By Frank Giammanco
As we all know, the practice of performing a refraction is one of the most intimate procedures an optometrist can perform. There are probably more instances of physical contact between OD and patient during the refraction process than virtually any other in a contemporary eye care practice.
Solutions born out of necessity
And since the outbreak of the Coronavirus pandemic, this fundamental exam has been virtually impossible for ODs to execute, causing many to close down their practices or limit service to just the most serious cases.
But resourceful eye doctors and a resourceful supplier came up with a solution. That was the case with Fabian Villacis, OD and Coburn Technologies, Inc.
An optimistic start
A newly minted entrepreneur having purchased independent practices in Waterbury and Prospect, CT within the last 15 months, Dr. Villacis knew from the outset that he wanted to be his own boss. A 2011 graduate of New England College of Optometry (NECO), he moonlighted at LensCrafters and Pearle throughout his residency and afterward worked for a large ophthalmology practice in Connecticut. “I learned a ton about great eye care,” he said enthusiastically, “but I knew that eventually I wanted to be my own boss.”
That was about when, first, the Waterbury practice came on the market, followed by the one in Prospect. The two locations are a mere four miles apart. He named them New Insight Family Eyecare, and went to work hiring a team, including four part-time ODs. But within a month of purchasing the second office in Prospect, the global COVID pandemic hit with full fury and forced him to close the two locations, ultimately keeping them shuttered for two months.
“We were only open for six weeks, but those six weeks enabled me to pay the bills,” he said. “I spent so much time with my family which was great; I’ll never be able to take two months off again.”
A change in practice
That’s when Coburn Technologies’ John Ingriselli came in. John had already established a relationship with Dr. Villacis, having sold him an edger and other equipment.
“John pointed out that our Prospect office had Greens Phoropters from the 1950s,” he said. “I already knew that I wanted to invest in automated phoropters, and with the COVID pandemic it just made so much sense.”
John introduced him to the Huvitz Digital Refractor HDR-9000, which is ideally suited to maintaining social distancing while performing a refraction. The system is comprised of a lensmeter, autorefractor and digital phoropter which can be operated remotely from the practitioner’s laptop or tablet via a Wi-Fi wireless connection.

“With the old phoropters your hand gets very close to the patient’s face,” he said. “Now I’m able to sit at my desk about six feet from the patient. I’m not getting close to them and that makes them feel more comfortable.”
A positive impact on patients
His patients have been pleasantly surprised by all the new technology. “They’ve heard about a new owner and they walk in and see that I’ve invested in the office, invested in the latest technology, and they’re extremely happy.”
Some, he said, are even a little amazed at the changes. “You mean you’re not going to move dials in front of my face?” they have told him. “You’re doing it all from your computer?”

According to Dr. Villacis, the HDR-9000 system has sped up the refraction process and helps it to be “a little more precise.”
The first step is to take the patient’s current Rx off their glasses, he noted. This information is sent wirelessly to phoropter. He will then perform an autorefraction and finally a subjective refraction where he will manipulate the phoropter dials remotely while also looking at chart on his computer screen, effectively seeing what the patient sees. He then modifies the final Rx using both objective and subjective results.

“In the end, I’m able to compare their last refraction to the new one and I can tell the patient what the new Rx will look like,” he said.
According to John Ingriselli, the HDR-9000 system is simple and quick to install, and staff training is equally efficient. “We usually train them for a half hour on the autorefractor, a half hour on the lensmeter and maybe an hour on the phoropter,” he said. “More customers are looking at it now because of the pandemic.”
New Insight Family Eyecare maintain a strict COVID protocol. Where they were seeing a patient every 10 minutes pre-pandemic, they’ve reduced that to one every 20 to 30 minutes. “We also maintain a virtual waiting room, meaning we ask them to stay in their cars and call us when they arrive,” Dr. Villacis said.
The practice does a temperature check on each patient (100 degrees or above requires a reschedule) and queries them about recent travel and possible COVID symptoms. His patients thank him for his diligence, he said. “They feel comfortable coming here, so they tell their 80-year-old grandma ‘You’ll feel safe there’.
“We love that we’re able to stay open and do it in a safe way,” he said.
About the HDR-9000 Digital Refractor
Manufactured by Huvitz, the HDR-9000 system increases practice efficiency, enhances the patient experience, and allows for the execution of a complete exam. It conveniently displays results for easy reading by both practitioner and patient. Its Wireless communication feature allows for social distancing during refraction and offers a higher degree of patient comfort and security.
Features include:
- Wi-Fi Wireless communication
- 21 Point Exam Package
- Tiltable body from 0 to 45 degrees
- LCD Chart Compatibility (linear and circular polarization)
- Fast and silent lens loading
- Dual cross cylinder lens as well as Jackson cross cylinder lens support highly accurate exams over astigmatism axis and visual acuity
- Monocular height adjustment within +/- 3mm
- Various charts and vision therapy-related contents
Frank Giammanco is a longtime veteran of marketing communications for the optical industry and professions. He is the founder and former CEO of First Vision Media Group, Inc., publishers of Vision Care Product News (VCPN).