How Daily Disposables Can Help Your Practice
Tips and tricks from practitioners in the trenches to put single-use lenses to work for you and your patients.
By Judith Lee

In a market dominated by two weeks ­ and now 30 days ­ of wear, daily disposable lenses might yet prove to be the biggest "sleeper" of all. Contact lens practitioners note that patients who wear daily disposables love them, lens prices have dropped and single-use lenses offer benefits their longer-wearing cousins can't quite match.

"We've noticed that daily disposable wearers are some of the happiest people in our practice," says Walter Choate, OD, of Nashville, TN. "They love the lenses, and this is all they want to wear. Daily disposables offer the ultimate in never having to fool with lens care."

"We present this to brand-new lens wearers as the safest, most convenient lens modality. You pretty much eliminate your risk for GPC and infections," says Michael Ward, MMSc, Director of Contact Lens Services at Emory University School of Medicine in Atlanta.

Says Lee Rigel, OD, of East Lansing, MI: "I wear them myself. They're safer and more convenient. I don't worry about solutions when I travel."

What's the Beef?

With all these benefits, why is it that these same practitioners admit to fitting less than 10 percent of contact lens patients with daily disposables? The answer to this may be a combination of factors, including patient and practitioner misperceptions, limited market penetration, plus no recent marketing "buzz" about the product.

"In the United States, about 5 to 6 percent of new fits are daily disposables," says Rick Weisbarth, OD, executive director of professional services for CIBA Vision. "Compare this to the UK and Japan, where well over 30 percent of new fits are in daily disposables. What's different about the U.S. market? The attitude of practitioners, for one thing."

He notes that while U.S. practitioners are high on the clinical benefits of daily disposables, they see cost as a drawback and may be reluctant to recommend them as strongly as they would otherwise. Indeed, a year's worth of lenses for two-week wear typically costs a patient about $180, while a year's worth of daily disposables might cost $365 (about $1 a day).

"Practitioners perceive cost as a drawback, but cost doesn't always mean the same thing to a patient. Perceiving something as 'too expensive' is very individual," says Dr. Weisbarth.

He makes two important additional points about the cost of daily disposables. First, the cost has come down drastically since daily disposables were first introduced at about $2 per day of wear. "Our research shows that at a cost of $1 per day, there is tremendous patient interest in daily disposables. Affordability is here," he says.

Second, many of the patients who prefer to wear daily disposables do not wear their lenses every day, further reducing the total cost for the year. "We've found that the cost of daily disposables is virtually the same as wearing 30-day lenses," says Dr. Weisbarth. "We haven't had any practitioners say that patients think 30-day wear is 'too expensive,' yet it's the same price as daily disposables. This tells us that it's the practitioner, not the patient, who thinks daily disposables are 'too expensive.'"

The experience of a British contact lens practitioner corroborates this view. Simon Donne, MCOptom, in Bedfordshire, UK, fits as many as 50 percent of new wearers in daily disposable lenses, even though the cost of the modality is about double that of two-week wear. He says he presents daily disposables as the healthiest way to wear contact lenses and then provides the patient with five days' worth of lenses to try. When the patient returns, he usually opts for daily disposables.

"Cost is rarely an issue when patients find out how comfortable and convenient these lenses are," Mr. Donne says.

Choose Your Patients

Practitioners who are succeeding with daily disposables say that many patients can benefit from daily disposable lenses. They say the following patients are "no-brainers" for single-use lenses:

• Ocular allergy patients
• Solution-sensitive patients
• Patients with a history of GPC
• Heavy depositors

"A patient who had a previous corneal fungal infection did not want to wear glasses. I was reluctant to refit him with contact lenses, but we went with daily disposables. He did very well," says Dr. Choate.

"Here, we have seasonal allergies from early March right through the first hard freeze," says Rex Ghormley, OD, of his St. Louis practice. "We significantly reduce or resolve allergy-related problems just by prescribing clean lenses every single day."

Dr. Ghormley also recommends daily disposables to those whose workplaces present a risk for lens contamination, such as construction sites, chemical plants and even hospitals and operating rooms.

Along with these clinical benefits, daily disposables present benefits for other patients:

• Children and teens
• Business travelers or vacationers
• The active and athletic
• Social wearers

"Daily disposables are particularly good for children and teens," says Glenda Secor, OD, in Huntington Beach, CA. "The lenses are so easy, convenient and safe. It's usually an 'easy sell' to parents when I point out the advantages of not having to worry about lens care or disinfection."

