New Opportunities in Contact Lenses

A Contact Lens Spectrum Staff Report
SEPTEMBER 1999

Cosmetic contact lenses can benefit your practice as well as your patients.

New developments in color and cosmetic contact lenses have made them more valuable than ever in generating patient enthusiasm and in building your practice. With styles ranging from enhancer tints to new opaque designs to specialty costume lenses, contact lenses are appealing to patients who require correction as well as to plano patients who are looking for a way to enhance their appearance.

If you've shied away from color contact lenses in the past, now is the time for you to reconsider what they can offer your patients. For example, experts maintain that new patterns in opaque color lenses have become more natural-looking. "Doctors who tried them when they first came out and weren't happy with them because they looked fake should try them again because they've improved tremendously," says Peter G. Shaw-McMinn, O.D., assistant professor at Southern California College of Optometry. He also serves on the board of the Better Vision Institute, Better Vision Council of America and is chair of the American Optometric Association Practice Management Committee.

Eyecare providers may also have other misconceptions about color and soft lenses. Many of them don't realize that they are available to correct astigmatism, says Dr. Shaw-McMinn. "Those are two niches that aren't being filled very well." Astigmatic patients are often astonished to learn that they too have the option of wearing soft lenses as well as color lenses. "You've got to think, if a person would undergo surgery to change their eye color, they'd probably pay for it -- as much as $5,000 or $10,000, and we can do it for $100," says Dr. Shaw-McMinn.

A Wider Scope

Color and cosmetic lenses open up a range of opportunities for your practice. Patients who are models, musicians and actors may opt for color or even specialty costume lenses, such as the recently-introduced Wild Eyes lenses from Wesley Jessen, which are available in correction and plano designs. Wild Eyes come in a variety of patterns, ranging from "alien" to "cat eye," and are particularly popular with teenagers during the Halloween season.

From a therapeutic standpoint, cosmetic lenses can offer significant advantages to patients who have eye deformities or scarring (see sidebar). In most cases, however, men and women select color lenses because they want to look more attractive. Color lenses are fun for patients, says Neil Gailmard, O.D., M.B.A., of Gailmard Eye Center in Munster, Ind. "They give the patient a different look," he says. "Sometimes it's not dramatic, but a little more subtle, which a lot of people like."

People who are interested in color lenses tend to be well-groomed and very concerned with their appearance, noted Patricia Feiten, O.D., Yakima, Wash. Some patients even purchase different shades of color lenses to match their clothing. "I get girls who come in asking for color contact lenses that will match the color of their prom dress," she says. "It's not something I would've expected." Practitioners report that some of their patients purchase several shades and switch them frequently.

Although women tend to be most attracted to color lenses, a number of men also prefer them. "One of my most unusual cases involves a man who wears a color lens in one eye," says Dr. Shaw-McMinn. "He only wears one lens for monovision for reading, but he likes using a color lens because he can see it better in its case. It looks very different and he gets a real kick out of it."

"We have a lot of weight lifters who like the green lenses," said Saul Mendelsohn, O.D., a private practitioner in Fresno and Visalia, Calif. "The complimentary green and regular green lenses have been extremely popular with them."

Some experts offer color lenses to all of their patients -- even plano patients. "We try to improve the lives of all of our patients," says Dr. Shaw-McMinn. "I think all optometrists should think about that philosophy because it's one of the nicest things about being in the eyecare field. As a doctor, we have the ability to improve the lives of almost every patient, even those without eye disease or refractive error."

"All patients should be given the option of changing their eye color in the exam room if their prescription is available in color lenses," said Paul D. Geller, O.D., of Salt Lake City, Sandy and Taylorsville, Utah. "A lot of people don't know about it until later. It behooves doctors to mention it to all of their patients because it's a nice option."

Spreading Excitement

Offering color and cosmetic contact lenses can help make your practice more profitable.

"It generates a little more excitement, a little more interest," says Dr. Gailmard. "In our office, we're always trying to gain referrals from our new patients. In our experience, the tinted contact lens wearer is more likely to discuss the type of lenses they wear, or are more likely to have somebody notice it . . . and that results in a referral."

"We get a lot of referrals," says Dr. Feiten. "Or girls bring their girlfriends in when they're trying them on and then they get excited and make an appointment."

The option of color lenses may also convince those who wear eyeglasses to switch to contact lenses, Dr. Geller says. "Their original idea was, 'I'll change my eye color just for the fun of it,' and later on, they find out that they like their contact lenses better than their eyeglasses," he says.

