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New niches opening for contact lenses
DOCTOR-DRIVEN DISPENSING New niches opening for contact lenses
‘‘T
he secret to increasing the number of patients in contacts lenses is so unbelievably simple that I cannot believe it needs to be said,’’ according to Paul Klein, O.D., immediate past chair of the American Optometric Association (AOA) Contact Lens and Cornea Section (AOA-CLCS). ‘‘Every optometrist should ask each and every patient (who currently wears eyeglasses), ‘Have you ever thought about wearing contact lenses?’ The answer, 90% of the
More patients can benefit from contact lens correction than ever before, and it takes just a few minutes to ensure patients are adequately counseled on their contact lens options, according to the AOA Contact Lens and Cornea Section. time, is going to be ‘yes,’’’ Dr. Klein said. ‘‘That is because it will occur to just about every vision-corrected patient, at one time or another in the course of daily life, that contact lenses might improve their appearance, prevent them from having to constantly be mindful of whether they have their glasses with them, or offer other benefits. It is simply up to the optometrist to ask the question,’’ Dr. Klein observes. Once the subject has been approached, patients generally will offer the reason they have never worn contact lenses (or, in some cases, have stopped wearing them), Dr. Klein says. ‘‘Generally, it will be something like: ‘I don’t want the hassle,’’’ Dr. Klein says. However, such patients often will respond favorably when single-use lenses for occasional contact lens weardsuch as going out for a special eveningdare suggested. Others may be pleased to learn that there are lenses that can be placed in the eye for a month, thereby eliminating the need to insert, remove, and maintain lenses on a daily basis. In many cases, the problem simply will be that the patient has never been offered the opportunity to try (or retry) contact lenses. Contrary to the expectations of many, widespread media coverage of contact lens–associated infections over the last 2 years has not caused a downturn in the contact lens Opinions expressed are not necessarily those of the American Optometric Association.
market, Dr. Klein reports. Most patients are more aware of the need for proper contact lens care but fully confident of their ability to wear the lenses successfully. Optometrists have been successful in ‘‘re-educating’’ their patients regarding the need for compliance with contact care regimens, Dr. Klein says. The biggest news in contact lenses today may be that, over recent months, ‘‘the pendulum has swung back’’ to single-use and conventional planned replacement lenses, which have traditionally been the ‘‘bread and butter’’ of contact lens practice. Although high-oxygen permeable 30-day lenses were widely forecast to represent the future of contact lens wear when they were introduced a few years ago, Dr. Klein finds many patients are not necessarily that concerned with the convenience of having lenses they do not need to remove for a month. Beyond simply making sure that every patient is at least offered the opportunity to try contact lenses, Dr. Klein believes one of the great keys to growth in the contact lens field over the coming years will be maximizing the corrective potential of contact lenses through the use of ‘‘niche’’ lensesdsuch as astigmatic, bifocal, and multifocal lensesdfor both new and existing contact lens patients. ‘‘Again, the key is asking,’’ Dr. Klein said. ‘‘Take, for example, an astigmatic patient who has been fitted in conventional spherical contact lenses. At some point, it will be appropriate to say to the patient, ‘Let’s do something to further improve your vision by correcting both the sphere and astigmatism in your eyes.’ Once astigmatic patients try astigmatic lenses, they will very often be so impressed that they will want to opt for them,’’ Dr. Klein said. There are a number of reasons astigmats and others who might benefit from specialized contact lenses are not being fitted with those lenses, Dr. Klein believes. Lack of information among patients on their contact lens options is a major reason, Dr. Klein contends. A recent survey, conducted by the polling firm Decision Analyst and sponsored by Bausch & Lomb, found that more than 4 in 10 astigmats believe they cannot wear contact lenses as a result of their astigmatic condition. Two thirds of astigmats who have never worn contact lenses, and nearly half of those who have worn contact lenses in the past, said they would be highly motivated to wear contact lenses if the lenses could correct astigmatism, the survey found. However, practice management demands being felt by virtually all health care practitioners today are also a factor. In today’s managed care–oriented environment, many
1529-1839/09/$ -see front matter Ó 2009 American Optometric Association. All rights reserved. doi:10.1016/j.optm.2009.06.006
