# Optical Forums > General Optics and Eyecare Discussion Forum >  The PD Battle Has Begun

## Browman

Eyeglass Start-Up Ready to Battle Industry Titan

Summary: Warby Parker has reconceptualized the PD question as a fight between Luxottica and the rest of the world. They continue to demonstrate that they have an excellent PR department and are capable of selling themselves as everymen who also happen to deal in eyewear, removing the distrust endemic to the optical retail industry.

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## theGross1

LC isn't technically doing anything wrong as I don't believe there is a "standard" for eye exams in terms of what is included.  Their rx pads used to have a place labeled PD. the newest revisions have removed this.  They release the rx but and all medical records upon request as they are required to.  They do not record the PD on any medical record this they are not required to produce one. In California, where the doctors are employeed by the company, the exam is clearly spelled out.  PD is exclude from the prescription.  I cannot speak to LC outside of California.

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## drk

Pupillary distance is by-and-large an optical measurement, and has nothing to do with an eye examination.  They can make all the fuss they want.

For that matter, they can have p.d.'s and the glasses would still stink.

Glad to see Luxottica wise up and not roll over.

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## optical24/7

WP is opening B&M locations. They will soon find out the *costs* of such locations. Either they will need a pricing restructuring or turn out being just another Eyemart Express...A cheap provider of mediocre product supplied by minimally trained staff.

Also, if you read the comments section you will find a huge disgruntlement over PD's not being provided by their examiner. Refusing this info is not a way to elicit loyalty from your patients. If you have it documented, you should provide it. If not, charge a nominal fee and engage them in why they don't find value in your services. It just may give you the opportunity to improve what you offer along with educating them with what you provide that online can't.

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## drk

Hey optical:

If they want Ks for CLs, I suppose you'd recommend the same course of action?

How about releasing their IOPs?  Do you think that's a good idea to elicit loyalty?

Maybe we should prescribe meds over the phone without an office visit?  I think that would elicit a whole lot of loyalty.

How about a no-questions-asked 90-day 100% guarantee?  That would be really big.

The customer is always right.

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## MikeAurelius

I've said it before and I'll say it again: the PD belongs to the patient because it is a physical measurement of the eye location with reference to the bridge of the nose, just like a prescription is the physical measurement of the powers needed to correct the vision. The places that refuse to give it out are just giving ammunition to the FTC to make a ruling requiring the PD be part of the prescription. The PD does NOT belong to the optician. It is part of the medical records and should be given to the patient.

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## optimensch

The liars at WP say the battle is against Luxottica, but really the battle is against optometry and opticianry, Luxottica provides a strawman for them.
Luxottica' s products are "expensive" just like Marchon's and Safilo's, how about silhouette? moscot? la eyeworks? why pick on lux?

anyway stuff your shops with a wide variety of products at many different price points, and yes, offer a WP-competitive package, it is NOT that hard to do. Now Zenni on the other hand, at sub $10 - they should do an attack PR campaign on Warby! Warby is charging 10X more for the same made-in-china garbage glasses that Zenni offers. 

Oh yes. the PD question. Absolutely give out a binocular PD upon request with the caveat that it is not the only measurement required to produce glasses, and does not guarantee a well-fitted or comfortable pair of glasses.

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## MikeAurelius

> Oh yes. the PD question. Absolutely give out a binocular PD upon request with the caveat that it is not the only measurement required to produce glasses, and does not guarantee a well-fitted or comfortable pair of glasses.


If you have the monocular PD on file, you should give that, otherwise you are providing inaccurate or incorrect information, for which you could face legal charges. You are supposed to be a professional. Act like it!!

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## optical24/7

> Hey optical:
> 
> If they want Ks for CLs, I suppose you'd recommend the same course of action?
> 
> How about releasing their IOPs?  Do you think that's a good idea to elicit loyalty?
> 
> Maybe we should prescribe meds over the phone without an office visit?  I think that would elicit a whole lot of loyalty.
> 
> How about a no-questions-asked 90-day 100% guarantee?  That would be really big.
> ...


Doc, how do you rationalize NOT giving medical records to patients? Aren't K's and IOP's part of that record? How does withholding info comply with HIPAA? Even if you have a (legal) leg to stand on, would you rather loose patients over it (along with the bad PR that would go along with it)? Why not let them *take a walk on the wild side*?

After years and years of watching a handful of patients purchase elsewhere, only to sheepishly return with bad stories of service, product, comfort, ect from other locations and become life long clients, I'm convinced that they see value in me. Even if they find similar service and products/pricing, they still don't get *me*. If you (or any of you) are loosing patients on price alone you are not providing value in their eyes. You have to ask yourself, why?

Lastly, the optical pie is HUGE. There are many markets and sub-markets. You can't be all things to all people. Pick your market and excel! Be it a burger joint or a fine steak restaurant, there are clients that will patronize them.

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## Stan Tabor

I understand that you do not need to take a PD to conduct an eye exam.  But isn't a PD a crucial part of the prescription?  I know, I know you need all kinds of other measurements as well to make a pair of digital free form lenses.  Maybe an explanation that it takes more than a PD to make a quality pair of glasses would be a more effective sales technique than telling the customer you do not "give" out the PD.    

I agree with the comment above regarding the FTC.  Withholding this info is further alienates the public that is already suspicious of being overcharged by opticals.  A reasonable person considers withholding this info to be unreasonable.     
This thread re-affirms that the best way to get 10 posts on a Monday morning is start a discussion about PD measurements.

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## drk

A professional follows the laws they have to, and takes care of the patient according to their professional judgement, Mike Aurelius.  

Legal charges are based on statues, board rules, and tort.  None of that may apply in these situations.

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## drk

I do what I'm required to do, by law, 24/7.  That means I release records when requested.  Not piecemeal, though.  Requesting records usually means transfer of care, and usually there is an administrative fee.

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## drk

No Stan, glasses fitting measurements are not part of a prescription.

As to the FTC, I have no doubt that my profession will bungle any hearing that they are called to, or will cower like children.

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## scriptfiller

I will gladly provide pat's with a "printed-out" PD stick.  I however, will not give-away the skill to use the instrument.

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## MikeAurelius

> A professional follows the laws they have to, and takes care of the patient according to their professional judgement, Mike Aurelius.  
> 
> Legal charges are based on statues, board rules, and tort.  None of that may apply in these situations.


Interesting you should bring up statutes, drk. Giving the patient the wrong or incorrect information causing the patient to have glasses remade because of the wrong or incorrect information falls under the statutes for fraud. Might also be cause to lose your license.

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## MikeAurelius

Oh, and let's all remember that this forum AND THIS THREAD are all available to anyone who wants to do a search, including investigators for the FTC.

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## drk

Blah blah.  

Let's see, unlicensed, possibly foreign, totally fly-in-the-face of existing rules and regulations online dudes get a pass, whereas those of us who are responsible for the visual welfare of the citizens of this country are criminals.

You need a perspective change, sir.

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## Stan Tabor

> No Stan, glasses fitting measurements are not part of a prescription.
> 
> As to the FTC, I have no doubt that my profession will bungle any hearing that they are called to, or will cower like children.


You may be right.  But here is the public's take away from such a discussion:  "Here is your prescription...But good luck getting it filled because I am not going to give you some very crucial information you need.  Unless of course you buy your glasses from me."  

For someone in optical, this is a complex topic with varying views.  But for the public, it is very simple.  In about two years, this will be a moot discussion.  There will be cell phone apps and webcam technology readily available for free that will be more accurate than a guy holding a metric ruler in your face.

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## drk

> I've said it before and I'll say it again: the PD belongs to the patient because it is a physical measurement of the eye location with reference to the bridge of the nose, just like a prescription is the physical measurement of the powers needed to correct the vision. The places that refuse to give it out are just giving ammunition to the FTC to make a ruling requiring the PD be part of the prescription. The PD does NOT belong to the optician. It is part of the medical records and should be given to the patient.


This is wrong in so many ways.

First of all, medical records belong to the professional as well as the patient.  So there's that.

Secondly, I suppose you'd say that shoe size, because it's a physical parameter of the patient, should be given out, too. It's their shoe size, right?  It's their HbA1C, right?  It's their tomogram of their cerebral vesicles.  So, exactly where is the distinction?  It's all about the patient's body.

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## drk

It's simple because the nimwits at Yahoo! don't know how to write an article, and some of us don't have critical thinking skills needed to understand the situation and communicate it effectively to the patient.

It's not about the p.d., Stan.  It never was about the p.d. and never will be about the p.d.  That is the world's largest red herring in this issue.

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## MikeAurelius

> This is wrong in so many ways.
> 
> First of all, medical records belong to the professional as well as the patient.  So there's that.
> 
> Secondly, I suppose you'd say that shoe size, because it's a physical parameter of the patient, should be given out, too. It's their shoe size, right?  It's their HbA1C, right?  It's their tomogram of their cerebral vesicles.  So, exactly where is the distinction?  It's all about the patient's body.


Let me put it in words in a way you might understand:

It would be like giving a patient a prescription for medicine to fill, not taking into account the patient's weight and requiring the pharmacist to figure that out and dose accordingly.

Riiiight....You go ahead and live in your own little world of denial.

You are trying to come up with any argument just to cloud the issue. Since you aren't a shoe store, nor do you do ultrasounds or MRI's, any purely medical insertion is pure BS and you know it. How about if you stick to the the point, Dr. K?

How, PRECISELY, is a monocular PD remotely a non-physical (and therefore private data) measurement as it relates to the correction of the patient's vision?

Oh, yeah, red herrings, your opposition to the release of PD's is full of them.

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## Uilleann

> I understand that you do not need to take a PD to conduct an eye exam.  But isn't a PD a crucial part of the prescription?...


Nope.  The onliners guess or use "standard" PD's for their patients _ALL THE TIME_.  To call this measurement "crucial" doesn't seem to apply in this scenario.  It's a vague guideline - and certainly shouldn't matter whether its bi or mono in the least with as fast and loose as these outfits often play with their "precision" eyewear.
 :Rolleyes: 

The burden of proof will likely fall to those who can prove harm - regardless of ANSI "standards" (which of course, aren't laws or rules at all, but voluntary guidelines).  It seems that, so far at least, the only thing the FDA can (and has) come down on the onliners for is missing impact requirements...which of course, is highly unlikely that anyone looking for glasses online cares about anyway.

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## Stan Tabor

> It's simple because the nimwits at Yahoo! don't know how to write an article, and some of us don't have critical thinking skills needed to understand the situation and communicate it effectively to the patient.
> 
> It's not about the p.d., Stan.  It never was about the p.d. and never will be about the p.d.  That is the world's largest red herring in this issue.


I agree with much of what you say but we live in a society that provides for 10 seconds of thought before forming a self serving opinion.        

To the patient it is and will continue to be about the PD.  Why? Because Warby Parker and others have convinced the public the only barrier to cheap glasses is a PD.  You see, they know how to communicate with your customer better than you and your colleagues.

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## drk

> Let me put it in words in a way you might understand:
> 
> It would be like giving a patientea prescription for medicine to fill, not taking into account the patient's weight and requiring the pharmacist to figure that out and dose accordingly.
> 
> Riiiight....You go ahead and live in your own little world of denial


.

Better yet, what about if I write an Rx for oral steroids and the misinformed or just plain stupid patient gets their medrol dose pack from drugswithoutaprescriptioninternational.com




> You are trying to come up with any argument just to cloud the issue. Since you aren't a shoe store, nor do you do ultrasounds or MRI's, any purely medical insertion is pure BS and you know it. How about if you stick to the the point, Dr. K?
> 
> How, PRECISELY, is a monocular PD remotely a non-physical (and therefore private data) measurement as it relates to the correction of the patient's vision?
> 
> Oh, yeah, red herrings, your opeosition to the release of PD's is full of them.


It's not about the p.d., Mike, don't you get that?  I guess not.

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## drk

Here's how I communicate, Stan.

"Can I have my p.d.?"  (Let's assume that I have one on file.) (Now, mind you, the question is more often: "Can I have my expired contact lens powers?)

"Why do you need that?"

"Uh, want to buy glasses online."

"We don't recommend that."

"Why?"

"Because it's an unregulated mess.  We prefer you fill our prescription with a licensed professional who will provide all the necessary measurements, instead of doing-it-yourself on the internet."

"Oh.  Can I have it anyway?"

"No."

Then, if they want their records, they can have their records.  For a fee.  And they are not going to be patients in our office at that point, anyway.

See how simple?

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## Stan Tabor

> Here's how I communicate, Stan.
> 
> "Can I have my p.d.?"  (Let's assume that I have one on file.) (Now, mind you, the question is more often: "Can I have my expired contact lens powers?)
> 
> "Why do you need that?"
> 
> "Uh, want to buy glasses online."
> 
> "We don't recommend that."
> ...


Very simple.  And very effective I am sure.

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## fjpod

.....nnnnnnnnnot that simple.  Mike is more right than wrong here.  I too feel the PD is the responsibility of the fitter, and not the prescriber.  But if optometrists or opticians keep refusing to give it, either with the Rx or as part of a record, then the FTC will step in like they did with Eyeglasses 1 (and we all know how much that helped the professions) and with the Contact Lens Fairness to Consumers Act (or whatever the exact name is...).  The FTC will come down hard like a ton of bricks in favor of the consumer, regardless of state law.  So, in those states where it is not required as part of the Rx...if you stand on this as "THE LAW", you are only going to speed up the process.  Pick your poison.    

I agree, it's lose-lose.  But it is a problem in search of an FTC "solution".  So give the damn thing and try to earn your patient's trust back.

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## drk

OR, if Optometry is heard by the FTC, we can actually win for once.  I'd love to testify. 

You are awfully cynical, and I'm kidding when I say we screwed the pooch before, and we'll do it again.  

If a guy like Montequilla goes up there, as opposed to a guy like Cummings, we stand a good chance of not getting steamrolled and the public health will win.

The fetal position is not the best way for us to go through life.

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## drk

> keep refusing to give it...as part of a record,


Anyone redacting medical records intentionally is already in trouble with the state boards, so the FTC is not needed.  The FTC would come in when the feds don't like the states' rules.

Do you have evidence or hearsay about ODs not giving out complete medical records?  I don't.

Do you have evidence or hearsay about ODs not giving out p.d. when/if required by law?  I don't.

What I'm hearing is ODs following the laws, and protecting visual welfare.  

The ones not following the laws are...you guessed it.

What you're talking about is pre-emptorially caving in to a smear campaign by online pirates and hapless two-bit journalists, and throwing optometric responsibility to the four winds.  Way to go.

