If contact lenses provide a myriad of benefits including clear, unobstructed vision, an enhanced ability to play sports and an opportunity for practices to expand their service – why is Australian market penetration lagging behind where many experts think it could be? Insight investigates how practices can leverage contact lenses for their business.
A recent report by the Contact Lens Institute (CLI), in partnership with the Vision Council, has highlighted a disparity between attitudes on contact lens dispensing in practices and the actual behaviours that back this up.
Entitled The Culture Calculation: Data-Backed Behaviors for Contact Lens Success, and published in October 2023, the report shines a light on the beliefs and behaviours of eyecare professionals and outlines opportunities for growth in this space.
Prior to the Culture Calculation report, CLI had developed a range of consumer research reports as part of its ‘See Tomorrow’ initiative detailing often overlooked opportunities for practice success. However, with the latest report, the CLI sought to identify how certain actions were prioritised and to make practices think hard about their own contact lens culture.
“A positive contact lens culture is something we have all experienced – a ‘we know it when we see it’ state. Our research was designed to pinpoint what elements are involved in creating, nurturing, and expanding on that ethos,” says CLI chairperson Dr Michele Andrews who doubles as vice president of professional and government affairs at CooperVision-Americas.
“Our hope is that our Culture Calculation report makes professionals question if their own behaviours and those of their team are helping or hindering their contact lens fits. If the latter, it’s exploring ways a team is falling short and making a plan to up their game.”
The survey was deployed to gauge the sentiments of individuals representing a range of eyecare professions in North America – including optometrists, opticians, ophthalmologists as well as practice managers. With 173 qualified responses received, the report uncovered the complexity of contact lens culture and its untapped potential, with the findings having potential implications for contact lens prescribing habits in Australia.
Insight talks to local practitioners with a special interest in contact lenses equipped with the expertise to counsel the industry on how to foster a positive contact lens culture in practices. They explain ways to leverage their benefits, have the right conversations with patients and implement strategic processes to harness the full scope-of-practice.
Cultivating a positive contact lens culture
In the Culture Calculation report, 94% of respondents said their practice has a positive contact lens culture. Yet, 84% of practices say they encourage doctors and staff to recommend contact lenses and encourage patients to consider contact lenses.
What’s more, only 49% of respondents admitted to discussing the possibility of contact lenses with most of their eligible non-wearing patients. Additionally, CLI’s 2022 research revealed that two thirds of vision-corrected patients did not recall having a conversation about contact lenses. And, in a related survey earlier in 2023, 44% of glasses-only wearers expressed interest in contact lenses, but stated the possibility was never raised by their doctor or staff.
These disparities perhaps represent a disconnect between beliefs and actuality.
“It’s good that almost nine in 10 practices encourage doctors and staff to recommend contact lenses, and encourage consideration by patients,” Andrews says.
“The struggle comes in doing so consistently – only half of practices discuss the possibility of contact lenses with the majority of their eligible, non-wearing patients at every encounter. And more than half of practices indicate that less than 40% of patients are prescribed soft contact lenses. This is a struggle of our own making.”
Mr Martin Robinson, a Tasmanian independent practice owner and national president of the Cornea and Contact Lens Society of Australia and optometrist of 30 years, believes optometrists envisage themselves as caregivers whose primary goal is to adhere to patient safety. Although true, this may mean that patient satisfaction is overlooked.
“We can achieve patient happiness by giving them the full benefit of ocular corrections. Not just health, not just making sure their eyes are healthy, but actually ensuring that their lives are fulfilled,” Robinson says.
Mr Gavin Boneham, of Boneham Optometrist Eyecare Plus in Sydney’s CBD – one of the oldest contact lens practices in the country – agrees with the sentiment that patient satisfaction should accompany patient safety.
“Optometrists feel like they’re clinicians and they shouldn’t be selling things, but it’s a service that you’re offering to people,” he explains.
The Culture Calculation found that eyecare professionals are often not discussing contact lenses with their patients who only wear glasses, as they assume the patient will ask if they’re interested.
Andrews says it’s important that professionals raise the topic and waiting for a patient to ask isn’t best practice. Patients’ lifestyles should be discussed, such as workplace routines, sports, fitness and fashion, so it can be determined if they are well-suited for full-time or part-time wear.