Travelers, weekend athletes and campers and social wearers all are bound by a need or preference to eliminate lens care, as well as an assurance that they'll have a new pair of lenses to insert any time they'd prefer to go without glasses. "I have some patients who will take only daily disposables on vacation. I have other presbyopes who use them for monovision when they play tennis," says Dr. Rigel.

"These lenses are a great convenience for the patient, and less worrisome for the doctor," says Dr. Ghormley. "You know the lenses aren't sitting around in a lens case for days in between wearings."

Educate Your Patients

You'll succeed with patients by zeroing in on benefits that matter to them. For instance, active presbyopes or those who prefer not to wear glasses for social occasions may never have considered daily disposables.

"I will ask, 'Do your glasses sometimes interfere with your golf/tennis/bicycling/swimming?' I've also asked women in their late 40s or early 50s, 'Have you ever thought about wearing contact lenses just for social occasions? It's inexpensive and easy.'" says Gary Moss, OD, MBA. Associate Professor of New England College of Optometry and author of Eye Care Business, Marketing and Strategy.

Whatever approach you use to educate patients about visual conditions and eye diseases will work well in presenting daily disposable lenses. "For allergy patients, I explain what's going on ocularly, and then tell them we have several options: they can go on medication, change the way they wear contact lenses or a little of both," says Dr. Ghormley. "I help them understand that it's important to do what's best for your eyes."

When presenting daily disposables to young patients and their parents, practitioners should ask pointed questions. "I like to ask, 'What does his/her room look like? Does the child brush his teeth twice a day without reminders? If not, what makes you think he/she will be conscientious about contact lens care?'" says Mr. Ward.

Stay true to yourself when developing your presentation. Almost any approach will work, as long as you are comfortable with it, Dr. Weisbarth says. "The practitioner must find a presentation style that's comfortable for him or her. Some like the medical approach, while others will ask, 'How would you like to take a vacation from lens care?' Your comfort level [with the approach] will be communicated to the patient," he says.

Allow Patients to Test Drive

Practitioners say that trialing these lenses will be your most effective technique. "We've found that if you give potential wearers these lenses on trial, six out of 10 patients will stay with them," says Dr. Weisbarth. He says five to 10 days of wear will convince most patients, and "the longer the trial, the more patients will stay in."

This is especially true for patients who have had previous contact lens problems of any kind. Says Mr. Ward: "If the patients had prior problems with contact lenses, we give a free 10-day trial of daily disposables. The vast majority of them will not go back to another lens modality. I can tell you that if you give 10 pairs to trial, the patient won't go back."

Try starting off with an in-office trial that doesn't seem like a trial. Says Mr. Donne: "When patients are trying on frames, we apply a pair of daily disposable lenses so the patient can see the frames. Then we offer to send some lenses home with the patient to try for a week or so."

The reason lens trials work so well with daily disposables is because the patient learns first-hand how easy this modality really is. Says Dr. Miffleton: "People have a fast-food mentality: 'Whatever is easiest, give it to me.' They have more money than time."

Plan for Growth

Practitioners who've tried to expand their daily disposable patient base say that it works, so be prepared for this niche to grow. "Last year, daily disposable lenses were the fastest-growing segment in contact lenses. This will continue, as patients hear more about the advantages of daily disposables," says Dr. Weisbarth.

As well as preparing yourself to present daily disposables effectively and equipping your practice with plenty of trial lenses, he suggests that you train staff to communicate a positive view of daily disposables.

"Everyone must be singing off the same sheet," says Dr. Weisbarth. "It's not going to work if your receptionist tells patients, 'Those lenses are really expensive' or 'We don't fit that many of those.' Make sure the staff understands the benefits of the lenses, and can talk with patients who might be candidates."

Practitioners say that daily disposables won't make you rich, but they will return about as much profit as other types of planned replacement lenses. More importantly, offering daily disposables will be one more way you can serve your patients more effectively with the latest in lens wear.

"Any time you recommend leading-edge concepts and technology to patients, it will be good for your practice," notes Dr. Rigel. "In contact lens practice, you cannot leave anything lying on the table. You must effectively present all appropriate options for the patient. If you don't, you will appear to be behind other contact lens practices."

Ms. Lee has been reporting on the vision industry since 1979. Along with her work as a researcher and reporter, she operates a communications consulting firm, Judith Lee Associates, in Atglen, Pa. You can reach her at judithlee@epix.net.