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## Uilleann

I don't think it's nearly as black and white as some would make it out to be.  The PD is part of the proper fitting of spectacles - no one is in disagreement of that.  With that said, the PD can change over time for numerous reasons.  There is no reason to expect that a PD from a year (or several) will never change and never need to be re-measured with each successive fitting of spectacles.  Indeed this should be a part of every new fit by a qualified optician.  I can see no legal basis for the FDA requiring an optical business to perform work that an online "optical" cannot.  Perhaps mandating the PD be required, should also mandate all online vendors to employ B&M "PD shops" that exist solely to serve their clientele.  The can hire opticians (or not as state statues allow) to do nothing but take PDs.  Otherwise I can see no legal basis for the FDA requiring any dispensary to take and then subsequently release any facial measurement for the sole purpose of serving one side of the business in this equation.

Perhaps dispensers should open their own PD only shops now.  Charge $300 per measurement, with no requirement of vendor to use, and further no guarantee whatsoever of efficacy, accuracy, or any adherence to any standard with regard to the finished product.  Then simply charge another $3-500 for troubleshooting and your time when they come back with issues related to fit or function.  Don't worry about maintaining a frame selection.  Don't worry about lens options, different vendors or warranties.  Just exist to fix the flood of problems that the internet glasses industry will continue to create.

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## Barry Santini

Once again, thank you GWB!

But I'm not so sure that the Feds will want to trample on individual state regs with regards to this...especially because it is medical.

The PD *is* a different animal from the sealed-vial CL and the actual starting Rx.

B

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## fjpod

> OR, if Optometry is heard by the FTC, we can actually win for once.  I'd love to testify. 
> 
> You are awfully cynical, and I'm kidding when I say we screwed the pooch before, and we'll do it again.  
> 
> If a guy like Montequilla goes up there, as opposed to a guy like Cummings, we stand a good chance of not getting steamrolled and the public health will win.
> 
> The fetal position is not the best way for us to go through life.


No need for personal attacks.  The AOA does work hard for dispensing rules...and not all of which members of this board would support.

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## fjpod

> Anyone redacting medical records intentionally is already in trouble with the state boards, so the FTC is not needed.  The FTC would come in when the feds don't like the states' rules.
> 
> Do you have evidence or hearsay about ODs not giving out complete medical records?  I don't.
> 
> Do you have evidence or hearsay about ODs not giving out p.d. when/if required by law?  I don't.
> 
> What I'm hearing is ODs following the laws, and protecting visual welfare.  
> 
> The ones not following the laws are...you guessed it.
> ...


I have heard of ODs and opticians withholding PDs.  I am on my state board and we get at least one complaint per week.  

And history tells me that if a practitioner holds onto the spectacle or CL Rx, the FTC will step in.  They didn't like the state rules back then, and I doubt if they like what they see right now.  And history also tells me that when organizations like AOA get too involved in these things (like the CL Rx release debacle), they get sued for $2million and lose because the issue appears to be self-serving.  

As you are demonstrating, this seems to be an issue that elicits high emotion.  It's as if your livelihood is being threatened.  This is the way the public will perceive it. 

It's not that simple.  No one is advocating roll over and play dead.

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## fjpod

> Once again, thank you GWB!
> 
> But I'm not so sure that the Feds will want to trample on individual state regs with regards to this...especially because it is medical.
> 
> The PD *is* a different animal from the sealed-vial CL and the actual starting Rx.
> 
> B


sorry B, betcha they will...movie at eleven.

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## drk

Well, FP, your credibility is enhanced by being on the NY state board, that's for sure.

I think there's an open-and-shut case against unregulated optical care, and it's simple one to make, IMHO.

The politics are already starting, as per the title of this thread.  If organized optometry and medicine and opticianry allows themselves to be "defined", as opposed to setting our own agenda on this issue, then we are saps.

The greedy, self-interested doctors vs. the child who goes blind from poor eye care.

This is standard, boilerplate, emotional, dirty politics as usual.

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## drk

> I have heard of ODs and opticians withholding PDs. I am on my state board and we get at least one complaint per week.


 
To be clear, though, they are well within their rights to do that, no?

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## Chris Ryser

*What is Pupillary Distance? How to Measure PD?*

*What is PD?**Measuring your PD**Getting a friend to measure your PD*
*
* 
*What is my PD?*
(also called *Pupillary Distance*, _Inter-Pupillary Distance or Pupil Distance)_
PD is the distance between the centre of one pupil to the centre of the other pupil. Prescription glasses are made so that the distance between the optical centres of the glasses' lenses, is the same as your PD. PD varies from person to person but once you are an adult, your PD does not change. Therefore, as an adult, if you have had it measured, then it will still be the same, even if your spectacle prescription has changed. Once you know your PD, you do not need to measure it every time you buy prescription glasses.
PD is measured either during the eye test or when prescription glasses are ordered. Obviously we cannot measure your PD over the internet, so it is best to make sure your PD is included in your glasses prescription.

The Diagram below represents a PD of 62mm.
If your prescription does not contain your PD:

Ask to have it measured at an optical shop  some may charge a fee. Contact an optical shop where you have previously purchased prescription glasses. Your PD has been measured if you have ever had prescription glasses made up.Your previous optometrist may have a record of your PD.Alternatively, try measuring your own Pupillary Distance as explained below. (_Note: Measuring your own PD may not be as accurate as having a trained person do it. If your head or the ruler moves during the measurement then the reading will be inaccurate)_
The higher the lens power in the glasses prescription, the more important it is to use an accurate PD. These procedures may not work for everyone. We recommend that you obtain a professional measurement of PD whenever possible.


*Measuring your own PD (Pupillary Distance):*

TIP: This should be done with glasses off, if the numbers on a ruler are difficult to see, then a magnifying mirror may help.
1. Whilst looking into a mirror hold a ruler against the bridge of the nose with one hand.
2. Close your left eye, and line the '0' up with the centre of the pupil of your right eye as shown in the diagram.

3. Without moving your head or the ruler open the left eye and close the right eye. Read the number that lines up with the centre of the pupil of the left eye. This number represents your Distance PD in millimetres. You have just used this technique to measure your distance PD.

4. Repeat this whole process at least 3 times to try and get a consistent measurement in millimetres. Make sure your head and the ruler do not move after lining up the zero on the ruler until you take the reading. This procedure may be difficult if one eye has very poor vision compared to the other eye.
When you enter your Pupillary Distance (PD) details on the Stingy Specs glasses prescription form, enter the number you have just measured  this is your distance PD. You then need to enter your near PD which is calculated as 3mm less than the distance PD.

e.g. Distance PD = 60
Near PD= 60  3 = 57    
Sometimes the centre of the pupil is difficult to see. Instead of lining up the ruler with the centre of the pupil, it is more precise to use the edge of the pupil as shown at the bottom of the page; (be careful to use the inside edge of one pupil and the outside edge of the other pupil.)
*Getting a Friend to Measure Your PD:*

This technique uses a second person to measure your Pupillary Distance (PD).
1. Both of you should be sitting down approximately 45cm apart. The person having their PD measured keeps both eyes open. When your friend is taking the measurement, they must keep one eye closed.

2. The ruler is held against the forehead as shown above. The person having the PD measured looks into the open eye of the person taking the measurement.
The 0 is lined up with the centre of one pupil. Record the number lining up with the centre of the other pupil in millimetres. This is the measurement for the near PD. Neither person should move their head during this procedure. This procedure will not work if the person having their PD measured has a turned eye. You have just used this technique to measure your near PD.
When you enter your PD details on the Stingy Specs glasses prescription form, enter the number you have just measured into the near PD field. Enter your distance PD which is calculated by adding 3mm to the near PD. (This rule is accurate for most people).
Eg Near PD= 57
Distance PD= 57 + 3= 60
Instead of using the centre of the pupils, you can use the edge of the pupils as shown below. (be careful to use inside edge of one pupil and outside edge of the other pupil.)

Please see the Entering my Prescriptionezine for information on how to enter your PD and your spectacle prescription into the Stingy Specs website when ordering glasses online.
Please note that when you measure your own PD by using these techniques you may not get the same result as an experienced professional. We recommend that you use the measurements taken by an optometrist or an optical dispenser whenever possible. This page is provided for information purposes only. We do not take responsibility for the accuracy of measurements taken by people referring to this information. Please note that professional optical dispensers and optometrists may use different techniques to measure your PD. 


To get a prescription, you need to have an eye exam by an optometrist or ophthalmologist. It is best to ask to have the PD included on the prescription.
Optometrist Directory: ACTNSWNTSAQLDTASVICWA


source ------------------------------->    http://www.stingyspecs.com.au/what-is-PD.html

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## drk

There'd better be online tutorials for p.d., because I ain't doin' it.

But again, let them make their own glasses, if they want.  Leave me out.  

Hey, do-yourselfer:

No seg heights.  Do it yourself.

No p.d.s.  Do it yourself.

No lens index help.  Do it yourself.

No frame fitting "tips".  Do it yourself.

No free adjustments.  Do it yourself.

No free troubleshooting.  Do it yourself.

No free prescriptions.  Do it yourself.

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## Barry Santini

> There'd better be online tutorials for p.d., because I ain't doin' it.
> 
> But again, let them make their own glasses, if they want.  Leave me out.  
> 
> Hey, do-yourselfer:
> 
> No seg heights.  Do it yourself.
> 
> No p.d.s.  Do it yourself.
> ...



drk, you're forgetting this is america:  if it's cheap enough, it'll be OK.

Doesn't matter if its cars, politicians, or anything else...

B

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## fjpod

> To be clear, though, they are well within their rights to do that, no?
> 
> 
> [/COLOR]


NYS says the PD is not part of a prescription that must be released at the time of the exam, but whether you are an OD/OMD or an optician, if you have the PD in your record, you must release it.  

I dunno how the state board in Ohio operates, but I am willing to bet it is not that much different from NY, but the purpose of the board is to protect the citizens of the state... not to protect the interests of the professions, and certainly not the economic interests of the profession.  

No one is going to go blind from you (or me) giving out a PD.  I can see how refusing to give out an expired CL Rx is a protection for the public...but a PD?  When the law already says eyeglasses can be duplicated at any time??  

We in NY, and I am sure in other states, have struggled with the unregulated sale of glasses for many years, decades already.  There is no open and shut case as you state.  In spite of it all, NYS's official dictate is that the online sale of glasses is illegal, as a face to face fitting and dispensing is required.  Even if the PD must be released, a hands-on fitting must occur by an appropriately licensed professional.   That being said, there is no way to enforce this, and NYS only responds to consumer complaints.  

There is no magic wand the AOA or the State Board can wave to make this problem go away.  It has nothing to do with the backbone of the volunteer leaders within our profession.  We can recommend and educate.  There are no dirty politics involved.  It has to do with consumerism and consumer protection... notice I did not say optician or optometrist protection.   That is now called a monopoly and there are laws against it.  

You may have heard me say before on this board that I think Eyeglasses 1 was one of the worst thing that ever happened to the ophthalmic professions.  It set the stage for the patient's right to have and take any information they want from one provider to another.   Really,... this isn't the most terrible concept in the world, but it hit the ophthalmic professions hard because we traditionally dispensed the goods that we fit or prescribed.  If the prescriber has to give away the Rx, then the fitter has to give away the PD, and so on, and so on...   Some call this free choice and consumer rights.   I call it fragmented care...but that's me.   

I may be on the state board, but trust me, I don't get to make the laws and neither does our profession.   I do get to sit down with decision makers in the State Ed Dept. (which controls our state board), and one of my jobs is to make a balanced presentation about issues, and not embarass myself and my profession, let alone get into legal trouble.  Although a bit off the subject, you would not believe the lengths our state goes through to make sure THEY avoid legal trouble...and THEY should.   You think the AOA is gun shy???  State government makes them look like cowboys.

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## fjpod

btw, I think the title of this thread should not be " the battle has begun" ...but "the battle is over".

----------


## drk

I appreciate your insight.  Ohio is like NY: must dispense face-to-face.  I think all it should take would be for the optical dispenser's board to make the violation of the rule worthwhile...that is, make it an expensive fine when an in-state transaction occurs.  That should more than pay for a few officials and make the state a little revenue to boot.

----------


## fjpod

> I appreciate your insight.  Ohio is like NY: must dispense face-to-face.  I think all it should take would be for the optical dispenser's board to make the violation of the rule worthwhile...that is, make it an expensive fine when an in-state transaction occurs.  That should more than pay for a few officials and make the state a little revenue to boot.


99% of the online businesses that violate the law are not even located in NYS.  Half of them are probably not even located in the US.  These businesses are not even registered with the State Ed. Dept.  Most often, there is no NYS licensed professional behind them.  The State Board can only discipline people that hold a NYS license...so, the responsible licensed people get in trouble, but the scofflaws don't.  Is that what we really want?

----------


## Chris Ryser

> *99% of the online businesses that violate the law are not even located in NYS. Half of them are probably not even located in the US. These businesses are not even registered with the State Ed. Dept. Most often, there is no NYS licensed professional behind them. The State Board can only discipline people that hold a NYS license...so, the responsible licensed people get in trouble, but the scofflaws don't. Is that what we really want?
> 
> **.....................btw, I think the title of this thread should not be " the battle has begun" ...but "the battle is over". 
> **fjpod*




Thank you fjpod for your last few post's. I hope that the message you have given sinks in where it should. 

I would just like to add that the manufacturing price level of eyeglass frames and eyglass lenses has reverted back about where it was 50 years ago. However the the retail selling price level has never reverted back, but only forward and upward. 

There have always been 2 classes of B&M opticians, retailing optometrists as well as retailing Md's:
1)  The ones that had their own finishing lab and did the manual work with their own equipment.
2)  The ones that relied on another finishing lab to do the work at a profit.

Frame and lens importers that never passed on the savings as material cost dropped big time when they started to get produced in the far east were also part of the high retail prices.

It was only a matter of time that some smart brains looked into a way to make money in the optical retail by selling to the masses of consumers eyeglasses at a markup that seems fair to them and beat the conventional retail market, with their pricing.
Just read the ESSILOR minutes from their annual meeting at the end of March 2013. "There are billions of people in need of glasses around the world and they want to make it possible for them to get it". 

There was a special in one Super Market of two of them in the same shopping center. Same brand smoked ham at 6 pounds was $ 8.47 and in the other store was $ 27.80. You guess which one I bought.

----------


## HindSight2020

> Just read the ESSILOR minutes from their annual meeting at the end of March 2013. "There are billions of people in need of glasses around the world and they want to make it possible for them to get it".


