriptions, and she uses that to achieve her endpoint more quickly. It saves her time showing patients the difference between old and new prescriptions and improves patient engagement in their own care decisions when changes in the prescription are numerically small. And she can walk out of her building at the end of the day without her shoulder throbbing.

Article originally published in Vision Source OD magazine. Learn more about Vision Source here.

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“Nearly Instantaneous” ROI on Marco Technology

Claudio Lagunas, OD, is a builder of practices. He has owned nine—with four at one time—but now has just two. One is his established practice in Woodlands, Texas. He and his wife Grisel Lagunas, OD, recently acquired an existing practice in Spring, Texas, when the opportunity was too good not to jump at it.

In order to grow a practice so that it becomes more profitable and efficient, Dr. Lagunas invests in technology. In his practice in Woodlands, there is an OPD3 wavefront system from Marco that he put in nearly 18 years ago. Then about seven years ago, he added the TRS refraction system. “I needed shoulder surgery, and I wanted to be proactive about protecting my other shoulder by being able to sit down and be comfortable versus reaching up and spinning the dial,” he says.

The surgery went well, and he regained full functionality. An associate, he jokes, “commandeered” the one exam lane he had converted to a fully digital system. He had been OK with that because he felt like he was completing exams efficiently with a manual phoropter. But as the doctors are building a new location to move that practice into, “all of our new lanes will be digital with the Marco systems as their quality and durability can’t be matched,” he says.

The six ODs in the larger Woodlands office cover the 50 hours a week that practice is open. In the smaller practice, there are four ODs. Creating efficiency and moving patients through the exam process more quickly result in additional time that patients can spend in the optical and help open the schedule for a few more patient exams.

In addition, the TRS includes what he calls “the money button” — a toggle switch that allows the patient to compare their current prescription with the one derived that day. “Patients can justify the purchase of their new eyewear more easily when they see that there’s a difference. It has increased our multiple pair sales and our capture rate,” he says.

Metrics he needs

What he most appreciates about the OPD-Scan III is its five-in-one functionality and space-saving design. It is an autorefractor, keratometer, pupillometer, corneal topographer and integrated wavefront aberrometer that captures diagnostic measurements in less than 10 seconds per eye.

That helps the doctors determine whether there are aberrations that might make a soft contact lens unsuitable. “Using the wavefront analysis, we can see right away if a soft lens isn’t going to work and can steer the patient to a specialty lens fit,” he says. And then they don’t have to rely on a series of empirical fittings to get to the final fit. “As doctors, we look really good when we can get the specialty lens fi t right from the start,” he says.

Exceeding expectations

For these two pieces of instrumentation, Dr. Lagunas says that the return on investment was “nearly instantaneous.” He justifies that by noting that they make the exams more efficient and quicker, allowing doctors to fit more patients into the day. They minimize transcription or other errors, virtually eliminating remakes due to this kind of mistake. They have helped increase the number of contact lens specialty fits and the capture rate.

With the remote control function now available that can allow doctors to operate the equipment remotely, the implications for being able to “see” patients in other locations or if the doctor is not onsite add to the appeal.

Dr. Lagunas has also added the Olleyes VisuALL from Marco, which helps him consolidate equipment into a single, portable headset. “We will be using this more extensively in our new location. It allows us to bring in virtual field testing without sacrificing floor space or efficiencies,” he says. He can also run these tests without having to dedicate a dark room to this testing. Since it’s so portable, the patient doesn’t have to be as mobile, or a test can be done in the exam room rather than taking the time to move the patient in and out of a special testing area. “In small locations, every square foot counts, so multifunction equipment is a benefit.”

These investments in technology are important to his patients, too. “They like to hear what we’ve added since their last visit,” he says. While some of the specialty instruments that he brings in are used only for patients with certain conditions, every patient sits at the OPD and many experience the TRS autorefraction system, too. They enjoy the experience and the knowledge that they are benefitting from technology that is going to help the doctor deliver the most customized visual solution for them.

Article originally published in Vision Source OD magazine. Learn more about Vision Source here.

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Automated Refractions Make Exams Faster And Easier – An Article From Women in Optometry

Original Article Published in Women in Optometry
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Automated system for refractions brings physical relief, too.

