Given that the prevalence of refractive error is high and largely
unaddressed it makes strategic sense for an eye care provider to
expand his services to include spectacle dispensing.
Spectacles are the simplest solution to refractive error
because they are cheaper, involve less technology and are easier to
dispense than other correction options like contact lenses and
refractive surgery.
By dispensing spectacles we can ensure
that your patients do receive the necessary correction and that the
spectacles are of good quality (the correct power, appropriate lens
and frames). As patients have been found willing to pay for this
service, it also serves to generate funds which may be used to
subsidize other services.
At Aravind, we have observed that
10% to 25% of the total outpatients need refractive correction. This
large volume justifies a dedicated set up for dispensing spectacles.
Today, setting up a spectacle shop is fairly risk-free as
the spectacle market is quite well-established, globally. With many
players in the market, both in the corporate as well as unorganized
sector, the raw materials are available at fairly cheap rates.
Spectacle dispensing is a fairly simple procedure with
minimal training needs. With sufficient demand being created
in-house and the low cost of goods, this could easily go beyond
being a sustainable venture and generate a surplus of funds.
Equipping an Optical Shop Besides the
showroom infrastructure and the necessary shelving arrangement for
the stock, certain minimum equipment will have to be invested in for
sales as well as for processing the lens to get the right power and
to fit them into frames. The range of equipment necessary for
spectacle dispensing, again, varies with the variety of products and
services provided.
For sales and order taking, only basic
instruments for taking the various measurements of the patients
face are necessary. This could range from a simple ruler to a
sophisticated digital pupillometer.
Processing equipment
include grinding or surfacing equipment and edging equipment.
Surfacing is the process by which the power is generated on the lens
surface by creating the desired curvature. Edging of lenses is done
to shape them in a way that they can be inserted into the frame.
These equipments are available in a wide range in terms of
automation and sophistication. Manual egders are available at cheap
prices and can be handled with basic training. Automatic edgers may
be used only where there is a high volume of work or where training
is not sufficient and the lenses require sensitive handling. Other
essential tools include:
- trial lens set or lensmeter to determine power of lens
- marking, chipping and cutting instruments to trace and
roughly cut the lens to the shape of the frame before fine edging
is done on the edger.
- screwdrivers to fit the lens into metal frames
- frame warmer to enable the lens to be fitted into plastic
frames
- adjustment pliers for adjusting the frame
Lens
surface generators or surfacing machines are also available from
basic manual models to fully automated CNC machines.
Workflow in a Typical Optical Shop
It
must be noted that not all the above processes need to be part of
dispensing. This will vary based on capacity and circumstance. The
following units show the processes that can be outsourced.
The set up will vary depending upon the number of spectacles
we can expect to sell. In order to be sustainable, the resources
employed must match the expected demand.
When
should you outsource an activity or process? In order
to remain sustainable and to preserve focus, certain processes can
be outsourced while some can be done in-house. The following factors
might help decide the processes that can be outsourced:
- Volume: The volume of any activity must justify the
amount of fixed investment that is incurred. For instance, if you
are debating about setting up your own surfacing unit, you would
want to look into the number of orders you receive and the number
of orders that one would need to make to order.
- Delivery time: It is also necessary to look into the
time involved in out sourcing an activity. It might be cheaper to
get it done by a contractor but it might take a longer time. In
order to save on time it can be done in house.
- Quality & reliability of contractors: To maintain
the quality standards of the product, a check if the contractor is
able to deliver equal or better service than if it were done in
house is necessary. His service would have to be reliable.
- Cost in outsourcing: Cost of outsourcing the process
must ideally be less than or equal to an in-house arrangement.
- Capacity to manage: Sometimes, cost and volume might
dictate that a certain process could be done in-house but
expertise or the capacity to manage it as well as a contractor
would might not be possible.
A trade off on all these
factors will help decide which activities to outsource and which to
arrange for within our set up.
Era of the Plastic
Lens Glass lenses were predominantly used for
spectacles. It is still so in most developing countries though
plastic has been introduced. Glass lenses are brittle and heavier
when compared to plastic which is shatter-proof and only half the
weight of glass, making it more durable and comfortable. (Plastic
lenses are more susceptible to scratches, but recent advances in
scratch-resistant coatings have made them durable).
Plastic
lenses have lesser shelf life and need more sensitive handling. Thus
the decision to dispense plastic lenses can have implications on the
nature of equipment used. World over the trend is moving towards
plastic lenses more so because it is becoming more affordable.
The Supply Chain The spectacle goods
market has evolved over the years making lenses, frames and
equipment accessible and affordable even for developing countries.
However, small retailers will have to be aware of huge mark-ups down
the supply chain that can escalate the prices. Thus, the closer up
the chain, cheaper it is. With a large number of players in the
unorganised sector, price regulations are absent. However, cost is
controlled by a very highly competitive environment. Today, China
has become a major source of good and inexpensive frames and lenses.
Finances The following illustrates the
finances involved in setting up an average sized optical shop that
handles 25 to 50 orders a day.
Initial Costs:
Initial investments for setting up the infrastructure for the
dispensing unit include:
- Space
- Furniture ($ 1000 to 1500)
- Equipment manual edger ($250)
- Inventory Lenses & Frames ($ 2000)
Overheads: Other indirect costs that are usually
incurred are:
- Rent
- Electricity
- Stationery
- Salary
- Freight
- Machinery maintenance
- Miscellaneous
Recurring Costs: Direct costs
incurred in manufacturing spectacles are to cost of:
- Frames
- Lenses
- Accessories
- Direct labour charges
The following are the average
unit selling prices* of spectacles at Aravind Eye Hospitals, India.
In outreach camps: Rs.200 (US$ 5) In the
free hospital: Rs.250 (US$ 6) In the paying
hospital: Rs.500 (US$ 12)
* These are not prescribed prices and do not serve as an indicator
of the prices of spectacles in this region
Human
Resources Spectacle dispensing involves human skills in
two major areas:
- counselling and salesmanship
- technical skill for fitting and surfacing
Thus,
training will have to be structured for both categories of staff. It
must include
- order taking
- salesmanship
- product knowledge
- vendor relationship management
- inventory management with an understanding of the latest
trends and fashion so that appropriate frames are stocked
It is equally important to continuously update the staff
on new developments, products and techniques.
Spectacles at Outreach Programmes
Outreach programmes make eye care accessible to rural and remote
areas. Thus, it is essential that the service is comprehensive and
complete. At Aravind we have observed that 10% of the camp patients
need refractive correction and now, dispense spectacles on the spot.
For an average camp seeing 500 outpatients, the expected
number of orders being 50, the following resources are needed:
- 1 sales person
- 1 technician
- Assortment of Frames (150 nos.)
- Inventory of Lenses (5000 nos.)
- Edging and Fitting equipment set
This ensures that the
patient receives appropriate correction.
Camps at Aravind
were generally focused on cataract services. However, today they
provide comprehensive eye care and now, special refraction camps are
conducted at schools to address the child population, and at
industries and offices for the working population.
|