The Business of Contact Lenses

Guten Tag

The Business of Contact Lenses

Guten Tag


One of the things that I love about being at the forefront of the profession (in my own small way) is that I have developed friendships with optometrists from all over the world. Patients are impressed when you have on the tip of your tongue the name of another qualified optometrist whom you know and trust in a city halfway around the world.

Being a Diplomate in the American Academy of Optometry is one way that I have come to know highly qualified optometrists from other countries. When I was in New Orleans for the 2015 Academy meeting, I met up with my friend and fellow Diplomate Dr. Stefan Schwarz. Stefan lives in Hildesheim, Germany, a small city of about 100,000 people that is west of Berlin and just south of Hanover.

I told Stefan that I would be in Berlin for a meeting the next week, and he invited me to visit his practice. So, after my meeting in Berlin, I took a train west to Hildesheim.

Similarities and Differences

I wanted to see how a German optometrist’s practice differed from my own. It was a very interesting experience. It was a Saturday, and his office was closed. His office is more modern and smaller by American standards, but bigger than I expected. However, much about his office was the same as an American practice.

He has two exam lanes and can use a third room where he keeps most of his ancillary testing equipment. His exam lane equipment is very high-end, which is not surprising. In Germany, optometrists cannot use medications at all, so they have to develop close working relationships with the area ophthalmologists.

Healthcare System Impact

I wondered how he made the finances of it all work. German optometrists charge privately for the ancillary testing that they perform, and the patients pay for it if they want the testing.

The more technologically advanced German optometrists have all of the best equipment, and they take their duty to diagnose eye diseases very seriously. Dr. Schwarz has all of the equipment that I would expect a Diplomate in contact lenses to have, but he also has all of the tools that an American optometrist who practices full-scope medical optometry would have. I was surprised by that.

He only recently added a 400-frame optical. I was surprised by that as well.

The German healthcare system is a hybrid of single payer and patient payer systems. Basic contact lens services and spectacles are not covered by the German healthcare system, so patients pay all of it out-of-pocket. One thing that they do not have in Germany are Vision Care Plans. Hmmm...

You Get Out What You Put in

After I was there for half an hour or so, Stefan’s wife arrived to do some bookkeeping, which she handles for the practice. One thing that Dr. Schwarz does that I think is genius is that he offers a payment plan where he adds together the costs of a contact lens examination, the proper number of lenses, and the proper amount of solutions for the year and divides the total by 12. He then automatically drafts this monthly from the patient’s account. It spreads out the cost over the year, and patients don’t have to deal with payments when they come to the practice. About 20% of his patients are enrolled.

He also has a sophisticated dry eye practice that even the best dry eye experts would envy.

So, there are some differences, but there are some real similarities. When I compared his office to some of the others in Hildesheim, I could see that some aspire to a higher level than others do, and those practitioners have invested in getting there. Sound familiar? CLS

Dr. Newman has been in private practice in Dallas since 1986 specializing in vision rehabilitation through contact lenses as well as corneal disease management, optometric medicine, and refractive surgery. He is a Diplomate in the AAO and a consultant or advisor to Alcon, Allergan, AMO, B+L, EyePrintPro, GPLI, Johnson & Johnson Vision Care, SynergEyes, TruForm Optics, and Zeiss Optics. Contact him at