Which includes competing against and stepping on any customer which gets in their way on their journey to global dominance.

Good job people, keep feeding them your business so they can stomp you.  They probably already have a consumer PD self measure device in development.

----------


## Stan Tabor

> Which includes competing against and stepping on any customer which gets in their way on their journey to global dominance.
> 
> Good job people, keep feeding them your business so they can stomp you.  They probably already have a consumer PD self measure device in development.


You are not going to stop advances in technology.  The pace of change continues to accelerate.  The eyewear industry has largely been late to the game with respect to changes brought about by e-commerce and consumer based technology applications.  You can adopt an attitude of "glasses are special, you need personal measurements, they are medical devices, blah blah blah" and refuse to innovate.  Ultimately you will get wiped out.  

Consolidation in the eyewear industry was inevitable.  It happens in virtually ALL INDUSTRIES.  As an example, when cars were first invented, there were literally hundreds of auto manufacturers.  Ford and later GM and Chrysler drove innovation and you had the big three.  Same thing happened in radio and TV.  

If you think the same was not going to inevitably happen in eyewear, you have not learned from history.  Mature businesses consolidate.  In the lab business, you now have E, Z, and H.  In frames, you have Lux, Saf, and Marchon.  You can make the same lists for optical retailers and insurance companies.  Any little guy who wants to compete in a mature industry is a niche player and better do one thing very well.  Embracing a new technology can be your ticket to success.   

So get beyond worrying about PDs and start thinking about the future of your business.

----------


## MikeAurelius

^^ +1

----------


## drk

You're right, fjp, I meant to say state Attorney General's office.

----------


## MakeOptics

> The burden of proof will likely fall to those who can prove harm - regardless of ANSI "standards" (which of course, aren't laws or rules at all, but voluntary guidelines).  It seems that, so far at least, the only thing the FDA can (and has) come down on the onliners for is missing impact requirements...which of course, is highly unlikely that anyone looking for glasses online cares about anyway.


You hit the nail on the head.  That's the only way in which harm can realistically occur in significant enough numbers to raise alarm and even then like you mentioned I don't think anyone is going to care since they got them cheap online.

----------


## drk

I call BS on your post, Chris.

It's not manufacturing costs.  It's the fact:
1. That anyone can start up a website with minimal cost
2. That has a huge marketplace
3. We are in the early phases so there are a lot of non-profitable websites
4. Essilor has put the hurt on so many private labs that they'll contract out
5. International labor and exchange differences

Yes, frame wholesale costs have gone up, but vision plan penetration is HUGE and no patients pays retail, anyway, so at the retail level they've been pretty steady.

----------


## drk

The real pinch will continue to come when deregulation takes fuller effect.  

"So your state dispensing laws are flouted?  Tsk tsk.  Well, no one ever died from a poor fitting frame."

"So refractor kiosks are in the mall?  Well, if they don't work, people won't use them, so..."

"So, that guy I got my eyes examined from isn't really an eye doctor?  Wow, he sure looked spiffy in that coat..."

"I can't tell who the he77 knows what they're doing, and I can't get glasses that work for my elderly mom."

"Hey, I just found a certified doctor that uses certified opticians and make quality eye glasses by a real, live company and I'm a lot happier."

----------


## HindSight2020

> You are not going to stop advances in technology. The pace of change continues to accelerate. The eyewear industry has largely been late to the game with respect to changes brought about by e-commerce and consumer based technology applications. You can adopt an attitude of "glasses are special, you need personal measurements, they are medical devices, blah blah blah" and refuse to innovate. Ultimately you will get wiped out. 
> 
> Consolidation in the eyewear industry was inevitable. It happens in virtually ALL INDUSTRIES. As an example, when cars were first invented, there were literally hundreds of auto manufacturers. Ford and later GM and Chrysler drove innovation and you had the big three. Same thing happened in radio and TV. 
> 
> If you think the same was not going to inevitably happen in eyewear, you have not learned from history. Mature businesses consolidate. In the lab business, you now have E, Z, and H. In frames, you have Lux, Saf, and Marchon. You can make the same lists for optical retailers and insurance companies. Any little guy who wants to compete in a mature industry is a niche player and better do one thing very well. Embracing a new technology can be your ticket to success. 
> 
> So get beyond worrying about PDs and start thinking about the future of your business.


I agree, but think you missed my point. The innovation already developed or in the future should only be sold/offered to consumers through ECP's (dealers), not consumer direct which is happening. 

Ford, Chrysler or GM do not sell brand new cars bypassing their dealers direct to consumer via the web or otherwise. People should really get their heads out of the sand and stop supporting the 'E'. Believe it or not, there is a great life out their without them and will no be no voids to fill in your practice without their absence.

----------


## drk

> _You are not going to stop advances in technology. The pace of change continues to accelerate. The eyewear industry has largely been late to the game with respect to changes brought about by e-commerce and consumer based technology applications. You can adopt an attitude of "glasses are special, you need personal measurements, they are medical devices, blah blah blah" and refuse to innovate. Ultimately you will get wiped out._


You have the perspective of a glasses guy.  The whole eye care industry is at least half medical model, if not more.  If people could get a custom-fitted vision correcting device out of a vending machine, by now there'd be that option.

We may have made all these "advances" (mostly in information technology, if you're honest), but the human body is the same old/same old.  Some things change very, very, slowly if at all.

----------


## Barry Santini

> WP is opening B&M locations. They will soon find out the *costs* of such locations. Either they will need a pricing restructuring or turn out being just another Eyemart Express...A cheap provider of mediocre product supplied by minimally trained staff.
> 
> Also, if you read the comments section you will find a huge disgruntlement over PD's not being provided by their examiner. Refusing this info is not a way to elicit loyalty from your patients. If you have it documented, you should provide it. If not, charge a nominal fee and engage them in why they don't find value in your services. It just may give you the opportunity to improve what you offer along with educating them with what you provide that online can't.


Actually guys and gals, you WANT to give out their PD while the online eyewear scene is still in its "wild-west" phase.  If you been doing you home work all along, then when they sample the "cheaper" eyewear, they may find them to be OK (for the money... at first), but I've been fitting FF SV for onto 5 years as my main lens, with good abbe material and proper frame choice. People who've trie Costco, Wize Eyes and other lower-end opticals..._who really value what we deliver._..are back, having "learned their lesson." Not everybody, but a filtered set of qualified clients.

There is no comparison.  To compete, you don't want to just lower prices.  You NEED to step up the quality.

And drop taking insurance directly.

B

----------


## vcom

I second Barry's post.  If you provide the best possible service, with the best possible product, you will find a loyal patient base to support a successful business.  I'm pretty sure 5 star fine dining restaurants don't stress too much about the dollar menu down the street.  If you have measured a PD for a previous pair of glasses, I'd give it out.  If you haven't, that's your chance to explain the importance of it, and the quality control concerns, and all that hubabaloo, giving the patient the chance to make an informed decision.  I've had enough people come back and buy glasses from me because I replaced nose-pads for free, that it's obvious consumers do care about personal service, and respect.  Denying PD's (if you have them) just seems petty and rude.

----------


## drk

> Denying PD's (if you have them) just seems petty and rude.


Is it going to be "petty and rude" when they swing by with a pair of frames from Lenscrafters or the net and want you to measure seg height?

_"C'mon, the website says it's only a two-second measurement.  What's the big deal?"

_What do you say to that?  Where do you want to draw the line?

_"C'mon, adjust my glasses.  What's the big deal?"

"Hey, doc, I can't see out of these glasses that I got with your prescription.  Please check them out.  What's the big deal?"

_
I ask you this: if you show up at Midas with a muffler you bought online and they say _"Sorry, we only put on mufflers that we supply"_ do you say: _"C'mon, what's the big deal?  A muffler's a muffler!  How petty and rude!"

_If you rationalizers don't stop participating with this, you're going to boil like a frog.  _"Oh, no, I won't go one step further!" _ Sure, you will.  You will compromise whatever license you may have, you'll compromise your profession, and you'll be cheating, really, those patients that you participate in their half-@$$ glasses behavior.

----------


## Stan Tabor

> You have the perspective of a glasses guy.  The whole eye care industry is at least half medical model, if not more.  If people could get a custom-fitted vision correcting device out of a vending machine, by now there'd be that option.
> 
> We may have made all these "advances" (mostly in information technology, if you're honest), but the human body is the same old/same old.  Some things change very, very, slowly if at all.


You may judge me as a "glasses guy" but I also view myself as someone who realizes that those who do not understand history are destined to repeat it.  The context of my post was why consolidation happens. 

You proved my point.  The recent history in the "medical model" is a prime example.  In most and if not all major metropolitan areas, the vast majority of hospitals have been bought up by regional or national hospital groups.  The independents left are either not worth buying or will soon be bought. Physician practices have been bought up as well.  We are in the age of corporate medicine.   The "independent doctor" is an endangered species.  Sure you see an occasional doctor who owns his own practice.  But Plastic surgeons and ODs are about the only doctors left whose practices haven't largely been gobbled up by hospital chains or insurance companies.  The cost of technology and infrastructure, malpractice insurance, the need for continuous training and many other factors made consolidation inevitable.  Change is coming to OD practices as well, especially if ODs continue in their desire to move up the "value chain" and move their primary focus beyond eye exams and tap into medical billing.  If you think you are going to make a stand as an eye doctor and stop change by not giving out a PD, in all sincerity, I wish you luck because you are going to need it.

----------


## drk

You missed the point. As a healthcare provider (you could be, too, if you wanted to move up the "value chain") you have a different standard. 

You provide a health care service.

They haven't figured out a way to digitize that, regardless of all your futurist language. If you think "more consolidated is better", you just wait.  Consolidated is blah.  Think about restaurants and the GAP, and every other stupid experience that we get from corporate America and then imagine your protologist and what could happen.

Think TWO steps ahead, not one. Zig when they zag, you know?

Barry's got the right idea (except for that "give out the p.d.'s now" baloney).

----------


## MikeAurelius

> I ask you this: if you show up at Midas with a muffler you bought online and they say _"Sorry, we only put on mufflers that we supply"_ do you say: _"C'mon, what's the big deal?  A muffler's a muffler!  How petty and rude!"_


And here we go again with the masked man fallacies. C'mon, drk, you are better than this.

----------


## Steve Machol

It seems to me that if you provide the PD for a pair of glasses you are not providing, then if something isn't right the patient will be much more likely to blame you for the problem and demand some remedy. That itself is reason enough not to do it.

----------


## drk

The only other model I can think of when it comes to DIY is Home Depot. They'll hire retired plumbers to work in the box and give free advice as to which toilet flapper to buy. 

You do it yourself, they provide the parts without any service, but then they give you minimum wage DIY advice. 

Get your orange aprons at the ready.

@Mike Aurelius: What other service provider provides a service without supplying the part?  Do you bring in the lumber, nails, glue, whatever and have some guy put in your hardwood floor and guarantee the outcome?  No, your cousin Bubba, will, though.

Will Earl Scheib let you bring in the paint from NAPA and guarantee the outcome?  (Well, Earl Scheib probably would, so bad example.)

Can you think of another example of those who would go halfsies (for free at that) with a DIY consumer?

----------


## MikeAurelius

> The only other model I can think of when it comes to DIY is Home Depot.  They'll hire retired plumbers to work in the box and give free advice as to which toilet flapper to buy.  
> 
> You do it yourself, they provide the parts without any service, but then they give you minimum wage DIY advice.  
> 
> Get your orange aprons at the ready.


The only problem with THIS fallacy is that the consumer does not own any spectacle manufacturing equipment. They are much more likely to own a wrench.

FAIL.

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## Labgeek

Guys, I am new here and have been reading about this whole ordeal over the PD and was wondering if we all are missing the big picture here. It is really not about giving or taking a PD for a patient its all about buying online eyewear. This matter is no longer relevant according to framesdirect.com (ESSILOR). This is directly off of their website "Pupil distance measurements are taken at the time of an eye examination.  Occasionally the PD information is omitted on an eyeglass prescription.Now, getting a PD measurement as accurate as the doctor's can be done from the convenience of your computer" or better yet just check out this link that is a full page explaining about the PD http://www.framesdirect.com/landing/...u-need-pd.html . So to me this is making the question of giving out the PD no longer an issue. I'm  sure all of the other online optical retailers are taking notes on how they can incorporate this for themselves.

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## vcom

DRK- so, what _exactly_ are you afraid will happen if the patient gets their PD?  So far it just sounds like you want to argue, and discount our profession to that of muffler installers, and Home Depot employees.

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## drk

I'm trying to get you guys up to the correct level of professionalism.  Don't worry, I have to crack on ODs that are as lackadasical.

I can't explain it any more.  I can't give analogies, apparently, without being accused of some "logical fallacy".  

Do what you want, guys.

But, remember (when you hand wring that the public doesn't know the difference between someone they pulled off the home good department and plopped down in the optical and you, who is trying to create some "brand" so patients can tell the wheat from the chaff) that licensure and degrees and boards and rules and malpractice, etc. are a quality control issue.  

If you water down your quality by equating yourselves with the online nobodies, you slowly become a nobody, too.  An optician is anything, everything, and nothing, all the same. 

Now, if you want to go the opposite direction, I think it does a good thing for society.  

But please, be sure to be nice to everyone!  Customer's always right, you know! :Rolleyes:

----------


## drk

> _"Pupil distance measurements are taken at the time of an eye examination. Occasionally the PD information is omitted on an eyeglass prescription.Now, getting a PD measurement as accurate as the doctor's can be done from the convenience of your computer" or better yet just check out this link that is a full page explaining about the PDhttp://www.framesdirect.com/landing/...u-need-pd.html 
> 
> 
> _


More lies, worthy of essilor.

----------


## optical24/7

> Actually guys and gals, you WANT to give out their PD while the online eyewear scene is still in its "wild-west" phase.  If you been doing you home work all along, then when they sample the "cheaper" eyewear, they may find them to be OK (for the money... at first), but I've been fitting FF SV for onto 5 years as my main lens, with good abbe material and proper frame choice. People who've trie Costco, Wize Eyes and other lower-end opticals..._who really value what we deliver._..are back, having "learned their lesson." Not everybody, but a filtered set of qualified clients.
> 
> There is no comparison.  To compete, you don't want to just lower prices.  You NEED to step up the quality.
> 
> And drop taking insurance directly.
> 
> B


Barry, this posts states exactly my thought with this post from page one....




