FITTING SPECIALTY LENSES

Building a Specialty Contact Lens Practice

A practical guide to laying the groundwork for growing this part of your practice.

By Thomas Quinn, OD, MS; LaMar Zigler, OD, MS; & Keith Ames, OD

Dr. Quinn is in group practice in Athens, Ohio. He is an advisor to the GP Lens Institute, and an area manager for Vision Source. Dr. Zigler is a faculty member of The Ohio State University College of Optometry, and is in private practice in Columbus, Ohio. Dr. Ames is currently in private group Optometric practice in Chillicothe, Ohio. He has published and lectured extensively on contact lenses.

Contact lens practice can be very enjoyable and rewarding, especially when you successfully fit both routine and challenging contact lens patients. This article contains information from a presentation given by the authors at the GP Lens Institute Annual Cornea and Contact Lens Residents symposium, which was held at The Ohio State University College of Optometry in August 2009.

How Can You Establish Yourself as a Specialist?

Be active in organizations. You can join the American Optometric Association (AOA) Contact Lens and Cornea Section as well as become an American Academy of Optometry member and then consider becoming a Diplomate in the Section on Cornea, Contact Lenses and Refractive Technologies. You can also join or start a local contact lens study group and/or national optometric study groups for further networking opportunities as well as lifelong friendships. These study groups can evolve into practice management forums as well as further your ties with industry and fellow practitioners. These groups can also help you build your contact lens practice.

You can also become involved in Food and Drug Administration clinical trials pertaining to new contact lenses and ultimately join contact lens industry speaker bureaus. Opportunities to lecture (local, state, and national) as well as to write for publications such as Contact Lens Spectrum will allow you to network with other contact lens practitioners and get your name out to the eyecare community.

Communicate to the community. Begin by letting your community know of your interest in specializing in contact lenses. Don't tell just your patients, but also inform other eye-care providers in your area about your specialty. This can be especially beneficial with the ophthalmologists in the region.

Take on the challenging cases. Many of the more challenging cases, such as irregular cornea patients, are not particularly difficult. They often require diagnostic fitting, careful evaluation, and—more often than not— your willingness to accept a far from alignment lens-to-cornea fitting relationship. Some fits won't look text-book, but if the patient is comfortable, sees well, and shows no evidence of physiological compromise from lens wear, the fit should be successful.

Essentially you are practicing the “no surprise” approach to eye care. Sometimes success is realized immediately; sometimes it takes a few modifications to get there. Let patients know up front that specialty lens fitting is a process. If at first you don't succeed, be willing to try something else. Explain your logic to patients to keep them invested in the process. Obtaining success will motivate you to tackle other challenging patients, and referrals from both patients and other practitioners are not uncommon.

How Can You Promote Your Office to Patients and to Other Practitioners?

Via the Web The Web site is essential in patient education, practice promotion, and providing general information about the practice. For contact lens specialists, that translates into providing information on specialty contact lenses such as soft and GP lenses for astigmatism and irregular corneas as well as soft and GP multifocals and orthokeratology. These specialities come up on search engines when consumers search for them.

You can also link to a site such as www.contactlenses.org and other consumer sites to provide additional information to your patients. Take advantage of “office locator” listings such as the GP Eye Care Professional Locator available at www.gpli.info.

Post your office brochures, newsletters, and even a patient history form (to be downloaded, completed, and brought to the office at the time of the examination) on your site. You can also have a “frequently asked questions” section with an emphasis on commonly asked contact lens questions.

Open Houses/Fitting Sessions You can conduct “open houses” and “fitting nights” on new contact lens designs, as are often conducted in Dr. Zigler's office. When you have a new specialty contact lens available, invite patients to come in for an open house fitting. You can fit several patients in the new lens over a two-hour time period. Representatives from the company can be present to help facilitate the fitting, talk with the patients, and provide refreshments and prizes. Due to the efficiency of fitting several patients with the same lens at once, you can offer a reduced fitting fee.

Facebook Page Recognize that the younger generation has moved away from e-mail and Web sites to Facebook and develop a Facebook page for your office. This page can be maintained by your staff members who are part of the “Facebook Generation,” and therefore understand all of the nuances of social networking. Your goal should be to have the Facebook page be a dynamic site with new information added numerous times each week.

Newsletters Sending newsletters to patients (by email if possible) two to four times per year is a great method to communicate advancements in contact lenses and what contact lenses are now available in the office. You can also promote upcoming fitting sessions.

On-Hold Messages When patients call the office and are briefly placed on hold, it is always beneficial to have a message communicating the types of contact lenses fit by the practitioners in that office.

How Do You Educate Your Patients to Optimize Lens Wear Success?

Handouts Each patient expressing interest in contact lenses in Dr. Quinn's office receives a handout customized to the type of lens he is recommending. The handout itemizes the costs associated with the service and materials (see example below). It also lists the practice refund policy. Fees are presented before any lenses are applied to avoid investing time, effort, and expertise only to have a patient object to the price. At the bottom of the handout is a list of benefits that patients enjoy when they purchase their contact lens materials through the office. Although most patients plan to purchase lenses through the office, Dr. Quinn has found the “Eight Great Reasons To Buy A One-Year Supply” (on this page) to be influential for patients who are “on the fence” about where to purchase their contact lenses.

Optimizing Compliance In Dr. Quinn's office, before new fit fees are presented, the practitioners discuss with patients the rationale behind their recommendation. This gets patients on board. Then the technician presents the fees, verbally reviewing a handout that is given to patients. When patients return a year later, they discuss purchasing new contact lenses with the opticians because the opticians are in the best position to discuss the spectacle-related perks that accompany purchases of annual contact lens supplies. Additionally, opticians are more comfortable with the retail aspect of practice than are the technicians, who are more healthcare-oriented. Dr. Quinn has found in his practice that they have a higher rate of patients purchasing annual contact lens supplies as well as spectacles when the opticians present these programs and fees.

Follow-Up Care In Dr. Ames' office, he optimizes patient retention by seeing each new patient who has been fit in his office three times: at dispensing, at one week, and at one month. This may not seem necessary in all cases, but it reinforces to patients that their practitioner cares and is truly committed to their success and well-being.

What Lens Inventories and Fitting Sets Should You Have in the Office?

It is important to obtain as many complimentary fitting sets as possible. If you are going to pay for a fitting set, ask the manufacturer how you can earn the cost back. Usually manufacturers will refund you the cost of the fitting set if you fit a specified number of patients within a designated time frame. This is particularly true of GP specialty designs (i.e., keratoconic, multifocal, hybrid, intralimbal, and semiscleral). Laboratory consultants can assist you during the entire fitting and problem-solving process. You can also initiate an open house to accelerate your learning curve on the new specialty lens, which will also give you a good start toward buying back the cost of your fitting set. Manufacturers are very willing to help you do mailings for these open houses.

When fitting any soft multifocal lens, a 0.25D change in distance power can make a significant difference in performance. It is therefore necessary to have multiple full fitting inventories of these lenses, in several different designs. Similarly, when fitting soft toric lenses, it is ideal to have axes around-the-clock so you can account for any subjective axis and any lens rotation and dispense lenses on the day of fitting. Once again, it would be preferable to have a few different designs available.

Summary

Practitioners who build a specialty contact lens practice will stand out in their local community because of their enthusiasm for managing the challenges of working with specialty contact lenses. The result is not only enthusiastic practitioners, but very satisfied patients who will refer other patients and provide the potential for tremendous practice growth. CLS