Younger patients have demonstrated compliance with contact lens replacement schedules and lens care. So it makes sense to introduce them to the most compliance-friendly contact lens modality, with single-use 1•DAY ACUVUE® MOIST® Brand Contact Lenses. In a recent study of approximately 500 myopic children ages 8 to 11 years old, children wearing contact lenses showed greater improvements in self-perception compared to children who continued to wear glasses.1 These improvements were specifically seen in the areas of physical appearance, athletic competence, and acceptance among friends. In addition, children who disliked wearing glasses felt more confident in their schoolwork when they began wearing contact lenses. These results make it clear that fitting your younger patients in 1•DAY ACUVUE® MOIST® Brand Contact Lenses can truly make a difference!
1. Data on file. Johnson & Johnson, 2008.
The level of maturity of each young patient and the degree of parental oversight and support should be taken into account in assessing whether the child can follow your recommended wear and care instructions and is a good candidate for contact lens wear.
ACUVUE® Brand Contact Lenses are indicated for vision correction. As with any contact lens, eye problems, including corneal ulcers, can develop. Some wearers may experience mild irritation, itching or discomfort. Lenses should not be prescribed if patients have any eye infection, or experience eye discomfort, excessive tearing, vision changes, redness or other eye problems. Consult the package insert for complete information. Complete information is also available from VISTAKON®, Division of Johnson & Johnson Vision Care, Inc., by calling 1-800-843-2020 or by visiting jnjvisioncare.com. ACUVUE®, 1•DAY ACUVUE® MOIST®, and VISTAKON® are trademarks of Johnson & Johnson Vision Care, Inc.
E-commerce affects nearly every product and service in the marketplace, and prescription eyeglasses will be no exception. Current estimates are that Internet sales of eyeglasses represents about 4% of all eyeglass sales in the US. That is already a significant segment and I believe it will continue to grow.
This new form of competition will prompt many questions and strategies for traditional eye care providers (ECPs). We can think of the challenges in two major categories: 1) how to manage patients who wish to purchase eyewear online and 2) how to compete with the new pricing model the Internet will bring to the marketplace. Here is a recent email I received from a reader that gets right to the heart of the first issue.
Q. How should we handle the following issue with patients? We've spent time with them finding a frame that will work with their Rx, fits them properly, and is the style they were looking for, etc. Then they let us know they would like the frame information so they can look at another optical where it is possibly less expensive, or to try to find the frame online and come back to us to have lenses made?
We read your Tip of the Week on Internet glasses, and have made a handout for those patients interested in purchasing the complete pair of glasses online. But we've had a few patients lately that would like the frame information for various reasons. We are hoping for suggestions on how to handle this.
What information to provide
I have had this situation in my practice as well, and I believe we will see it more often in the future. Here is how we handle it: my opticians will freely provide the frame brand, model number and color upon request; we'll even write it down for the patient. To not provide the information that would allow shopping around is to be uncooperative and you will damage the patient relationship. Let's not forget how valuable that relationship is. You want to remain the eye doctor for this patient and his family for many years to come, even if you only provide eye exams. And there is a good chance that the patient will return to your office to buy this pair of glasses after they shop around, if you handle the situation well. In many cases, the patient will purchase a frame on the Internet and then bring it in to your office to have lenses made for it. You have a huge advantage in patient loyalty and trust that other eyeglass vendors don't have, let's not blow it.
We also provide our advice about what lens material, design and options would be best for the patient because I view that as part of good eye care. That information may be discussed in the exam room by the doctor or in the optical by an optician. We counsel patients about the differences in quality that exist in among lenses and lens treatments and caution them to avoid low quality products.
What we don't provide
On the other hand, when we are not selling the product, I don't believe we are obligated to provide the technical services that go with the order. Those services are generally paid for in the markup of the materials, although some ECPs outside the U.S. charge a dispensing fee instead. In any case, it is the responsibility of the seller to provide the measurements. While that can be a challenge for Internet vendors, traditional ECPs should not be lulled into thinking they will not find ways to overcome the obstacles of seg heights, PDs and other fitting requirements. Technology already exists that can remotely provide this data and it will improve.
My opticians decline to provide eyeglass fitting information to patients wishing to shop elsewhere by politely telling the patient that we provide those services for eyeglasses purchased from our practice. If glasses are purchased somewhere else then that supplier will take the measurements. If the patient says he intends to buy the glasses online, we certainly understand and we inform the patient that the Internet source should provide instructions for those measurements. We go on to explain that we take full responsibility for the eyeglass measurements when we make the glasses, but we can't accept that responsibility if another company makes them.
I define the eyeglass fitting information as the seg height, PD, vertical optical centers, eye size, bridge size and temple length. If a vertex distance is needed, that is clearly part of the prescription and should be provided. The PD is debatable and could be considered part of the spectacle Rx although many experts would say it is in the domain of the optician. Always follow applicable laws if the PD is a requirement in a lens prescription, but we don't typically measure the PD accurately until we actually order glasses.
Eye size, bridge size and temple length could be factors that patients request your assistance with because they may feel like it is basic frame information that is available if they are trying on frames in your office. Our approach here is to always be honest and helpful. We would explain that an eye size or bridge size is not like a shoe size where it is generally the same for any given foot. Eye sizes can vary quite a bit and still provide a good fit. Much depends on the frame style and shape, the lens Rx, and the look the patient wants to achieve. After the brief explanation we would tell the patient the sizes of any frame they try on so they have the information, but we would not actually approve the fit unless we are selling the glasses.
I think it helps the situation to not take the measurements or finalize the frame sizes until the patient commits to the purchase. Once the frame selection is finalized, the optician can move on to lens design. After all lens options are determined and prices are presented, the optician should have a good idea if the sale is going to occur. If necessary, he can simply ask if we should go ahead and order these glasses. At that point, the frame is given a final size check and seg height and PD is measured. If the patient reveals his intention to shop elsewhere, there is no need to do the fitting work.
Teach your staff to remember the principle that the long term patient relationship is more important than the eyeglass sale, so always try to cooperate with the patient's wants and needs but stay within office policies. An educational patient handout about Internet eyeglass purchases is a very smart idea. See Tips #358 and #359 for more on this.
A non-emotional view
Let's recognize that the consumer has a right to buy products from any source he chooses and saving money is a motivation most people share. Indeed, many of us buy products online after browsing for them in local stores. I understand that eyeglasses require some technical services to be fitted well, but the principle still applies. The free marketplace system serves us well, even though it can present new challenges in the form of innovative competition. I suspect traditional ECPs will increasingly offer e-commerce services for eyeglasses on their own practice websites, just as many do now for contact lens ordering.
Online eyeglass sellers have a huge advantage in reduced overhead because they don't have a “bricks and mortar” outlet and fewer highly trained employees. These companies may not even have an inventory of frames and lenses but rather just place orders for products as they arrive from the consumer.
What do ECPs have going for them that strict online retailers do not? We do have bricks and mortar offices, well-trained employees and an inventory. Our advantage is that we can provide the professional and technical service that makes the eyeglass sales process and the finished product better. Those services allow us to charge more for the product. The market will decide, ultimately, what that additional markup is worth.
Best wishes for continued success,
Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week
Dr. Gailmard's new book, Practice Management in Optometry: A Blueprint for Success Based on the Optometric Management Tip of the Week, is now available on Amazon.