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Front of house staff (FOH) need to strike up a contact lens conversation with customers with confidence, recognising the opportunities this can offer both the patient and the business.
The accessibility of FOH staff means that they are often bombarded with questions – not all of which can be answered accurately. A frequently asked question is ‘how much are contact lenses?’ If only prospective wearers knew all the possible permutations and combinations that exist, they would better appreciate the challenge in giving an answer.
It can be frustrating for patients to get responses such as ‘it depends’. In many cases, they simply want some information – any information. They need an idea of the mystery that is the ‘contact lens’. They often do not know what is involved in buying them, let alone the process of fitting and deciding which lens is best for their eyes and appropriate for the amount of time they would like to wear them; some do not even realise there are so many to choose from.
To answer the ‘how much?’ question, a little more detail about contact lenses and the process of being fitted is needed, as well as imparting a little information about the most recent and popular contact lenses currently available. After all, the objective is to turn an enquiry into a happy contact lens wearer.
Potential contact lens wearers need you!
[CaptionComponent="2187"]For many, wearing contact lenses can change their life for the better. Yet more than half of people who could wear contact lenses do not know this is a possibility for them. Whilst it would seem natural for them to ask, they often do not, and are reliant on their eye care professional (ECP) or staff in the practice to make the suggestion.
When making appointments, ask if the appointment is for spectacles or for contact lenses, as this question gives everyone an opportunity to express their interest. During the course of their practice visit, having the eye examination and choosing new spectacles, people often forget to ask about the possibility of trying contact lenses. Be sure to ask this question up front, so no one is missed.
In some cases, the idea of trying contact lenses has never come to mind. Discovering their experiences wearing spectacles, and uncovering the situations in which spectacles are not ideal for them, highlights opportunities where contact lenses could be a complementary solution to their spectacles. A common myth is that someone is ‘either a spectacle wearer or a contact lens wearer’; in reality, mixing and matching is a very popular choice.
When someone is a happy spectacle wearer, it can be good to suggest contact lens wear for occasional use, and this is often very appealing. To hear someone say ‘no one has ever suggested that before, what a great idea!’ is very rewarding and helps boost customer confidence and loyalty.
FOH staff are well placed to open up conversations leading to potential contact lens consultations. For the prospective contact lens wearer, finding information on which to base their purchasing decision is difficult. This is why so many resort to the only sensible question they are able to ask – ‘how much?’. Success with contact lenses is driven by achieving good comfort and good vision. Most people considering contact lens wear do not realise there are many different types of soft contact lenses from which to choose. Soft lenses are typically replaced on either a daily disposable, single-use basis or a reusable, frequent replacement programme.
In addition to this, there are a wide variety of lens powers to cover the vast range of needs from long-sightedness to short-sightedness, a wider than ever range of lenses for astigmatism. Over the past few years, there has been significant development in the manufacturing of disposable soft contact lenses for astigmatism, and this means that many more people with astigmatism can wear contact lenses. In addition, there are multifocal lenses for patients who require an additional prescription for near work (usually from the age of 40-45).
One of the main reasons someone chooses to wear contact lenses is to be cosmetically free from spectacles. There are, of course, other more practical reasons, such as taking part in sports where spectacles might move up and down on the nose too much, fall off or steam up, or that spectacles cannot be worn comfortably under a helmet or visor/diving mask.
For some occupations, such as tradesmen, where they have to negotiate ladders or lie under things to fit or repair something, spectacles have a limited area of vision and the wearer can find themselves looking underneath the rim and not being able to see properly. Contact lenses provide all round vision and move with the eye, which means the wearer has vision at all distances. This is especially the case once people reach the stage where they need a ‘reading add’ with their prescription, and require progressive varifocal lenses, bifocals or separate reading glasses. Multifocal contact lenses can make the difference in being able to continue in the same occupation or hobby, or not. Awareness of multifocal contact lenses is low, so these products need even more discussion to help promote them in the practice.
[CaptionComponent="2188"]Lens selection
Whilst the ECP will use the up-to-date spectacle prescription as the basis for choosing the best lens for vision (eg a spherical lens, a toric lens, toric lens for astigmatism, a multifocal lens for those with presbyopia who require a reading addition), there are other choices to be made which impact on the ‘feel’ of the lens.
The most popular soft lenses prescribed are either single-use, daily disposable or frequent replacement (replaced monthly or more frequently and used with a daily cleaning and disinfecting solution and stored overnight in a case in disinfecting solution). When discussing these two options, daily disposability is the most convenient and hygienic way to wear contact lenses. However, in some cases, due to a more unusual prescription, frequent replacement is the only option.
The key benefits of daily disposable lenses to highlight with prospective wearers are:
• Single-use – wear once, and then simply throw away
• No need for any cleaning or disinfecting solutions – simple and convenient to use
• Compact – so they are great for travel (easy to carry a spare pair or two)
• Hygienic – a fresh pair is used for each wear
• Comfort – due to single use fresh lens are at their best every day (lenses that are reused suffer from a film building up on the surface of the lens which increases as the lens ages)
• Great range to choose from – there are many possible prescriptions as well as a great range of different materials to choose from (including high oxygen silicone hydrogels especially for wearers who need long duration wear).
