A Recent Rash of Lens Remakes on External Prescriptions Underscores the “Art” portion of Vision Correction.  Learn The Steps We Are Taking to Ensure Your Outside Prescription Is Accurate.

Lens remakes are the bane of any optometrist’s existence.

Not only are they costly for both the practice and the labs, but they also create frustration with patients and clients who may have to endure one or more lens remakes before they are actually able to see clearly.

No one wants them and every optician and optometrist works hard up-front to avoid them.

However, they do happen every now and then.

Why?

Well, unfortunately, sometimes a lab will make a mistake and get the script wrong.

Sometimes what a patient thought was “clear vision” during the exam isn’t so “clear” when they actually put the finished glasses on.

Other times, we just need to “tweak” a prescription and lens a few times, especially for new progressive wearers or people with complex vision correction needs like prism.

In very rare instances, a person’s vision may literally change between the refraction and the delivery of the finished frame and lenses.

Our Philosophy: We Work Until We Get Your Lenses Right. Period.

In all of these cases, we continue to work with the patient until we get the finished product right, and often we do this at considerable extra cost to Urban Optiques – both in additional lab rework fees and the staff’s time.  It’s just part of the process of providing good vision care and an accepted cost of business for us (even though we want to minimize it.)

The good news is that when we actually perform the eye exam and refraction at Urban Optiques, we have an extremely low remake rate. There are few specific reasons for this, which I’ll touch on a bit later.

But first, let me tell you about a recent “mystery” at Urban Optiques around remakes.

Why Have Lens Remakes Increased Recently? A Mystery, A Discovery and a Solution

Over the past few months, I’ve noticed a trend of more lens remakes than usual (or acceptable) at Urban Optiques.  I was understandably concerned.  So I dug into each one of the remakes to understand exactly what was causing them.

What I discovered was that with the exception of a handful, the vast majority of the remakes were coming from patients who brought in an outside prescription from other eye care practitioners. Of those outside scripts that had to be remade, most came from large retail or discount vision chains or from offices that utilize technicians to perform the refraction portion of the exam.

I don’t want to paint any of these business with too broad of a brush. I have many colleagues who work at them, and they are great doctors writing accurate prescriptions each day.

Realize, however,  that there can be a substantial difference between an eye exam at an independent optometrist’s office and one that you get at a chain.

Because of the volume chains and franchises experience, they typically try to squeeze in as many exams as possible in a day, which means that you may actually only spend 15 minutes with the eye doctor for the entire exam. This emphasis on speed and volume can sometimes reduce the accuracy of the prescription.

Over the past four years, this practice has had history of running on a large percentage of outside prescriptions. One of the main reasons for this was limited doctor availability under the previous ownership.  This changed in November when I bought the business.  We can now schedule eye exams six days a week and eyeglass dispensing from patients who also received their eye exams from Urban Optiques continues to increase week-over-week.

However,  outside prescriptions have also continued to grow as a percentage of our business because of increased positive word-of-mouth, and our broader efforts to market our unique and large  eyewear selection to all of Metro-Detroit

We now have people who had their exam six months or a year ago at someplace other than Urban Optiques finding us because they weren’t pleased with the selection or the eyewear they chose, and they want to replace it.

While we encourage people who are due for an eye exam come directly to us, we still welcome outside prescriptions because it tells us that we have a product that our clients want, but can’t find anywhere else.

There is a downside to outside scripts, however.

It’s causing our remakes to go up significantly.

Not only does this cause frustration with clients and our own staff, but we’re also concerned about how possible inaccuracies in a outside prescription are negatively impacting the quality of our final product for the patient and our overall reputation fro quality.

In other words, as the provider of most costly portion of a pair of eyeglasses (the lenses), we bear the brunt of the client’s frustration with an inaccurate prescription, even though we weren’t responsible for that prescription.

The Science and Art of Vision Correction: More Knowledge of You is Better

This is not to suggest that there are junky prescriptions floating all over the place.

Vision correction is part science and part art.

While there is definitely an objective, technical aspect to correcting vision through refraction, there are also lots of individual variables that go into obtaining an accurate prescription.

