Before you can determine whether or not you are Independent Strong when it comes to managing contact lenses, you must first understand at least some basic facts about them, according to the Centers for Disease Control: [i] An estimated 45 million people in the U.S. wear contact lenses. Two-thirds of contact lens wearers are female. The average age of contact lens wearers worldwide is 31 years old. An estimated 8 percent of contact lens wearers are under 18 years old, 17 percent are aged 18-24, and 75 percent of adults age 25 and older wear contact lenses. In the average practice, 16 percent of the practice gross revenue collected comes from contact lens patients. Keeping those basic facts in mind, now you can add several keys to successful contact lens wear.
Do you consider every patient a possible contact lens wearer?
Here’s a typical exchange that occurs every day. See if you can find what is wrong with this conversation.
Dr. Wilson: Jamie, our testing today shows that you have a moderate amount of nearsightedness with a little bit of astigmatism. That’s why your vision is blurry when you look at things in the distance. I’m going to prescribe new glasses for you today to address this problem.
Jamie: Dr. Wilson, could I wear contact lenses?
Dr. Wilson: Why yes, Jamie. You should do well in contact lenses.
Here’s what’s wrong with the above conversation: 72.5 percent of patients who wear contact lenses had to ask their doctor. A better conversation would start with the doctor saying, “I’m going to prescribe contact lenses and new glasses for you today to address this problem.” Don’t wait to have the patient ask for contact lenses. Be proactive and prescribe contact lenses for every patient who is a candidate.
Here is one of the easiest ways to immediately increase your contact lens practice. The EASE study[ii] (Enhancing the Approach to Selecting Eyewear) was a multi-center, practice-based study about the effect of applying contact lenses prior to spectacle dispensing. A total of 91 patients were divided into two groups after an eye exam. One group was taken directly into the optical dispensary just as would happen in a typical practice. The other group was offered contact lenses to first correct their vision before they went into the optical dispensary to help them choose their new glasses. Some study subjects rejected the idea, and some had prescriptions that were outside the parameters of any trial lenses in the office. However, 88 percent accepted the offer of putting in single-use contact lenses before the optical dispensary then removing them before they left the office.
Here are the results of the EASE study: The patients entering the optical dispensary with contact lenses in their eyes reported “a superior subjective spectacle dispensing experience.” They spent 32 percent more on their spectacles than the other group. One-third purchased contact lenses, compared with 13 percent of the direct-to-optical group.
Wouldn’t you jump at the chance to obtain these three results to improve not only your contact lens sales but your spectacle sales as well, especially if you didn’t have to purchase new equipment or hire new employees. There is nothing holding you back from introducing this to your practice today and having significantly more people choose to go into contact lenses than your current population.
Do you prescribe (when appropriate) both glasses and contact lenses instead of glasses or contact lenses?
Here’s another typical conversation that occurs every day. See if you can find what is wrong with how the doctor presents his prescription here.
Dr. Wilson: Jackson, our testing today shows that you have a moderate amount of nearsightedness with a little bit of astigmatism. There has been a little change since your last prescription, so I’ll update you to the new prescription. I see you’ve been wearing contact lenses, so I’ll put the new prescription in your contact lenses.
Here’s what’s wrong with this conversation. Glasses were not prescribed. There is a change in the prescription, the doctor makes the point to change the new prescription in the contact lenses, but no mention is made about changing the glasses prescription. The discussion should never be glasses or contact lenses; the discussion should always be glasses and contact lenses.
Do you prescribe sunglasses for all of your contact lens patients?
If you want your patients to have 100 percent UV protection, then they need to invest in a good pair of sunglasses. This pertains to all of your patients – all of your patients who wear eyeglasses, and all of your patients who wear contact lenses, including those contact-lens-wearing patients wearing a contact lens with some UV protection
Here are five reasons for your patients to wear sunglasses in addition to their contact lenses:
- to protect eyes from the harmful UV rays of the sun
- to protect eyes from high energy visible light (harmful blue light)
- to keep eyes from drying – especially when wearing contact lenses
- to reduce glare
- for eye protection from larger objects (balls) and smaller objects (dust)
Not all sunglasses are interchangeable, so it’s important that doctors and their teams be able to explain to patients the differences. The important differences to highlight are the quality of the lenses (i.e., no wavy vision through the lenses) and the total amount of UV-A, UV-B, and UV-C that is blocked. The best is 100 percent.
Do you prescribe different wearing modalities for every contact lens patient?
Many of your contact lens wearers would like to have two different contact-lens-wearing modalities. For example, all of your two-week and monthly contact-lens-wearing patients should also be offered single-use contact lenses. Consider this scenario:
Dr. Seigal: Tom, I see that you like to ride horses.
Tom: Yes, I try to get out at least twice a week.
Dr. Seigal: Do you ever notice any discomfort when you are wearing your two-week contact lenses after you clean out the barn?
Tom: All the time. It’s really dusty and dirty in the barn.
Dr. Seigal: I’m going to prescribe single-use contact lenses for you in addition to your two-week lenses. You can put them in the day you are going to clean out the barn, then just throw them away when the day is over.
Tom: Yes, I think that would help a lot.
Do you prescribe annual supplies of contact lenses for every patient?
We know from experience that patients with annual supplies of contact lenses tend to be more compliant with following their contact-lens-wearing schedule. People who purchase less than an annual supply tend to stretch their lenses. The following dialogue is unfortunately common:
Dr. Connors: MaryAnn, it’s good to see you. What brings you in today?
MaryAnn: Well, Dr. Connors, I’m out of contact lenses.[Looking at the patient record, Dr. Connors notices that only one box of contact lenses was purchased after the last examination 12 months ago.]
Dr. Connors: Did you purchase contact lenses anywhere else than from us last year?
MaryAnn: No, only here.
Dr. Connors: Are you wearing your contact lenses as I prescribed them to be worn? Throwing the old lenses away and putting the new lenses in as I told you?
MaryAnn: Exactly as you prescribed, Dr. Connors.
Do the math. MaryAnn is overwearing her contact lenses. If MaryAnn had purchased an annual supply of contact lenses, experience and statistics show she would have been more compliant with her wearing schedule.
Another important concept about an annual supply of contact lenses is this: Patients who purchase annual supplies of contact lenses are taken out of the contact lens market for a year. Think about how many advertisements you encounter for contact lenses. They are on the radio, on the internet, in emails, on the back of your receipt … it seems they are everywhere! To the patient who is already stocked with an annual supply of contact lenses, these advertisements pass unnoticed. However, the patient who does not have an annual supply of contact lenses is probably listening intently.
[ii] Atkins NP, et al. Enhancing the approach to selecting eyewear (EASE): A multi-centre, practice-based study into the effect of applying contact lenses prior to spectacle dispensing. Contact Lens & Anterior Eye (2009), doi:10.1016.