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Why aren’t optometrists dispensing more plano sunglasses? Bob Pieper

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rivate practice optometrists long ago abdicated themarket for plano sunglasses to the drug stores anddepartment stores, notes respected practice man-

gement author Irving Bennett, O.D. As Southern Cali-ornia College of Optometry practice management pro-essor Peter Shaw-McMinn, O.D. has noted in thisublication, (see Here comes the sun, “Practice Strate-

ies,” June 2000), many patients leave an eye careractice office only to purchase sunwear somewhere else.hat is, in part, because very few private practice optom-trists carry a large supply of plano sunglasses, Dr.ennett suggests. Maintaining an inventory of plano

unwear represents an additional expense for a practice,e notes. Many practitioners may feel the return onnvestment may be questionable.

However, several optical chains, particularly Lenscraft-rs, are trying to bring plano sunglasses back into theealm of the eye care professional, Dr. Bennett notes.hey may have good reason. Americans are buying morelano sunwear than ever, according to the Vision Councilf America’s (VCA’s) VisionWatch market study (Sec-nd Quarter 2005 VisionWatch-VCA Sunglass Indexeport). The survey suggests annual U.S. sunglasses

ales are poised to break the $100 million mark. Sales oflano sunglasses totaled $99.9 million in the 12-montheriod ending June 2005, up from $94.6 million 2 yearsgo— or an 8.6% increase from 2003.More than 191 million Americans (86% of the nation)

wn plano sunglasses, according to VisionWatch. Thatncludes 101 million women (88% of the nation’s femaleopulation) and 89.5 million men (83% of the maleopulation). A substantial number of people are nowilling to buy high-quality sunglasses, according to sun-

mericans are buying more sunglasseshan ever. However, most of those sun-lasses are not being purchased throughptometrists who can help ensure thatunwear provides adequate ultravioletrotection.

ear industry representatives. That is, in part, as a result g

529-1839/06/$ -see front matter © 2006 American Optometric Association. Alloi:10.1016/j.optm.2006.01.021

f the growing public concern over the effects of ultra-iolet (UV) radiation, they say. Manufacturers also main-ain the increase reflects their efforts to offer new styles,uality features, and greater value.Counseling patients on properly protecting their eyes fromV radiation and dispensing quality eyewear to provide thatrotection clearly belong within the scope of optometricractice, according to noted optometric researcher and AOAommission on Ophthalmic Standards member Donalditts, O.D. Still known in some eye care circles as “the

nventor of UV,” Dr. Pitts, decades ago, conducted thereakthrough studies that demonstrated the effects of UVnd infrared radiation on the eyes. He also developed theoncept of a numeric UV index, which is now prominentlyeatured in weather forecasts across the nation (see Pitts,G. A comparative study of the effects of ultraviolet radi-

tion on the eye. J Am Optom 1970;47:535-5465; Pitts DG.he ocular effects of ultraviolet radiation, presented as thelenn A. Fry Lecture, Am J Optom and Physiol Opti978;55:19-35; and Pitts DG. The threat of ultravioletadiation to the eye—and how to protect against it. J Amptom 1981;52:949-957). “Indeed, the OD is the practitio-er who has the knowledge to advise the patient of theequired protection against UVR,” Dr. Pitts said.However, marketing research indicates optometrists con-

inue to account for only a minority share of the sunglassesold in the United States. Of the $1.89 billion Americanspent on sunglasses during the 12 months ending June 2005,unglass specialty stores accounted for $617 million—fullyne third of the market, according to VisionWatch. Grocery,rug, convenience, variety, and other mass merchandiserslaimed the next largest share, $556 million. Independentpticals (which VCA defines to include most ophthalmolo-ists, optometrists, and opticians) placed a distant third with231.3 million in sunglasses sales. Optical chains came inourth with $139.1 million in sunglasses sales, followed byports stores ($135.8 million), department stores ($121.2illion), and flea markets ($14.1 million). Moreover, mar-

eting research shows the percentage of patients with properV protection (not just plano sunwear but UV protective

pectacle lenses or UV protective contact lenses) variesreatly from practice to practice, Dr. Shaw-McMinn notes.Dr. Shaw-McMinn suggests a program of education onV protection be implemented as part of the patient care in

very optometric practice. However, to make such a pro-

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ram truly effective, a two-fold approach may be necessary.

