Diagnostic Instrumentation

Updated Refraction Instrumentation: Take Exam Experience to Next Level

David I. Geffen, OD, FAAO


High-tech refraction instrumentation takes your exam process to the next level–and sends a positive message about your practice brand.


SAVE TIME WITH AUTOMATION.No more, “One or two, better or worse?”

TRAIN STAFF. Take advantage of complimentary training.

SEND A HIGH-TECH MESSAGE. Show patientsthatyou provide a cutting-edgeexam experience.

We live in a high-tech world, with updated smartphones, televisions and other products on the market nearly everyday. Updated technology also has a place in your office, and patients appreciate it. Two years ago, I purchased a PSFRefractor from VmaxVision. PSFstands forPoint Spread Function, a common term used in the optics of the eye. All wavefront equipment is utilizing point spread function to asses aberrations of the eye. In terms of the functionality of the instrument, it means we are using more advanced technology than the Snellan letter chart, which the phoropter uses. The PSF Refractor costs around $40,000.We purchased the unit outright, and recouped our investment in six months. The technology enables us to more easily show the advantage of higher-end, custom lenses, generating greater revenues in our dispensary.

We previously used a common phoropter for refraction, the oldest piece of equipment we have in our offices. With all the high-tech equipment we have, many patients noticed that we still checked their prescription the “old fashioned way.” When I saw the Vmax PSF unit, I knew I found the answer to replace my phoropter. The PSF refractor is accurate to 0.05D of power, much more accurate than my phoropter. I have found it to be easier on my patients who hated the “which-is-better, one or two” questions. Point spread function is easier for most of my patients to respond to.

Dr. Geffen refracts a patient using the PSF Refractor. Dr. Geffen uses the tablet to connect to the office’s electronic records.


Practice efficiency is vital in this time of heath care reform. Utilizing the Vmax refracting system has saved time in my exam room.

More importantly, due to the increased accuracy of the refraction, I have been able to demonstrate the difference between standard or lower quality products compared to digitized lenses such as the Encepsion Lens, which is marketed by Vmax Vision. By helping my practice show the benefits of higher-end lenses, we are seeing increased revenue in my optical.

It is also so much faster that patients appreciate less fatigue. The ability to show the difference between their old glasses and new prescription with a touch of the button is a great asset.

The ability to refine the prescription to hundreths of a diopter provides a more exact and customized prescription for the patient.

Propters only prescribe to 0.25 diopters while the Vmax goes to 0.05 diopters. You need to be able to make the lens to take advantage of this small difference, so the enception lens can be made to that specification. Since making our purchase of the PSF Refractor, a newer version of the product has been released, featuring a self-contained unit which does not need an exam lane to use it in. The new unit projects the target in virtual space, so you can perform a refraction in very small rooms. The voice activation can be used to help teach the staff to use the instrument and help the patient with the exam if you wish.


To best utilize the instrument,it is important to properly train your staff, and most importantly, yourself and other doctors in the practice. I found it takes about two weeks of utilization to become comfortable with the device, and once you have become comfortable, you will not like going back to a phoropter. Vmax provided two weeks of excellent complimentary training for us.


Our patients talk about the ‘high-tech” refraction they had at our office and refer their friends for this experience. The purchase of this piece of equipment goes perfectly with our practice brand. We have always prided ourselves on bringing the latest technology to our patients. We promote our new technology to our patient base in newsletters and advertising. Explaining a device like this to patients is a huge winner as it shows you are ahead of the curve and cutting edge.

We continue looking for ways to send this high-tech message and give our patients the most up-to-date exam experience. When looking at new refracting equipment you need to look at what can take you into the next generation of lens materials and take advantage of the opportunity to correct your patients’ vision to the best of your capabilities. Up until now materials have outpaced our ability to prescribe. Now we have caught up with the Vmax.

Related ROB Articles

Instrumentation: A Major Expense–But a Practice-Builder

Removing Roadblocks to Change: Advanced Instrumentation

Explain Your Instrumentation…and Send a High-Tech Message

David I. Geffen, OD, FAAO, is a partner of Gordon-Weiss-Schanzlin Vision Institute in La Jolla, Calif. To contact: dig2020@aol.com

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