Contact Lens Issue: Hit Refresh on Your CL Practice

Follow these five steps to revitalize this area of your practice.


Hit Refresh on Your CL Practice

Follow these steps to revitalize the contact lens area of your practice.




When was the last time you put your finger on the pulse of your contact lens (CL) practice? If it’s been a while, you might be due for a change.

CLs are vital to a healthy practice, and continuous CL innovations provide growth opportunities for novice and specialty fitters alike. Consider the following: CL patients can generate 91% more revenue through a six-year period vs. spectacle patients, based on CL-related services and fees, eyeglass purchases and median exam revenue.1

So, how do you recover from anemic CL revenue or stagnant growth? Follow these steps to get your CL practice back on track.

1 Increase CL knowledge

Commoditization is the all-too-often excuse cited by practitioners for both dwindling professional interest in CLs and declining profitability.

With the ever-increasing numbers of new lens designs and modalities, clinical complacency is inexcusable. Increasing your knowledge is essential to delivering the highest quality patient care and achieving professional and patient satisfaction, the latter of which increases practice revenue.

Take advantage of educational and training opportunities available to both you and your staff. Online training modules on many vendor websites provide excellent product overviews. For hands-on experience, attend live workshops and wet-labs at national and regional meetings. Also, the Gas Permeable Lens Institute ( features a large database of and is a comprehensive resource for rigid and specialty lens labs and products, fitting techniques, coding and billing.

2 Diversify your CL mix.

Much like an investment portfolio, it’s not wise to put all your “CL eggs” in one basket.

While you’ll always gravitate toward materials and designs that deliver the best mix of vision and comfort, there’s more than one way to achieve this. When clinically equivalent, it is my opinion that you should choose products that are “special” on at least one level: wholesale cost, consumer cost, profit protected/proprietary design (i.e. not available on the Internet).

Also, seek products from small, specialty laboratories that deliver on two critical levels: (1) they are clinical problem solvers, and (2) they are “custom.” Virtually all modalities are currently available as a profit protected/proprietary design. This includes daily disposables, torics, multifocals, hybrids, GPs and sclerals. Working with custom designs enables precision fitting for unique refractive errors and corneal curvatures outside the standard ranges.

In addition, consider utilizing a custom bifocal or multifocal design for your presbyopic patients currently wearing toric lenses. Offering these technologies not only promotes your expertise as a specialty fitter, but it also ensures patient loyalty and ties prescription refills to your practice.

To control wholesale costs, identify your most successful brands, and benefit from volume discounts and rebate programs. Consider joining one of the growing number of buying groups/practitioner networks, which help to leverage the buying power of independent optometrists. This year, we saw the introduction of a new daily disposable lens with a fixed retail price. This approach to leveling the playing field across all suppliers is likely to be repeated as new products come to market and other companies follow suit.

3 Revise your fee structure/charges.

Separating your examination fees from CL material fees allows you to charge according to the complexity of the case. In our practice, a new patient is billed for these components: consultation, diagnostic evaluation (amount depending upon complexity of case), insertion and removal training (if applicable), CL materials and follow-up care.

Consider the example of a newly presbyopic patient currently wearing monthly toric lenses who elects to be fit with toric multifocals. When presenting fees to the patient, our administrator would say, “Mrs. Jones, the doctor will be fitting you with an updated CL lens technology to reduce your dependency on reading glasses. The total cost comes to $XX. This covers the examination, lens fitting, a year supply of CLs and follow-up care for one year.” If the patient requests a price breakdown, explain the individual components in further detail.

Also, update your charges, which can help refresh your CL business.

You can take a variety of approaches to this, but I recommend factoring in the MSRP and Internet price to help determine a price or a target minimum profit margin for each lens brand. Consult your CL representative for suggested or average pricing, and research the general pricing trends among the various provider outlets and settings in your practice locale. This information allows you to set your fees based upon your desired profit margin, the socioeconomic status of your region and/or competitor pricing.

