Ten top tips to build your contact lens business

Nick Rumney and Simon Donne describe how adopting a proactive approach will increase contact lens fittings and offering products and services that deliver the greatest benefits can strengthen patient loyalty

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While the recent amendments to the Opticians Act have undoubtedly brought new challenges for those eye care professionals involved in contact lens practice, they also provide an even greater impetus to ensure that we are communicating with, and proactively managing, our contact lens patients at every opportunity.

It is only by differentiating ourselves from alternative supply outlets, that merely resell contact lenses as just another commodity, that we will provide our patients with a compelling reason to remain loyal to us and to our practices.

With the legislative change requiring that patients visit their practitioner to renew their contact lens prescription before the expiry date in order to establish continued suitability before further purchases are made, we have the ideal opportunity to manage and retain those patients at least once every single year.

This article will focus on how, by properly communicating and demonstrating our skills and knowledge and offering products that fully meet their needs, patients will better appreciate and value our service, rewarding us in turn with their loyalty.

Additionally, by differentiating our practices by offering quality service and products we are best placed to attract new patients based on that strongest means; personal recommendation. Ten suggestions will be made as to how to succeed in the current situation.

Top Tip 1

Make sure your staff are trained and support the practice policies set out in the remaining nine tips

Without enthusiasm and belief by the practice team in the ideas and actions set out below, any unilateral action by the eye care professional will result, at best, in limited success, and, at worst, in failure. Taking the time to train, retrain and support your support staff will pay tremendous dividends over time.

There are excellent training materials available from several major lens manufacturers, including the Academy in Practice six-module programme from Johnson & Johnson Vision Care1 (to be serialised in optician during the next 12 months) and the Bausch & Lomb Academy of Knowledge.

If the practice staff fully understand the benefits that using quality contact lenses can bring to both patients and the practice and ideally actually wear the lenses they promote, they can act as powerful advocates of the strategy.

It is worthwhile getting a close friend to make a mystery phone call to your own practice. Get them to ask about contact lenses and get them to comment on their perception as to the knowledge and manner of your employees in your practice.

Top Tip 2

Get support staff to identify potential wearers and patients who could be upgraded at the time of booking an appointment

By asking some simple and general questions at the time an appointment is booked on the telephone or even when prospective patients are browsing, the practice staff can identify those patients who would be interested in trying contact lenses, those current wearers who are experiencing problems with lens comfort and might benefit from upgrading to lenses that offer performance benefits or those who previously tried lenses and lapsed from wear and might like to consider lenses again.

By marking the patient record accordingly they can set the scene for the discussion that follows in the consulting room. Such questions might be: 'are you a contact lens wearer, have you ever worn contact lenses in the past' and 'is the appointment purely for an eye examination or do you wish to discuss contact lenses as well'. People rarely make a decision on something like contact lenses in isolation and with the receptionist planting another seed your suggestion during the appointment resonates further, making it more likely that they will give them a try.

Top Tip 3

Explain simply and clearly what you are doing as part of your routine and why

This will help patients to better understand how what we do is so important in keeping their eyes healthy, vision optimal and contact lenses comfortable.

An informative commentary builds a professional standing with the patient, making them appreciate the expertise that we provide - for example describing what we are doing when checking for staining using fluorescein under a cobalt blue light, careful monitoring of changes to the limbal vasculature with a red-free filter, evaluating the tears, everting the lids - takes minimal time and serves a valuable purpose.

Be careful with jargon and terminology that you understand implicitly, to practitioners fluorescein is a dye, to a patient a dye may be a permanent stain!

Top Tip 4

Inform patients about new product developments, the benefits that they provide, and offer a chance to trial

This demonstrates a strong desire to provide patients with the best products, care and advice. Patients attending routine aftercare appointments may well be reassured that 'all is well' and 'no change is necessary', but with increasing consumer advertising educating patients, they are far more knowledgeable than ever before and could begin to question whether their existing lenses remain the most suitable option for them.

Be very careful to look for subtle early signs of adverse events such as solution reactions or signs of hypoxia. Be sure to address these at the end of the aftercare visit with appropriate guidance.

By taking this informative and educational approach, we can expect our patients to see the value of maintaining a closer relationship with us than with supply-only outlets, trusting us to look after their eyes and keep them in the healthiest and most comfortable contact lens products.

Top Tip 5

Use in depth questioning during aftercare visits

Recommending trying a new product is more compelling when it addresses an issue highlighted during discussions with the patient. By using in depth questioning, we can relate the product benefits to issues such as long wearing times, reasons for having changed from full-time to part-time wear, their need or desire for overnight wear or symptoms of dryness and discomfort, and so improve their experience with contact lenses.

Moving away from decisions on which lenses to fit based on modality alone and instead towards discussions around benefits is a far more patient-centric approach to take.

With evidence to suggest that we have been failing to adequately address contact lens-related dryness and discomfort, and hence missing the single largest reason for patients discontinuing contact lens wear, it is not surprising that this has become the focus of much attention by some contact lens manufacturers when designing new products.

Top Tip 6

Focus in on discomfort and dryness with specific questions

It is our professional duty, by using careful questioning, to skillfully reveal any issues that surround the level of dryness or discomfort being experienced by the patient.

Patients will often not think to mention it - typically being something they accept as 'normal' or 'expected' and ignored as 'unimportant' by the eye care professional, especially as frequently there are no clinical signs to support it.

