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Digital Refraction Systems: A Complete Guide

An Overview: What Are Refractors?

Those who don’t have 20/20 vision have what is called a refractive error. This vision hindrance indicates that light is not bending correctly when it passes through the cornea and retina. To detect this common vision impairment, ophthalmic professionals conduct a refraction test, which determines the patient’s prescription to correct his or her vision.To conduct a refraction test, the ophthalmic professional utilizes a refraction system. This system is made up of several pieces of equipment with the refractor, sometimes referred to as a Phoroptor, being the key piece. It is used to check and verify a patient’s optical prescription. Patients will most likely identify refractors as the mechanical-looking mask placed in front of his or her face during this exam.

Through the mask’s lenses, the patient looks ahead at a chart, about twenty feet away. The doctor then manipulates the refractor’s lenses while asking the patient a series of subjective vision questions and feedback in hopes of finding a lens combination that brings his or her vision back to 20/20.

A Brief History of Refraction Systems

The history of the refraction system and invention goes back as far as 1909. Like most medical equipment, the timeline of its invention and evolving technology is not particularly linear; however, here is a general overview of the history of the refractor system:

1909: The monocular optometer was invented and had a range of +0.25 to +6.00 diopters. That same year, the DeZeng Phoro-Optometer was patented with a range of +15.75 to -19.75 as well as a Maddox rod and Risley prism for each eye.

1920: A smaller DeZeng Phoro-Optemeter was released.

1925: The American Optical Company bought Dezeng.

1927: A larger DeZeng model with increased lens size and a mounting bar for hanging was released. Before, the refractors were supported by a bar below.

1948: This was a revolutionary year for the refractor system; the newest model was larger and more modern.

1956: The redesigned digital refractor systems this year became the archetype for modern manual refractors used today.

In the years since, technology has accelerated rapidly in the medical equipment industry. Digital refractor systems were created to allow all aspects of a refraction exam, such as lens combinations and data entry, to be controlled by one panel; yet, some ophthalmic professionals continue to use these manual systems based off the prototype invented in the late ‘50s.

Common Issues with Manual Refraction Systems

Although technology has advanced, many ophthalmic offices have not upgraded from their manual refraction systems. As technology progresses, ophthalmic doctors now have the ability to control each aspect of an exam with one digital panel; yet many are hesitant to make the switch to digital refractor systems.

Regardless of these ophthalmic professionals’ concerns, manual refractor systems present regular issues that can potentially jeopardize the overall function of these offices over time. Manual equipment results in tedious exams, repetitive motions and other common issues such as:

  • Human Error
  • Inefficiency
  • Physical Pain

Because standard refraction systems are not integrated, ophthalmic professionals are required to manually enter data from separate testing machines. By relying on manual diagnostic testing, observation and recording, the likelihood of human error increases exponentially, which results in a loss of time and money.

When not equipped with the best tools available, ophthalmic offices are missing out on an opportunity many others are taking advantage of. Manual refraction testing is time-consuming and tedious when compared to a digital system.

Refraction is perhaps the most common procedure performed by optometric professionals, resulting in awkward postures and movements with manual systems. By repeating these motions every day, repetitive motion disorders often follow. Physical pain is quite common among ophthalmic doctors, who report mild to severe pain, swelling, tingling and loss of strength or flexibility caused by the repetitive motion of manually adjusting equipment.

The Now: Digital Refractors

Although manual refraction systems are still used by some ophthalmic professionals, digital refraction systems are quickly becoming the equipment standard for modern day ophthalmic offices. And this shift is happening for a good reason; digital refraction systems provide benefits for the ophthalmic doctor, the patient and the office as a whole. Now, ophthalmic doctors can control the functions of a refraction exam with one digital dial pad to put more emphasis on the accuracy and satisfaction of each exam.

The Benefits of Digital Refraction Systems

The benefits of upgrading to digital refractors are overwhelming, including increased efficiency, dispensary revenue and patient satisfaction.

