Optical confusion- a guide to buying glasses

 by Jill Shuman, M.S., R.D., E.L.S.

If you're one of the 140 million Americans who needs glasses, you've probably noticed that eyeglasses have become both a fashion accessory and a highly profitable retail industry. Although the average price of a pair of glasses has increased more than 75 percent in the past five years, understanding the vision care industry can help keep the cost of buying glasses down.

The American Optometric Association suggests that people age 35 and older have an eye check-up every one to two years. While many chain stores provide the convenience of on-site optometry services, there are advantages to having your eyes checked by an independent specialist, because he/she has no financial incentive in prescribing new glasses.

You need not purchase your glasses from the person who writes your prescription. By law, you must be given a copy of your eyeglass prescription free of charge if you request it. This enables you to comparison shop with prescription in hand for quality, selection, and value.

The high price of eyeglasses is due primarily to the significant markup on frames. "Designer" frames are especially pricey, and are not uncommonly marked up 200 percent or more. A Consumer Reports survey found considerable price differences at five major eyeglass chains for the same pair of glasses--sometimes as much as $135. This discrepancy is due to a lack of pricing consistency between chains. Instead, most advertise weekly low-priced specials designed solely to attract new customers.

After reading the fine print, however, these specials may not be that attractive. They may be limited to a small group of frames, or may include just a basic frame and a single-power lens, with oversized lenses, tints, coatings, bifocals, or high-power lenses priced separately. In spite of this unpredictability and a very strong sales hype, you can still get a good deal on your next pair of glasses.

All eyeglasses used to have glass lenses, and glass still remains a popular material. Its primary drawback is its weight; if you have a high-powered prescription, the weight of glass lenses can be very uncomfortable. Plastic lenses are safer, more impact-resistant than glass, and fit more comfortably, especially in a large frame. However, they scratch more easily than glass. High-index plastic lenses are at least 30 percent thinner than regular plastic lenses of the same prescription. They are expensive but useful for very nearsighted people who want to eliminate the thick, "Coke-bottle" look. Polycarbonate plastic lenses are made of a lighter, impact-resistant plastic and are recommended especially for children and athletes. Although they cost $30-$40 more than glass or regular plastic, you can probably find an eyewear chain that will use polycarbonate in children's lenses at no extra charge.

Scratch-resistant coatings make lenses resistant to the tiny scratches that result from normal cleaning and handling. However, they won't prevent scratching if you mishandle your glasses or lie them lens-side down. Scratch resistance, a $20-$25 option, is unnecessary on glass lenses, but is recommended for plastic lenses and essential for polycarbonate ones.

You might also be tempted to purchase an antiglare coating, which is a $35-$40 option. Consider it only if you do a lot of night driving, as it does deflect headlight glare. Unfortunately, one of the drawbacks of antiglare treatment is its tendency to smudge, so you'll have to be fastidious in keeping your lenses clean.

What about ultraviolet filters, purported to protect against ultraviolet (UV) rays from both sunlight and indoor sources, such as computer monitors? According to the American Academy of Ophthalmology, the majority of UV light is filtered by any glass or plastic material, so that under normal conditions, additional protection is unnecessary. And, according to the same source, "The amount of UV light that comes from a computer screen is so minute that it is a non-issue." However, if you want extra peace of mind, you can add a UV filtering dye to glass or regular plastic lenses for about $25. High-index and polycarbonate plastic lenses act as natural UV filters, so they need no additional protection.

Photochromic lenses provide single-pair convenience by going from lighter to darker depending on light availability. However, they don't provide good UV protection when driving long daylight distances, because the windshield blocks out UV light, which is necessary to stimulate darkening. Keeping photochromics in the refrigerator overnight expedites the darkening response. A recent alternative to photochromics are frames that come with matching sunglass clip-ons.

Talk with your vision care specialist and make a list of the options you want. Compare identical products and identical brands, and then ask for an itemized price that includes the lenses, the frames, and the coatings. And, don't forget to ask about money-back guarantees; although many brands of frames, lenses, and coatings carry them, you won't routinely be offered the information. Bring along a friend when you shop so you don't have to rely on a commissioned salesperson to select your frames for you. If your prescription has changed but you'd like to save some money, you can have new lenses inserted into your old frames. As you comparison shop, don't neglect your neighborhood optical shop. Surveys repeatedly show that independent shops provide variety, competitive pricing, and personalized service, due primarily to lower overhead and a satisfied clientele.

Wherever you buy your glasses, don't leave the store until you're satisfied with the fit. Your vision shouldn't be distorted in any way, nor should you feel dizzy or disoriented. Walk around the store for at least 20 minutes, and discuss any problems you encounter right away. Do not hesitate to return to the store at any time in the future if you find that your glasses need adjusting, or if you are dissatisfied with the way you see.

Opticians are technicians who make and fit eyeglasses. They cannot write prescriptions for corrective lenses or diagnose disease. Certification by the American Board of Opticianry is an indicator of appropriate training.

Optometrists earn a doctor of optometry degree (O.D.) from a 4-year college of optometry. They are licensed by the American Optometric Association and are allowed to examine eyes, diagnose eye disease, and prescribe glasses and contact lenses.

Ophthalmologists are medical doctors who have completed several years of residency training in the study, diagnosis, and treatment of eye disease. Unlike optometrists, they can perform surgery and prescribe medications.

On national average, ophthalmologists charge $30 more than an optometrist for an equivalent eye exam. However, price should not be the sole determining factor in choosing a vision specialist, especially if you have diabetes, hypertension, or glaucoma.