> ... Even if you have a (legal) leg to stand on, would you rather loose patients over it (along with the bad PR that would go along with it)? Why not let them *take a walk on the wild side*?
> 
> After years and years of watching a handful of patients purchase elsewhere, only to sheepishly return with bad stories of service, product, comfort, ect from other locations and become life long clients, I'm convinced that they see value in me. Even if they find similar service and products/pricing, they still don't get *me*. If you (or any of you) are loosing patients on price alone you are not providing value in their eyes. You have to ask yourself, why?
> 
> Lastly, the optical pie is HUGE. There are many markets and sub-markets. You can't be all things to all people. Pick your market and excel! Be it a burger joint or a fine steak restaurant, there are clients that will patronize them.

----------


## optical24/7

And just for you Doc;

"_If you love them, set them free. If they return it was meant to be."_  :Biggrin:

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## Uilleann

> The only problem with THIS fallacy is that  the consumer does not own any spectacle manufacturing equipment. They  are much more likely to own a wrench.
> 
> FAIL.


I don't know - this analogy may be closer to the mark than you make it.

The  customer doesn't own the key cutter at the Home Depot either...but it's  still cheaper to run in, have something cut and pray to the flying  spaghetti monster that it works - rather than hiring a qualified,  trained, licenses and insured master locksmith to do it once, and do it  right.

Sure, you may have to drive back to the store and deal  with re-cuts and the dreaded exchange/returns desk, broken keys stuck in  your lock, damaged tumblers/barrel/pins/etc on your lock itself, and so  forth.  But hey, it was cheap, so it's clearly the way to go!

America  is killing itself in it's ever present search for "cheap" vs paying  that little bit more for quality and service.  Then we b**ch and moan  all the way to the Walmart for cheap tissues and ice cream to console  ourselves.  Meanwhile, Main St continues to die off.

Pts/clients  that are worth keeping will continue to seek out and find exceptional  service and quality.  And more perhaps than we give credit for are  willing to pay more for much better service/quality.  Our job is simply  to show the value in what we bring.  There are always going to be those  that choose to try and beat up everyone the encounter on cost and cost  alone.  You don't need them.  And they'll get precisely what they pay  for - all perceptions aside.   :Rolleyes:

----------


## Stan Tabor

> You missed the point. As a healthcare provider (you could be, too, if you wanted to move up the "value chain") you have a different standard. 
> 
> You provide a health care service.
> 
> They haven't figured out a way to digitize that, regardless of all your futurist language. If you think "more consolidated is better", you just wait.  Consolidated is blah.  Think about restaurants and the GAP, and every other stupid experience that we get from corporate America and then imagine your protologist and what could happen.
> 
> Think TWO steps ahead, not one. Zig when they zag, you know?
> 
> Barry's got the right idea (except for that "give out the p.d.'s now" baloney).


Actually, you missed the point.  Technology is a leading driver of how healthcare is delivered.  

I am not always the biggest fan of consolidation either.  I grew up in a different era when small business ruled the day.  But there is a reason why consolidation occurs.   That big hospital can afford the $1.2 million MRI unit with the best scanning technology.  Joe Independent Radiologist cannot.  A regional hospital group can afford to put in a state of the art cardiac unit in one of its hospitals.  A stand alone independent cannot. 

Further, you prove the point by mentioning the Gap.  More evidenced that corporate America has the means to wipe out the little guy.  

For decades, the fragmentation in the optical industry stifled innovation.  That is changing as the roll ups are creating a scale unseen before in the industry.  We are also seeing innovation driven by people that are not the traditional eyecare professionals.  An OD clinging to a PD measurement is not going to stop the acceleration of change.    

Time for Stan to take his nap.

----------


## Barry Santini

I just posted the following in the comments section of Yahoo, where the original video aired:

_"If PD was really important, then over-the-counter readers, aka OTCs, which are available up to 3.00 diopters (85% of all prescriptions are found under 3.00 diopters), would have coughed up some bodies by now. Besides, online vendors have methods using credit cards and picture analysis algorithms that can interpolate a person's binocular PD pretty adequately."

_We should all aspire to the high standards of care espoused by drk, Which I share.  However, legislatively, only "adequate" or minimal standards are legally and politically possible in our country.
_
_Buyer beware._

_B_

_

----------


## EyeCare Rich

Right on the mark as usual Barry!  However unfortunate, it is very correct.  I understand and agree with were Drk is coming from, but it's an endless argument that will never be won.

----------


## globaljp

WP does have their own webpage for getting pds. Its pd.w......p......com. Its accurate if done according to the instructions, at least based on that we have used it a few times just to see. I have done this photo & credit card deal many times in the past to make lenses for out of state patients and never had it not work. Its similar to what a lot of the either ipad apps or machines do except you have to do the math. We charge $15 for a patients pd if we have never made glasses for them or they just want an exam. We explain we will verify the RX and adjust them when they get them. Once we explain we are responsible for the measurement and want to make sure the glasses get made properly they pay it and dont give much grief. 

The society is one that people want what they want for cheap. Those people are not our customer so we dont get upset. In fact some of our customers just want a cheap back up or 2nd pair and I cant compete with $100. Well we could, we just choose not to. They can tell the difference and know they are getting a much better product. I really feel instead of putting up a wall and upsetting the person, charge them a small fee so you are not wasting your time and build a relationship. Instead of trying to straighten the chairs on the titanic, build your own lifeboat and save your own people. WP cant make the glasses feel good on them. They will fall apart soon enough. I would rather spend energy toward my great customers who have money and understand our value. The person upset with you is 10x more likely to badmouth you to everyone they know. 

If you do some research, WP is not profitable. Without the investors they would have been long gone. The online model is one that is here to stay. So adjust and survive. Service will always bring people back.

My 2 cents

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## drk

> However, legislatively, only "adequate" or minimal standards are legally and politically possible in our country.


Medical standard of care is not legislated.  It's regulated in the torts.  There's no way that you can get away with minimal standards of care.  You have to do what your peers would do, and that's a pretty heavy lift with good colleagues.

Any statute that IS on the books, however, such as licensure, is indeed to provide a floor and establish a minimum standard for what defines a profession.  After that, a true profession self-regulates.  (There are demeaning exceptions, such as Florida defining what an eye exam is or isn't.)  It's up to us, folks.

----------


## drk

> We charge $15 for a patients pd if we have never made glasses for them or they just want an exam. We explain we will verify the RX and adjust them when they get them. Once we explain we are responsible for the measurement and want to make sure the glasses get made properly they pay it and dont give much grief.


You seem like a nice guy.  But I ask you, what are your patients paying for whatever services you provide them?  Let's not get into parts plus labor specifics, but if you measure and verify a guy off the street for $15, are you charging your patients the same ridiculously low price?

----------


## globaljp

Who says $15 is low? It takes me what 5 mins to measure and check them out. We are nice. We don't let people walk on us at all, however, get the guy out of my store who is not my customer and make $15. It's a win win. They are at most mildly perturbed they had to pay for it. And I made enough to pay for my time. Our lens pricing is competitive to Clarkson and LC at least in the ballpark. We are a super busy shop and I don't want to waste energy arguing with people. We don't currently charge for adjustments. My only point is to analyze what your time and energy is worth. We come from the stance to be positive about everything we do. 

We have only had to do this a handful of times. In fact WP sent one guy to us. Now that is funny ! !

----------


## CCGREEN

Good WP..........have to wonder if their dream is large enough to give Wally-World a good old fashion spanking in the optical business.  :Biggrin:  This I have to watch  :Biggrin:  popcorn soda anyone?

----------


## drk

Warby Parker could be gone in a year, meanwhile we're lowering our professional standards.  Kind of sad.

----------


## Robert Martellaro

> Warby Parker could be gone in a year, meanwhile we're lowering our professional standards.  Kind of sad.


There are principally two kinds of people in the present day ophthalmic community- the James Sheedy type, and the Jimmy Swaggart type. I'm putting my money on the former, and will expose, not compete with the latter.

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## Quantrill

> Interesting you should bring up statutes, drk. Giving the patient the wrong or incorrect information causing the patient to have glasses remade because of the wrong or incorrect information falls under the statutes for fraud. Might also be cause to lose your license.


I'm just wondering if this also applies to the many "Doctors" that constantly have to re-write RXs.  As a conservative estimate I would say 90% of my remakes are because of this.  

Thanks to Mike Aurelius I think I will start a lawsuit against pretty much every Optometrist/Ophthalmologist in the country for "Giving the patient the wrong or incorrect information causing the  patient to have glasses remade because of the wrong or incorrect  information".

Great idea!!!

----------


## eyedude

Many of the replies about supplying PD's refer to opticians being professionals. How can you consider an optician as a professional when many states doesn't require the individual to have a state license or it's ok to take the path of apprenticeship. Formal education and state licensing is the only future for opticianry. That's what you should be fighting for. Not debating about PD's.
WAKE UP.

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## Stan Tabor

> Warby Parker could be gone in a year, meanwhile we're lowering our professional standards.  Kind of sad.


Forget about Warby Parker.  Frames Direct and Eyebuy Direct aren't going anywhere.  They are part of a corporation with a market cap of over $17,000,000,000 and growing.

----------


## Lee H

> Forget about Warby Parker.  Frames Direct and Eyebuy Direct aren't going anywhere.  They are part of a corporation with a market cap of over $17,000,000,000 and growing.


+1

----------


## Quantrill

> The "independent doctor" is an endangered species.  Sure you see an occasional doctor who owns his own practice.  But Plastic surgeons and ODs are about the only doctors left whose practices haven't largely been gobbled up by hospital chains or insurance companies.  The cost of technology and infrastructure, malpractice insurance, the need for continuous training and many other factors made consolidation inevitable


While you are correct that FAR fewer doctor's now own their practices, the ones who truly are smart have already seen the writing on the wall and are "going direct".  They are reaching potential customers/patients and saying "for $$$ per year I will see you as many times as I need to and I will solve your problems".  They are doing this in spite of many people already having insurance plans and in spite of all the corporate nonsense that goes on. They are truly "on call" as doctors used to be.  It is amazing to me to see things comes full cycle.  I love it.

----------


## Chris Ryser

> *I call BS on your post, Chris.
> *
> It's not manufacturing costs. It's the fact:
> 1. That anyone can start up a website with minimal cost
> 2. That has a huge marketplace
> 3. We are in the early phases so there are a lot of non-profitable websites
> 4. Essilor has put the hurt on so many private labs that they'll contract out
> 5. International labor and exchange differences
> 
> ...






and I am sending the BS right back at you...............

Manufacturing prices always defined an end to the consumer pricing. Manufacturers of optical frames are selling frames today at the level they cost in the early 1960's. Having been a major brand name distributor for 20 years I do know that business. I am following OptiBoard rules and will not mention them.

However there is no more just a couple of hands full of them, there are in East Asia (128637) of them competing against each other. You can verify that on a public site at http://www.alibaba.com/trade/search?...optical+frames ...........................and check them out. I can get you the link for lenses too if you still feel like it.

Once you have done that please explain to us were the difference between the manufacturers selling price and your selling price has disapeared to and if the on-liners are going to disapear soon.

----------


## optilady1

Why do we keep arguing about this?  I swear it's split down the middle.  It's clearly impolite to talk about religion, politics, and pd's on optiboard.  Until there is some kind of ruling from the FDA, everyone's opinion on this thread is just that, an opinion.  

I've worked for places that don't give it out, and I've worked for places that do.  Guess what?  We've lost the patient at both places whether we give it out or not.  Do what seems best for you and your practice.  Now let's stop debating something that will go on for 9 more pages then get shut down because some hot head will call someone a poopy head.

----------


## fjpod

> Why do we keep arguing about this?  I swear it's split down the middle.  It's clearly impolite to talk about religion, politics, and pd's on optiboard.  Until there is some kind of ruling from the FDA, everyone's opinion on this thread is just that, an opinion.  
> 
> I've worked for places that don't give it out, and I've worked for places that do.  Guess what?  We've lost the patient at both places whether we give it out or not.  Do what seems best for you and your practice.  Now let's stop debating something that will go on for 9 more pages then get shut down because some hot head will call someone a poopy head.


Yyyyup.

----------


## MikeAurelius

> Now let's stop debating something that will go on for 9 more pages then get shut down because some hot head will call someone a poopy head.


ur a poopy head.

There, I said it. Can we be done now?  :Tongue:

----------


## SeaU2020

I wouldn't mind giving out the pd so much if I knew that the glasses rx's were being verified with the prescribing Dr. and they are not using expired rx's.

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## 4554lake

Im not going to "happily" give out PD's  for free unless my licensing body requires me to do so. 

We charge $30 for a pd measurement and that dosent include any adjustments/ verification of internet glasses.

If anyone questions the fee, they're told that... industry standard is that PD's and any other measurements (excluding the rx),   related to eyeglass fabrication is the responsibility of the seller of the glasses.  Any qualified dispenser should be able to do this.

Most people pay, those who dont are free to go elsewhere or try to do it themselves.

Im not opening up the can of worms of verifying internet glasses for free or as part of the pd fee ,   or accepting any responsibility for anything to do with the internet eyeglass fabrication.

People who want to save money by sidestepping the dispensing fee have to accept the consequences if things dont work out.

Im not sure why a lot of posters seem to agonize over the pd issue in terms of releasing or charging for it, because they're afraid to offend someone who isnt a customer  (anymore )   anyway.


Im not in business to give away my services to help the online competition.

IF the optical across the road didnt have competent personal to do the measurements, I sure as heck wouldnt be doing it for them....especially for free....

So why would I do it for the online competition who doesnt have the same overhead costs and responsibility as I do?

----------


## fjpod

> Im not going to "happily" give out PD's  for free unless my licensing body requires me to do so. 
> 
> We charge $30 for a pd measurement and that dosent include any adjustments/ verification of internet glasses.
> 
> If anyone questions the fee, they're told that... industry standard is that PD's and any other measurements (excluding the rx),   related to eyeglass fabrication is the responsibility of the seller of the glasses.  Any qualified dispenser should be able to do this.
> 
> Most people pay, those who dont are free to go elsewhere or try to do it themselves.
> 
> Im not opening up the can of worms of verifying internet glasses for free or as part of the pd fee ,   or accepting any responsibility for anything to do with the internet eyeglass fabrication.
> ...


Yeah...but...the real problem is... when a client of yours, who has bought glasses from you within the last year or two, asks you for a copy of the PD that you have in his or her record.  If you are in NYS, or most states, you will be required to give it without charging an additional fee except perhaps for a photocopy.

