The nuts and bolts of creating a successful practice or subspecialty focused on the contact lens needs of children.

The escalating myopia epidemic is one of many reasons why there is a growing need for pediatric contact lens care. Here, we describe what we have learned while building our clinics, our passion for treating pediatric patients with contact lenses, and how to build an eyecare practice focused on pediatric patients.


There are multiple benefits for children who wear contact lenses. The Adolescent and Child Health Initiative to Encourage Vision Empowerment (ACHIEVE) study group demonstrated improved physical appearance, athletic competence, and social acceptance self-perceptions among 8- to 11-year-old myopic children wearing contact lenses as compared to glasses.1 These benefits increase as myopia increases and, combined with the many benefits of myopia management technologies, are enough to consider corrective contact lenses or corneal reshaping for almost every young myope. In addition, corneal scarring, disfigurement caused by trauma or disease (Figure 1), and strabismus in non-seeing eyes are just a few examples of conditions that can be managed with specialty contact lenses—and yes, in kids!

Figure 1. Traumatic aphakia, mydriasis, and corneal scarring in this 7-year-old patient indicates a need for a specialty contact lens.

What other children can benefit? Aphakic patients, who until just a few decades ago would have gone blind, are now able to experience quality vision if highly oxygen-permeable contact lenses are introduced early in life. Children who refuse to wear glasses, amblyopes who refuse a patch...the list goes on and on. In short, contact lenses are a great treatment option for almost all children who have visual needs.


  • Motivated and knowledgeable practitioner(s) and staff
  • Understanding of patient and caregiver needs
  • Child- and contact lens-friendly office
  • Well-developed marcom plan
  • Marketing integration
  • Commitment to improving children’s vision and health


Eyecare practitioners may avoid introducing contact lens options for children if they anticipate that greater chair time will impact the patients throughout the process. The extra time required to evaluate kids is controllable, however, and largely relates to application and removal training. Using staff members who are specially trained to work with children will mitigate increases in chair time. With proper training, children as young as 8 years old experience no more contact lens-related problems than do teenagers.2 This is a helpful point to bring up to parents who express concern over their child’s safety as it relates to his or her age. Younger patients, especially those who require specialty lenses, also do very well with contact lenses when the family is motivated.

Beyond potentially impacting practice efficiency, it is important to invest time into maintaining pediatric and contact lens knowledge. Even though additional training is time-consuming and potentially costly, it will pay greater and greater dividends as your skills improve.

Building a pediatric contact lens clinic also means hiring and training staff to focus in this area. Ideal staff members have an easy manner with children and abundant patience. They should also be adept at handling parents’ concerns and at teaching parents who may assist their younger children with application and removal. As children all learn differently and can react unpredictably to the sensation of contact lenses, having more than one pediatric-focused staff member is helpful, as they can offer different approaches if needed.


The first step in building a pediatric contact lens practice is equipping the practitioner(s) to do so. A pediatric contact lens subspecialty bridges several areas of primary care, pediatrics, and contact lenses. To become comfortable within all of these areas, it is important for practitioners to strengthen any areas of weakness. Symposia, journals, and online learning available through professional organizations such as the American Academy of Optometry (AAO), the College of Optometrists in Vision Development, and the Contact Lens & Cornea Section of the American Optometric Association (AOA) are a good place to start. Most practitioners have limited exposure to areas such as therapeutic lenses and aphakic infants and young children, so finding an experienced mentor is mandatory. Eyecare practitioners should also have referrals ready for patients who require surgery or for other services and testing not provided at the practice.

The second step is equipping the practice. The office should be kid and parent friendly. There should be space to accommodate siblings, a place to play, and a private room for crying children, baby care, and nursing mothers. If there isn’t one already, provide a place for parents to change a diaper. If the waiting room has a coffee bar, make sure that it is out of reach for children. Consider where you will evaluate small children. Although parents can often hold small children in their lap, kindermats, changing tables, or a procedure table make both evaluations and application/removal easier. If the office has an optical, offering a good selection of kids’ frames is a must. Making the office comfortable for this demographic streamlines pediatric care and demonstrates the practice’s understanding of the needs of these patients (Figures 2 and 3). This goes a long way in building relationships with parents.

Figure 2. Dr. Williamson’s goal is a great experience for every pediatric patient.

Figure 3. Fitting Mike Wazowski with a “contact lens” made from a demo lens helps Dr. Williamson acclimate young patients to the concept of contact lens wear.

The third step is establishing a focus on contact lenses for pediatric patients. Whether creating a standalone specialty clinic or adding a subspecialty to an existing pediatric or contact lens practice, practitioners need to continually develop this niche skill set. Similarly, the practice overall should continually evaluate parent and patient feedback and strive for ideal patient outcomes. Parents generally want the best for their kids, so if the practice offers the best pediatric contact lens care available in a given area, it will be successful. Achieving this takes commitment on the part of both practitioner and staff.

Practitioners should also consider getting involved in professional organizations and public health initiatives that support children’s vision. Supporting programs such as InfantSEE and organizations such as Prevent Blindness conveys a commitment to children’s health to your patients. The AOA and the AAO are excellent resources for clinical information as well as for information on the most current efforts to address pediatric vision-related public health needs.


