Curbing the Dropout Rate

How to translate the science of contact lens care into business growth


Curbing the Dropout Rate

How to translate the science of contact lens care into business growth

By John Rumpakis, OD, MBA

Science is the difference maker in our practices because we apply it every day to provide the best care. If contact lens wearers aren't happy, they go from professional to professional until they find one who best meets their needs. That's why we can't separate the science from the business of practice.

Based upon my research,1-3 the discomfort issue addressed in this supplement is the top reason patients stop wearing contact lenses or become dissatisfied. Here, I'll discuss how to apply the business of eye care to address this issue.


Data that monetize the cost of drop-outs (patients who stop wearing contact lenses for any reason) in practices or, more importantly, developed strategies to address the reasons for dropouts are significantly lacking. To help in these efforts, I ask that you contribute your practice data to a longitudinal study at so I can continue to report back to you and the industry. We have excellent contact lens and care solution technology, but how we apply these in our practices is another story. I'm certain the data will show that we can prevent dropouts by being proactive in practice—striving to anticipate what will happen, instead of reacting to what has happened.

A total of 69% of the respondents at this meeting of contact lens enthusiasts in the Philippines said they recommend a care solution when prescribing a contact lens. But how often do we tell our customers what to do without telling them why they should do it? Unless a recommendation includes the benefits to the wearer, they're unlikely to follow our directions. Keep in mind that in the absence of personalized information, purchase decisions will almost always be based upon price rather than the value of the item.


If price becomes the only issue for decision-making, then we have provided a path for customers to leave our practices. Contact lens wearers don't call to tell us they're leaving the practice, they just leave or stop wearing their contact lenses. The economic impact of a contact lens dropout is huge, but we don't measure it because it's lost income that never shows up on the bottom line. Most of us don't measure it, but one thing is certain: it's income we can regain if we understand how to take a proactive approach.

It's thought that 100-120 million people wear contact lenses globally, in contrast to a decreasing number of patients available in a shrinking refractive surgery market. So what are we doing to take advantage of this opportunity? Do we simply add up the amount of eyeglasses, contact lenses and care solutions we sell and determine if we've had a good or bad day? If so, we may be getting as complacent about our businesses as we often say CL wearers are about their contact lenses.

With this reactive approach, all we care about is the short-term profit—buying the cheapest materials, marking them up as much as the market will bear and selling them for the highest margin. In this scenario, we don't care if contact lens wearers return because we've maximized our profit on these individuals. But that's a very myopic approach because these customers don't return to build our business year after year. We should take a customer-centered approach. We should invest in our customers, not only maintaining relationships, but also building relationships with them. We need to deliver the best quality products, helping contact lens wearers benefit from the latest technologies. We need to educate them about their eyecare needs and not simply sell them products.


To make the practice changes needed to address dropouts, you should set specific goals that include strategies and tactics to do so. A method I recommend is a technique described by the acronym SMART. Set goals that are Specific, Measurable, Achievable, Realistic within a Timeframe. For example, recommend a particular contact lens and care solution system based on a customer's lifestyle and health needs, telling him the solution will optimize performance of the lenses and keep him safe and comfortable throughout his wearing cycle. Fifteen seconds is all you need to provide a well thought-out, clear, concise message that you're doing everything you can to help him. Again, make sure the customer understands the benefits of your recommendation, so he appreciates the value of what you're recommending and doesn't revert to price-based decisions later.

New Practice Data: Asia-Pacific Region vs. U.S.
A study1 out of the U.K. found that the drop-out rate was about 10%, a figure that is often cited by people who claim the contact lens marketplace is flat and not growing. My ongoing study and the data I have gathered so far points to a different conclusion. We have evaluated responses from 27 countries between Jan. 1 and June 30 of 2009. Roughly 372 statistically valid surveys were completed during this period, including 43% from the Asia-Pacific region. Doctors from the Asia-Pacific region reported about 4,500 patient encounters per year, compared to about 3,000 in North America.
Data from the survey show that about 40% of patients in the Asian-Pacific region are wearing contact lenses, compared to 33% in North America. A total of 25.6% of new wearers are coming into the Asia-Pacific market. This helps determine if your market share is growing or shrinking.
Patients in the Asia-Pacific region spend slightly lower amounts on contact lens wear than those in the U.S., primarily because of insurance coverage issues. Practices in the Asia-Pacific region report a 31% dropout rate, compared to 17% in North America. So if 25% worth of patients are flowing into the marketplace and 31% are leaving, you have to ask if your practice is growing or shrinking and what you can do about it.
Consider that the lifetime value of a patient in the Asia-Pacific region is $18,200 when converted to U.S. dollars. The life-time value of a patient in the U.S. is $36,700. If I took one year's worth of new contact lens patients from the Asia-Pacific area and converted the associated revenue to U.S. dollars, the amount of earnings would be worth $636,000. That is a significant amount to earn by being proactive, recommending appropriate care products and keeping those patients in their lenses.
The number one reason for dropout in the Asia-Pacific region and U.S. is discomfort or fit. Interestingly, though, the number two reason in the Asia-Pacific region is fear of eye infections or disease. So nearly 60% of all users stop wearing their contact lenses because they're uncomfortable or they're afraid of getting an infection. That is a big chunk of practice, considering as many as 40% of the patient base is in contact lenses. Expense was cited by only 11% of wearers as a reason they stopped wearing lenses.

1. Morgan P. Is the UK contact lens market healthy?Optician. 2001;221(5795):22-26.


Do you recommend the cheapest pair of progressive lenses? Or do you take the time to explain different types, including those that provide excellent performance? If you take that time, you're differentiating premium products. Up-selling through education is simply matching a patient's needs and wants appropriately and delivering excellent value. The same approach applies to your contact lens products and services. When you invest time in educating your customers and helping to solve their problems, you create value that will keep them coming back instead of going to the next professional.

Use quality products from quality suppliers. Before you fit your customers in contact lenses, tell them the top two reasons that other patients don't succeed—safety and discomfort. Tell them you can address these issues with lens types and care solutions that will help avoid complications and lead to long-term success.

Remember that you have two customers, your staff and your patients. Speak appropriately to each. Translate science into useful information because technology and value, when applied and explained properly, change a price-based decision into one that is based upon the value we provide.

Remember that every moment you and your staff have can be used as an opportunity to educate contact lens wearers about the premium services and products that you offer, to show them how you can solve their problems—problems that they may have thought were normal.


If you offer customer-centric eye care, based on education and retention, you'll be providing your patients with the best products and services. This means changing your strategy from what you're doing now. It means working smarter, not harder to achieve better outcomes for your customers. If we can prevent dropouts from occurring, we can recapture a significant amount of income for our bottom line while taking better care of patients.CLS

1. Rumpakis JMB. New data on contact lens dropouts: an international perspective. Review of Optometry. 2010 Jan; 1-4.
2. Rumpakis J. Contact lens drop out: the cause and effect. Poster; Global Specialty Lens Symposium; January 28-31, 2010. Las Vegas.
3. Rumpakis J and Kern J. The economic impact of contact lens dropout in Europe. Poster presented during the annual meeting of the British Contact Lens Association; May 27-30, 2010. Birmingham, U.K.