Since opening her own practice in 2003, Rachel Tellez, OD, has moved Vision Source Leon Springs in San Antonio, Texas, into a newer location just a few hundred feet away, seen patients grow and bring in children of their own and added an associate OD.

Something that has continually aided the practice’s growth, she says, has been the Marco technologies that bring efficiencies to the exam process. For the first almost 30 years of her career, Dr. Tellez utilized an old-fashioned, bulky phoropter that required her to spend much of her days with her arms outstretched, spinning dials.

Dr. Tellez—a regular at physical therapy with two bad shoulders—read a colleague’s account of using an automated refraction system. A visit to The Exchange®, the Vision Source annual meeting, in 2016, held in her hometown that year, solidified her decision to update her lanes with the Marco TRS-6100 Automated Refraction System with Infinity Remote Software.

“I only updated one lane and kept the old phoropter around in case we ever needed it,” Dr. Tellez says. “It didn’t take me long before I realized we needed the same equipment in our other two lanes. I was never going back.” Rather than relegating her other exam lanes to
second-tier status because she didn’t OD want to use them, she added the Marco equipment to both. The advantages were immediate.

THE WOW FACTOR

Patients who have been seeing Dr. Tellez for years are able to experience some of the high-tech instrumentation. Every patient sits at the Marco TRS, so they all appreciate the change from the stress of having to answer questions about clarity of numbers.

FASTER REFRACTIONS 

With the process of obtaining the refractive correction more quickly, Dr. Tellez and the patient have more time to talk about other ocular health issues, the need for backup eyewear, dry eye treatments or other concerns the patient may have. Or the patient is able to get into the optical area faster to pick out their new eyewear.

MORE DATA, MORE QUICKLY

With the OPD-Scan III Wavefront Aberrometer and the VisuALL virtual reality visual field perimeter, Dr. Tellez captures more information on each patient. The systems talk to each other, so staff members don’t have to load data manually. And Dr. Tellez has all the topography and perimetry data right on her screen.

Since the VisuALL system is portable and allows the user to perform several tests without having to move the patient from one machine to another, that system has also sped up the data-gathering process. “Within a minute or less, the refraction, keratometry and topography are all on one screen, showing both eyes, much faster than compared to performing these tests with three separate instruments,” Dr. Tellez says.

She easily can find results that are automatically saved onto a data card and then transferred into the TRS. “We don’t have to input the data manually, which increases accuracy and definitely saves time,” she says.

PATIENT CHOICE

It’s challenging for any doctor to determine whether a small refractive change means that the patient “needs” new eyeglasses. The OPD screen features side-by-side comparisons so
patients can compare their current prescription to the one she derived that day. This puts the decision on whether new eyewear is worth it in the patient’s hands. Even small
refractive changes can make a big difference to some patients, and if they decide that’s the case, they feel great about buying new eyewear.

SHORT LEARNING CURVE

Dr. Tellez says that technology mastery is not one of her strongest suits, but within 15 minutes of sitting down with her Marco representative, she felt confident with the technology and what it could do. Patients also appreciate how easy it is.

GOODBYE, SHOULDER PAIN

Dr. Tellez can operate the autorefraction system by tabletop console, so she can relax her body. The shoulder pain that bothered her has completely disappeared, she says.

Advanced technology not only makes patients more confident in the care they receive, Dr. Tellez says, but it also ensures she is giving her patients the most appropriate options. “These patients are getting a more in-depth exam, and it’s easier on me and my team,” Dr. Tellez says.

Hearing about the experiences that her colleagues have had with products and technologies gave Dr. Tellez the push she needed to learn more. She’s grateful she listened and cannot imagine still practicing the way she did just a few years ago.

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Make Exams Faster and Easier

Rachel Tellez, OD, has been with Vision Source® since she started her career as an associate OD at one of the very first Vision Source practices in the San Antonio, Texas, area in 1990. Once she became a part of the Vision Source community, she says, it stuck with her, so when she opened her own location in 2003, she took advantage of all the benefits of membership for her new startup practice.

Since then, Dr. Tellez has moved her office into a newer location just a few hundred feet away, seen patients grow and bring in children of their own and added an associate OD. Something that has continually aided the practice’s growth, she says, has been the Marco technologies that bring efficiencies to the exam process.

