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Educating the Patient

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Patients are better informed about their eye health than ever before, thanks to the many online resources now available to consumers. But that’s only a starting point. Doctors must still provide detailed explanations of new procedures and products and advise patients about which options are best for them.

Although many doctors rely on in-office videos, often supplied by vendors, as discussion aids, advanced production techniques and new delivery systems such as iPads are making video an increasingly valuable educational tool. One popular choice is Eyemaginations’ Luma software. Available in video form and as an iPad app, Luma is driven by 3D-animated visuals and an intuitive interface. The latest version of the app includes a vision simulator that allows patients to experience vision with a variety of eye conditions. Doctors say such tools help them present complex information to patients in a way that’s accessible and easy-to-understand.

Andrew Morgenstern, OD, uses Luma at Washington Eye Physicians and Surgeons, a busy practice in Chevy Chase, Md. with nine ophthalmologists and two optometrists on staff. “We have a couple of dedicated iPads that we bring into the exam room to show patients,” said Dr. Morgenstern. “If a picture is worth a thousand words, a video is worth a million. It lets them understand the disease and the solution, and it helps them formulate questions.”

Dr. Morgenstern said Luma helps him with documentation while providing the patient with useful information. “If we documented in a chart that a patient saw a video, the patient can’t later say ‘you didn’t tell me.’ Also, the video provides consistent messaging, which is great.” Dr. Morgenstern said the Eyemaginations platform also allows his staff to e-mail videos to patients pre-operatively or pre-appointment, upon request.

 
 Dr. Andrew Morgenstern.
Dr. Morgenstern said investing in technology such as Luma reinforces the idea that his practice, which is in an upscale neighborhood, is providing superior care. “Perception is reality,” he observed. “If your patient thinks your practice is high tech, those patients are going to be your ambassadors of referral.”

Richard Levin, OD, of Total Vision, a Pikesville, Md.-based practice with five locations, also relies on Luma to teach patients about new products and procedures. He said a major benefit of this approach is improved patient flow. “One of the hardest parts of our job is patient education,” he noted. “It can be very tedious. That’s what locks us up and prevents us from seeing the next patient more quickly.”

Dr. Levin uses Luma to educate patients about premium intraocular lenses, which are an important part of his practice. He likes being able to send patients a post-appointment video that includes testimonials from patients who have successfully undergone cataract surgery and had an upgraded IOL implanted. “Patients are often scared after their office visit, but then they see video, which explains the mechanical aspects of how the lens works and has testimonials. This desensitizes them. Now they understand and want it. The patients are happier. In turn, our conversion rate is close to 40 percent for upgraded IOLs versus the national average, which is about 15 percent. It’s better for them clinically, and it’s very profitable for the practice.”

Dr. Levin said Luma is also helpful when prescribing Ophthonix lenses, which require doctors to measure the patient’s higher order aberrations using a special aberrometer. Luma lets him show the patient how the process works by illustrating how light passes through the eye.

 
 Dr. Richard Levin educates patients with ocular images such as this one shown on Eyemaginations’ Luma system.
The results have been impressive, he said. “At first, we were only selling a couple of iZon lenses a month. Now we’re up to 40 a month. As with the IOLs, there’s a very significant profit margin with insurance. We’ve built our practice on enhancing the patient experience,” Dr. Levin remarked. “My apples are the same apples that everyone else offers, but it’s how we deliver them to the patient that differentiates us.”

Other companies are also offering refraction systems that feature new, patient-friendly technology. One such system, i.Scription by Zeiss, incorporates technology for measuring, designing and dispensing eyeglasses. Introduced in the U.S. in late 2010 by Carl Zeiss Vision and VSP Vision Care, i.Scription employs wavefront aberrometry to generate a compensated prescription that can be used to design a new type of customized lens. These lenses deliver better night vision, improved contrast and richer color perception to eyeglass wearers, according to Zeiss.

i.Scription technology consists of three elements: i.ProfilerPlus by Zeiss, an instrument that combines corneal topography, autorefraction and aberrometry; i.Scription software, an algorithm that combines the aberrometry data from i.ProfilerPlus with the doctor’s subjective refraction to create a prescription that is accurate to 1/100th of a diopter and is optimized for the effects of the patient’s high-order aberrations; and for dispensing Zeiss and VSP Reveal free-form customized lenses.

 
 i.Profiler Plus by Zeiss
is a three-in-one-system.
Steve Klein, OD of Total Vision Care, which operates two locations in San Diego, Calif. likes the Zeiss technology because it helps him personalize the patient experience in his practice. “With the i.Profiler, I review the test results on screen with patients,” said Dr. Klein. “The unit captures different pupil sizes, so I show them day vision versus night vision, which I think is a critical component. Patients may not understand why their vision is blurred at night. We can show them why their vision is different with a small pupil versus a large pupil.”

Dr. Klein said his patients are impressed with the Zeiss technology. “It captures data so quickly. Each new version of the equipment seems to get quicker and easier for patients. We’ve always tried to stay on the leading edge of technology,” he said. “Patients are aware of this, and they make comments during the exam. The onus is upon our team to explain to patients what new features this new equipment has, and what benefits they get. By the time the patient is in the exam room, they’re well aware of what these features are, and the benefits of having a more personalized prescription.”

Another new refractive system is the PSF Refractor from VMax Vision. The company claims the PSF Refractor has higher sensitivity, greater accuracy and is faster and easier to operate than a traditional phoropter. Its Point Spread Function corrects refractive errors and neutralizes higher order aberrations. Active patient participation makes it easy to refine vision to the best possible end point, according to VMax. The PSF Refractor also offers a Subjective Nighttime Refraction designed to help patients with nighttime vision problems. Used in concert with VMax’s proprietary Encepsion progressive and single vision lenses, it creates a customized vision correction system.