Optometry Podcast: Prescribing Progressives with Dr. Ryan Powell

Dr. Ryan Powell, O.D. President, Vision Source Eye Care

There are a few constancies in life we can all count on: death, taxes, and presbyopia.  And while every one of our patients will experience the classic symptoms of difficulty adjusting their focus near to far, and feeling like their arms are too short (and joking about it in the exam chair!), the visual demands of each of our patients’ days are completely unique. Despite this fact, a 2016 survey by 20/20 Magazine found only 38% of a practice’s progressive lens sales are for personalized or customized progressives. We sat down with Dr. Ryan Powell, founder and CEO of a ten office group private practice in Kansas City, Missouri about the success he has found in prescribing for presbyopia and how young and new graduate doctors can avoid mistakes early in their career that could undermine successful prescribing.

Dr. Powell’s biggest advice for other doctors?  Take a few moments to ask questions and listen. How does your patient spend their day? What areas of their vision are giving them difficulty? If they are in front of a computer during the day, how many screens are they viewing and what is the height and distance they sit from those screens?  It also helps to pay attention to the patient’s natural working distance and height. A tall patient with long arms will likely not hold their near work as close to their face as a more petite patient with shorter arms. Take this into account when setting up the phoropter!

Do you need to make a fudge-factor in your prescribing to account for progressive zone sizes?  Not in today’s world of improved progressive lens technology! Dr. Powell usually starts with age norm add when checking near vision in the phoropter, and then takes away plus until things get blurry.  That helps ensure he isn’t over powering his patients with more prescription than they need in the bottom portion of their lens.

Another key to success is explaining to his patients that the prescription he just wrote will only be successful in the specific lens design he has prescribed. He has measured and prescribed a personalized lens solution that requires newer, state of the art technology lens designs to accomplish the best vision.  Progressives (or no-line bifocals as he’s found his patients better connect with this description) have been around for many years. Older lens technology was designed decades before cell phones and device use became so ubiquitous. How many of you are carrying around an original, first generation iPhone 1? Things have improved, and greatly, and he prescribes only the best technology for his patient’s needs.

Dr. Powell is a huge advocate of the new Varilux® X Sseries™ progressive lens to meet those modern era visual demands. The lens has a much wider and more fluid depth of vision than previous iterations, eliminating the need for patients to move their head and point their nose to see clearly at arm’s length and near activities. This has greatly minimized the amount of time his optical staff has to spend in education at dispense, and speeds up the patient’s adaptation time to their first progressive considerably!

As young practitioners, it’s sometimes difficult for us to completely relate to our patient’s experience of presbyopia.  We’ve never had to wear a progressive before! At this year’s Vision Expo West, doctors and students can get a chance to experience the lens in simulation at Essilor’s exciting new Varilux®  Xperience: A Varilux X Series R&D Simulation.  This is a first of its’ kind interactive look into the revolutionary research and development process that led to the creation of Essilor’s most advanced and successful progressive lens to date. Join us in experiencing the innovation at Essilor’s VEW Booth #LP11065.  If you can’t make the conference, be on the lookout for our Facebook Live from the booth at 1:00PM PST on Thursday 9/27.

Varilux®  Xperience: A Varilux X Series R&D Simulation

Thank you to our partner Essilor for supporting the production of this podcast.

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