Boosting Your Color Lens Business

To expand the use of color contact lenses in your practice, follow these steps:

1. Be Prepared -- Practitioners who want to become more involved in offering color contact lenses need to stock a range of trial lenses, says Dr. Feiten, explaining that she often sees patients with prescriptions from other offices who are looking for a larger range of colors. "We have a wide range of trials for them to try on," she says.

When offering color lenses, she says, it also helps to have enough staff members to work with patients as they try on the colors, because it can become time consuming.

2. Ask Questions -- "We always find out what our patients do for a living and what they like," Dr. Shaw-McMinn says. "If we find that color lenses will improve their lives in some way, we recommend them."

Many practitioners offer the option of color lenses once a patient decides to opt for contact lenses over eyeglasses. "When we talk about contact lenses with someone, we approach the matter as if tinted lenses are a normal thing and we say, 'What color lenses would you like?'" says Dr. Gailmard. "It puts a whole different spin on it and then they can choose clear if they want, which is fine."

"Inevitably, if we don't ask about color, we get done fitting, the patient gets out the door with their lenses and then they say, 'I wanted color,'" says Dr. Feiten. "Then we have to start all over."

It may also help to involve your staff. A 1998 study of in-office marketing techniques sponsored by Wesley Jessen found that patients were most likely to purchase color enhancer lenses when the technician recommended them.

Free trial contact lenses can also be an incentive. At one point in his practice, Dr. Gailmard says, when patients picked up a fresh supply of lenses, the staff tucked a free sample of color lenses in their bag. "The patient would name the color and we'd throw a pair into their supply bag and send them home. It was kind of like a bonus for the visit -- a little freebie from the doctor and a little bit of fun and excitement when they got home and tried them on.

Many of them would call afterward and order some boxes of the color lenses or ask for them at their next visit. It was a great way to introduce a large number of people to tints and it took no chair time at all." With such a program, Dr. Gailmard adds, contact lens companies are happy to supply lenses to introduce their products to so many potential buyers.

Practitioners often rely on two approaches to demonstrate color lenses in the office. Some use a computerized video monitor to take a photograph of the patient's face and simulate what color lenses would look like on the patient, but many believe that trial lenses work best.

"It's pretty hard to predict what a contact lens is going to do on an eye," says Dr. Geller. "You can look at a patient's eye and say, 'Let's try an opaque blue or enhancer blue,' and you think you know what it's going to look like, but you're totally wrong."

"We use trial lenses because it's a fun experience," says Dr. Shaw-McMinn. "My staff goes back there and the patients start laughing and giggling as they look at the lenses and pictures and decide on which ones to try on. The staff makes it a really enjoyable experience."

3. Plant the Seed -- You will find it less necessary to ask your patients about color lenses if they bring up the topic first. Referrals from satisfied patients and a good marketing plan will prompt others to ask about these options.

To market color and cosmetic lenses, some practitioners rely on advertising in the Yellow Pages. Others use direct mail pieces or newspaper advertisements, particularly for items with seasonal appeal, such as Wild Eyes.

Dr. Mendelsohn has been advertising on television for the last 18 years. "I've done so much television advertising that at one time, Wesley Jessen came out with a national commercial and I had people calling me on the phone and saying, 'Hey Dr. Mendelsohn, they forgot to mention your name in the commercial.' They're associating me with color contact lenses."

Dr. Feiten also recommends asking the manufacturer for promotional point-of-service materials, such as posters and brochures.

Staff members who wear color lenses also may spark patient interest in this option. "I can tell you the number of patients using these lenses is going to increase significantly because my receptionist is getting color contact lenses this week," says Dr. Shaw-McMinn.

4. Choose the Right Lens -- Although practitioners have lenses they prefer, there are certain factors that ultimately dictate which lenses a patient can wear. "We give them choices," says Dr. Mendelsohn. "Usually we want to know whether they want disposable or yearly lenses; color or clear. That's how we narrow it down."

Dr. Shaw-McMinn explains that, of the color-enhancing lenses, which can be used only for people with light eyes, aqua is a favorite. Aqua enhances a blue-green eye, making it greener, he says, but other eyes will appear light blue. "It looks extremely natural," he says. "It's the most common color by far." He explains that blue color enhancers are used less frequently because they make the color much deeper. They work best in patients with very light blue eyes, making the color more vivid. Green is also popular, especially in olive-skinned patients, he said.