----------


## 4554lake

> Yeah...but...the real problem is... when a client of yours, who has bought glasses from you within the last year or two, asks you for a copy of the PD that you have in his or her record.  If you are in NYS, or most states, you will be required to give it without charging an additional fee except perhaps for a photocopy.


Not a requirement here.

----------


## braheem24

You should be happy to give it to an existing patient so they SEE the difference in quality and never question your prices again.

No need for a board to get involved or upset them by charging them for information they;ve already paid for.

----------


## Uilleann

> Yeah...but...the real problem is... when a client of yours, who has bought glasses from you within the last year or two, asks you for a copy of the PD that you have in his or her record.  If you are in NYS, or most states, you will be required to give it without charging an additional fee except perhaps for a photocopy.


I've been charged $20-$40 for records in the past...even for a single page to be copied and mailed or just scanned and emailed.  That seems to be fairly standard practice in numerous medical offices.  Don't see any reason the same wouldn't apply here.

----------


## fjpod

> You should be happy to give it to an existing patient so they SEE the difference in quality and never question your prices again.
> 
> No need for a board to get involved.


I tend to agree.

Just an interesting side story... My family is having two weddings this summer and I had to get measured for two tuxedos.  As it would have been difficult for me to go to the second shop due to time and distance, I asked the "measuring guy" at the first shop if he would give me the measurements (they measure neck, sleeve, waist, inseam, outseam,...whatever else) so I could order from the second shop.  He said, "Sure, no problem".  They had special cards pre-printed and he just filled the measurements and handed it over.  He never flinched.  He didn't make me sign a disclaimer form.  He didn't charge me a fee.  There is probably no law that requires him to do that. He just did something gracious for a customer.

I don't advocate working for nothing, but taking care of your customers is important.  If they paid for it...it's theirs.  Just give it to them.

----------


## fjpod

NYS law says you can only charge a patient up to 75 cents per page for records.  Anybody who charges a patient/customer 75 cents for a copy of the record which contains the PD is nuts.

And remember Eyeglasses 1???  Among other things it said you couldn't charge a patient extra for releasing a prescription...  If we keep denying release of PDs, or overcharging for it when it is already in the record, regardless of state law, some Senators spouse is going to get pi$$ed, and get her husband to call the FTC...as has been done in the past with the Fairness to Contact Lens Consumers Act.

----------


## Uilleann

> I tend to agree.
> 
> Just an interesting side story... My family is having two weddings this summer and I had to get measured for two tuxedos.  As it would have been difficult for me to go to the second shop due to time and distance, I asked the "measuring guy" at the first shop if he would give me the measurements (they measure neck, sleeve, waist, inseam, outseam,...whatever else) so I could order from the second shop.  He said, "Sure, no problem".  They had special cards pre-printed and he just filled the measurements and handed it over.  He never flinched.  He didn't make me sign a disclaimer form.  He didn't charge me a fee.  There is probably no law that requires him to do that. He just did something gracious for a customer.
> 
> I don't advocate working for nothing, but taking care of your customers is important.  If they paid for it...it's theirs.  Just give it to them.


And yet - while the ill-fitted tux may only produce tittering and muffled giggles from the other wedding guests, an improperly measured, crafted and fitting pair of glasses may well do worse than this.  Certainly you can appreciate that.  And in all honesty, what is the likelyhood that you would return to your first fitter, and threaten with a lawsuit if his measurements were off and guy number 2 made you look like a clown?  There is far more of that mentality when it comes to healthcare today.  Have you SEEN your malpractice premiums lately?

----------


## fjpod

> And yet - while the ill-fitted tux may only produce tittering and muffled giggles from the other wedding guests, an improperly measured, crafted and fitting pair of glasses may well do worse than this.  Certainly you can appreciate that.  And in all honesty, what is the likelyhood that you would return to your first fitter, and threaten with a lawsuit if his measurements were off and guy number 2 made you look like a clown?  There is far more of that mentality when it comes to healthcare today.  Have you SEEN your malpractice premiums lately?


My malpractice premiums are very low.  No one is going to go blind or get into a car accident from a slightly off or old PD.  

Secondly, I did shorten the story a bit.  The two tuxedos were really for my 5 year old grandson.  I own my own tux.  I ALWAYS look sharp. I still think the first store did me a service.

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## MikeAurelius

"You guys" keep talking about the bad things that can happen if the "measurements are off".

And yet, for all that, there are tolerances in ANSI for up to 3(?) mm variance in the PD, plus any power measurements. As someone noted above, there are countless redos because of inaccurate or incorrect refracting.

Are you really trying to tell people that being off 3 mm in a PD measurement is going to cause them to go blind? Really?

I call major B.S.

----------


## Uilleann

> My malpractice premiums are very low.  No one is going to go blind or get into a car accident from a slightly off or old PD.  
> 
> Secondly, I did shorten the story a bit.  The two tuxedos were really for my 5 year old grandson.  I own my own tux.  I ALWAYS look sharp. I still think the first store did me a service.


Think of it this way:  Would your 5 yo grandson have been doing quite so well if he were a +9 that was 10mm off?  (Assuming a typical 52 PD for a little guy...vs the "standard" 62 that online often uses.)

Not likely.

Congrats on getting him in two tuxes though.  Most kiddos that age I see at the wedding I play for can barely keep a shirt tucked in, let alone wear a clip on tie or wear a tux jacket more than 2 minutes before it magically 'disappears'!  Though, to be fair, many, possibly most 5 y olds don't give a toss if their tux is fitted or not either.   :Wink:

----------


## fjpod

> Think of it this way:  Would your 5 yo grandson have been doing quite so well if he were a +9 that was 10mm off?  (Assuming a typical 52 PD for a little guy...vs the "standard" 62 that online often uses.)
> 
> Not likely.
> 
> .


He is the cutest guy in a tux.

ehhhhhhh...but you're misreading the situation.  I didn't say I didn't get him measured at all.  I got him measured once, by a professional, or at least as professional as it gets in measuring a tux, and I asked for the measurements to go get another tuxedo at another shop.  Neither party flinched at giving the data or accepting it.

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## MikeAurelius

> (Assuming a typical 52 PD for a little guy...vs the "standard" 62 that online often uses.)


And where is your proof of this? 

Massive FAIL.

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## Uilleann

> And where is your proof of this? 
> 
> Massive FAIL.


Mike good friend - look around at what the sites are actually doing.  THAT is the fail sir.  You might be amazed at exactly how flippant many are about the need for any PD at all, let alone a correct one.

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## MikeAurelius

Ok, stop with the bon homme, it doesn't work for you.

I've seen what many of the sites are doing. I've seen the step by step suggestions on how to measure a PD. I've seen examples given. 

NO WHERE do I see a "default" or "standard" PD of 62 mm. Using 62 mm as an example is not the same as using it as a "default" or "standard".

Respectfully, I ask that unless you have factual evidence that "they" use a 'default' or 'standard' of 62 mm, that you use some other reason not to like what they do.

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## Steve Machol

Let's keep it civil guys!

----------


## Barry Santini

BTW, I believe that MIL-spec for a non-adjustable binocular device is 62-63mm.

B

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## Darryl Meister

> the PD belongs to the patient because it is a physical measurement of the eye location with reference to the bridge of the nose, just like a prescription is the physical measurement of the powers needed to correct the vision. The places that refuse to give it out are just giving ammunition to the FTC to make a ruling requiring the PD be part of the prescription.


This is certainly the perspective of online retailers, but it ignores what I consider to be some fairly obvious facts:

1. In my opinion, an accurate PD measurement for spectacle lenses is generally _not_ part of an eye exam. At least, I have never seen an optometrist or ophthalmologist bother to take his or her own accurate monocular PD measurements of a patient with a pupilometer. Instead, they generally have their staff optician or technician take this measurement at the time of an eyewear purchase. A rough estimate of the separation of the patient's eyes is needed to position the phoropter or trial lenses during the exam, which some techs may take during a pre-test, but that's about it. Of course, once the measurement has been taken for an eyewear purchase, it may be added to the patient's medical record for future reference.

2. The "PD" is _not_ part of an eyeglass _prescription_ unless the doctor actually _specifies it on the Rx_. Otherwise, opticians couldn't fill 99% of the Rx forms out there. And there really isn't any compelling reason for the doctor to specify a PD, unless he or she feels that it will not be measured correctly by the optician for some reason. Further, if a doctor _does_ specify a PD, he or she immediately assumes responsibility for its accuracy. No one would argue, for instance, that a segment height measurement is part of an eyeglass prescription. In fact, the most accurate mono PD measurements, captured using video centration devices, are specific to the chosen frame (and how it fits on the wearer). I suspect that the misconception regarding PDs as part of the Rx has been inadvertently generated by a few well-meaning eye doctors who jot down on the Rx whatever they set their phoropter to, perhaps out of some misguided sense of professional courtesy.

3. While the PD may represent a physical parameter of the patient, someone must be paid to measure it, and it typically _isn't_ the optometrist or ophthalmologist. (Of course, patients are certainly welcome to try to measure their own PDs.) I think this is where the biggest issue comes into play. A brick-and-mortar optical store or practice employs someone to take these measurements, which is factored into the mark-up price of the eyewear. Online optical companies save a great deal of money on overhead because they _do not_ pay anyone to take these measurements. The same goes for adjusting the frames, which is obviously not possible with an iPhone app. So the online eyewear consumer gets a cheap pair of eyeglasses that lacks the accuracy and comfort of a properly fitted and dispensed pair from a local eyecare professional. Getting what you paid for is certainly not a new concept.

Best regards,
Darryl

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## Barry Santini

Even *if* a PD was a mandated part of te prescription, does it really matter?

Think of it this way: We all compete now based on _someone else's_ _prescription.

_How is this any different from using someone else's PD?

Prescriptions often need to be tweaked - PDs often do too! (Ask me about a mis-calibrated pupilometer)

FWIW

B
_


_

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## MikeAurelius

> This is certainly the perspective of online retailers, but it ignores what I consider to be some fairly obvious facts:
> 
> 1. In my opinion, an accurate PD measurement for spectacle lenses is generally _not_ part of an eye exam. At least, I have never seen an optometrist or ophthalmologist bother to take his or her own accurate monocular PD measurements of a patient with a pupilometer. Instead, they generally have their staff optician or technician take this measurement at the time of an eyewear purchase. A rough estimate of the separation of the patient's eyes is needed to position the phoropter or trial lenses during the exam, which some techs may take during a pre-test, but that's about it. Of course, once the measurement has been taken for an eyewear purchase, it may be added to the patient's medical record for future reference.
> 
> 2. The "PD" is _not_ part of an eyeglass _prescription_ unless the doctor actually _specifies it on the Rx_. Otherwise, opticians couldn't fill 99% of the Rx forms out there. And there really isn't any compelling reason for the doctor to specify a PD, unless he or she feels that it will not be measured correctly by the optician for some reason. Further, if a doctor _does_ specify a PD, he or she immediately assumes responsibility for its accuracy. No one would argue, for instance, that a segment height measurement is part of an eyeglass prescription. In fact, the most accurate mono PD measurements, captured using video centration devices, are specific to the chosen frame (and how it fits on the wearer). I suspect that the misconception regarding PDs as part of the Rx has been inadvertently generated by a few well-meaning eye doctors who jot down on the Rx whatever they set their phoropter to, perhaps out of some misguided sense of professional courtesy.
> 
> 3. While the PD may represent a physical parameter of the patient, someone must be paid to measure it, and it typically _isn't_ the optometrist or ophthalmologist. (Of course, patients are certainly welcome to try to measure their own PDs.) I think this is where the biggest issue comes into play. A brick-and-mortar optical store or practice employs someone to take these measurements, which is factored into the mark-up price of the eyewear. Online optical companies save a great deal of money on overhead because they _do not_ pay anyone to take these measurements. The same goes for adjusting the frames, which is obviously not possible with an iPhone app. So the online eyewear consumer gets a cheap pair of eyeglasses that lacks the accuracy and comfort of a properly fitted and dispensed pair from a local eyecare professional. Getting what you paid for is certainly not a new concept.
> 
> Best regards,
> Darryl


Actually, Darryl, I didn't "ignore" those facts, they were just not my part of the discussion.

What I was trying to get across in my post is that if/when the FTC makes a ruling forcing the recording of PD's on the patient's prescription, it will become an added procedure in the exam room. As you have pointed out, techs are already examining existing spectacles (for a starting point if the patient is new, or verification of an existing Rx). If they can go through the process of an initial phoropter exam, they can certainly measure a PD. And at that point, it becomes part of the prescription.

Now, as Barry and others have pointed out, yes, the PD DOES change, albeit slightly in a year (if at all), and if the PD is taken at the time of the change, then all is well. Does this mean the optician won't take it again? No, they SHOULD take it again. After all, with the number of incorrect exams being done every day, the PD could very well be off, but it then becomes incumbent on the optician to note the change on the patient's Rx for future reference, and again, this is part of the Rx, and belongs to the patient.

Y'all are looking for ways not to do it, ignoring the many ways it could/can be done. In my opinion, PD's WILL become a required part of the patient's Rx. Whether it is done in the exam room or in the original first dispensing office, they are still part of the Rx, and it belongs to the patient. Since EG1 forbids the practice of charging for an Rx, and since the PD is part of the Rx, then charging an additional fee for an existing patient is illegal. Now, I'm definitely NOT saying you cannot charge someone who is not your patient a fee for measurement, and have them sign a disclaimer, that's your business to do what you want. But if the PD is anywhere in the patient's records at either the doctor's office or the optician's office, EG1 requires you to release that information at no additional charge.

Since you cannot have an Rx without a PD, as you so rightly posted, Darryl, you prove my point. It *IS* part of the Rx. I agree with your point on seg heights, as those are centered on frame choice and bifocal type. We can argue back and forth all day on where seg heights should be located (and I think there are plenty of threads on that here on the board).

----------


## optical24/7

Mike, just to clarify, states optometry boards decide what constitutes an Rx. I'm very familiar with Texas Optometric laws (and many other states too). PD's are not considered part of an Rx here, some states do though.

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## MikeAurelius

> Mike, just to clarify, states optometry boards decide what constitutes an Rx. I'm very familiar with Texas Optometric laws (and many other states too). PD's are not considered part of an Rx here, some states do though.


Until the FDA/FTC redefine the rules, as they did with EG 1.

But, yes, I do know that information.

----------


## Browman

Oh, wow. 

