Ophthalmic Lenses

How the Science of Prism is Transforming How I Care for Patients

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By Paul Karpecki, OD, FAAO

Oct. 14, 2020

Eye strain and headaches caused by eye misalignment can cause patients great discomfort, reducing functionality and quality of life. Fortunately, I have found a spectacle lens that is changing how I approach care of patients challenged by this condition.

That spectacle lens, neurolens, has greatly improved many of my patients’ lives while helping my partners and I build our practice.

Next-Generation Technology
Neurolens is a forward-thinking eyecare system that measures eye misalignment in any direction. Information obtained from each patient is fed back into a central database. To date, over 10 million data points are in that system. That massive amount of information is then complemented by artificial intelligence technology that helps me find the ideal amount of prism for each patient’s glasses.

The neurolens system measures eye misalignment (among many other measurements) in less than three minutes and prints out the exact amount of prism necessary to correct the patient. Much of that measurement is based on help from the system’s AI component.

Previous measurements for eye misalignment required the patient to identify the point of overlap between the eyes. Historically this has been too subjective and too variable. Past research has reported that even the most experienced practitioners find it difficult to be consistently accurate within three prism diopters for many of their subjective cover test and phoria measurements. Neurolens is objective and neutralizes the eye movements to refine the correction down to tenths of a diopter.

Furthermore, traditional prism was a single amount for the entire lens, meaning at distance and near. We know over 90 percent of patients have a great prismatic need at near – known as convergence insufficiency. The new contoured prism of neurolens allows for a greater amount of prism at near compared to distance.

A Growing Area of My Practice
I currently have 80-100 patients wearing neurolens glasses. This equates to around $36,000 annually coming into the practice.

In addition to tired eyes and headaches, patients with eye misalignment often complain of dry eye symptoms, yet, upon examination, do not appear to have dry eye. Rather than dry eye treatments, it is a pair of neurolens glasses that makes the greatest difference for these patients.

Good for Both Patients and Practice
Prism-powered neurolens glasses change peoples’ lives, and the patients whom I have prescribed these lenses tell hundreds of other patients about our practice.

From a practice management perspective, neurolens increases efficiency as I no longer have to do Von Graefe testing or other elaborate subjective ways of measuring phorias. Additionally results are quick and I don’t have prism creep or need to remake glasses. This saves time and money compared to practices that don’t have the technology.

Prism in spectacle lenses is one of the few highly underutilized options that has a significant impact on a patient life and retention to an optometric practice. Patients who are prescribed prism never leave the practice that they received the glasses from. If it’s taken away, they are no longer comfortable even if they see 20/20 or better.

Create a Practice Differentiator
Neurolens instantly sets you apart. Patients impacted by eye misalignment and discomfort are so grateful they tell far more patients about our practice than patients with any other condition I have treated. Think about having tried injections, numerous expensive drugs and still experiencing three or more migraines per week–and then having the problem resolved with a pair of glasses containing prism. No wonder these patients tell so many people about our practice.

Even small amounts of prism for patients with milder symptoms makes a significant difference. They expect clear vision, but they also want comfortable vision, and it’s the comfort that has them spreading word-of-mouth referrals to our practice.

Relieving Eye Misalignment & Eye Strain Never More Needed
The greater time most people are spending online during the pandemic has meant many more people experiencing digital eye fatigue syndrome. An eyecare system, like neurolens, that can pinpoint when this discomfort is due to eye misalignment, is just what patients need right now.

Patients are more aware of their eyes, and digital device use results in exacerbating any eye misalignment. Patients experience trigeminal dysphoria more often if they have misalignment. They also experience more dry eye as the blink rate decreases. Those with eye misalignment also are exposed to greater amounts of high energy visible light (HEVL) that can possibly affect photoreceptors long-term, and in the short-term definitely affects circadian rhythms and sleep patterns. With less sleep, patients experience more dry eye and have less tolerance for eye misalignment. So, it’s a vicious cycle.

Explaining the Science of Prism to Patients
I explain that the eyes have to work together to look at an image. If there is a microscopic difference between the eyes, or where the brain thinks the eyes are, this will result in overstimulating the nerves leading to headaches, dry eye sensation, dizziness and neck stiffness or soreness.

Patients appreciate the advanced treatment for eye misalignment offered by neurolens, and they appreciate that they have access to that system through our practice. Neurolens has been a way to provide the precise help many patients need while growing our practice.

Paul Karpecki, OD, FAAO, is a partner with Gaddie Eye Centers in Kentucky and clinical director, Corneal Services and Advanced Ocular Surface Disease at Kentucky Eye Institute. To contact him: karpecki@karpecki.com 

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