Diagnostic Instrumentation

Automated Phoropter: Pain-Free OD, More Doctor-Patient Time

By Tommy Lim, OD

March 6, 2019

Your patients expect a high-tech, efficient, pleasant exam-room experience. And you, as doctor, expect technology that can best support your exams while keeping you physically comfortable. For all those reasons, my purchase of an automated phoropter a few years ago has been a success. Here are the details.

More Efficient & Higher-Quality Time with Patients
We added the Topcon CV-5000S during the Christmas holiday season in 2016. We purchased two for a little under $40,000, and have already recouped that investment in the added time I have with each of my patients, which allows me to better discuss eye-health and visual concerns, and then take more time explaining my prescriptions. This, in turn, allows us to improve care and our capture rate in the optical.

I must admit I was a little hesitant to make such a drastic technological change during the busiest season of the year, but thankfully, my Topcon distributor, Dusty, from Ophthalmic Instruments, is local. He was able to work around my schedule and was there for follow-up support when we needed it.

I’ve been in practice for over 40 years, and a lot of my patients have become good friends. Using the CV-5000S gives me back one of the most important parts of my examination: more quality time talking to my patients about their eye health, eyewear needs and their life in general, without causing delays in my schedule.

The extra few minutes I am able to spend with my patients explaining the results of their exam, and explaining the benefits of progressive lenses, the different lens-treatment options, and other eyewear solutions, puts the patient in a place to make a more informed decision. This has resulted in an increase in lens upgrades and the purchases of prescription sunglasses.

My purpose in acquiring the CV-5000S was not to increase the number of exams I could see each day, but to make the entire patient experience a better one, resulting in better patient education and a more accurate refraction. The patient experience and the personal relationships developed is what will continue to make private practices successful, despite the challenges from the optical chains and online eyewear retailers.

Minimal Space Required
I didn’t have to change my exam room at all. Dusty from Ophthalmic Instruments came in, took my old phoropter and projector down, put the new system in its place, and I was off and running.

My exam room essentially looks the same as most OD exam rooms. Sometimes patients don’t even know I have a new refracting instrument until they hear the subtle sound of the gears changing in the phoropter.

Lens powers now are changed via a handheld keypad versus physically changing lenses.

The keypad of Dr. Lim’s automated phoropter. Dr. Lim says using a key pad enhances his ergonomic comfort.

Exceed Patients’ Expectations
Our patients see advertisements on television for “digital exams,” and wonder why we are “still doing it the old way.” In today’s fast moving technological market, we need to ensure our technology and services are keeping pace with, if not outpacing, the newer entrants into our world.

I can’t tell you how impressed my patients are with our new way of refracting. If a practice is going to compete and thrive in today’s high-tech world, having an auto-phoropter is the first step in this progression. Our smartphones are changing every few years, so how can we tell our patients that the part of the eye exam they remember the most hasn’t changed in over 20, 30, 40 years? And if we did tell them this, would they question how up-to-date we really are?

I love to hear the comments patients have about our auto-phoropter. “Wow, this is way different than the old way you used to do this,” is a common thing I hear from my patients. And comments like, “Oh, I saw something like this on TV” Or: “This is really high-tech.” After practicing optometry for more than 40 years, I appreciate hearing from my patients that I am “high-tech.” The impression that we are technologically advanced is especially important, as our practice is based in the Silicon Valley area, where technology is born and moves at a rapid pace.

Creating an Ergonomically Healthy OD Environment
Surprisingly to some, optometry is a physically demanding job. The repetitive motion of using a traditional phoropter and projector takes a toll on your neck, shoulders and back. Using the CV-5000S allows me to sit in a more ergonomically healthy position relieving stress that was causing almost debilitating pain in my neck and shoulders.

A few weeks after I purchased the Topcon CV-5000S, I told Dusty that I could “finally lift my hands over my shoulders without pain.” It had been years since I was able to raise my hands over my head without significant repetitive-motion pain in my shoulders. The damage has already been done, but I am in a much better place than I was 2-3 years ago.

Better, But Not a Radical Change
Going digital doesn’t mean changing everything you do; it simply means making your work life easier, providing a new and improved experience for your patient, and in my experience, alleviating the doctor’s physical pain from conducting many traditional refractions.

“It’s just sphere, cylinder, axis and prism, nothing has changed” was the mantra that Dusty kept repeating during my training. He wanted to make sure that I knew that everything I did before with my traditional phoropter was still the same, but that the CV-5000S was going to make the exam experience more enjoyable for me. I still have my 30+ year old phoropter in a box in my office, but I am quite certain it will never be used again.

Easy to Use
The CV-5000S is remarkably easy to use, though I was a little uncomfortable with it in the very beginning. Dusty installed the CV-5000S after my last patient the day before our training. I came in the next morning and spent about an hour and a half with him, going over the features and programming in my exam sequence. After that, I saw patients while Dusty stayed close in the next room, just in case I had any questions, which I did.

Overall the first day went great. The training was complimentary, as were the follow-up sessions we did to hone my refraction sequence. We are only about 25 minutes away from Ophthalmic Instruments, our distributor, which I feel was important to our success and relatively fast learning curve. I would highly recommend you buy from someone local to your area, and create a true partnership with your distributor. It definitely made life easier for me.

Tommy Lim, OD, is the senior partner of Berryessa Optometry in San Jose, Calif. To contact him: drlim@berryessaoptometry.com

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