First off, I'm very sorry for any animosity or bad  blood this thread may have created. It wasn't intended. I posted the  story for a few reasons, which I'll elaborate upon below: 

1) PD  is becoming part of the public lexicon. What has been, until now, a term  known only to those in the optical world and those attempting to order  glasses online is slowly becoming a buzzword familiar to the eyeglass  wearing world at large. 

2) On the tail of #1: As PD becomes a  more familiar term, individuals may become indignant at the idea of it  being refused to them. Americans have a very "I want it because it's  mine" attitude towards things, even if they don't necessarily need or  want the thing(s) in question. The thought that a number which allows  them to get glasses may be withheld from them may lead to individuals  asking for it on nothing more than principal; especially in today's  political climate, the thought of someone in a position of power  restricting access to something someone views as inherently "theirs"  could create a major backlash. 

3) On the tail of #3: The  likelihood of a lawsuit being generated over a PD issue becomes  increasingly higher under these circumstances and in this climate.

4)  The article represents why WP has succeeded thus far and why they'll  become the real force to watch, as opposed to Coastal, EyeBuy, etc. WP  knows that the online question is largely a matter of winning hearts and  minds, as well as wallets. Anyone with the money can begin an online  startup and offer a catalog of anonymous glasses and lens options. WP  makes the consumer feel like they care, and has created a unique  corporate culture and identity itself in order to give the customers  something they feel like they can care about as well.

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## Darryl Meister

> What I was trying to get across in my post is that if/when the FTC makes a ruling forcing the recording of PD's on the patient's prescription,


That would be analogous to forcing a tailor to measure every person who walked in his shop door for a suit, and to provide those measurements to the customer, regardless of whether the customer actually purchased a suit from the tailor. In any case, I'm not sure that the FTC would have much luck in forcing optometry and ophthalmology to add regulated services to what is already considered a medical examination, especially if it is in support of a consumer practice (the purchase of online eyewear) that is illegal in many states with licensed opticianry. But stranger things have happened.




> Since you cannot have an Rx without a PD, as you so rightly posted, Darryl, you prove my point. It *IS* part of the Rx. I agree with your point on seg heights, as those are centered on frame choice and bifocal type


Actually, I said that the majority of Rx forms _do not_ have a PD indicated on them (at least in Missouri, back when I was dispensing). So, how in the world could anyone argue that the PD be required part of a _prescription_? For that matter, the easiest solution here for eyecare proefessionals is to simply stop measuring and noting the PD of patients before they decide to purchase eyewear from you. However, once you _have_ measured the PD, for whatever reason, you may eventually be legally compelled to provide it to the customer.

Best regards,
Darryl

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## shanbaum

I agree with Darryl; if a customer has purchased eyewear from you, the record of that purchase might (though wrongly, I think) be construed to be "a prescription."  If he hasn't purchased from you, I can't foresee a regulation that would require you to provide a service for free.

I could argue that the PD is not simply the distance between the pupils (or optical axes), but a value derived from that, which includes other variables such as panoramic angle and vertex distance of the lenses in as-worn position, making the number that does attach to the spectacle order, specific to that order.  Of course, that would require that you do that sort of thing...

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## becc971

Personal Policy:  i will not take and give out a PD so someone can buy  online.  the first and last time i ever did it the lady's glasses ended  up being mens, measured completely incorrectly, and just an overall bad  fit, and guess who she blamed.  this kid.  As an optician, i retake PD's  even if they ARE on the RX, because i don't trust anyone's measurements  but my own.  

i feel like if a doctor wants to take and give out  the PD on their own, more power to them, but other than that this kid  wipes her hands of the whole situation.  

That being said, WP is  doing it right, they've built a huge business, the frames really aren't  garbage having seen some myself, now that they're starting in on having  actual store fronts i'll be interested to see if the cost goes up with  that.  thats a whole bunch of extra and expensive stuff they haven't had  to pay for before.  BUT, they play on my generation VERY well.  even i  think they're cool :) I'll be interested to see how this all plays out.




> Oh, wow. 
> 
> First off, I'm very sorry for any animosity or bad  blood this thread may have created. It wasn't intended. I posted the  story for a few reasons, which I'll elaborate upon below: 
> 
> 1) PD  is becoming part of the public lexicon. What has been, until now, a term  known only to those in the optical world and those attempting to order  glasses online is slowly becoming a buzzword familiar to the eyeglass  wearing world at large. 
> 
> 2) On the tail of #1: As PD becomes a  more familiar term, individuals may become indignant at the idea of it  being refused to them. Americans have a very "I want it because it's  mine" attitude towards things, even if they don't necessarily need or  want the thing(s) in question. The thought that a number which allows  them to get glasses may be withheld from them may lead to individuals  asking for it on nothing more than principal; especially in today's  political climate, the thought of someone in a position of power  restricting access to something someone views as inherently "theirs"  could create a major backlash.  (i feel like this is one of the major problems with society in general today? the whole "give it its mine" attitude, without wanting to learn why professionals would withhold it in the first place.  or the ever indignant "i spent $XXX on these glasses 5 years ago they shouldn't scratch!" when really their INSURANCE spent most if not all of that money on the glasses and the patient paid about $50 in copays, and then tells me they've only been cleaning them with alcohol the entire time *sigh*.  it seems as though they only think the PD is "theirs" because the internet told them so, and we know the internet is always right ;) 
> 
> 3) On the tail of #3: The  likelihood of a lawsuit being generated over a PD issue becomes  increasingly higher under these circumstances and in this climate.
> ...

----------


## Steve Machol

> Personal Policy:  i will not take and give out a PD so someone can buy  online.  the first and last time i ever did it the lady's glasses ended  up being mens, measured completely incorrectly, and just an overall bad  fit, and guess who she blamed.  this kid.


Exactly the point I tried to make earlier. Once you have contributed something to this prescription you become liable for the results, at least in the customer's eyes if not the law.

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## Barry Santini

Mike's right: If you can't supply a binocular PD that is within 3mm of whomever decides what the "real" PD value is....

Then....FAIL!

B

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## jakef

I'm with Becc971. Warby Parker has a trendy feel and a positive market presence in my generation. I've even ordered a pair to see what the quality was. They are not poorly made, and I didn't feel like I was getting the cheapest thing out there. That being said, my WP glasses would have been miserable to wear had I not properly adjusted them, and I've helped other patients trouble shoot issues with WP glasses. I think the concept of holding out or charging for a PD is an overly defensive attitude. The opticians at our optical are currently coming up with a complete online service package that we can sell, so if people want to buy online that's OK, we'll even help! A PD is really one of the least expensive services our opticians give in terms of time invested and difficulty. Our intention is to shift our goods in a direction that more clearly reflect the services we offer, and what they are worth.

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## Darryl Meister

> I could argue that the PD is not simply the distance between the pupils (or optical axes), but a value derived from that


Yes, this is the point that I alluded to earlier when discussing video centration devices. Unfortunately, the industry has dumbed down important concepts like this to the point that a layperson no longer perceives any real knowledge or skill in the fitting and fabrication of eyeglasses. _This_ is what has allowed online optical to secure a foothold in this industry. The art and science that was opticianry has been reduced to something that John Q Public thinks he can do just as well by printing something off from a cheap website or with an iPhone app.

Best regards,
Darryl

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## Barry Santini

I think it's important again to move away from discussing/classing eyewear into pass/fail categories, and move to using more fuzzy terms, like adequate, more adequate, tec.

The public will find, I predict, that SV eyewear made  and delivered over the internet, is adequate _for the price paid._

Let it simmer for a while, and, if you've been doing the right thing all along, I also predict they will be back.

B

----------


## Robert Martellaro

> Until the FDA/FTC redefine the rules, as they did with EG 1.


That would require an EG 3. The FTC is not going to be able to preempt and rewrite state statutes, no way no how.




> I could argue that the PD is not simply the distance between the pupils (or optical axes), but a value derived from that, which includes other variables such as panoramic angle and vertex distance of the lenses in as-worn position, making the number that does attach to the spectacle order, specific to that order.  Of course, that would require that you do that sort of thing...


_Monocular PDs are of no use without reference to the frame. -_ Mo Jalie

----------


## drk

> NYS law says you can only charge a patient up to 75 cents per page for records. Anybody who charges a patient/customer 75 cents for a copy of the record which contains the PD is nuts.
> 
> And remember Eyeglasses 1??? Among other things it said you couldn't charge a patient extra for releasing a prescription... If we keep denying release of PDs, or overcharging for it when it is already in the record, regardless of state law, some Senators spouse is going to get pi$$ed, and get her husband to call the FTC...as has been done in the past with the Fairness to Contact Lens Consumers Act.


Yeah, but where do YOU draw the line? The p.d., that's it.  No, verification, that's it.  No, seg heights, that's it. No, free troubleshooting if they can't see, that's it.  What's the limit to how much you can get pushed around?  How scared are you?

----------


## drk

> if/when the FTC makes a ruling forcing the recording of PD's on the patient's prescription, it will become an added procedure in the exam room. As you have pointed out, techs are already examining existing spectacles (for a starting point if the patient is new, or verification of an existing Rx). If they can go through the process of an initial phoropter exam, they can certainly measure a PD. And at that point, it becomes part of the prescription.
> 
> After all, with the number of incorrect exams being done every day, the PD could very well be off, but it then becomes incumbent on the optician to note the change on the patient's Rx for future reference, and again, this is part of the Rx, and belongs to the patient.
> 
> In my opinion, PD's WILL become a required part of the patient's Rx. Whether it is done in the exam room or in the original first dispensing office, they are still part of the Rx, and it belongs to the patient. Since EG1 forbids the practice of charging for an Rx, and since the PD is part of the Rx, then charging an additional fee for an existing patient is illegal. 
> 
>  But if the PD is anywhere in the patient's records at either the doctor's office or the optician's office, EG1 requires you to release that information at no additional charge.
> 
> Since you cannot have an Rx without a PD, as you so rightly posted, Darryl, you prove my point. It *IS* part of the Rx.


On what planet is anything you wrote more that just your opinion?

----------


## drk

Another thing driving this online eyewear stuff is this geek chic push.  When that wears off, the whole Warby Parker Nerdo vibe goes out the door.  

Not saying it will put an end to people doing it themselves, but it is driven (I'd suppose) by 20-somethings upgrading to zyl.

What may propel it, however, is the demise of the vision care plan.  When people find out what a rip off it is to purchase themselves, they'll be looking for alternatives.

----------


## Robert_S

> Actually, Darryl, I didn't "ignore" those facts, they were just not my part of the discussion.
> 
> What I was trying to get across in my post is that if/when the FTC makes a ruling forcing the recording of PD's on the patient's prescription, it will become an added procedure in the exam room. As you have pointed out, techs are already examining existing spectacles (for a starting point if the patient is new, or verification of an existing Rx). If they can go through the process of an initial phoropter exam, they can certainly measure a PD. And at that point, it becomes part of the prescription.
> 
> Now, as Barry and others have pointed out, yes, the PD DOES change, albeit slightly in a year (if at all), and if the PD is taken at the time of the change, then all is well. Does this mean the optician won't take it again? No, they SHOULD take it again. After all, with the number of incorrect exams being done every day, the PD could very well be off, but it then becomes incumbent on the optician to note the change on the patient's Rx for future reference, and again, this is part of the Rx, and belongs to the patient.
> 
> Y'all are looking for ways not to do it, ignoring the many ways it could/can be done. In my opinion, PD's WILL become a required part of the patient's Rx. Whether it is done in the exam room or in the original first dispensing office, they are still part of the Rx, and it belongs to the patient. Since EG1 forbids the practice of charging for an Rx, and since the PD is part of the Rx, then charging an additional fee for an existing patient is illegal. Now, I'm definitely NOT saying you cannot charge someone who is not your patient a fee for measurement, and have them sign a disclaimer, that's your business to do what you want. But if the PD is anywhere in the patient's records at either the doctor's office or the optician's office, EG1 requires you to release that information at no additional charge.
> 
> Since you cannot have an Rx without a PD, as you so rightly posted, Darryl, you prove my point. It *IS* part of the Rx. I agree with your point on seg heights, as those are centered on frame choice and bifocal type. We can argue back and forth all day on where seg heights should be located (and I think there are plenty of threads on that here on the board).


Mike, I like reading your posts for the most part but I totally disagree with you on this subject. The online supply of eyewear isn't good for anyone but those selling it. They assume the provision of services which they don't have to pay for, like an eye exam, troubleshooting issues, fitting the frames, and of course this topic, centration measurements. Please tell me how it is fair for one company to profit at the expense of an infrastructure that is essential to the public? The worst thing is that, on top of this parasitism, most online retailers spread and perpetuate the myth that they are saving the public from our greed. _Our greed!_

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## drk

And they have a disinformation program about who is responsible for the "all important" p.d. measurement.  

Reminds me of 1-800's _"Where's the prescription?  It's on the box!"_ propaganda.

And we're the unethical ones, right?  What a load of crap.

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## Browman

> Another thing driving this online eyewear stuff is this geek chic push.  When that wears off, the whole Warby Parker Nerdo vibe goes out the door.



You're many years behind the times in your thinking...

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## MikeAurelius

drk: It's ALWAYS my opinion, unless I specifically cite references. Just the same as when you write your words, those are your opinions. I cherish the fact that you feel strongly about your opinions, please give me the same respect for mine.

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## drk

> You're many years behind the times in your thinking...


1. My market is a desirable suburb of one of the few slightly growing midwestern cities, so my clientele isn't off by more than 12-24 months of what the coasts do.

2. I'm involved in the optical, hands on.

3. I read Eyecare Business, 20/20, and VCPN in the bathroom

4. I go to the mall sometimes.

5. I used to subscribe to People Magazine.

So no, I'm not behind the times.  I may be a contrarian, but I'm current.  

You probably wear ostrich-skin cowboy boots, though.  Admit it.

----------


## drk

> drk: It's ALWAYS my opinion, unless I specifically cite references. Just the same as when you write your words, those are your opinions. I cherish the fact that you feel strongly about your opinions, please give me the same respect for mine.


Fair enough.  (Plus you are probably the best out there at what you do, so there's that.)

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## MikeAurelius

> Fair enough.  (Plus you are probably the best out there at what you do, so there's that.)


Thank you. I appreciate it.

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## Stan Tabor

> Another thing driving this online eyewear stuff is this geek chic push.  When that wears off, the whole Warby Parker Nerdo vibe goes out the door.  
> 
> Not saying it will put an end to people doing it themselves, but it is driven (I'd suppose) by 20-somethings upgrading to zyl.


