Four years of R&D have been invested in the latest phoropter technology from Essilor, the Vision-R 800 supplied by OptiMed, that Australian optometrists say is transforming the refraction experience for practitioners and patients.

First developed in the early 1900s, the phoropter has been synonymous with vision care, becoming a central tool in the optometrist’s technological armamentarium. While many optical instruments have been eventually superseded, this iconic instrument has withstood the test of time and remains fundamentally similar to original models developed more than 100 years ago.

One of the largest advances in phoropter technology has been the introduction of digitalisation and automatic functions. But ophthalmic lens and equipment manufacturer Essilor has been exploring ways to optimise the phoropter even further for a better patient and practitioner experience. Thus, in 2020, it introduced the Vision-R 800 auto phoropter to the Australian market.

Supplied by Sydney-based ophthalmic device distributor OptiMed, which formed a joint-venture with Essilor in 2019, the Vision-R 800 is said to offer continuous power changes and makes refraction more precise, easier to perform and more comfortable.

For example, in the traditional refraction procedure, values are rounded to 0.25 D at each stage where inaccuracies accumulate. Whereas the Digital Infinite Refraction procedure on the Vision-R 800 means the refraction is conducted with 0.01 D increments and the final value is rounded to the nearest 0.25 D, with four solutions presented for the optometrist. The final prescription can be offered to the patient as a precise refraction for Essilor Advanced Vision Accuracy (AVA) lenses or conventional for standard type lenses.

It achieves this with a revolutionary optical module Essilor has developed containing a precisely adjustable novel liquid lens, in addition to a smart refraction program using unique algorithms.

Further, optometrists are reporting that the smooth power changes and a wider field of vision make refraction comfortable for the patient. The eye test is shorter and along the refraction procedure, variation steps are adjusted to patient sensitivity, making differences easier to perceive. At the end of the test, the Vision-R 800 phoropter also offers patients the experience of comparing refractions in simulated real-life conditions, a key tool for practices to demonstrate the value of their products and service.

Optometrist Ms Alison Steer operates the first Western Australian practice to have the Vision-R 800 installed. This occurred in 2020 amid a major upgrade of her namesake independent practice in Albany – located 400km south of Perth – just as Essilor’s latest phoropter was being released. Since then, it has reaped major clinical benefits while also increasing her business’ profit margin.

Before the installation, the practice’s existing phoropter was manually operated and had no links to her Sunix practice management system, so she was keen to upgrade to an automated phoropter, both for ongoing ergonomics and patient experience.

Steer ultimately invested in a complete integrated system that also incorporated Essilor’s new WAM (Wave Analyzer Medica) 800 auto refractor.

“It has been an excellent patient experience and we have got a lot of positive comments regarding the ‘new equipment’. Apart from the clinical benefits, the Vision-R 800 promotes a progressive, clinically up-to-date image and experience for my patients,” she says.

“Clinically it gives a streamlined examination process and the ability to refine the prescription to a greater degree than other phoropters on the market. We can offer a greater degree of vision accuracy for those clients who prioritise high precision for their eyewear solutions. In one simple step we can demonstrate the difference between the standard ‘0.25’ step refraction result and the high precision option.”

Commercially, she’s also now able to demonstrate the benefits of a new prescription easily and efficiently which has enabled increased sales.

“We are now able to offer the high precision lenses which is a great pointof- difference and increased profit margin.”

In terms of which features she has found most impressive, Steer describes the ease of comparing the old spectacle prescription with the new high precision subjective prescription as an excellent function.

She has also found useful the ability to customise the testing programs to her own protocols and system. The instant data transfer into Sunix also means less manual transfer and less opportunity for transcription errors.

As a medium-sized independent in a regional centre, Steer says it is vital optical businesses like hers continue to invest in leading-edge technology so she can continue to support two fulltime optometrists and five additional staff to service the community of Albany, in the WA’s Great Southern Region.

“I have had a strong relationship with OptiMed for many years as they provide excellent equipment, advice and backup service. Mark Stapleton and Brad Miller, our local team, provide advice, backup and servicing as required and excellent installation,” she explains.

“Independents need to have access to all the latest technology to be able to offer the high-end examination experience and diagnostic capabilities to their patients. Our point-of-difference is to offer patients a premium, customised experience throughout the visit and the Vision-R 800 is part of that process.”

A significant investment that was worth it

Around 400km west of Albany, patients at Margaret River Optical are also benefiting from the precision of the Vision-R 800, which adds to the practice’s other Essilor instruments including a Visioffice digital dispensing system and ALM 700 vertometer.

After deliberating for several months, principal optometrist Ms Allyson McIvor decided to invest in the technology to replace her manual phoropter and has been impressed with the visual outcomes of her scripts and the subsequent increased foot traffic brought about by word-of-mouth recommendations.

In particular, introducing the Vision-R 800 – and its 0.01 D increments – has allowed her to elevate her lens offering with premium-level Essilor lenses incorporating its AVA technology, offering prescription accuracy within 1/100th of a diopter.

Although some practices charge extra for this level of service, McIvor has decided not to, and has applied it for distance, multifocal and occupational lens prescriptions on a routine basis – which has been beneficial for those patients who might be more sensitive to small changes. “It was a significant investment and we did consider it for a few months beforehand, but I don’t regret it at all. It did take a

while to adapt and fine tune until I was comfortable with it, but as an independent practice it’s important to have a point-of-difference through the ability to order the most up-to-date lenses. There is no one in the surrounding area who has anything like this,” she explains.

“People are loving their vision and glasses; there’s definitely a ‘wow factor’ that comes with it and we have people visiting the store saying they have come for the technology. We’ve also had great success in terms of accuracy, I can’t remember our last remake.”

Like Steer, McIvor has found the script comparison feature easy for patients to follow.

“Also, instead of images on a chart, the Vision-R 800 has the ability to display real life images that can incorporate visual cues such as depth and shading so patients can get a real-life idea about how the prescription will impact their distance vision for driving, for example. There’s also a setting that can change to night time vision that you can prescribe for, a lot of binocular vision functions are easy to use and, I will add, in this climate, it’s COVID-friendly because you’re not standing over the patient adjusting the dials.”

Specialeyes is a four-practice optometry business also located in WA, with stores in Perth, Subiaco, Cottesloe and the University of WA. Its Cottesloe site is well established with two optometrists and five front-of-house staff, catering to an upmarket demographic.

Principal optometrist Mr Simon Hogan, who took over the practice from his father after practising in the UK for several years, says the practice’s old refractor head looked dated. But after a practice renovation, the new Vision-R 800 offered the possibility of more precise refraction, while still being easy-to-use and good for retinoscopy.

“I have been surprised how much difference the precision Rx makes with some patients,” he explains.

“Being one of the first with the new technology it also helps separate our services from the competition. Our patients are seeking a different offering to the one’s being so well marketed by the corporates, so everything we can do to stay ahead and at the very worst, level with them, is important.

“OptiMed’s support has been fantastic with their implementation.”

• Patented automated optical module powered by digitally controlled motors • Simultaneous and instantaneous changes or sphere, cylinder and axis • Sphere range -20.00 D to +20.00 D, in 0.01 D increments • Cylinder range 8.00 D in 0.01 D increments • Axis range from 0° to 180° in 1° steps • All changes in a continuous and smooth way

Optopol PTS 2000 – Fast and precise perimetry

OptiMed has myopia management covered