Off-the-shelf, mass-produced contact lenses, in my opinion, have become a commodity, with dwindling profit margins due to their online accessibility. While specialty contact lenses are differentiated products that offer eyecare practitioners (ECPs) an opportunity for greater return on investment, one modality that North American specialty fitters often struggle with is prosthetic soft contact lenses. Having practiced in both the United States and in Canada, in addition to having access to online forums on which frustrations about the fitting of this niche contact lens category are frequently reported, I can appreciate ECP concerns regarding the challenges of fitting these lenses and the respective dwindling profit margins.

Time Is Money!

The biggest challenge that I’ve heard about from colleagues is accessibility to this category of contact lenses. Only a handful of labs manufacture true prosthetic contact lenses, and most ECPs are not familiar with these labs because they are so specialized. So, when they have a patient who would benefit from this type of lens, they don’t know where to turn.

In addition, many of these labs are in the United States. The lenses can already be quite costly for U.S.-based ECPs; but in Canada, this can mean hefty price tags in U.S. dollars and associated shipping and duty cost considerations. Naturally, these costs should be passed down to consumers, but the consumers in these cases are typically patients who require the specialty lens for medical necessity and may have difficulty affording the extra expense.

To help with this, I have compiled a list of these labs to cut the time needed for you to determine where to start. All of the labs/companies listed offer contact lenses that are U.S. Food and Drug Administration- and Health Canada-approved Class 2 medical devices. I can email the list upon request (see bio).

Choose the Lowest-Hanging Fruit for Financial Gains

There are many considerations when fitting prosthetic lenses, and the more customized a lens required, the higher the costs. If your patient has functional vision, a clear or translucent pupil may be needed rather than a blackout pupil. If the lens is solely for cosmesis in the case of a disfigured, white cornea, a larger, hand-painted soft lens with high-quality detail may be required to better satisfy your patient’s expectations. These highly complex fits will require more chair time and administrative time on your part, which should be reflected in your professional fitting fees.

For some cases, you can get creative in your approach to color matching a non-affected eye. Even a non-customized colored lens can become a prosthetic lens (Figure 1) and should follow a different fee schedule compared to that for a colored lens fit to cosmetically change eye color in a patient who has normal ocular health.

“Feels Good” Gains

The reward of restoring confidence in a patient who feels self conscious about and struggles with the presentation of one or both disfigured eyes can be priceless for ECPs. These patients may initially present with their head down or wearing sunglasses to hide their facial asymmetry. Know that you will gain these patients for life when you successfully fit them, and they often serve as a source of word-of-mouth referrals that can drive future revenue for your practice.

Despite the known limitations of prosthetic soft contact lens fitting, I encourage you not to shy away from the challenge(s). They can be among the most rewarding and memorable fits of your career. CLS