For the first almost 30 years of her career, Dr. Tellez utilized an old-fashioned, bulky phoropter that required her to spend much of her days with her arms outstretched, spinning dials. Dr. Tellez—a regular at physical therapy with two bad shoulders— read about a piece of updated tech in an earlier issue of Vision Source OD magazine. A visit to The Exchange® in 2016, held in her hometown that year, solidified her decision to update her lanes with the Marco TRS-6100 Automated Refraction System with Infinity Remote Software.

“I only updated one lane and kept the old phoropter around in case we ever needed it,” Dr. Tellez says. “It didn’t take me long before I realized we needed the same equipment in our other two lanes. I was never going back.” Rather than relegating her other exam lanes to second-tier status because she didn’t want to use them, she added the Marco equipment to both. The advantages were immediate.

The wow factor

Patients who have been seeing Dr. Tellez for years are able to experience some of the high-tech instrumentation. Every patient sits at the Marco TRS, so they all appreciate the change from the stress of having to answer questions about clarity of numbers.

Faster refractions

With the process of obtaining the refractive correction more quickly, Dr. Tellez and the patient have more time to talk about other ocular health issues, the need for backup eyewear, dry eye treatments or other concerns the patient may have. Or the patient is able to get into the optical area faster to pick out their new eyewear.

More data, more quickly. With the OPD-Scan III Wavefront Aberrometer and the VisuALL virtual reality visual field perimeter, Dr. Tellez captures more information on each patient. The systems talk to each other, so staff members don’t have to load data manually. And Dr. Tellez has all the topography and perimetry data right on her screen. Since the VisuALL system is portable and allows the user to perform several tests without having to move the patient from one machine to another, that system has also sped up the data-gathering process. “Within a minute or less, the refraction, keratometry and topography are all on one screen, showing both eyes, much faster than compared to performing these tests with three separate instruments,” Dr. Tellez says. She easily can find results that are automatically saved onto a data card and then transferred into the TRS. “We don’t have to input the data manually, which increases accuracy and definitely saves time,” she says.

Patient choice

It’s challenging or any doctor to determine whether a small refractive change means that the patient “needs” new eyeglasses. The OPD screen features side-by-side comparisons so patients can compare their current prescription to the one she derived that day. This puts the decision on whether new eyewear is worth it in the patient’s hands. Even small refractive changes can make a big difference to some patients, and if they decide that’s the case, they feel great about buying new eyewear.

Short learning curve

Dr. Tellez says that technology mastery is not one of her strongest suits, but within 15 minutes of sitting down with her Marco representative, she felt confident with the technology and
what it could do. Patients also appreciate how easy it is.

Goodbye, shoulder pain

Dr. Tellez can operate the autorefraction system by tabletop console, so she can relax her body. The shoulder pain that bothered her has completely disappeared, she says.

Advanced technology not only makes patients more confident in the care they receive, Dr. Tellez says, but it also ensures she is giving her patients the most appropriate options. “These patients are getting a more in-depth exam, and it’s easier on me and my team,” Dr. Tellez says.

Hearing about the experiences that her colleagues have had with products and technologies from Elite vendors like Marco gave Dr. Tellez the push she needed to learn more. She’s grateful she listened and cannot imagine still practicing the way she did just a few years ago.

Article originally published in Vision Source OD magazine. Learn more about Vision Source here.

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The Right Exam Lane Technology Can Make The Day Easier – And More Fun – An Article From Women in Optometry

Original Article Published in Women in Optometry
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Karen Wrigley, OD, with two practices, Wrigley Eye Associates and Visual Eyes, in the Philadelphia, Pennsylvania, area, has always tried to keep her practices updated with the latest technology. Yet when she brought in new exam lane equipment from Marco recently, she was impressed by not only how it sped up the refraction and exam process but also by how much patients are enjoying the experience.

Dr. Wrigley originally added an OPD-Scan III, and a Marco TRS automated refraction system to one of her two exam lanes in each office. She added a second TRS and a new slit lamp with the ION camera in June of this year. In the pretest area, technicians can capture wavefront aberrometry, topography and keratometry, among other features, with the OPD-Scan III. This data provides the doctors with more information about the surface of the patient’s eye before they are even in the exam room, which is particularly helpful with specialty lens fittings. Now, those patients with complex fitting needs can receive even more customized contact lens prescription, helping them see and feel better. The updated slit lamp has also allowed for a more precise patient examination.