  • Increased Efficiency
  • Patient “Wow” Factor
  • Reduction of Physical Pain for the Doctor
  • Less Errors, Fewer Remakes
  • Increased Capabilities
  • Connectivity of Equipment
  • High Return on Investment
  • Integration with Electronic Medical Records (EMR)

Even the most efficient ophthalmic offices do not reach their highest capabilities of expediency whenworking with manual systems. With a digital refractor, however, every aspect of an exam is linked through one digital source, so there are no lulls or waiting time. For example, comparing a patient’s old Rx to their new one is streamlined to make the prescription process quick and easy, saving you time and money.

As an ophthalmic professional, you are still practicing the same methods and prescription techniques you practiced for years—the digital refraction system simply allows this process to be much more efficient. In fact, switching to a digital refractor allows doctors to see two to six more patients per day (source).

Increased efficiency is not only a benefit to your practice, it also benefits and impresses patients, whose satisfaction is invaluable to the foundation of your ophthalmic office. With less time spent adjusting manual equipment, you gain more face-time with patients while reducing tedious and uncomfortable movements. Impressed by your efficiency, quality time and modern technology, patients will provide referrals and positive reviews, resulting in an overall increased dispensary revenue.

Digital refraction systems reduce tediousness, including repetitive movements for ophthalmic doctors. This means you can stay in one place and still control the functions of the testing equipment. With less awkward, uncomfortable movement, digital refractors can actually decrease or potentially eliminate your pain and discomfort altogether.

Due to the consistent nature of digital systems, accuracy is exponentially increased and results in far fewer prescription errors and glasses remakes. Features such as programmable sequences, wireless interface with pre-test equipment and electronic medical records allow for more effortless, error-free exams. This, in turn, saves time and money for your entire office—not to mention overall patient satisfaction. With all patient information saved to one location, digital records and prescription checks and updates have never been so easy and accurate.

Digital refractors have more features, which means these pieces of equipment can do things manual systems can not. Digital refractors, for example, have a dual cross cylinder. So, when testing for astigmatism (cylinder and axis), the digital refractor presents a split prism to patients. Normally, the ophthalmic doctor has to manually flip the images back and fourth for the patient to provide feedback. With dual cross, the images are presented at same time, minimizing your exam time. Additionally, the auto lensometer takes a reading from the patient’s current glasses prescription and puts it into digital refractor system. When the patient’s final, updated prescription is prescribed, the ophthalmic doctor can compare the old prescription to new one at the end of the exam. Now, patients are much more likely to pay to update their prescription by seeing the difference immediately.

With manual refraction systems, data taken during the pretest has to be manually entered into both the refractor and the patient’s record. With digital systems, however, each piece of equipment is essentially able to communicate with each other. Now, the pretest data can be automatically sent to the refractor, and from there, go directly into the patient’s record.

Investing in new equipment can be daunting; however, calculating the individual cost of the combined equipment of a refractor and keratometer, along with the time saved and the increased benefits, results in a substantial return. Download Veatch’s ROI calculator to see how much money your personal office would gain.

According to government mandate, all doctors are required to convert paper records to electric in order to increase transparency (source). Digital refraction systems make filling out forms easier than ever by collecting data throughout exams and minimizing multiple entries. In fact, at the end of an exam, all of the patient’s data is transferred directly into his or her file, making it much easier to keep up with EMR.

Common Concerns About Switching to DigitalIf you’re hesitant or concerned about switching to a digital refraction system, you’re not alone. Perhaps due to the upfront cost or the adaption to a new system, some offices do not look deeply into digital equipment, although the return on investment is substantial and results in a multitude of benefits. There are typically four common concerns when it comes to making the switch to digital:

  1. Cost
  2. Training and Adapting
  3. “Will I be Replaced?”
  4. “What Happens if it Breaks?”

Equipment is never cheap, and making the switch to a more advanced system seems like a large initial cost. While this may be true, the return on your investment is substantial. Veatch created an extremely accurate return on investment calculator to break down your profitability ratio after the upfront cost of switching. If you’re interested in receiving a detailed look at your personal return on investment, download the ROI calculator here.

