What do a barista and a beauty shop employee have in common? Apart from the obvious fact that both are customer facing, they share stark similarities in their approach to service. Both welcome customers with a smile; ask precise, relevant questions; engage in conversation; recommend confidently; and are proactive. What about eyecare professionals (ECPs)? Do they demonstrate the same kind of enthusiasm in greeting their patients? Do they ask the right questions to acquire relevant, valuable information? Are they equally proactive in recommending contact lenses?

Unfortunately, there isn’t a resounding “yes” to any of these questions. And, digging into old literature only endorsed my fears. It has been more than 20 years since a study revealed that contact lenses were discussed with fewer than half of potential wearers (48%) during a routine eye examination, and surprisingly, only 27% of discussions were initiated by the ECP (NOP Healthcare, 1996).

Typical ECPs spend a great deal of time and effort on getting the eye examination right. However, do they give enough thought to improving their contact lens practice?

Author Ken Poirot says: “Be proactive not reactive, for an apparently insignificant issue ignored today can spawn tomorrow’s catastrophe.” ECPs have state-of-the-art products in their armory yet often hesitate to recommend them. If they did, they could take their practice to the next level.

Cause and Effect

Out of the estimated 70% of people (5.3 billion) who require vision correction worldwide, only about 175 million wear contact lenses on a full- or part-time basis. This translates into roughly 3.3% of contact lens penetration in this population (Akerman, 2018). In India, the penetration of contact lens wear is even lower. According to the latest estimates, from a target group of 28 million potential wearers, only 1.6 million Indians wear contact lenses (Thite et al, 2018).

Clearly, the evolution of lenses (in terms of materials, designs, wear modality, and care products and systems) does not seem to have proportionally translated into growth in penetration. There are so many potential wearers who are not offered the opportunity to try contact lenses, but whose loss is this?

A Silver Lining

The impact of a proactive approach to contact lens prescribing has long been recognized. Jones et al (1996) highlighted the importance of proactive recommendation by ECPs in increasing the number of patients fitted with contact lenses. And, Atkins et al (2009), in their Enhancing the Approach to Eyewear Selection (EASE) study, showed a higher uptake of contact lens wear in a test group in which lenses were introduced in a “low key” manner as an aid to spectacle selection.

Two recently published studies have reinforced this message. One prospective, randomized, multi-center study evaluated the impact of Indian optometrists’ proactivity on contact lens prescribing (Thite et al, 2018). Of 120 patients recruited, 53% purchased contact lenses as a mode of vision correction within the three-month study period. Conventional proactive recommendation showed a higher conversion rate from contact lens experience to prescribing compared to the EASE approach. The study also demonstrated that a high proportion of patients (72%) with no previous contact lens experience were willing to try them when offered by the practitioner. Tangible experience created an overall positive impression of lens wear. This was true even in those who did not opt for contact lenses. This suggests that providing a contact lens-wearing experience has a direct and indirect influence on patients requiring vision correction.

In a second study, researchers recruited five optometry practices in the United States to assess the EASE approach. Of 410 patients, 205 were offered contact lenses to wear while selecting new spectacle frames. As in the original study, patients who wore contact lenses spent more on their eyewear purchase, were more likely to have received or scheduled a fitting trial, and were more likely to consider a contact lens fitting in the future (Mayers et al, 2019).

The Gold Mine

If the benefits of a proactive approach remain clear, what else has changed over the past 20 years? Today, contact lenses are available for almost all age groups and conditions, and the industry is on a constant mission to launch better and more advanced products.

Young adults are an established target group. The industry is trying to cater to their “digital” lifestyles by improving existing silicone hydrogel lenses and introducing biocompatible materials.

For children, various options for myopia control—including multifocal lenses and orthokeratology—are becoming widely available. These options are similar in safety for children compared to for adults (Bullimore, 2017). Contact lenses provide additional benefits of better cosmesis, enhanced confidence, and improved performance in sports due to better optics and dynamic vision compared to spectacles.

A large population of current lens wearers is becoming presbyopic. They are already looking for options that can provide correction for near while allowing them to enjoy their existing lifestyle. ECPs have a plethora of lens options to offer to this high-potential group of wearers, including multifocals in better designs and biocompatible materials.

Call to Action

Sometimes complex problems require simple solutions. The magic may actually be in our smile, a conversation, or in taking the first step toward improving our patients’ lifestyle. Providing a contact lens-wearing experience is that magic wand. What are we still waiting for?

How about taking a simple step today: Open that conversation, engage with patients, recommend with confidence, and give just one of them a contact lens trial every day. Imagine what ECPs could achieve together if each of them followed this routine. It is time to be proactive and to recommend contact lenses to all potential wearers. CLS

The author would like to thank Alison Ewbank for reviewing this article.

For references, please visit www.clspectrum.com/references and click on document #290.