While the fees on most lenses you sell will be a bit higher than Internet pricing, you can remain competitive by emphasizing service and convenience, such as liberal exchanges and returns, and by providing “emergency supplies.”

4 Optimize ordering and delivery.

To generate revenue from CL material sales, your efficiencies of operations are critical. With the availability of patient online ordering being “de rigueur,” you must provide this service, in addition to a combination of dispensing from inventory or doctor-directed delivery to effectively compete.

To build a “CL store” into your practice’s website, contact your CL distributor — most provide this service at no charge, and the uploaded pages are designed to match your existing website. Also, implement doctor-directed delivery of new patients’ first six-month or one-year supply, or dispense from in-office stock. This ties them to your practice from the outset.

Additionally, provide helpful reminders, such as a printed wallet-sized card, that detail your practice’s web address and online ordering instructions, should they require extra lenses between visits. Many distributors or web-based patient communication systems e-mail refill reminders to patients as well.

5 Rethink your CL marketing.

The key elements of healthy traffic flow are generating a steady influx of new patients and maintaining a high recall rate on current patients. If you see a drop-off in either of these areas, take a critical look at your internal and external marketing strategies, including the following:

Recall system. Efficient methods include pre-appointing at each visit or sending e-mail or postcard reminders at the six- or 12-month interval. Run an analysis every six months of the patients who did not present on schedule for their appointments, and generate a second reminder. Telephone follow-ups are an effective next step for those not responding.

In-office discussions. There is no better way to market your skills and expertise than through direct conversation with each patient. Ask lifestyle questions at each visit (for example: “Do your glasses fog up or get in the way during your workout?”) This allows you to provide the best patient care, thus increasing revenues and loyal referrers.

These patient encounters include:

1. Refitting current wearers. The returning CL patient is, by far, your most captive audience. The “routine” annual exam is an invaluable opportunity to educate this patient on a new technology, such as daily disposables or rigid aspheric multifocals. Also, be proactive and describe upcoming new products that will target their specific needs, such new materials aimed at combating dryness or new designs offering improved computer vision.

2. Recommending part-time CL wear. This is probably the most commonly overlooked opportunity. Don’t think of patients in terms of glasses or CLs. Patients who wear both enjoy the flexibility and convenience, and you benefit from the duplicate revenue stream. Include questions in your patient history form to identify eyeglass wearers who may be interested in part-time wear.

For returning patients, your technician should probe interest during pre-testing. For example, “You know, Mrs. Smith, now that you will need your glasses for driving and distance vision, you might benefit from CLs for tennis and skiing.”

3. Suitable primary care patients. These patients have a healthy ocular surface and express an interest when the subject is broached. (Your comprehensive anterior segment examination reveals any medical contraindications to CL fitting, such as extreme dry eye or corneal disease.) Spark interest by discussing the enhanced lifestyle and optimized visual performance of CLs.

Additionally, actively identify and treat ocular surface disorders (OSD) in your CL patients, so they remain in CLs. Also, keep in mind that the evaluation and treatment of OSD is a medically billable service.

Internet presence. Be sure your practice website prominently features a section on CLs and the broad categories of lenses you fit. Emphasize your expertise in “problem-solving” custom fitting. Also, create a blog for a “real-time” web presence, and include a link on your website.

Third-party plans. Participating with third-party plans that draw from a heterogeneous demographic gives you access to a broader mix of potential patients and their families. Contact the HR departments of local, private sector and government employers to learn which plans they contract with.

Finishing the project

Set targeted goals, and develop a realistic timeline to implement changes that will revitalize CL profitability. Use this approach, and your patients (as well as your bottom line) will thank you. OM

1. Weisbarth, R. Superior Professional and Financial Rewards from Contact Lenses. Academy for Eyecare Excellence. Accessed December 11, 2013.


Dr. Resnick is a principal in the New York City-based practice of Drs. Farkas, Kassalow, Resnick and Associates, a contact-lens specialty practice. E-mail her at, or send comments to