462 optometrists feel pressure to see as many patients as possible per hour. Astigmats and other specialized contact lens patients take longer than other patients to fit; meaning fewer patients will be seen in the course of a day, Dr. Klein acknowledges. Taking the time to fully counsel and fit patients with special correction requirements can really throw a practicedparticularly a high-volume practicedoff schedule. However, Dr. Klein maintains a high-volume practice that emphasizes not only contact lenses but specialized lenses. Providing contact lenses for patients with special requirements and sustaining an economically viable (or even high-volume) practice are not mutually exclusive, Dr. Klein believes. The increased professional fees appropriate for such fits, as well as the higher profit margins associated with specialized lenses, can offset any decrease in total patient numbers, he notes. Dr. Klein suggests 3 steps that he believes virtually any practice can take, without serious disruption to the practice’s workflow or cash flow, to make specialized lenses available to more of the patients who may benefit from them. Slightly longer appointments. Add a few minutes to each appointment slot to accommodate possible specialized contact lens fits, understanding the increased fees and margins will help maintain total practice revenue. Follow-up appointments. Quickly suggest the possible benefits of specialized lenses when examining astigmats and other appropriate patents. When a patient responds favorably, schedule a follow-up appointment to fit the lenses. Paraoptometric contact lens specialists. Every practice should have a trained paraoptometric who will act as the practice’s contact lens specialist, Dr. Klein contends. After the optometrist has determined the proper lenses for a patient, the trained paraoptometric can then fit the lenses before the doctor checks the final fit. Training in contact lens fitting is available to paraoptometrics through the AOA Contact Lens and
Practice Strategies Cornea Section and other sources. Although such formal training is highly advisable, Dr. Klein said, the practitioner will probably also want to make time to personally train the practice’s designated contact lens specialist regarding how long a fit might take, the types of lenses that might be appropriate for patients, and various practice policies and procedures pertinent to contact lens patients. In addition to utilizing these strategies, the optometrist must of course have an inventory of specialized contact lenses in the practice, Dr. Klein notes. Most practices today do not, however, and there is little reason for that, he maintains. Most contact lens makers will provide trial sets of specialized lenses just as they will provide trial sets of regular lensesdprovided practitioners appear serious about fitting them. Virtually all manufacturers of major-market disposable contact lenses will supply lenses at no charge. To obtain custom-made disposable or nondisposable lenses, practitioners generally will have to buy the first lenses and then obtain exchange privileges or discounts for subsequent lenses. In the case of rigid gas-permeables, most labs have loaner trial sets that can be borrowed for use in completing a fit. The practitioner will then have the option to purchase the trial set or return it after fitting. In most cases, practitioners will be able to obtain 80% of the lenses necessary to provide patients with a complete range of contact lens options at no charge, he estimates. Practitioners must also remain up to date on all of the latest developments in specialized contact lenses. Training on specialized contact lenses is available through the AOACLCS and through manufacturers’ representatives. Courses are generally offered at Optometry’s MeetingÒ, state optometric meetings, and other major optometric meetings. ‘‘There is no one shoe that fits all. There is no ‘magic bullet’ that will correct all vision problems. The optometrist needs to be able to provide patients with a complete range of vision correction options. We must have a full toolbox and be proactive in using the tools on a daily basis,’’ Dr. Klein said.
‘‘T
he secret to increasing the number of patients in contacts lenses is so unbelievably simple that I cannot believe it needs to be said,’’ according to Paul Klein, O.D., immediate past chair of the American Optometric Association (AOA) Contact Lens and Cornea Section (AOA-CLCS). ‘‘Every optometrist should ask each and every patient (who currently wears eyeglasses), ‘Have you ever thought about wearing contact lenses?’ The answer, 90% of the
More patients can benefit from contact lens correction than ever before, and it takes just a few minutes to ensure patients are adequately counseled on their contact lens options, according to the AOA Contact Lens and Cornea Section. time, is going to be ‘yes,’’’ Dr. Klein said. ‘‘That is because it will occur to just about every vision-corrected patient, at one time or another in the course of daily life, that contact lenses might improve their appearance, prevent them from having to constantly be mindful of whether they have their glasses with them, or offer other benefits. It is simply up to the optometrist to ask the question,’’ Dr. Klein observes. Once the subject has been approached, patients generally will offer the reason they have never worn contact lenses (or, in some cases, have stopped wearing them), Dr. Klein says. ‘‘Generally, it will be something like: ‘I don’t want the hassle,’’’ Dr. Klein says. However, such patients often will respond favorably when single-use lenses for occasional contact lens weardsuch as going out for a special eveningdare suggested. Others may be pleased to learn that there are lenses that can be placed in the eye for a month, thereby eliminating the need to insert, remove, and maintain lenses on a daily basis. In many cases, the problem simply will be that the patient has never been offered the opportunity to try (or retry) contact lenses. Contrary to the expectations of many, widespread media coverage of contact lens–associated infections over the last 2 years has not caused a downturn in the contact lens Opinions expressed are not necessarily those of the American Optometric Association.