After they have gone home…
One of the great concerns that ECPs have once a wearer begins their journey, is how well they stick to the advice on how to wear and care for their lenses. In the case of daily disposable lenses, the instructions are simpler. The wearer needs to always wash and dry their hands prior to lens application and the same routine is also followed prior to removing their lenses. In the case of reusable lenses, not only does the wearer have to always maintain good hand hygiene, but they also have the extra steps of cleaning and disinfecting their lenses after every wear.
Additionally, they have to disinfect their lens case after every use and replace it as recommended. Case care is an essential element of good hygiene practice, as the contact lens case harbours germs and quickly becomes contaminated if not cared for as directed. Removing the requirement to clean and disinfect along with storage case use (i.e. moving to daily disposable lenses) removes the risks. Hand washing, cleaning and disinfecting and case care are common failures with contact lens wearers, and they need constant reminding at their progress visits to comply with the recommended advice.
Disinfecting a lens case
Wearers who use reusable lenses with solutions must be up to date with the latest case cleaning advice:
• Rinse the lens case and lids with disinfecting solution use tissue to dry the lens case
• Leave to air dry face down on a clean tissue — preferably not in a bathroom which can have mobile germs, some of which come from the ‘aerosol effect’ when a toilet is flushed Contact lens cases are best kept in a bedroom, and if stored in the bathroom, this should be inside a closed cabinet to minimise contamination.
The first few days of wear
It is important to be aware that one in four new wearers stops wearing lenses in the first 12 months of wear, with a quarter of these ceasing wear in the first 30 days and almost half of them giving up at or around the two month stage.
This means all new wearers should be closely supported, especially during this critical learning phase in order to increase their chances of success. The most common reasons for dropping out include vision problems, discomfort and handling difficulties. All advice given about these elements amplifies the potential for success (both in terms of the type of lens fitted as well as handling strategies that optimise comfort).
For example, an inside out soft lens tends to move around more on the eye which, in turn, could affect both vision and comfort. An inside out lens will not affect vision or harm the eye in any way, but it will not be comfortable and it will tend to move about more or even get blinked out. A new wearer, due to lack of experience, does not yet know what ‘comfortable’ feels like, and this means they can often mistake an inside out lens as being OK and wear a lens this way round all day with relatively poor comfort and variable vision.
Teaching this well is paramount to long-term success, so any new wearer experiencing difficulties with this must be given another opportunity to master the technique. Mastering this when being taught how to handle lenses is an essential starting point.
New wearers need to be viewed as ‘new babies’ requiring a great deal of nurturing in their early days. Six months on, and they are more or less an accomplished wearer. When the time involved in fitting a new wearer is considered, it seems a false economy to spend little time training them on handling skills and not keeping a careful eye on them in the first couple of months.
What strategy is followed for your new wearers?
[CaptionComponent="2189"]Below are some suggestions that help support new wearers at the start of their contact lens-wearing life. Arrange to make contact by phone in the first week after collecting the lenses – ideally by the member of staff who taught the patient how to wear and care for their lenses. Questions to ask:
• How are you doing with your new contact lenses? If prompts are needed:
• How is the comfort?
• How is the vision?
• Handling represents a significant area which impacts vision, ease of use and convenience, time taken at the start of the wearing day, and, importantly, comfort:
• How do you find taking the lens out of the packet/case?
• How are you getting on with telling if the lens is the right way round/inside out?
• How are you managing with applying the lenses?
• How are you finding the comfort of your lenses immediately after application?
• How have you got on with removing your lenses?
Pre-appoint the follow-up visit with the ECP 7-14 days after lens collection and have a system in place for any wearer who does not turn up for this appointment. Non-attendance needs to be followed up – perhaps the new wearer could not manage to get their lenses on that day? Re-book another follow-up appointment.
Pre-appoint a follow-up visit at 2-3 months (as advised by ECP) for a progress check to evaluate if the current lenses are matching needs or whether a different lens type would be more appropriate.
Follow-up
Progress visits (sometimes referred to as aftercare appointments) are important for the long-term success of the contact lens wearer. Not only are the contact lenses checked for vision performance, an assessment is also made on how that specific contact lens product is performing for the individual wearer and how they want to wear their lenses.
In some cases, a lens of different material, edge design or replacement frequency is required to enhance comfort, or perhaps additional lenses are required for a specific holiday or event. Servicing the wearer in this way helps to provide them with the opportunity to report on any areas for improvement. Given that contact lens technology is fast moving, wearers should expect new product innovations over time. Their attendance at the practice is essential if they do not want to miss out on future developments.
First lens, right lens?
Whilst the ECP endeavours to prescribe the best lens first time for the new wearer, it is inevitable that a period of evaluation is needed. Keeping in close contact with new wearers helps in this review process, and front of house staff can assist ECPs by relaying the feedback obtained from new wearers.
Carefully managing every new wearer as a precious ‘new baby’ is key to their success and the long-term growth of contact lens sales in the practice. It could be you who makes a difference to someone’s life. Just one question from you to start the conversation could be all that is needed to save someone from a lifetime of feeling self-conscious in glasses – or even prevent them from giving up at the very start of their contact lens-wearing journey with just a simple tip on lens handling.
Read more
Part 2: Why are disposable contact lenses ideal for the new wearer?
Part 3: Keeping everyone up to date with contact lenses
Part 4: Dealing with enquiries about contact lenses
Sarah Morgan BSc (Hons) MPhil, MCOptom, FAAO, FBCLA is an optometrist and an internationally-recognised communication expert, and a vision sciences fellow at the University of Manchester.