contact lens practice pearls
All You Have to Do is Ask
BY THOMAS G. QUINN, OD, MS, FAAO

How do you explore a patient's interest in contact lenses without feeling pushy? Many surveys have shown that patients may be interested in contact lens correction, but if their doctor doesn't bring it up, then they don't either. Here's how to bridge the gap.

The Written Approach

I've never felt comfortable verbally approaching patients about their potential interest in contact lenses. But not providing some avenue for patients to express interest didn't feel right either. A brief questionnaire turned out to be the right balance for us.

We give the "Patient Visual Needs Assessment" questionnaire to all patients when they arrive for a comprehensive exam. It's one page long and takes from one to two minutes to fill out (to see a copy, go to www.clspectrum.com/content/archive/2004/may/form.htm).

The Contact Lens Question

The questionnaire simply asks "Are you interested in considering contact lenses?" We then list the following response choices:

• For daily wear
• For occasional wear
• For wear continuously up to one month
• Haven't considered
• I already wear
• Not interested

The "wear daily" choice is what most people think of when they consider contact lens wear. However, some may not be interested in full-time lens wear, but would enjoy the freedom provided by contact lenses while exercising, participating in sports or attending social events. This questionnaire lets these folks know that lenses that are designed to be worn on an occasional basis are available.

Continuous wear lenses are still new enough that many patients aren't aware that they're an option. Continuous wear seems particularly appealing to patients who are considering refractive surgery but are afraid of it or of the cost associated with it.

A Challenge!

Whenever I see the "Haven't considered" option circled, I interpret it as the patient saying, "Tell me what contact lenses can do for me." It's not expressing overt interest, but it leaves the door open to educate the patient about how contact lenses may serve to improve his visual performance.

Accept "No" For an Answer

If a patient selects the "not interested" option, that's okay. At least I've asked the question and the patient knows I provide this service should he be interested in the future. I still may discuss contact lenses if the patient is a particularly compelling candidate, such as an anisometropic or keratoconic patient.

Discuss All Options

The questionnaire also asks patients to list specific visual demands they encounter at work and at play, as well as their current mode(s) of correction. As our goal is to meet our patient's visual needs, by whatever means, we explore the patient's interest in all forms of visual correction. In addition to contact lenses, we inquire about attitudes toward laser treatment and corneal refractive therapy (CRT). Because CRT is unknown to many patients, we define it briefly as "wearing an oxygen permeable device overnight to gently re-shape the eye, so when removed in the morning, uncorrected vision is clear."

You can learn a lot about patients in a little time with this form. Whatever method you choose to explore your patient's visual needs, just make sure you bring up their options.

Dr. Quinn is in group practice in Athens, Ohio, and has served as a faculty member at The Ohio State University College of Optometry.