For example, sometimes people are tired during their exam and this causes them to make choices during their refraction that they may not prefer later on.

In other cases, people are pressed for time and despite the doctor’s best attempt to slow them down, they make hasty decisions between powers.

Occasionally, a patient may not disclose medical conditions that can impact their vision or some people just prefer one power on Monday and another on Tuesday.

In one case, I even had a patient arrive for an eye exam after a couple of beers.  We obviously rescheduled that one.

The Advantages of Performing The Eye Exam Ourselves

One of the advantages of performing the eye exam ourselves, versus just taking an outside script, is that we have a better understanding of your individual vision preferences and can make the necessary adjustments to the lenses, material, etc. This is especially useful for first time progressive lens wearers, who need some additional tender loving care as they adapt to their lenses.

During a thorough eye exam, we can usually correct for most of these things. That’s why we have you fill out a detailed medical history and I ask plenty of questions during your exam. Optometrists are trained to identify the subjective things that might impact vision correction early on and tweak the final prescription to compensate for this.

We also deliberately spend more time with you than most practices (especially compared to corporate chains and discount optical shops) — especially during the patient health history and refraction.

We like to ask questions about  your current vision through your existing glasses and learn about areas that need improvement.  For example, is your near vision blurry?  Do you have eye strain and eye fatigue associated with computer work?  Is your distance vision at night not so hot?

Also, after every refraction, I perform a direct assessment on every patient.  What this means is that the difference in prescriptions between what I obtained in the phoropter (the “which is better: one or two?” machine) and what is in your glasses is displayed to you using trial lenses.

This extra step ensures the prescription is better than your current glasses.

Performing a direct assessment also provides you with buy-in to the prescription so that you can be immediately confident that the prescription filled will be one that meets your specific preferences.

Understand that this is not a standard practice of most optometrists, especially those filling outside prescriptions. But we think it’s critical to helping you have crystal clear vision and we believe it differentiates us from everyone else, in particular the chains.

We’ve also recently invested in the Zeiss Eye Terminal, a cutting-edge new technology that customizes your prescription to your face and eyeglasses.  This is particularly effective at improving the final lens product, especially for progressive wearers, and we are only one of only a handful of Metro-Detroit practices using the Zeiss Eye Terminal to individualize patients prescriptions.

Sometimes, despite our best efforts, the final script will need tweaking. When that happens, we make the adjustments or lens reworks at no cost to you.  Yes, it can cause a delay in getting your glasses, but if you can’t see, we haven’t accomplished our primary goal.  So we will work tirelessly at getting it right, as long as you are willing to work with us.

All of these things combined are why we have such low remake rates on patient s who get their eye exams from Urban Optiques.  It’s also why remakes are higher for patients who bring a script in off the street — they aren’t always getting this level of examination and the final product suffers.

How We Are Changing Our Approach to Outside Prescriptions: Free Basic Refractions

Since we never want to turn a client away just because they have an outside prescription, we’ve recently instituted some changes in how we work with outside prescriptions.

We think these steps will dramatically reduce the need for remakes and increase patient satisfaction.

Going forward we will now perform a free basic refraction and/or direct assessment on all clients who bring us an outside prescription.

I can tell you this is a highly-unusual practice in our industry.  Very few doctors will recheck an outside prescription at no cost, since it involves what would normally be billable time for the doctor.

We’ve decided to do it because we believe it will practically eliminate remakes on all but the most tricky prescriptions.  We also think it underscores our commitment to putting your vision ahead of mere profits, and believe it will encourage you to come directly to us for future eye exams.  While we may not be able to always control the conditions under which an outside prescription was achieved, we can double-check it ourselves.

With every eyeglass we deliver to client, our reputation is on-the-line, even if the prescription didn’t originate with us.  Since providing the highest quality vision, customized for the unique needs of each of our patients, is our core mission at Urban Optiques, we think the time and cost associated with these extra steps is well worth the price to us.

In the end, it should result in more accurate, crisp vision and happy clients who want to come back the next time to us for not only their frames and lenses, but also ideally their eye exam.

We’ll keep you posted on how it works!