Novel Visual Alignment Technology for Practice Growth
By Matt Dixon, OD
Like most doctors and practice owners, I’m always looking to incorporate the new and emerging technologies that have the potential to positively impact both my practice and our patients. This openness to new technologies is what led me to Neurolens, a company that commercializes product innovations that both diagnose and treat binocular vision disorders. Neurolens has grown substantially in the last several years, but I’m proud to have been an early adopter of this technology back in 2018. And in my extensive experience utilizing this technology, it has had a measurable impact on patient and practice alike.
Balancing being both a medical professional and a business owner is often challenging, potentially when it comes to integrating new technologies or processes into your practice. Even if the change will ultimately benefit the business, there are often challenges and roadblocks along the way. Although my practice has benefitted greatly from Neurolens technology, I admit that I was somewhat hesitant at first. As with any new technology, we were initially somewhat skeptical about the results and were not confident in our ability to sell the lenses. Neurolenses are not covered by insurance, and they can certainly seem expensive compared to a “standard” pair of glasses. When evaluating back in 2018, several key factors came into play: a low entry point for capital investment, a short learning curve, and the strong recommendation of a trusted friend and colleague. Once I made the decision to incorporate the technology, the scope of the underlying issue quickly became apparent.
As an eyecare provider, I certainly understood that many of my patients were experiencing symptoms such as headaches, neckaches, eye strain, and even dry eye. I was also fully aware of terminology in the eyecare industry to describe these symptoms, such as Computer Vision Syndrome (CVS) or—more recently—Digital Vision Syndrome (DVS). Finally, I also understood that these symptoms could be tied to issues with convergence. However, I did not fully appreciate how broadly these issues were impacting my patients, nor how directly related these issues were to their binocular vision. Driven by extensive research, these lenses definitively linked extended periods of convergence—as would be required for extensive digital device utilization—with these common symptoms, and specifically with the trigeminal nerve.
It is well-understood that proprioceptive information is sent to brain via the trigeminal nerve; but when there is a proprioceptive mismatch between misaligned eyes and your vestibular and muscular systems, this creates a neural conflict and leads to an inaccurate gaze response. This leads to an overstimulation of the trigeminal nerve, and this overstimulation leads to a painful stimulation of several parts of the face and neck. This is why patient symptomology can so often be tracked back to binocular vision issues.
Our playbook is simple, and we aim to be very consistent with it. We have each patient scan a QR code that links to a brief online symptom survey. Having this as standard practice for every patient is helpful because patients are often hesitant to volunteer their level of discomfort until prompted by specific questions. This information is then sent to the Neurolens Measurement Device, Gen 2 (NMD2), a device that captures a huge amount of objective data, including distance and near phorias. A greater amount of exophoria at near compared to distance is very common, and often triggers symptoms. Interestingly, we have learned that the amount of misalignment is not relevant to the degree of symptoms experienced. For example, a patient with 1PD exophoria and a patient with 10PD exophoria with no other ocular or extraocular problems related to DVS might experience a similar magnitude of symptoms.
When a patient presents as symptomatic and has measurable phoria, I share their results with them using an online portal and demonstration tool. I typically have the patient describe their symptoms just to hear it in their own words. I explain in the simplest terms the connection between misalignment and signals in the brain that cause discomfort. Their eye misalignment is then addressed with a proven lens solution, which provides a contoured prism lens design that gradually delivers more prism in the lens corridor from distance to near. The lens are proven to have a profound impact on a patient’s visual clarity and comfort, which I have witnessed firsthand with my own patients.
Almost immediately upon adopting this process we confirmed that between 50% and 65% of the existing patients who come to our office were highly symptomatic, but they had been reluctant to disclose or describe their symptoms. Our confidence in prescribing grew very quickly as we heard stories from our patients about how much their quality of life improved after wearing Neurolenses. Our success rate is quite high, and our return rate is very low—in the single digits.
As I talk with patients, I’m careful not to overexplain the condition. I focus on listening to their story and giving them a brief idea of why they are having issues and how we can help. Like any other medical treatment, I prescribe with confidence then make my hand-off to our opticians. The value proposition to the patient is the key to success, and for those who are ready for relief, they are willing to make the investment.
I’m compelled to share one of my patient’s stories that deeply resonated with me. She’s a computer programmer around 40 years old who was working in the US military and undergoing some stressful life experiences; all while spending about 16 to 18 hours a day on screens. She was suffering from extreme headaches, neckaches, and fatigue. We prescribed Neurolenses and her symptoms improved dramatically. And because she was already spending a large amount of money each month for other less-effective treatments, she actually saved money with this option. She remains extremely happy and symptom-free.
In addition to headaches and eye strain, light sensitivity has also been linked to the trigeminal nerve; and there are few effective treatment options for patients. One patient told me that he would often find it necessary to pull over to the side of the road until an approaching car passed because of how debilitating those moments could be. His symptoms were fully alleviated by this technology.
In the past I would not have believed that 4D to 6D of near exophoria could cause such problems, but I’m now convinced. Doctors need to know that patients are looking for solutions to these chronic issues, and they are willing to pay out-of-pocket to get relief. Beyond symptom relief, patients tell me that they are more productive at work and can also more thoroughly enjoy activities such as reading.
For most of us in practice, these past few years have been challenging in many ways. As we were reopening our practice back in 2020, we worked to get patients taken care of and to reboot our profit centers. Initially we were only measuring a small percentage of our patients with the NMD2. But many of those customers ultimately made a purchase. In working with my Neurolens consultant, we agreed to be more consistent measuring patients, and sales began to skyrocket. Now we consistently help upwards of 35 patients each month to get relief from binocular vision issues.
I’m often approached with questions about the technology by peers and colleagues. As I talk with other doctors across the country, I hear a few increasingly common questions. I first explain that our patients are more symptomatic than what we might believe. Then I emphasize that these symptoms are very often the result of eye misalignments once thought to be clinically irrelevant. Finally, I stress how prevalent these symptoms are. It’s no secret that most people spend 6 to 8 hours a day using a digital device—regardless of age! We see older patients as often as younger patients who enjoy using an e-reader or tablet or spending time on social media sites; and they are very often symptomatic. We have been successful with both our adult and pediatric population.
In short, this new technology has had a huge impact on our patients and our practice. We are especially happy that we have created a profit center that is not subject to deep vision plan discounts which have become so common. The process is easy to implement—and in fact much of the work can be delegated to a trained staff member—and beneficial to your business. Most importantly, it’s very rewarding to be able to alleviate increasingly common symptoms and improve the lives or our patients.
Matt Dixon, OD is a graduate of Asbury College and the University of Alabama School of Optometry. He practices at Advanced Eyecare Center in Perry, GA.
Dr Dixon discloses that he is a key opinion leader for Neurolens and Investor for Lumify