Special Edition 2011
The Business of Contact Lenses

Satisfied Patients Make Better Customers

the business of contact lenses

Satisfied Patients Make Better Customers

By Gary Gerber, OD

While I've always advocated not defining patients by their mode of vision correction (eyeglasses vs. contact lenses), in this case, I'll do so to make a point. You've probably heard or read about the the profitability difference between contact lens vs. eyeglass patients. Generally, since lens wearers tend to be more loyal and visit the practice more often and eventually do buy eyeglasses, contact lens patients are more profitable than eyeglass wearers. Our data shows they visit the practice about every 18 months vs. every 25 months for eyeglass patients.

Consider then what happens when a current contact lens patient chooses to discontinue lens wear. More often than not, the reason is due to discomfort from dry eye. While it's a common reason for patients to drop out of lenses, it's not that common for most of us to go the extra mile to do whatever we can to keep those patients in their contact lenses. Most of us would probably consider at least trying another lens material or when indicated, changing solutions. However, beyond that, it's rare that we would mentally transition this patient from a “contact lens patient” to a “dry eye patient” and then focus on treating them accordingly. Consider these five areas, which highlight the economic impact of not doing so.

1 The patient requires more chair time and should be charged accordingly. Whatever your dry eye treatment regimen entails (drops, punctal plugs, supplements or anything else), you would not treat a spectacle dry eye patient for free and you shouldn't do so here either.

2 If you attempt to solve the problem with a different lens design, you should consider an additional fitting fee for the chair time. This varies practice to practice as some practices charge a global fee, under which this type of service would be included. However, not all practices do so. Additionally, the time between when the patient was first fit and when they returned with symptoms also needs to be considered. Generally, the longer that time is, the more reasonable it is to charge for your time.

3 As mentioned above, contact lens patients are notorious for having “back-up” eyeglasses with an outdated prescription. If temporarily discontinuing lens wear is part of your treatment plan, those patients will need to have a new pair of eyeglasses—or at least lenses.

4 While it's probably impossible to put a dollar figure on it, just as an enthusiastic lens wearer is a great practice-building evangelist, a dropout can be equally disruptive. Consider the positive excitement when a new wearer shows up at dinner with their friends without their usual eyeglasses. Now reverse that. The conversation probably goes something like, “I've never seen you in glasses before. Did you just start wearing them?” Fill in the rest. Obviously, the script doesn't have a happy ending as the patient discusses the tale of woe that led him no longer wearing contacts.

5 The long-term revenue loss from dropouts is significant. Our data show that patients stay with most practices for about 8 years. That means a contact lens wearer will have 5.3 eye examinations vs. 3.8 for an eyeglass patient. Additionally, when a patient drops out of lenses, he's probably dissatisfied and more likely not to become YOUR eyeglass lens patient. Unfulfilled, he is more likely to seek care from someone else who can solve his problem and get him back into contact lenses.

Yes, patients complaining of dry eye can be challenging. However, over the long haul, it is certainly worth the extra effort and time to do what you can to try and keep these patients in contact lenses. CLS

Dr. Gerber is the president of the Power Practice–a company offering consulting, seminars and software solutions for optometrists. You can reach him at (800) 867-9303 or