WOW THE PATIENTS

Dr. Wrigley’s office serves as an internship site, and she says that while the manual phoropter provided interns a good learning experience, it was outdated and more difficult. It’s ergonomically stressful for the user, and the process can be stressful for the patients.

“If we’re going to update our technology, let’s wow our patients,” Dr. Wrigley says. The new slit lamps have updated camera software so that Dr. Wrigley and her team can show patients their images right there in the exam room. Plus, the new TRS technology lets doctors use a tabletop console to sit a distance back from the patient, supporting social distancing, which puts both parties more at ease.

The TRS and OPD systems in her two offices have created more efficiency while allowing the doctors to provide even better care to their patients. Dr. Wrigley has been able to minimize downtime in exam lanes, thanks to the updated technology in her offices. She or her technicians can complete the refraction faster, and she gains the measurements she needs accurately.

Leveraging her Vision Source member benefits, Marco brings doctors the “best bang for their buck” on upfront costs, lease programs and technical support, she says. Marco’s support is stellar; technician assistants will fix equipment on-site or remotely, which has also helped save the practice time and avoid downtime as, in many cases, they no longer have to ship equipment out for repairs or updates. She also appreciates that her representative is just a phone call away for pricing, advice, support and tech questions.

Dr. Wrigley has seen a positive return on investment and the intangible benefit of happier customers with the Marco systems. “Our vision statement at the practice is helping patients see well and look great. The new technology has helped us achieve this,” Dr. Wrigley says. “My goal is to always keep up and push forward.” She says her patients have even noticed the office updates. Those who have jumped to another practice for their eye care often come back to her because “they know we keep up with the latest and greatest in the industry,” she says. “It is so nice that they see what I’m trying to provide for them.”

Dr. Wrigley has been able to prioritize the best care for her patients without it burdening her team or herself; in fact, it actually makes her days easier.

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Post-Pandemic Safety Concerns Prompted Purchases That Have Yielded Far More Benefits – An Article From Women in Optometry

Original Article Published in Women in Optometry
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Like every doctor who purchased a practice in mid-2019, Nyssa d’Hedouville, OD, could not have anticipated that just seven months in the future, the COVID-19 pandemic would force her to close Mashpee Vision Care, the Mashpee, Massachusetts practice she acquired, for two-and-a-half months. But she sees some positive developments that came out of that time. “I updated every area of the practice while we were closed to routine patient care,” she says.

While the practice did have a visual field analyzer and older optical coherence tomography equipment, she wanted a higher-tech experience for her patients.

She added Marco diagnostic and lane equipment, include the TRS 6100 automated refraction system, the OPD-Scan III and iON imaging system. The advanced technology has been a benefit in a number of ways.

First, it has sped up the time it takes to get an accurate refraction. “The technician measures the patient’s current eyewear in the lensmeter and performs an OPD scan. That is all uploaded into the TRS when I come into the exam room,” she says. Patients love not being asked the old “1 or 2” question, and she sees an immense benefit to being able to toggle back and forth between their previous prescription and the new one. “Patients are much more likely to purchase new eyeglasses if they understand what the difference in their vision is going to be. It’s much faster than dialing the prescriptions in and going back and forth,” she says.

The simulator that generates a depiction of the patient’s visual acuity is great for patients – and parents of young patients. “I had a young man who came in with his father. The patient had been diagnosed with keratoconus and could not achieve clear vision with eyewear. I was able to use the simulator to show his father how higher order aberrations made his son’s vision so poor. Suddenly, the father understood why getting the son fit with specialty contact lenses became imperative. Because I had those measurements ahead of time, I could save time, instead of repeating what had happened so often before when doctors were unable to get him seeing clearly with eyeglasses.” Similarly, that strategy works well for parents of young children, too.

Best of all, she can conduct her exam with just as much personal attention – but at a great distance with the TRS and iON. “I’m able to sit further away than I could during earlier slit lamp examinations. Plus, it’s great for patient education,” she says. She can share the images with the patient and explain what she’s looking at, whether that’s blepharitis, dry eye, nevi or lid lesions. “It’s so much easier for the patient to understand what we can see when they look at the image. It helps show the value of what we do, especially when we can use the first day’s measures as a baseline and then show them the effectiveness of the treatment.”