Like any new piece of technology, there is somewhat of a learning curve when it comes to adapting to a digital refraction system. Veatch provides training, assistance and tools to those who purchase their equipment. Additionally, this new transition serves as an opportunity for your ophthalmic office as a whole. With a new system, consider training your entire staff, including technicians and office managers, so the office operates as a more streamlined unit. By inviting all employees to learn about each other’s systems and tasks, the workplace will take on a transparent and expedient atmosphere.

One of the largest concerns, and misconceptions, when it comes to upgrading to digital equipment is that the system does all of the work for the ophthalmic professional. While technology has come a long way, a digital system can never replace the years of training and experience provided by a medical professional; instead, this digital system acts as an assistant at most. Eye care professionals will still follow the same steps of an exam, but executing all functions and data collecting from one control panel. The goal of a digital refractor system is to keep you, the ophthalmic professional, organized and efficient.

While this is an uncommon occurrence, the resolution is easy. When it comes to Veatch digital systems, potential failures are typically software based and can be fixed on the phone or over the internet within an hour, regardless of distance.

Additionally, Veatch has two dedicated service teams: one team that responds to technical and software issues, and another team dedicated to mechanical support. All team members are factory trained and all parts are stocked by Veatch, meaning the entire maintenance process is handled by one company. Whenever necessary, Veatch makes in-house repairs that are typically completed within one day, as well as advanced repairs that generally take no more than three days and includes free loaner equipment while under warranty.

Digital Refraction Systems from Veatch Ophthalmic Instruments

If you are considering a digital refractor system, Veatch offers the most competitive prices on the market for state-of-the-art equipment and unmatched service. In fact, Veatch’s digital refractors are typically half of the cost of competitors’, simply because there is no middle man involved.

But perhaps the most valuable aspect of purchasing Veatch equipment lies in the overall service both during and after a purchase. Veatch offers long-term security in your investment, including:

  • Two factory-trained teams dedicated to offering support for our digital refraction systems
  • A two-year warranty, double what most competitors offer
  • All equipment parts stocked by Veatch
  • In-house repairs, typically completed within the same day
  • Advanced repairs that typically take no more than three days
  • Free loaner equipment during repairs while under warranty
  • If you are past your warranty period, these loaners are provided for a modest fee

Testimonials and Results

At Veatch, we understand how daunting it may seem to upgrade your refractor equipment. The results, however, are hard to ignore:

"Since going to a completely automated office, each individual doctor has been able to see approximately six additional patients per day in the same time period and the bottom line has improved accordingly."

- Steven Richlin, Beverly Hills, CA

"The bottom line is that the system allows me to do a better exam, more accurately and in a shorter period of time which adds 2-4 patients per day. The wow factor alone increases patient referrals."

-Jay Rosenfeld, Clearwater, FL

“…I had reached the point of seriously considering retirement. After so many years of using the old phoroptors, my right shoulder was giving me so much pain I didn’t look forward to going to work. Also quite frankly it was getting a bit boring.

After you installed the (digital refractor, auto refractor and lensometer) my attitude completely changed. What a joy it is to work with the equipment. No more sore shoulder, pain or headaches. Everything is right in front of me and at my fingertips…with a touch of a button the tech has sent to the digital refractor the patients present RX and the auto refractors information. The digital refractor is so fast and accurate. I see a large number of Native Americans who have high amounts of astigmatism so it is nice to have a refractor that goes up to 8 ¾ cylinder. It is a joy to use and the patients absolutely love it too.”

-Ralph Lightle, OD Farmington, NM

Are You Ready to Switch?

As manual refractors are quickly becoming a thing of the past, there is no better time to make the switch to digital. At Veatch, we offer high-end equipment at an affordable price that will benefit all aspects of your practice. Contact us today for a free consultation and information on how you can improve your office with digital refractor systems.

Download Veatch’s Free ROI Calculator to Find Out How Much Money Your Practice Could Gain!