editor's perspective

Challenges in Today's Contact Lens Practice

By Jason J. Nichols, OD, MPH, PhD, FAAO

I was fortunate to recently lecture at the annual Bronstein Contact Lens and Cornea Seminar. It was a true honor to attend this meeting, which has been solely dedicated to promoting the art and science of contact lenses for more than 35 years. Dr. Bronstein was one of the pioneers in the contact lens industry; he both invented and developed many lens designs and unique instruments along the way. While attending the meeting and interacting with many of the advanced contact lens practitioners who have attended it since its inception, several important issues facing the practice of contact lenses dawned on me.

The meeting itself is one of the few remaining in the United States that is solely dedicated to contact lenses. This is worth noting in and of itself, and is a reminder to me of the current state of many practices today. There are issues facing the general practice of contact lenses that make it difficult day-in and day-out. Each year, reimbursements for contact lens fittings are reduced, and specialty contact lens fits are sometimes not even acknowledged in reimbursements. Likewise, “big-box” stores price contact lens materials below their actual costs—a so-called “lossleader.” The thinking is to get consumers into the store to buy something (such as contact lenses) so that they fill up that shopping cart. How can a private contact lens practitioner compete with this? And what is the implication of these issues on specialty contact lens practitioners and practice?

Amongst discussion with many tried-and-true contact lens practitioners attending the meeting, there was a definite feeling of concern regarding who the next generation of contact lens experts might be. For example, one commented to me that although the American Academy of Optometry's Section on Cornea, Contact Lenses and Refractive Technologies has great section leadership, the next generation of section leadership is not apparent. Likewise, we see more and more students drawn toward the appeal of disease residencies at the expense of cornea and contact lens residencies, only to later acknowledge limitations in their mode of practice given this advanced training.

These are just a few issues facing the practice of contact lenses, and there are others that could be acknowledged. It's important that the field take note of these issues and work together to make sure that contact lenses have a bright future.