I think the people at Warby and other fashion oriented onlines are smart enough to re-invent their look just like many other brands. These twenty somethings will soon be thirty somethings and there will be another crop of twenty somethings coming on board who will be even more comfortable buying online.  

Getting back to the topic of the thread, like others have mentioned, needing an optician to get a basic PD will soon be moot.  At one of the tradeshows last year in Europe (Mido or Silmo, I can't remember which), I saw a demo being given by a European company of an online PD tool by one of the virtual try-on companies. He used a camera on his computer with a credit card to scale to the face.  He claimed their PD measurement tool has statistically proven to be more accurate than manually taken PDs.    

There are still opticians using rulers and putting dots on lenses.  If some consider this state of the art, I can't believe a webcam or cell phone cam with a credit card for scaling can achieve this level of accuracy.  It is only a matter of time before PD becomes an easy diy.

Free advice from an old guy that has made many mistakes: re-channel your energy to competing in eyewear's new economy.

----------


## Browman

> 1. My market is a desirable suburb of one of the few slightly growing midwestern cities, so my clientele isn't off by more than 12-24 months of what the coasts do.
> 
> 2. I'm involved in the optical, hands on.
> 
> 3. I read Eyecare Business, 20/20, and VCPN in the bathroom
> 
> 4. I go to the mall sometimes.
> 
> 5. I used to subscribe to People Magazine.
> ...


You should know, then, that "geek chic" is right up there with disco and the guy in a sportcoat with the cuffs rolled up in terms of outdated, ugly fads now subscribed to only by a small fraction of the population. This about sums it up.

As far as footwear goes, though... wingtips.

----------


## Stan Tabor

> You should know, then, that "geek chic" is right up there with disco and the guy in a sportcoat with the cuffs rolled up in terms of outdated, ugly fads now subscribed to only by a small fraction of the population. This about sums it up.
> 
> As far as footwear goes, though... wingtips.


Browman- please be careful where you go with that wingtip comment.  I still got a pair of gunboats from florsheim (crown imperials) from when florsheims were made in the USA.

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## Browman

> Browman- please be careful where you go with that wingtip comment.  I still got a pair of gunboats from florsheim (crown imperials) from when florsheims were made in the USA.


?? Not sure what you mean by "where you go." Wingtips are my own favored footwear (as opposed to boots).

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## Quantrill

I don't even know if I can count high enough to figure out how many times OD techs have come up with an incorrect rx by using an auto-lensometer.  If people are counting on accurate PDs from these folks then I truly weep for them.

A pd is not part of a prescription anymore than what type of lens is recommended. I guess if the doctor selected 1.67 with AR then I as an optician have no choice in what material to provide.

Does this also mean I am only allowed to use Varilux Comfort?

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## CNG

They will try to convince everyone that they are ethical, that PDs are required to examine eyes, that it is the law (their law), that opticians must allow them to use their showrooms for free, that opticians are required to adjust their eyeglasses for free...nothing further than the truth. They are opportunistic, they are deceitful.

If you are an optician, you do not have to give a P.D. No one can force you to do so. The eye examination does not require one. The Prescription is just the refraction data and with that information a patient can get their eyeglasses anywhere. The PD is optional. Requiring the PD from eye doctors will increase the exam fee and the FTC does not want to see that. The seg. height and the monocular frame bridge to pupil will become the norm in optical measurements instead of the PD. The seg height and the bridge to pupil requires the real frame for precise measurements. 

Good idea no?

CNG

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## drk

Bridge to pupil!  I love it.

----------


## fjpod

> They will try to convince everyone that they are ethical, that PDs are required to examine eyes, that it is the law (their law), that opticians must allow them to use their showrooms for free, that opticians are required to adjust their eyeglasses for free...nothing further than the truth. They are opportunistic, they are deceitful.
> 
> If you are an optician, you do not have to give a P.D. No one can force you to do so. The eye examination does not require one. The Prescription is just the refraction data and with that information a patient can get their eyeglasses anywhere. The PD is optional. Requiring the PD from eye doctors will increase the exam fee and the FTC does not want to see that. The seg. height and the monocular frame bridge to pupil will become the norm in optical measurements instead of the PD. The seg height and the bridge to pupil requires the real frame for precise measurements. 
> 
> Good idea no?
> 
> CNG


You're kidding, right?  Do you know what your state law requires if a patient asks you for a copy?  At the risk of repeating myself, in NY, you would be required to release it.  

I also don't follow your reasoning as to why a prescriber MUST release the Rx, but an optician shouldn't have to release a PD.  

if the FTC thinks that forcing you (and me) to release fitting information will help consumers to get lower cost eyewear, they will do it in a flash...they have done it twice already. It just takes one complaint from the right person.

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## Darryl Meister

> I also don't follow your reasoning as to why a prescriber MUST release the Rx, but an optician shouldn't have to release a PD... if the FTC thinks that forcing you (and me) to release fitting information will help consumers to get lower cost eyewear, they will do it in a flash.


In this scenario, _if the patient has paid the optician to measure his or her PD_ (through, at the very least, the purchase of eyewear in which this cost has been factored), this might be the case. However, if the patient _has not_ paid for this service, which is often the case for those planning to make an online eyewear purchase, how could the FTC or any other federal agency require the optician to work for free?

Best regards,
Darryl

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## CNG

Yes I'm kidding but it is a good idea. Maybe Darryl can elaborate on this new and precise measurement. As for the PD I think it has become clear that It is not required in order to get eyeglasses from the alternative sources. Sure people will try to get their Pds and it is their right. In my stores (In Florida) I rarely see kids and younger adults. The PD is rarely asked from older adults because they know that that measurement (seg. height) is a precise measurement and it requires the frame. People at that age are well more savy. Haven't you had a patient ask you "Will a progressive fit in that small frame? I had many times. 

CNG

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## drk

Hey, that wasn't my quote...

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## CNG

So Darryl opticians should take the Pd before the sale in order to avoid this issue? I think that lab orders are part of the equation and have PDs. I hardly know of a lab that does eyeglasses without the Pds for real opticians...maybe the virtual labs do...LOL. Please study more the bridge to pupil measurement I think is great.

CNG

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## Darryl Meister

> So Darryl opticians should take the Pd before the sale in order to avoid this issue?


First, I think that eyecare professionals should stop referring to any set of numbers that nominally refers to the separation of the patient's eyes as "_the_ PD" as opposed to "_a_ PD." There are many possible PD measurements, depending upon the application and number of variables considered.

Second, eye doctors should stop noting any kind of PD on the Rx form, unless there is some compelling clinical rationale for doing so. Chances are, this was not a particularly accurate "PD" measurement in the first place. Besides, why bother assuming responsibility for the accuracy of the measurement?

Third, I see little reason for eyecare professionals to take PD measurements for a new pair of eyeglasses _before_ the patient has actually committed to the purchase. You are basically devaluing your professional time by doing so, particularly if the customer chooses not to purchase eyewear from you.

Fourth, eyecare professionals need to embrace the fact that taking PD measurements is a professional service, and should be treated as such. This means taking a careful, accurate measurement, preferably with a device, not a ruler. I would also recommend posting a clearly visible charge for this service for customers (note that they are not patients in this case) who just want only a PD measurement.

Fifth, eyecare professionals should learn to appreciate the difference between an accurately measured monocular PD for the purposes of fabricating precision eyewear versus some rough estimate used only to position phoropter or trial lenses in front of the eyes during an eye examination.

Sixth, opticians should learn the subtle nuances of taking accurate PD measurements, including the differences between Far and Near PDs, the influence of power and the position of wear, frame monocular PDs versus CRP PDs, et cetera. Investing in a video centration device would be ideal, but at the very least a corneal reflex pupilometer should be used. Showing the patient that the measurement can be eyeballed with a ruler is definitely not a good idea.

Seven, if you are an eye doctor who routinely takes or has taken the patient's PD measurement during the eye exam, and notes this measurement in the patient's _medical record_ as "the PD," you should understand that there may, indeed, come a day in which you are required by law to provide this to the patient on the Rx form.

Eight, proactively fight the trend to devalue the professionalism of optical dispensing, this goes for opticians, optometrists, and ophthalmologists. Fight legislation that seeks to deregulate or undermine the legitimacy of optical dispensing, and support legislation that increases its legitimacy. Promote the safety, comfort, and effectiveness of properly fitted eyewear.

Of course, I also realize that some people love to debate these topics more than actually finding a suitable resolution, but for those who are looking for some practical suggestions that could be implemented immediately, I believe that these represent a good start. But these are just my opinions.

Best regars,
Darryl

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## optical24/7

For all of you that wish to alienate your current patients that ask for info you have on record, but want to refuse; If you truly believe that they are going to get inadequate eyewear, where do you thing they will be going when they *learn their lesson*? Most certainly not back to you, because you were not very helpful in their minds. Or is it that you yourself only provide *adequate* eye wear and feel threatened by the competition? Give 'em their friggin' PD, along with a seed of knowledge about "proper" measurements. More than likely, if you've been providing them with excellent eye wear, they will be back for life, and not become a new client for your *real* competition...The B&M down the street from you.

----------


## jefe

> I agree with Darryl; if a customer has purchased eyewear from you, the record of that purchase might (though wrongly, I think) be construed to be "a prescription."  If he hasn't purchased from you, I can't foresee a regulation that would require you to provide a service for free.
> 
> I could argue that the PD is not simply the distance between the pupils (or optical axes), but a value derived from that, which includes other variables such as panoramic angle and vertex distance of the lenses in as-worn position, making the number that does attach to the spectacle order, specific to that order.  Of course, that would require that you do that sort of thing...


The placement of the OCs can also depend on the asymmetry of features on the wearer.  One frame may rest in such a way that the frame isn't perfectly (e.g.: zyl frame on crooked nose) centered while another (metal frame with adjustable nosepads) may be.   So to me, the PD is a starting point and shouldn't be assumed to be a constant for all frames; the values should sometimes be tweaked as fit warrants.

----------


## drk

> For all of you that wish to alienate your current patients that ask for info you have on record, but want to refuse; If you truly believe that they are going to get inadequate eyewear, where do you thing they will be going when they *learn their lesson*? Most certainly not back to you, because you were not very helpful in their minds. Or is it that you yourself only provide *adequate* eye wear and feel threatened by the competition? Give 'em their friggin' PD, along with a seed of knowledge about "proper" measurements. More than likely, if you've been providing them with excellent eye wear, they will be back for life, and not become a new client for your *real* competition...The B&M down the street from you.


There are assumptions in your post that I doubt you realize:

1. That patients will be put off when you tell them you don't recommend DIY online.  My patients are actually suprised (yea, I hate that) to hear we don't endorse it, but they appreciate the education.
2. That this is about competition, or money.  It's not.

----------


## MikeAurelius

> First, I think that eyecare professionals should stop referring to any set of numbers that nominally refers to the separation of the patient's eyes as "_the_ PD" as opposed to "_a_ PD." There are many possible PD measurements, depending upon the application and number of variables considered.
> 
> Second, eye doctors should stop noting any kind of PD on the Rx form, unless there is some compelling clinical rationale for doing so. Chances are, this was not a particularly accurate "PD" measurement in the first place. Besides, why bother assuming responsibility for the accuracy of the measurement?
> 
> Third, I see little reason for eyecare professionals to take PD measurements for a new pair of eyeglasses _before_ the patient has actually committed to the purchase. You are basically devaluing your professional time by doing so, particularly if the customer chooses not to purchase eyewear from you.
> 
> Fourth, eyecare professionals need to embrace the fact that taking PD measurements is a professional service, and should be treated as such. This means taking a careful, accurate measurement, preferably with a device, not a ruler. I would also recommend posting a clearly visible charge for this service for customers (note that they are not patients in this case) who just want only a PD measurement.
> 
> Fifth, eyecare professionals should learn to appreciate the difference between an accurately measured monocular PD for the purposes of fabricating precision eyewear versus some rough estimate used only to position phoropter or trial lenses in front of the eyes during an eye examination.
> ...


Concise and direct to the point, as usual. Awesome post, Darryl!!

----------


## optical24/7

If they are still determined to try online they will do it with or without the endorsement. Personally, I'll be banking on them not being as satisfied with their decision to go *anywhere* else. I want the door open for their return, not left with a perception that I'm not here to really help them (you know,the greedy ECP, in their eyes). I've seen it many, many times over the years with other B&M's around me, and I'm worried about a faceless computer?  The best way for your patients to appreciate what you bring to the table is to let them sample service/products/knowledge elsewhere. 

As far as #2, I know, for you, it's not about the competition. It's about the ethics of delivery that online lacks. But the facts are, online isn't going away and our government will not be stepping in to stop them. If they step in it will most certainly not be in a way you would like. To my knowledge there is not a study published on safety of the public from wrongly made eyewear. If such a study is possible British Columbia would be a great start since they've de-regulated eye wear. But can you imagine, if they find no dead bodies in the street? We very well could be de-regulated as well.

----------


## Plausible

> first, i think that eyecare professionals should stop referring to any set of numbers that nominally refers to the separation of the patient's eyes as "_the_ pd" as opposed to "_a_ pd." there are many possible pd measurements, depending upon the application and number of variables considered.
> 
> Second, eye doctors should stop noting any kind of pd on the rx form, unless there is some compelling clinical rationale for doing so. Chances are, this was not a particularly accurate "pd" measurement in the first place. Besides, why bother assuming responsibility for the accuracy of the measurement?
> 
> Third, i see little reason for eyecare professionals to take pd measurements for a new pair of eyeglasses _before_ the patient has actually committed to the purchase. You are basically devaluing your professional time by doing so, particularly if the customer chooses not to purchase eyewear from you.
> 
> Fourth, eyecare professionals need to embrace the fact that taking pd measurements is a professional service, and should be treated as such. This means taking a careful, accurate measurement, preferably with a device, not a ruler. I would also recommend posting a clearly visible charge for this service for customers (note that they are not patients in this case) who just want only a pd measurement.
> 
> Fifth, eyecare professionals should learn to appreciate the difference between an accurately measured monocular pd for the purposes of fabricating precision eyewear versus some rough estimate used only to position phoropter or trial lenses in front of the eyes during an eye examination.
> ...


boom!!! +2

----------


## drk

> If they are still determined to try online they will do it with or without the endorsement. Personally, I'll be banking on them not being as satisfied with their decision to go *anywhere* else. I want the door open for their return, not left with a perception that I'm not here to really help them (you know,the greedy ECP, in their eyes). I've seen it many, many times over the years with other B&M's around me, and I'm worried about a faceless computer?  The best way for your patients to appreciate what you bring to the table is to let them sample service/products/knowledge elsewhere. 
> 
> As far as #2, I know, for you, it's not about the competition. It's about the ethics of delivery that online lacks. But the facts are, online isn't going away and our government will not be stepping in to stop them. If they step in it will most certainly not be in a way you would like. To my knowledge there is not a study published on safety of the public from wrongly made eyewear. If such a study is possible British Columbia would be a great start since they've de-regulated eye wear. But can you imagine, if they find no dead bodies in the street? We very well could be de-regulated as well.