For color enhancement, Dr. Geller says that his practice tends to use CIBA Vision or Bausch and Lomb lenses.

Patients with dark eyes must rely on an opaque lens to change their eye color. "It's the opaque-color lenses where we're having all of the new improvements," Dr. Shaw-McMinn says. The first opaque lenses were disappointing. "They honestly looked fake. It was hard for me to recommend them, but they've been developing new patterns and they're making them look much more real."

Wesley Jessen's FreshLook ColorBlends lenses, which blend three colors in each lens, and CooperVision's Natural Touch Opaque lenses with a limbal ring have been particularly popular brands of opaque contact lenses.

"We have moved largely into the Wesley Jessen FreshLook lenses because we like the disposability and the new appearance of their tints," says Dr. Gailmard. "That's our number one color lens."

5. Emphasize Safety -- Safety is important to any lens wearer, but there may be particular concerns with color and cosmetic lenses. For example, with some of the costume lenses, wearers may take shortcuts because they don't want to be bothered with multi-step cleaning processes.

"We've known for many years that after 6 months, 85 percent of our patients will start making errors in their lens care regimens," says Dr. Shaw-McMinn. "One study in Australia showed that this occurred in 100 percent of patients. I've had patients come in after 3 years, who I've found had been using just saline. They never disinfected their lenses."

Whenever a plano patient is interested in using contact lenses for cosmetic purposes, they often use them on a part-time basis, which raises special concerns. For occasional wearers, Dr. Gailmard often recommends QuickCare by CIBA Vision. "It's the only disinfecting system I know of that doesn't need to be done the night before or doesn't require a minimum of 4 hours of soaking time to be effective," he says. "It's effective in 10 minutes and can be done immediately before insertion, because usually the patient may not remember to go through the process the night before." He also emphasizes to patients that when lenses have been soaking for longer than 3 days, the disinfectant is no longer effective and the lenses must be re-disinfected.

Concerns have also surfaced about people purchasing contact lenses on the street and over the Internet without a prescription. Some patients also try on other people's contact lenses. To prevent these types of occurrences, it's important to discuss the risks with patients. "The doctor should have a little discussion with them, reiterating that contact lenses are medical devices, that there are risks associated with wearing them, that they shouldn't ever loan them to a friend and that they have to be fit precisely," says Dr. Gailmard.

"Patients come in and say, 'I was wearing my friend's lenses and I want some,'" says Dr. Feiten. She explains to these patients that they need an eye exam and that a prescription is required. "There seems to be a lot of interchanging, which we try to discourage," she says. "I always point that out, especially to young girls," she says.

Looking Ahead

"If bifocal lenses start coming in colors, I think that will be beneficial in a couple of ways," says Dr. Shaw-McMinn. For example, they will be easier for presbyopes to handle since they will be easier to see. Because the iris tends to gray with age, he adds, a color lens will make the eye more vibrant looking, and thus, help to make people feel and look younger than they really are.

Life-Enhancing Options

For patients with eye deformities, such as iris coloboma or scarring from injury, custom hand-painted lenses and new opaque lens designs can significantly boost their self-esteem and enhance their quality of life.

"We have several patients who have had eye injuries and misshapen pupils or coloboma of the iris," says Dr. Gailmard. "Although it's not very common, when we fit lenses for eye abnormalities, the patients have a tremendously improved outlook on life. They really have a feeling of improved self confidence."

For some of these patients, Dr. Gailmard uses Wesley Jessen's opaque lenses. "The concern there is that you have to use a match for the other eye," he says. "Sometimes we will fit both eyes and the match isn't quite as critical because it's an opaque lens. In some cases we've used special custom-tinted lenses from companies like Adventure in Colors, Inc. (Golden, Colo.) that can custom tint any soft lens in a variety of iris colors and pupil sizes." Dr. Gailmard adds that he has used custom lenses for a patient with double vision who needed an opaque black pupil painted on the lens. "If we didn't occlude the eye totally he'd still be seeing double," says Dr. Gailmard. "He had almost no iris on that eye. We wanted to replace his blue iris, put a black pupil of about 3mm diameter on that iris, and occlude the eye to give it a normal look to match the other eye. We were able to do that with a custom-tinted Adventure in Colors contact lens."

"There aren't many patients like that," he says, "but after you fit a couple, suddenly more appear. You have become a source. The word gets out."