In order to uncover the reality, we might ask 'Are you wearing your contact lenses as long as you want to?' or 'Are your lenses as comfortable at the end of the day as they are at the beginning?'

To understand perhaps whether more regular lens replacement could enhance their comfort, the question might be phrased 'Does replacing the lenses make you feel more comfortable?' Dryness symptoms can also be uncovered by listening out for any comments around blurriness, fluctuations of vision, as well as tiredness or heaviness of the eyes while wearing their contact lenses, especially towards the end of the day.

Top Tip 7

Do discuss ocular health

Today's consumers are far more interested in their health than previous generations. Such matters as improved oxygen delivery with new materials leading to whiter eyes, lower modulus materials resulting in less mechanical induced adverse events, ultra-violet blocking reducing the risk of sun-related ocular damage and more frequent replacement leading to reduced incidence of allergies can, and arguably should, be discussed with every patient.

The eye care professional in the high street is uniquely placed to inform patients of all matters relating to eye health and doing this can only lead to a higher standing in the patient's estimation. By combining the dual approach of addressing health benefits and lifestyle benefits, the practitioner can better meet the patient's needs.

Top Tip 8

Offer the best products first

While it may be tempting to offer 'Optician only' products first, ask yourself do they best meet your patients' needs and is this really a long-term strategy to retain patients? The drop-out rate from contact lens wear is surprisingly high. In 2004, 850,000 new fittings took place, but also 800,000 people decided to stop wearing contact lenses.4

If we are determined to grow our contact lens practice, keeping patients wearing lenses has to be a top priority. This is best done by offering products that best meet their needs in three key areas: comfort, vision, and health.

The best products deliver exceptional comfort and vision even in challenging environments like air-conditioned offices and cars, when spending time looking at a visual display such as a computer monitor and when exposed to smoky environments. Many patients restrict their lens wear to fewer hours in a day or fewer days per week than they really want.

A strategy for presenting products to patients in terms of the benefits they offer is set out in Figure 1. In this approach, the best products are offered first and presented in terms of the multiple benefits they offer the patient.

Top Tip 9

Offer a short CL trial to all suitable patients

Research has shown that being proactive and discussing contact lenses with all suitable patients and offering a short 'comfort trial' can increase purchase by 86 per cent.5 This is a simple as saying 'there are two forms of vision correction.

Let me tell you about both of them'. Then the relevant benefits of the two forms of correction can be detailed for that individual patient. A contact lens trial need only last up to a week. With modern high quality products the initial comfort should be extremely high. The purpose of the trial is to ensure that high initial comfort is retained throughout the day and that the lens meets the patient's needs in terms of visual performance without compromising corneal health in any way.

A contact lens trial can be offered in other ways: a highly ametropic patient can be offered lenses to wear while choosing spectacles or while having a visual field examination. This provides another opportunity for patients to experience the benefits of contact lenses and emphasises the importance of a multi-disciplinary approach to contact lens dispensing.

Top Tip 10

Charge appropriately for clinical time

If steps 1-9 have been followed then it should be obvious to the patient that they are being examined in a practice that is offering high quality tailor-made care. This is not available at all the outlets in the high street and certainly not available in supermarket pharmacies or from internet suppliers.

If professional time is clearly identified in the package that the patient agrees to fund then the product can be offered at a price that is extremely competitive with alternative sources of supply, especially if the practitioner deals with companies that offer a pricing policy that does not award high discounts to those sources of supply and operate a 'level playing field' pricing policy.

Additionally there are companies who can help a practitioner evaluate what charge is appropriate to meet their individual practice overheads. For example, the authors have used Practice Plan Plus in conjunction with Johnson & Johnson Vision Care to properly cost out their professional time as a basis for determining their monthly service fee for contact lens patients.

This makes the practitioner the 'primary product'.
However, whatever plan you instigate, be aware that many patients require flexibility. Absolute transparency in charges for fees and product enables patients to choose and ultimately many will upgrade to an all-inclusive package once they understand the benefits.

Summary

In conclusion, by emphasising our professional skills and offering new innovative products to our patients as a way of meeting their comfort, visual and ocular health needs, we are taking important steps in building and maintaining their confidence in our professional capabilities, while underlining their dependence on our expertise, helping them to continue enjoying comfortable, healthy contact lens wear in the long term.

Viewing the changes in the legislation relating to contact lenses as anything other than an opportunity to communicate openly and transparently our belief in the standards of care we provide is an opportunity missed and the start of a downhill spiral of confidence.

By systematically adopting the strategy set out above, the authors have seen a significant increase in the number of lens fittings in the last three months and an increase in practice turnover from contact lens work.

This is beneficial for both the patients and the practice. Despite new entrants into the marketplace, the independent optician will continue to thrive providing he or she adheres to the essential principles that have distinguished the sector in the past: offering a level of unsurpassed personalised service using products that meet the needs of every individual patient.

References
1 Morgan S. 'Training the Team.' optician, 2005; Vol 229 No 6003.
2 Young G, Veys J, Pritchard N and Coleman S. 'A multi-centre study of lapsed contact lens wearers.' Ophthal Physiol Opt; 2002; 22:2 516-527.
3 Chalmers R, Begley C. Use your ears (not your eyes) to identify CL-related dryness. optician, 2005; Vol 229, No 6000.
4 Vision Trak TNS, May 2004 data.
5 Star Study NOP Healthcare 1996. 

* The authors have spent a combined total of 44 years in clinical practice and own practices based in Hereford and Bedford