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188 Practice Strategies

ye health educationndustry representatives and practitioners who spoke withPractices Strategies” agree the public has become more awaref the dangers of UV radiation in recent years. Perhaps becauseedia coverage has increased public awareness of UV, some

ractitioners may feel that it is not necessary to counselatients regarding the potential effects of UV on the eyes.owever, a 2002 survey by Transitions Optical found that

lthough 79% of Americans knew that extended exposure tohe sun can cause skin cancer, only 6% knew it can damage theyes (see How to offer the best UV protection for patients’yes, “Practice Strategies,” October 2002). In many cases,ractitioners may find patients are knowledgeable about theun protection factor (SPF) rating system used for sun screen

ut will still go outside in the noonday sun without protective m

enses. That may be because sunburns are easily visible, butamage to the eye, although it can occur relatively quickly, isot as immediately apparent.In many cases, practitioners may need to more specifically

xplain to patients how UV can damage the eyes. Practitio-ers should explain that both UV A (wavelengths 400 to20 nm) and UV B (wavelengths 320 to 290 nm) can haveffects on the cornea and the lens. Practitioners should alsoxplain that UV radiation (depending on the particularavelength of the radiation and the length of the exposure)

an affect the retina, leading to conditions such as macularegeneration. In many cases, it may be necessary for prac-itioners to explain that various sunglasses offer variousevels of protection against UV A and UV B. Practitioners

ay also need to explain the benefits of various sunglasses

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Practice Strategies 189

esigns, such as wraparounds. Patients may also not under-tand that protecting the eyes from UV radiation is not justmportant on “sunny” days.

Success in educating patients on the importance of UVrotection may, in many cases, be a matter of repetition. Theoncept of UV protection should be emphasized throughouthe patient visit, according to Sue E. Lowe, O.D., immediateast chair of the AOA Sports Vision Section. She reportser Snowy Range Vision Center in Laramie, Wyomingispenses a considerable volume of plano sunwear. “Wemphasize the need for UV protection throughout the prac-ice, in the examination room, in the contact lens depart-ent, and in the dispensary,” Dr. Lowe said.Discussion of some visual sensations, such as those that

ccompany the transition from the indoors to the outdoorsand that can signal retinal damage) may provide an oppor-unity to meaningfully relate the importance of UV protec-ion to patients. Parents may be interested to know that,ccording to the U.S. Environmental Protection Agency’sunwise Web site (www.epa.gov/sunwise), an estimated0% of their children’s lifetime sun exposure will probablyccur by age 18. When providing presbyopic correction,see Reaching Baby Boomers: 2020 and beyond, “Practicetrategies,” February 2006), practitioners have an opportu-ity to educate middle-aged patients on the increasingmportance of UV protection to guard against age-relatedacular degeneration later in life. Practitioners will oftennd it easy to convincingly explain the benefits of sunwear

o contact lens patients who are light sensitive.Many practices use on-hold messages to educate patients

egarding UV. Some provide scripts to help opticians andther staff members reinforce patient education on UV.any practitioners use fliers, fact sheets, and brochures.

he AOA Order Department offers a fact sheet, Protectingour Eyes From UV Radiation, as well as a brochure,unglasses Are More Than Shades, intended for use inatient education. (To order call 800-262-2210 or see theOA Order Department page, under Member Resources, on

he AOA Web site.)

