HIGH Times for High-Index

From aesthetics to hands-on pointers, a guide for working with high-index

By Karlen McLean, ABOC, NCLC

High-index expands dispensing options. Image courtesy of ProFit Optix

More practices are turning to high-index lenses to satisfy patients' aesthetic and visual requirements, and practices' profit and service goals. Honing high-index expertise comes down to four components: matching the Rx with appropriate frames, fitting and measurements, product knowledge, and high-index processing savvy.

FRAME FITTING TECHNIQUES

With all the high-index options available now, it's exciting to be able to offer rimless or semi-rimless eyewear to patients who have been unable to wear rimless styles in the past due to high-power Rx's. "Usually a high-index recommendation is a high-myope, so the customer is sensitive to lens edge thickness," points out Jim Lewis, president of Harvey & Lewis Opticians in Hartford, Conn. "We try to steer patients away from grooved rimless and into plastic and thicker metals. We will use high-index for drill mounts if I think it will make a big difference in the appearance of the final product."

Steering patients to the right frame choice is crucial when patients have a high-powered Rx, but it's easier now that high-index lenses have expanded possibilities. "If a patient with a high-powered Rx wants a semi-rimless frame and their PD is narrow, say 58, we recommend high-index," says Milena Nelson, LDO, and store manager of SEE–Selective Eyewear Elements in Winter Park, Fla. "If the power is over +3.00 or even +2.50 with a narrow PD, we offer high-index in every case, with the option of poly, and let the patient decide."

High-index works with rimless and full-rim eyewear. Image courtesy of Seiko Optical Company

Nelson adds: "We don't suggest full rimless as the high-power Rx patient's primary pair of eyewear, although if the patient is getting more than one pair, a rimless drill mount in 1.67 would be a good eyewear wardrobe choice."

Plastic frames, however, are still usually the top choice for high-Rx patients, and now, with the marketplace trending to plastics, it's easier than ever to pair plastic frame options with high-index lenses for those who are "visually challenged."

"We usually suggest a full plastic frame for high-powered Rx's," Nelson affirms. "They're so fun now! That Ugly Betty, geek chic look is our number-one choice for high-Rx patients."

With "clunky plastic frames" that are popular right now, bevel placement is less of an issue since the frame in many cases conceals lens thickness. No matter what the frame material may be, the key is to make sure frames for high-powered high-index lenses are small.

LENS CASES

Sometimes the best way to learn is by experience that becomes practice protocol, as these cases show.

Case 1: SEE–Selective Eyewear Elements in Winter Park, Fla., has a high-Rx patient who splits his year between Winter Park and New York City. He prefers to use contact lenses to correct his everyday vision and wears an old pair of eyewear at night.

High-index offers a blend of technology and artistry to create a premium visual experience. Images courtesy of, clockwise from above, Polycore, Optima, and Hoya Vision Care North America

"He got a new prescription after seven years and decided on a plastic frame and 1.67 lenses," Nelson says. "He went back to New York, where we also have a store, and reported there that he was having a problem seeing and getting headaches."

The doctor checked the prescription and the opticians checked the eyewear; both were fine. The opticians also checked his old glasses and found that he had been wearing standard plastic lenses.

"The conclusion was that his vision naturally changed and the prescription changed, and it had been a long time since he wore glasses full-time, so there was some adjusting to do," Nelson recalls. "We took him out of 1.67 and put him in poly. He's currently wearing poly and making the decision of which lens material he prefers."

IMAGE BY PRODENSTOCK

Lesson: Always check the patient's eyewear to determine what lens material they've been wearing.

Case 2: East Coast Optometric Associates, PA, in Wilmington, N.C., looks into the patient's profiles for personalized solutions.

While the practice recommends AR on all high-index lenses, Devon Dvorzsak, OD, points out a particular demographic: "I always recommend high-index lenses with anti-reflective properties for anyone who is actively engaged in public speaking. Observing a speaker with thick, reflective lenses can be a large distraction," he says.

Additionally, he recommends high-index photochromics for anyone who spends time outdoors. "We're located on the North Carolina coast and have a lot of people who enjoy the outdoors," he mentions. "I love the protection that photochromic lenses can provide."

Lesson: Doctors, make a point of always recommending lens options from chair side. EB