market, Dr. Klein reports. Most patients are more aware of the need for proper contact lens care but fully confident of their ability to wear the lenses successfully. Optometrists have been successful in ‘‘re-educating’’ their patients regarding the need for compliance with contact care regimens, Dr. Klein says. The biggest news in contact lenses today may be that, over recent months, ‘‘the pendulum has swung back’’ to single-use and conventional planned replacement lenses, which have traditionally been the ‘‘bread and butter’’ of contact lens practice. Although high-oxygen permeable 30-day lenses were widely forecast to represent the future of contact lens wear when they were introduced a few years ago, Dr. Klein finds many patients are not necessarily that concerned with the convenience of having lenses they do not need to remove for a month. Beyond simply making sure that every patient is at least offered the opportunity to try contact lenses, Dr. Klein believes one of the great keys to growth in the contact lens field over the coming years will be maximizing the corrective potential of contact lenses through the use of ‘‘niche’’ lensesdsuch as astigmatic, bifocal, and multifocal lensesdfor both new and existing contact lens patients. ‘‘Again, the key is asking,’’ Dr. Klein said. ‘‘Take, for example, an astigmatic patient who has been fitted in conventional spherical contact lenses. At some point, it will be appropriate to say to the patient, ‘Let’s do something to further improve your vision by correcting both the sphere and astigmatism in your eyes.’ Once astigmatic patients try astigmatic lenses, they will very often be so impressed that they will want to opt for them,’’ Dr. Klein said. There are a number of reasons astigmats and others who might benefit from specialized contact lenses are not being fitted with those lenses, Dr. Klein believes. Lack of information among patients on their contact lens options is a major reason, Dr. Klein contends. A recent survey, conducted by the polling firm Decision Analyst and sponsored by Bausch & Lomb, found that more than 4 in 10 astigmats believe they cannot wear contact lenses as a result of their astigmatic condition. Two thirds of astigmats who have never worn contact lenses, and nearly half of those who have worn contact lenses in the past, said they would be highly motivated to wear contact lenses if the lenses could correct astigmatism, the survey found. However, practice management demands being felt by virtually all health care practitioners today are also a factor. In today’s managed care–oriented environment, many
1529-1839/09/$ -see front matter Ó 2009 American Optometric Association. All rights reserved. doi:10.1016/j.optm.2009.06.006
462 optometrists feel pressure to see as many patients as possible per hour. Astigmats and other specialized contact lens patients take longer than other patients to fit; meaning fewer patients will be seen in the course of a day, Dr. Klein acknowledges. Taking the time to fully counsel and fit patients with special correction requirements can really throw a practicedparticularly a high-volume practicedoff schedule. However, Dr. Klein maintains a high-volume practice that emphasizes not only contact lenses but specialized lenses. Providing contact lenses for patients with special requirements and sustaining an economically viable (or even high-volume) practice are not mutually exclusive, Dr. Klein believes. The increased professional fees appropriate for such fits, as well as the higher profit margins associated with specialized lenses, can offset any decrease in total patient numbers, he notes. Dr. Klein suggests 3 steps that he believes virtually any practice can take, without serious disruption to the practice’s workflow or cash flow, to make specialized lenses available to more of the patients who may benefit from them. Slightly longer appointments. Add a few minutes to each appointment slot to accommodate possible specialized contact lens fits, understanding the increased fees and margins will help maintain total practice revenue. Follow-up appointments. Quickly suggest the possible benefits of specialized lenses when examining astigmats and other appropriate patents. When a patient responds favorably, schedule a follow-up appointment to fit the lenses. Paraoptometric contact lens specialists. Every practice should have a trained paraoptometric who will act as the practice’s contact lens specialist, Dr. Klein contends. After the optometrist has determined the proper lenses for a patient, the trained paraoptometric can then fit the lenses before the doctor checks the final fit. Training in contact lens fitting is available to paraoptometrics through the AOA Contact Lens and
Practice Strategies Cornea Section and other sources. Although such formal training is highly advisable, Dr. Klein said, the practitioner will probably also want to make time to personally train the practice’s designated contact lens specialist regarding how long a fit might take, the types of lenses that might be appropriate for patients, and various practice policies and procedures pertinent to contact lens patients. In addition to utilizing these strategies, the optometrist must of course have an inventory of specialized contact lenses in the practice, Dr. Klein notes. Most practices today do not, however, and there is little reason for that, he maintains. Most contact lens makers will provide trial sets of specialized lenses just as they will provide trial sets of regular lensesdprovided practitioners appear serious about fitting them. Virtually all manufacturers of major-market disposable contact lenses will supply lenses at no charge. To obtain custom-made disposable or nondisposable lenses, practitioners generally will have to buy the first lenses and then obtain exchange privileges or discounts for subsequent lenses. In the case of rigid gas-permeables, most labs have loaner trial sets that can be borrowed for use in completing a fit. The practitioner will then have the option to purchase the trial set or return it after fitting. In most cases, practitioners will be able to obtain 80% of the lenses necessary to provide patients with a complete range of contact lens options at no charge, he estimates. Practitioners must also remain up to date on all of the latest developments in specialized contact lenses. Training on specialized contact lenses is available through the AOACLCS and through manufacturers’ representatives. Courses are generally offered at Optometry’s MeetingÒ, state optometric meetings, and other major optometric meetings. ‘‘There is no one shoe that fits all. There is no ‘magic bullet’ that will correct all vision problems. The optometrist needs to be able to provide patients with a complete range of vision correction options. We must have a full toolbox and be proactive in using the tools on a daily basis,’’ Dr. Klein said.