To be successful, a practice must first be discoverable. There is no point in telling people to look for you if you cannot be easily found. A website, Google listing, and participation on various insurance panels help make it easier for patients to find the practice.

Second, when communicating with patients, all representatives of a practice must be consistent with the message that is delivered. This means continued staff training and group discussion to ensure that the messages that patients receive from everyone in the practice are on target and repeatable. It also means making sure that all non-personal communications, such as the practice website, convey the identity of the practice when patients are searching for services and options. As the website is often the first point of contact for new patients, it must be professional and easy to navigate, and it must present the desired image for the practice.

Branding helps a practice identify itself and conveys this identity to the target audience. It is not simply the practice’s logo, but how people describe the practice to others who have never been there. Poor branding can confuse people and can lead to a missed opportunity for word-of-mouth referrals. Branding is a critical step that should not be overlooked by any niche practice.

Devising a marketing communications—or marcom—plan helps practices focus and review marketing efforts. Marcom is not simply advertising, but rather is a multifaceted campaign with several critical areas of consideration (Figure 4). The intent of a marcom plan is to identify the marketing objectives of a practice, target a specific audience, devise and implement a plan to carry out the objectives, and measure results.

Figure 4. Elements of a successful practice marcom plan.

A marcom plan for a pediatric contact lens practice should use multiple communication streams at various times to interact with customers. While mass communications such as television, radio, and print have become less effective, there are exceptions. An example is a locally produced parenting magazine. Such publications are read in pediatric waiting rooms, daycare centers, and other parent “hotspots” around town, making this a potentially viable option for a print advertisement describing your services or for a practitioner-written article about children and contact lenses.

Community outreach, such as sponsorship of local children’s teams and events, is effective in communicating a practice’s commitment to children or increasing community awareness of the practice, but the return on investment in terms of new patients can be difficult to track.

Today, targeted methods of communications are the most successful. The model is no longer communication solely from business to consumer; it is an interactive, ongoing conversation occurring through social media, websites, face-to-face encounters, traditional advertising, and word of mouth. Personal or semi-personal interactions between a practice and the practice’s target audience are required. Examples of this include allowing parents to guest blog on the practice website about their child’s experience and directly asking for social media interaction. Engaging the target audience promotes the practice in several ways and should always be a goal within a practice’s marcom plan.

Integration of marketing efforts helps a practice repeat the intended message and strengthens each arm of the marcom plan. An example might be to host an informational night for parents to unveil a new contact lens or technology in the practice, then posting an abbreviated video or image collage to Facebook about the new product. Further integration could include asking parents who attended to interact with the practice via social media for follow-up questions. Repetition is key for audience retention of the message. It also helps the message rise above the noise of communications from other businesses and day-to-day distractions.

Once these efforts have paid off and patients are coming to a practice, the practice must deliver on the promised message. Asking for feedback via satisfaction surveys helps the practice understand how well this has been executed. For example, if a practice advertises a child-friendly environment, but a parent expresses concern over suitable children’s frame offerings, the practice has an opportunity to improve and to make that parent feel validated and heard.

If a patient has a good experience, the practice has an opportunity to maximize word-of-mouth marketing, which is important for pediatric and contact lens niche practices. Actively asking for friends and family referrals and online reviews can help maximize marketing gains.

Although social media marketing offers unique opportunities, negative patient encounters are easily shared, and even the most caring and competent practitioner will at some point have a bad review. As consumers are more likely to make decisions based on negative reviews than on positive ones, everything should be done to limit their exposure and to reframe the narrative by responding to bad reviews positively. Additionally, as it presents an opportunity for the practice to publicly demonstrate its commitment to patients, the way that a practice responds to a negative review can be more important than the review itself.


Once a practice is up and running, the goal is to stay successful. Taking care of the practice’s financial health ensures many years of being able to provide services. Close monitoring of accounts receivable and returns on investment for various marketing efforts and practice expenses is critical. Continual growth of the practice’s patient base through sustained internal and external marketing ensures that as existing patients are lost to follow up, new patients are coming in.

A commitment to lifelong learning on the part of practitioner and staff is critical not only for top quality patient care, but also for the lifespan of the practice. Advances in technology and research correlate to improvement in the standard of care, and a thriving practice is aware and ready to implement these changes when appropriate. A practice that offers the latest services and contact lens options will be observed by parents and the public as a community leader in this niche area.

Lastly, practitioners must remember that with success comes responsibility, and there is no greater responsibility than caring for the next generation. Managing a child’s vision is a great honor bestowed on a practitioner by the child’s caregiver. To thrive, a practitioner must always be thankful for this opportunity and show gratitude to parents and patients at every visit. CLS


  1. Walline JJ, Jones LA, Sinnott L, et al. Randomized trial of the effect of contact lens wear on self-perception in children. Optom Vis Sci. 2009 Mar;86:222-232.
  2. Walline JJ, Jones LA, Rah MJ, et al. Contact Lenses in Pediatrics (CLIP) Study: chair time and ocular health. Optom Vis Sci. 2007 Sep;84:896-902.