contact lens economics
Make Patient Convenience a Priority with Silicone Hydrogels
BY WALTER D. WEST, OD, FAAO

One lesson we learned from the refractive surgery market is that the primary "well" from which the surgical candidates have been drawn is the contact lens-wearing population.

While many optometrists were hesitant to refer their contact lens patients for refractive surgery, those who readily embraced it found that they were not only in command of the pre- and post-surgical care, they maintained ongoing patient relationships so necessary to the financial survival of their practices.

A second lesson we learned from the LASIK market: patients did not elect surgery because of visual complaints with their lenses, but because they found eyeglasses and contact lenses cumbersome and inconvenient.

The Importance of Convenience

Convenience contributes to the widening appeal of new silicone hydrogel products. Silicone hydrogels provide convenience and flexibility that rivals the convenience of refractive surgery.

In the lens arena, prior to the advent of silicone hydrogels, the industry's answer to "patient convenience" was single-use daily lenses. While many patients are quite happy with this modality, others find it inconvenient to handle their lenses twice a day.

Approximately 65 to 70 percent of my patients in silicone hydrogel lenses wear them for 30 continuous days, and about 20 percent wear them 7 to 14 days continuously. The rest, about 10 percent, wear them on a daily-wear basis over 30 days. For this last group, I use silicone hydrogels as a problem solver for dry eye or marginal tear film situations. The low water, non-ionic makeup of the materials lends itself perfectly to this challenge.

The benefits of silicone hydrogels offer definite incentives for your patients to wear them. But what's in it for you?

Practitioner Benefits

Silicone hydrogel materials are markedly different from those we have used in the past. A large percentage of my patients were wearing Group IV (high water, ionic) materials that are very forgiving in the way they drape the cornea. Silicone hydrogels have a much higher modulus or stiffness, and a sloppy fit is not well tolerated by most patients. You must work with several sagittal depth options, which are now available.

Simply put, these lenses require more professional skill and expertise in both fitting and patient management than most other soft lenses. Managing patients wearing lenses for 30 continuous days requires more practitioner and staff up-front counseling as well as ongoing patient care and interaction. As more such designs are introduced, practitioner skill will become even more critical.

Because we are dealing with new products that require new fitting skill sets and enhanced patient management skills, the "early adopters" of silicone-hydrogels will find that they can charge professional fees commensurate with the level of care they provide.

The extended-wear scares of years ago still have many patients and practitioners edgy about 30-day lens wear. The rules of the game have change with better materials, better manufacturing, improved practitioner skills and a vastly increased armamentarium for diagnosing and managing corneal involvement. I don't downplay the possibility or seriousness of corneal inflammation, but point out that the likelihood is much reduced and the treatment options much greater than were historically available.

Embracing new technology is the cornerstone of a progressive optometric practice. The silicone hydrogel lenses currently available and those yet to come offer us another opportunity to bring new technology to our contact lens patients.

Dr. West practices in Brentwood, TN, and lectures nationally and internationally on contact lens and practice management topics.