I have made it my commitment to always practice with the best interests of my patients in mind. We all do this, right? It is more challenging than we think. We are bombarded with options, time constraints, and practice commitments that mean to distract us from this goal. How can we make it a daily reality, and how can we strive to do it in a profitable manner?

As many of you know, Mile Brujic, OD, FAAO, and I collaborate on most of our optometry functions that are not related to our direct patient care. We hold the belief that if we do what is best for our patients, it will always be what’s best for our practices and, ultimately, the industry.

By “do what is best for my patients,” I mean that I place my emphasis on their eye health first, their vision second, and their pocketbook last. Let me give you an example of how this benefits my patients, my practice, and the industry.

Meet Betty

A 45-year-old patient (we’ll call her Betty) new to the practice is wearing a quality monthly disposable lens that she overwears while using a store-brand, out-dated care solution. Betty has been noting slight lens discomfort at the end of the day and reports some mild eyestrain at that time as well. Her screening dry eye evaluation reveals no signs of dry eye, making me believe that her comfort issues are due to her overwear and solution. She is a –3.00D spherical patient and has an add of +1.00D that has never been corrected.

What’s Best for Betty

I discuss with Betty why I believe she is uncomfortable (lenses and solution) and that I feel a multifocal lens is in order based on her end-of-day eye strain. In this conversation, I have addressed Betty’s top two concerns for her visit: her lens discomfort and her eyestrain.

Then I share with her my fix: a silicone hydrogel daily disposable multifocal lens. I want to give Betty as many advantages as possible, and I believe that a single-use lens will help resolve her compliance and solution issues. I feel that silicone hydrogel is the best material choice, and I chose a multifocal lens power based on the millions of dollars of research that the companies have invested in their fitting guides.

Lastly, I share with Betty why it is so critical to maximize her comfort on a daily basis. Only 30% of contact lens wearers are wearing lenses over the age of 44 (Nichols, 2015). I explain that most people complain about discomfort and dryness (Riley et al, 2006) as their primary symptoms. This, I explain, is the reason why I have selected a lens that is breathable as well as fresh and clean every single day.

I make these decisions based on what is best for Betty. I don’t worry about Betty’s pocketbook or any pushback because I know that Betty has entrusted me with what is best for her eyes.

If for some reason she asks, I will explain that the cost of single-use lenses is higher, but somewhat negated by not having to buy care solution. I will also explain that she is at a point at which her eye health, habits, and vision necessitate these lenses to maximize her long-term vision and eye health.

Benefits for My Practice

That was all for Betty, but here is how it benefits me. I charge more for a multifocal fit because of the added complexity. Single-use lenses, which I fit for eye health, also generate more revenue compared to frequent replacement lenses.

Additionally, by selecting a silicone hydrogel single-use multifocal lens, I am telling our industry that this is what matters to me and my patients—lenses that are better, healthier, and cover more prescription options. I want to move our industry with my selections. I want to benefit my practice with the revenue. And, most importantly, I want to solve Betty’s problems and give her the best lens possible.

If Betty comes into your office today, say hi for me. CLS

To obtain references for this article, please visit and click on document #250.

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.