Some people may think I'm greedy, but I defy anyone to interact with me or my staff for a short time and think we're out for our own interests.  If someone is worried about the "greedy" charge sticking to them, then maybe someone should re-double their efforts and re-analyze how they do business.  We are advocates.  We are professionals.  Yes, we charge a fee, but how can we be greedy?  By selling stuff a patient doesn't need?  By overcharging?  By overpromising and underdelivering?  We don't do that.

We don't know what the future will hold regarding regulation.  It's ridiculous to suggest that anyone does.  Self-fulfilling prophecies do occur, though, and, dammit, we are the eye care professionals, aren't we?  I know we're used to grabbing the ankles a lot, these days, but let's not get cowed or cynical.  Man up.  We have a public to serve.

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## optical24/7

Greedy ECP's aren't my words Doc, it's in tons of posts by consumers in the comment section of the OP's source. And I'll admit my views may be different than some others here, mainly because still, to this day I have not been asked to take or give out a PD or any info to order glasses elsewhere.

----------


## drk

Well, I would presume you are not a greedy *******.  In fact, there are relatively few of them in our industry; most of us are very professional.  What an outrageously defamatory thing for essilor and Warby et al to perpetrate.  But they do, so they can make money the unethical way.

Patients aren't without blame for being so gullible, and a vast Leslie Stahlian conspiracy about how we're all getting rich off the backs of the public one job at a time is pathetic and laughable, especially if they'd check out the cars we're driving.  She's looking for a story, and these onliners are trying to justify their low prices so their stuff doesn't look like cheap crap.  Hence, the "greedy middlemen ECPs".  Yeah, that's it.  Cut them out.  And don't feel bad about doing shady stuff on the internet, because we'll supply you with the moral justification.

----------


## fjpod

> In this scenario, _if the patient has paid the optician to measure his or her PD_ (through, at the very least, the purchase of eyewear in which this cost has been factored), this might be the case. However, if the patient _has not_ paid for this service, which is often the case for those planning to make an online eyewear purchase, how could the FTC or any other federal agency require the optician to work for free?
> 
> Best regards,
> Darryl


I was only referring to the case where the optician had the information in their files from a previous encounter.  I don't envision opticians being forced to measure a PD for free or a fee...although, a few states have adopted the rule that a PD must be included on the prescription.  So, optometrists are already being forced to provide PDs as part of their exam and Rx...whether the patient purchases eyewear from them or not.  

What goes around, comes around.

----------


## Darryl Meister

> although, a few states have adopted the rule that a PD must be included on the prescription.


I wonder whether this is the result of Independent Optometry's decreasing interest in optical dispensing. Optometry has managed to secure TPA and DPA certification in every state through legislation, and glaucoma treatment in quite a few. I would find it surprising that they were unable to block such a requirement, if they had aggressively pursued it.

Best regards,
Darryl

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## Stan Tabor

I was just looking at a website for a retailer in the UK.  Has an online pd measurement tool.

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## Traci

Hmm.  If you are a doctor's office, why not just do the measurement on everyone, and add the fee on the exam charges as a usual and customary fee.  If you are an independent optician, how about charging a fee on everyone's bill as a customized measurements fee.  In many cases we are using digital lenses which use PD + VD, panto, and wrap measurements.  Just make a separate charge line for the customized measurements.  No more should we incorporate the measurement as part of the glasses purchase, but its own fee.  Then, it would truly be the patients, and not complimentary, and you get paid every time whether or not the patient requests it.  Just my thoughts.

----------


## chuckbednarik

Not sure how many ophthalmologists have commented, but to me, and I'm sure to the vast majority of ophthalmologists, the PD is not part of the prescription, and never will be...I don't take it, and I won't take it.  It isn't what I was trained to do, although I was briefly instructed on how to do it.  Just like surgery, if it's not something you regularly do, don't do it, or you'll end up getting yourself in trouble and harming the patient.  It's the job of the optician, and that's what I tell the rare patient who asks for it.  I explain that they can go to any optical shop they want, and for the specs to be made, the optician will take all the necessary fitting measurements.  It is a fitting measurement, not a refractive measurement.  If they choose to purchase online, they are in essence becoming their own optician, and they are responsible for any errors.

----------


## Happylady

I give the PD if requested, my company wants me to. 

I wish I could give it in inches rather then mm!

----------


## Fezz

PD measurement?

You better bet that I give them out!

Where should I start?

Parkinson's disease 
peritoneal dialysis 
Paget disease 
palladium 
Pancreas divisum 
pancreatic duct 
panic disorder 
Parkinson disease 
pars distalis 
personality disorder 
phase difference 
Pick disease 
poorly differentiated 
postural drainage 
preferred direction 
prism diopter 
progression of disease 
progressive disease 
protein degradation 
proton density 
pulmonary disease 
pupil diameter 
Pupillary Distance 
pyloric dilator 
Pyrimidine dimer 
interpupilllary distance 
paddle 
Paget disease of bone 
Paget's disease 
Paget's disease of bone 
paired domain 
pancreas disease 
pancreatic diabetes 
Pancreaticoduodenal 
pancreaticoduodenectomy 
pancreatoduodenectomy 
Panhypopituitary Dwarfism 
panic disorders 
papilla diameter 
papular dermatitis 
Paracoccus denitrificans 
paralyzing dose 
parental ditype 
parkinsonian dementia 
parkinsonism-dementia 
Parkinson's disease patients 
Parkinson's disease with dementia 
Parkinson's disease without dementia 
Parkinson's diseases 
paroxysmal discharge 
paroxysmal discharges 
partial deficiency 
partial denture 
partially dependent 
passive diffusion 
patent ductus 
patient day 
Patient-Days 
Pattern Deviation 
PDte 
pediatricians 
penetration depth 
percentage difference 
percentage dissatisfaction 
perceptive deafness 
percutaneous device 
Percutaneous devices 
percutaneous discectomy 
percutaneous drain 
Percutaneous drainage 
Perfusion defect 
perfusion defects 
perinatal death 
Perineal descent 
periodic disease 
periodontal disease 
periodontal diseases 
periodontitis 
perioral dermatitis 
peritoneal dialysate 
peritoneal dissemination 
peritoneal drainage 
peroxides 
perphenazine decanoate 
persistent defect 
persistent defects 
Persistent diarrhea 
persistent diarrhoea 
personal database 
personality disorders 
personality-disordered 
Peyronie's Disease 
pharmacodynamic 
pharmacodynamics 
Phosducin 
phosphate dehydrogenase 
phosphate depletion 
phosphate dextrose 
phosphodiester 
phosphodiesterase 
phosphorus depletion 
photodetection 
photodiagnosis 
Photodissociation 
Photoreceptor dysplasia 
photosensitivity dermatitis 
Physical Database 
physical development 
Pick's disease 
pirfenidone 
piribedil 
PK-pharmacodynamic 
plasma defect 
plasma density 
plasma desorption 
plasma-derived 
plasmodesmata 
plastid-dividing
pneumatic dilatation 
Pneumatic dilation 
pocket depth 
pocket depths 
Polistes dominulus 
polydextrose 
PolyDypsia 
PolyDypsic 
polymeric diet 
population doubling 
population doublings 
positive deviance 
posterior deltoid 
posterior descending 
posterior descending artery 
posterior descending coronary artery 
posterior division 
postnasal drainage 
postnatal day 
postnatal days 
Postpartum Day 
postpartum depression 
Postprandial dip 
Potential derived 
potential differences 
power densities 
power Doppler 
power of definition 
power of discrimination 
Predicted Differences 
predilatation 
prednisolone 
prednisone 
Pregnancy Diagnosis 
premature delivery 
Prenatal diagnosis 
Prenatal diagnostics 
prescribed dose 
prescription dose 
presenile dementia
present disease 
pressor dose 
pressure-diameter 
Preterm delivery 
primary dysmenorrhea 
primidone 
prism diopters 
prism dioptres 
Prisoner's Dilemma 
probable disease 
Probing depth 
probing depth reduction 
Probing depths 
problem drinker 
problem drinking 
prodynorphin 
progestin-dependent 
programmed death 
progressed 
progressing disease 
progression disease 
Prolidase deficiency 
proliferative disease 
protease domain 
protein deficient 
protein deposition 
protein deprivation 
protein deprived 
protein diet 
protein digestibility 
proton density-weighted 
protopanaxadiol 
provocation dose 
proximal-distal 
proximodistal 
pseudodeficiency 
psychiatric disorders 
psychological debriefing 
psychological distress 
psychotic depression 
pulse duplicator 
pulsed diastolic 
pupillary diameter 
pupillary distance, peritoneal dialysis 
purine derivatives 
putidaredoxin 
P-wave dispersion 
pyloric diameter 
pyridinoline 
pyridostigmine 
pyridostigmine bromide 
pyrimidine dimers


That's all I have to say about that!

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## chuckbednarik

> PD measurement?
> 
> You better bet that I give them out!
> 
> Where should I start?
> 
> Parkinson's disease 
> peritoneal dialysis 
> Paget disease 
> ...


Most of these, when given out, lead to litigation.  :Eek:

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## Wes

> PD measurement?
> 
> You better bet that I give them out!
> 
> Where should I start?
> 
> Parkinson's disease 
> peritoneal dialysis 
> Paget disease 
> ...


Could the measurement for Peyronie's Disease be given as radius of curvature?  Also, I didn't see Pelvic Diameter listed.  Why the oversight?

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## huskypaul

> Not sure how many ophthalmologists have commented, but to me, and I'm sure to the vast majority of ophthalmologists, the PD is not part of the prescription, and never will be...I don't take it, and I won't take it.  It isn't what I was trained to do, although I was briefly instructed on how to do it.  Just like surgery, if it's not something you regularly do, don't do it, or you'll end up getting yourself in trouble and harming the patient.  It's the job of the optician, and that's what I tell the rare patient who asks for it.  I explain that they can go to any optical shop they want, and for the specs to be made, the optician will take all the necessary fitting measurements.  It is a fitting measurement, not a refractive measurement.  If they choose to purchase online, they are in essence becoming their own optician, and they are responsible for any errors.


 Amen, I have had patients bring me a prescription with a PD assigned, for arguments sake let us say Mr Doe has 30/30. When taking my own IPD measurement via their corneal apex reflex, I come up with 33.0/33.5. Am I too Assume that the prescribing Dr is using a different tool, they want horizontal prism, the patient has been accustomed to the OC set this way, is the RX for near, is it the method they use or is it my method for taking IPDs. Who's do I use and who is responsible. Thus begins the circle of life.

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## LandLord

If someone put a gun to your head and told you to dig your own grave, would you do it?  Not me.  I'd dive for the gun and try to shoot the guy.  Then I'd dig his grave.

Online retailers got successful by first breaking the rules.  Why would you follow a new rule that was made up to accommodate them?

Charge a $100 PD measurement fee or no deal.

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## MakeOptics

> If someone put a gun to your head and told you to dig your own grave, would you do it?  Not me.  I'd dive for the gun and try to shoot the guy.  Then I'd dig his grave.
> 
> Online retailers got successful by first breaking the rules.  Why would you follow a new rule that was made up to accommodate them?
> 
> Charge a $100 PD measurement fee or no deal.


Comprehensive eye exams cost less at some offices, how could anyone possibly justify charging $100 for a simple measure.

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## fjpod

I do believe some states require the PD as part of the Rx.  It is a small minority, but I suspect it will grow.   Not sure if it is required of ODs and OMDs.  Perhaps someone from those states can elaborate.

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## Barry Santini

I think it's time to restate a sentiment I find increasingly attractive:

Just de-class eyewear as a medical device. It's already at the bottom of the lowest risk class now, so a small nudge shouldn't be a big political deal. And OTCs and online delivery of Rx eyewear have already shown no evidence of coughing up bodies. Today, at the dawn of OTC, user-adjustable "Rx" eyewear, it really makes no sense to continue to regulate this product category. Exams yes. Eyewear no.

So with eyewear no longer regulated, the whole suite of PD/Rx/EHR/compliance/Insurance issues simply evaporates. No longer do private eyewear stores have to deal with business-busting dog****. As eyewear margins are heading downward anyway, I can't see where such a change would make the pricing dynamics free market change in any significant way.

Zenni already defines the bottom. There'd still be a quality hierarchy, linked to price.

A simple solution. I say don't resist it. In fact, you shoud lobby for it.

B

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## optimensch

I agree with Barry.... deregulation is the way to go. The simplest reason is that people are increasingly making eyewear purchases online, with or without a PD measurement from a professional. People are even shipping their old glasses to an onliner to "duplicate" the Rx.
At the same time real professional establishments are being handcuffed by regulators (here in Quebec it is forbidden for anyone other than a licensed OD or optician to handle even the simplest frame adjustment) in a manner that simply keeps costs high and further drives people to onliners. it makes no sense.
The next frontier will be unregulated online eye exams delivered by the likes of Zenni. But let's leave that for another thread...
you want your pd? there is an app for that anyway -

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## Christopher

> You are not going to stop advances in technology.  The pace of change continues to accelerate.  The eyewear industry has largely been late to the game with respect to changes brought about by e-commerce and consumer based technology applications.  You can adopt an attitude of "glasses are special, you need personal measurements, they are medical devices, blah blah blah" and refuse to innovate.  Ultimately you will get wiped out.  
> 
> Consolidation in the eyewear industry was inevitable.  It happens in virtually ALL INDUSTRIES.  As an example, when cars were first invented, there were literally hundreds of auto manufacturers.  Ford and later GM and Chrysler drove innovation and you had the big three.  Same thing happened in radio and TV.  
> 
> If you think the same was not going to inevitably happen in eyewear, you have not learned from history.  Mature businesses consolidate.  In the lab business, you now have E, Z, and H.  In frames, you have Lux, Saf, and Marchon.  You can make the same lists for optical retailers and insurance companies.  Any little guy who wants to compete in a mature industry is a niche player and better do one thing very well.  Embracing a new technology can be your ticket to success.   
> 
> So get beyond worrying about PDs and start thinking about the future of your business.


This is the smartest thing I've read yet in this thread....

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