tyleWe emphasize the health issue,” Dr. Lowe says. However,hen patients select sunglasses, “it’s very much a style

ssue,” she acknowledges. Unlike most of the measures thatan be taken to improve vision or protect eye health,earing sunglasses is fun, manufacturers note. And that isood, they add. The color, style, and image of plano sun-ear offerings can serve to encourage use. The right choice

n sunglasses is actually the one that patients will want toear most of the time when outdoors. Moreover, the in-

reasing variety of sunwear on the market offers practitio-ers greater ability to provide the patient with sunglasseshat will be comfortable and will meet exact needs. Practi-ioners should not necessarily be reluctant to use style andashion to encourage patients to use sunglasses.However, that means dispensaries must have a wide

ariety of sunwear to accommodate the lifestyle and activ- c

ties of patients, manufacturers say. “A good selection ismportant,” confirms Dr. Lowe. “We carry them all: Oakley,

aui Jim, Bole, Rudi Project, Smith.” It also means prac-itioners must pay some attention to trends in the sunglassndustry to meet patient demand.

Some close to the industry say the current trend inunglasses is away from novel “retro” and “bling” styles toore subtle designs that infer status, luxury, and quality.arge, enveloping plastic frames reminiscent of Jacquelinenassis are still popular. However, vibrant fashion colors

or plastics have given way to black, with various demi-rowns and some softer earth tones. Gold frames continueo be popular, whether on aviators or molded into metalliclastics. New variations on the classic aviator frame incor-orate subtle changes to curvatures and detailing in bothlastics and metal. Polarized lenses, of course, remainopular often with high-fashion frames.Manufacturers say practitioners must be aware that

emand in sunglasses will always be shaped, in part, byhe styles patients see in magazines and on the fashionage. However, sunglasses inventory must be selected onore than just popular styles, emphasizes Dr. Lowe. “It’s

he quality of the lenses, the quality of the frames,” sheaid. One of the reasons patients will opt to obtainunglasses from their optometrists is the assurance thathey are getting quality lenswear that will last, she said.

he importance of dispensing planounglassesrom a practice management perspective, an argument

Internet ResourcesThe following Web sites offer educational informa-tion for patients or information on UV related re-search for eye care practitioners:

— U. S. Environmental Protection Agency (EPA)Sunwise Program (www.epa.gov/sunwise)

— National Oceanic and Atmospheric Administra-tion’s UV Radiation and the Eyes Web page(www.srrb.noaa.gov/UV/resources/uveyes_final.pdf)

— The World Health Organization (WHO’s) Inter-Sun Programme (The Global UV Project) Webpage (www.who.int/peh-uv)

— The Federal Provincial Territorial RadiationProtection Committee of Canada’s PositionStatement and Overview on Solar & ArtificialUltraviolet Radiation: Health Effects and Pro-tective Measures (www.labour.gov.sk.ca/safety/radiation/ultraviolet/printpage.htm)

— National Eye Institute (www.nei.nih.gov)Courtesy: Transitions Optical

an easily be made for the dispensing of plano sunwear

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190 Practice Strategies

y eye care practitioners. Sunwear, as a segment of theverall ophthalmic market, is growing faster than con-entional frames and lenses or examinations fees, accord-ng to the VisionWatch survey. However, as in all aspectsf optometric practice, the welfare of patients should behe primary consideration. With today’s scope of prac-ice, optometrists routinely counsel and care for patientsith diabetic retinopathy, glaucoma, and macular degen-

ration. Optometrists comanage refractive surgery andataract patients. They can provide care for young pa-

ients with learning-related eye problems and older pa- t

ients with low vision. Adequately counseling patients onV protection and providing patients quality UV protec-

ive sunglasses is consistent with that care. Optometristsan be glad that the media and the public have becomeore conscious of the need to protect eyes against UV.ptometrists should not hesitate to reinforce that mes-

age in their practices and be prepared to provide sun-lasses that patients will use to adequately protect theiryes.

The opinions expressed do not necessarily represent

hose of the American Optometric Association.