Just as important as the physical distance – the feature that most attracted her when she was able to start welcoming patients back into the office – is the patient education aspect. The result is increased face time, where she’s talking directly to the patient about a refractive or ocular health issue.

The diagnostic instruments also provide her with a better idea of what she’s facing. For example, the patient may have said nothing about dry eye symptoms, but the OPD-Scan III data indicates that the patient might have dry eye. “So often, when I tease out whether the patients have symptoms, they tell me that they do, but they did not think it was significant or that I could do anything about it.”

Finally, the data from the TRS is uploaded directly into her electronic medical record, which means she doesn’t have to worry about transposition errors.

As these benefits revealed themselves, they reinforced the value of bringing this equipment it. “As business owners, we’re always worried about our return on investments. But rather than ask whether it’s something you can afford, take a look at how it can affect your practice. For me, this technology has halved the amount of time I need to do a refractive exam. My technician has already gathered good data, and I can finish that portion of the exam more quickly. The patient can see whether the new eyewear would help, so it has resulted in more sales and a higher capture rate,” she says.

“I got it because I was worried that I wasn’t going to be able to open without having this technology. But now I enjoy it for all the other benefits it brings.”

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Refraction System Provides Efficiency, Accuracy And A Little Distance – An Article From Women in Optometry

Original Article Published in Women in Optometry
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When Monica Brown, OD, purchased Baymeadows Vision Center in Jacksonville, Florida, one of the two exam rooms had a TRS refraction system from Marco, while the second had a manual phoropter. “I kept the manual for a while because I do a lot of orthoptics, and I was comfortable with the process. I didn’t know if the TRS would do it as well.” Dr. Brown earned a master’s degree in orthoptics before attending optometry school.

However, the more she worked with the TRS system, the more she learned that she could use it for prism and binocular testing, as well as, if not better than, the manual system. Nearly three years after she bought the practice, she converted her second lane to include a TRS system, too.

She has found that adding the second automated refraction system helped her improve her efficiency, in large part because it allows her to look over other pretesting data and enter information into the chart from the patient’s history. “Patients have the wow factor while they’re going through this very easy refraction, and I am minutes ahead in my data collection and entry,” she says.

During her practice remodel in October, she also added the TruVue viewing system. “It’s a digital screen, and the clarity is unbelievable.”

For the past year, the added efficiency and speed, as well as the increased sales that result from using this system, “have been a godsend. Patients love seeing how clearly they would see with new eyeglasses. Even if it’s just an axis change, many patients can see the difference. And when I show them, saying, ‘Here’s how you could see with today’s new prescription,’ the majority say, ‘I want that.’”

PHYSICAL DISTANCE

Even as restrictions on physical distancing are lifted in some settings, providers and patients still expect and want some physical distance in a medical setting. “With the TRS, I’m not right there in the patient’s face for the whole exam. I’m at my desk; they’re in the chair. I barely have to get behind the slit lamp with the data I’m able to obtain now.”

OPD INSIGHTS

Adding the OPD-Scan III into the workup room routine has saved her even more time. The technicians run the process, and with the push of a button, that information is transferred to the exam lane. “I can show patients an unusual topography or tear film deficiency. It provides us with a quick and understandable explanation for why we might not get the vision to 20/20,” she says. Regularly, it saves her time because the OPD-Scan shows her a higher order aberration or other data point that will impact the final prescription. “I can explain to patients why, no matter how much we tweak the prescription, we are not going to be able to achieve 20/20,” she says.

For patients with tear film deficiency, however, she can also help them understand why compliance with a dry eye regimen she provides can help address their comfort and vision. Plus, on subsequent visits, she can compare the results from the most recent OPD-Scan.

Having the data on hand can help her describe her patient’s visual symptoms sometimes even before they do. “I might say, ‘Is this what you see at night?’ They are surprised and often tell me that I’m describing their exact experience,” another “wow” experience for those patients.

By staying current with technology, she meets the goals of her mission statement: to provide each and every patient a lifetime of healthy vision through superior comprehensive eye care thereby enhancing their quality of life.

ERGONOMIC BENEFITS

Dr. Monica Brown wants to avoid the physical pains that some ODs experience, so she has incorporated ergonomic features like a stand-up desk when she remodeled the practice. Her Marco TRS refraction system has also been helpful. “I can operate the console, and I don’t have to reach my arms up. I try to keep my elbows at my side as much as possible,” she says.

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