The Business of Contact Lenses

What to Say When Patients Are Dissatisfied With Their Lenses

The Business of Contact Lenses

What to Say When Patients Are Dissatisfied With Their Lenses


It's been about a year since you've seen Ms. Pleasant. At her last visit, which was about nine months ago, she walked out of your office a happy toric contact lens camper. Or so you thought.

"What you brings you in to see us today, Ms. Pleasant? I'm assuming you're here for your yearly examination?" you ask.

"Well yes, I am. And also, the contact lenses you tried to fit me with last year never worked. I stopped wearing them after my last visit," she replies.

As your heart sinks, you start sifting through the alternatives before you. Admonish her for not telling you sooner? Compassionately acknowledge her "defeat" and move on—or tacitly ignore the comment altogether? While situations like this don't occur frequently, we've all been confronted with them. How we choose to handle (or overlook) them can set the tone for how patients respond to future care from your office.

Find Out What Happened First

As far as which choice of the three (and there are certainly others) is preferred, I recommend that you start by assuming an inquisitive exploratory tone and determine what issues led the patient to go from skipping out of your office to throwing the lenses in a sock drawer.

Here's how one scenario could go that would easily allow the patient to continue wearing contact lenses.

"Why did you stop wearing the lenses? You seemed to be doing great at your last visit."

"I was doing great. But after two weeks of using the lenses every day I realized that it was just more work than I wanted to deal with. I could see fine and the lenses were comfortable. They were just taking too much time and I'm so busy in the mornings that I just couldn't continue."

"Well, I have great news for you. Since you were here, lenses have become available in your prescription for continuous wear, which means you won't have to handle the lenses as frequently."

When the Problem is the Lens

Of course, the scenario could (and usually does) go something like this:

"The lenses were okay, I guess. But honestly, I never could really see as good with them as with my glasses and the comfort was never that good, even after I tried several pairs of lenses."

At this point the proverbial practice building rubber meets the road, and what you say next can either cement your relationship to the patient or destroy it. I'd recommend you say something like, "That's unfortunate. I really wish the lenses worked better for you." If other alternatives are available, you can add, "There are some new developments available that I'd be willing to try if you want to give it another shot." If no new alternatives are available, "Unfortunately, there isn't anything else we can do right now. But, should that change, I'll call you right away. Would you like that?"

What Not to Say

Notice that neither explanation said what most of us are thinking: "Why didn't you tell me sooner?" Sure, we're all thinking that, but as a practical matter, even if the patient did tell you sooner, nothing in your case disposition would have changed. Your goal at this point should really be to assess the patient's desire to continue attempting lens wear or to stop or delay their use. You should uncover that information in a nonaccusatory, nonconfrontational, supportive manner. Done in such a way, whether Ms. Pleasant chooses to continue wearing contact lenses or not, she most likely will at least continue to be a patient in your practice. CLS

Dr. Gerber is the president of the Power Practice – a company offering consulting, seminars and software solutions for optometrists. You can reach him at (800) 867-9303 or