Contact Lens Practice Pearls

The First Contact Lens Fit, From a Patient’s Perspective

Contact Lens Practice Pearls

The First Contact Lens Fit, From a Patient’s Perspective


I didn’t have a clue what I was getting into. I walked into the office thinking that this was going to be like every other healthcare appointment I’d had. I filled out my forms, answering some very off-the-wall and even personal questions. Why did they need to know about my height, weight, and social drug use? I waited for 17 minutes until I was told that they were going to “get me ready.” Ready for what?

Then I had to stick my head in some odd machines, had some uncomfortable things done to me, and after 19 more minutes, I finally met the woman whom I had come to see. My optometrist was new to the office that I had been going to for years. She asked me more questions, and even though I am 52 years old, she asked me whether I had ever considered contact lenses. I explained that I had when I was 25, but was told I couldn’t wear them because of my football-shaped eyes. She said that there are lenses that can be worn part time if I don’t want to wear them every day, and it might be nice for when I play golf and go hunting (Wow, she actually read the forms that I filled out).

I opted to try it, and she told me that we could “do it today.” Wait…today?! Oh my, what was I in for? We talked about my glasses and about the contact lenses that I would be trying. Next, we proceeded to an area where I was to learn how to “apply and remove” them. Holy cow, I’m about to put something in my eye…

Put Yourself in Their Shoes

Have you ever thought about what your patients go through when you fit them with their first pair of lenses? What are their expectations? What are they anticipating? How has their experience been prior to seeing you? What goes through their head when you tell them about lens design, material, solution, wear time, etc.? I am 99% certain that they are 100% overwhelmed by the time we put a lens on the eye.

Consider these aspects of the contact lens fitting process:

1) When is the best time to do application and removal training? Is it good to do it on the day of the exam, or better to bring patients back? If you do it on the day of the exam, patients will already be overwhelmed and may elect to not purchase glasses because of the time commitment. If you do it on another day, patients don’t get the immediate experience of freedom from glasses and may have second thoughts. Each has its drawbacks and benefits.

2) How do you simplify the lens replacement selection? Do you offer new patients options? I personally think that prescribing the best option to patients helps to de-commoditize contact lenses; however, I want to be able to answer questions for why I chose the lens type that I did.

3) What do you do to simplify the “pain” of first applying a lens? Touching the eyes is not something that we were designed to do. In fact, it is opposite of natural. I personally think that it is best to help patients out by applying the first lens for them. That demonstrates how painless the process is once they get the hang of it. Additionally, it shows them how comfortable contact lenses can be before they start poking at their own eyes.

It’s Not Routine to Them

Let’s face it: we do this everyday, but if you put yourself in your patients’ shoes, you would be skeptical of the initial lens fit. Let’s go back to basics and ask ourselves some tough questions about how we can simplify this process for our patients. It will make the experience better for everyone. CLS

Dr. Kading owns the Specialty Dry Eye and Contact Lens Center in Seattle. He is the co-owner of Optometric Insights with Dr. Mile Brujic. He has received honoraria for consulting, performing research, speaking, and/or writing from Alcon Laboratories, Allergan, Bausch + Lomb, CooperVision, Johnson & Johnson Vision Care, Oculus, OptoVue, RPS Detectors, Paragon Vision Sciences, TearScience, Valeant Pharmaceuticals, Valley Contax, VSP, ZeaVision, and Zeiss. Follow him on Twitter @davekading.