“We’ve found that many practices are waiting for patients to ask about contact lenses, while the patients are waiting for their eyecare professionals to raise the subject. There’s massive opportunity if we simply talk about what contact lenses offer, how they may improve a patient’s life and then recommend a trial,” she says.
There’s also a myth that discussing contact lenses may take an inordinate amount of time, which Andrews says is far from accurate, especially if practices build those conversations into multiple aspects of the patient visit, from the intake form to the exam lane to check out and follow-up. She says this small investment of time can result in higher patient satisfaction and practice success.
However, if patients are aware of the option, but apprehensive to the idea of contact lenses, Boneham emphasises the need for important conversations to quash fears, provide alternatives and offer a tailored service.
“I find it to be pretty natural, to have a fear of putting something on your eye. Almost everyone has that fear,” Boneham says.
Andrews says candidacy should not be a limiting factor, with most patients able to wear contact lenses. However, many people are unaware of their candidacy which results in low uptake.
“For many patients, they’re simply not aware that they are candidates for contact lens wear. They may have presbyopia and are not familiar with multifocal contact lenses. They may have worn lenses years ago and aren’t familiar with advances in comfort and vision that could shift their experience. They may have heard a myth from a friend that scared them off, which our research says is not all that uncommon,” Andrews says.
Benefits on many fronts
For many patients, the benefits of contact lenses exceed the drawbacks. Chief among these is the seamless vision correction and unobstructed peripheral vision, according to Boneham.
“The visual field of contact lenses is not restricted like it is with glasses. And patients often remark ‘wow, this is really good’,” he says.
Ms Jillian Campbell, of Richard Lindsay & Associates in Melbourne, which primarily serves specialty contact lens wearers, uses benefits such as lifestyle flexibility, wide field of view and convenience as ways to drive contact lens uptake.
“For patients, the benefits include improved vision quality, lifestyle flexibility, and comfort. For other (non-contact lens) practices, increased uptake supports their business by diversifying their services and enhancing patient satisfaction, which in turn promotes loyalty and referrals,” Campbell says.
Robinson adds: “I’ve got a patient that wears disposables for a month each a year. She goes up to the tropics and dives every day. That’s what she uses contact lenses for. That’s something that gives her an ability to enjoy her passion,” Robinson says.
The benefits of contact lenses extend beyond patient satisfaction and enable practitioners to expand their scope-of-practice too. Not only are there diverse options available, but selecting the right one for the patient and tailoring the service can make optometric practise more invigorating for the clinician.
“Contact lenses are much more interesting to work with. Even though the latest contact lens technology is really good, you still have to choose the right ones and choose the right fit for people,” Robinson says.
Boneham says that despite practitioners’ concerns that people will source contact lenses online, the service provides opportunity to expand the patient base.
“Optometrists may think, ‘if I’m going put all this effort into teaching this patient how to put these lenses on and take them off, then they’re just going to go start buying them over the internet’. They may think that’s a bit of wasted time,” he says.
“The patient network doesn’t end with this patient. They may tell friends or family about the service they’ve received. Fundamentally, clinicians are providing a service to patients and will respond positively.”
Andrews agrees, stating that there can also be revenue advantages, whether through providing both contact lenses and glasses, offering sunglasses, and through contact lens-specific services.
“Beyond that – and our culture research points this out – 75% of practices believe fitting lenses leads to emotional gains among staff. They’re directly changing lives,” she says.
Education is the crux
A first step in driving a positive contact lens culture is self-awareness. Making a conscious effort with staff empowerment and education can be key to cultivating this.
Andrews cites the CLI’s See Tomorrow reports as a great baseline for enhanced practice productivity in this space, offering invaluable tools to identify challenges, and areas of strength that could still be improved.
“Ongoing education offers fantastic opportunities to address those needs. That includes manufacturer-led training from the contact lens industry, whether at conferences, online, or within the practice environment. Reaching beyond the eyecare world to more general business management seminars might also provide a spark,” she says.
The CLI’s report found 81% of respondents placed the greatest value in education and in-practice advocacy. In alignment with this, Campbell, Robinson and Boneham describe education as the crux of a positive contact lens culture – for patients and staff alike.
They dedicate time during each staff meeting where they review the science and latest technology of contact lenses. If staff are up-to-date, this knowledge will help bolster purchasing incentives and provide a point-of-difference.
“We emphasise continual education, ensuring our team is well-versed in the latest contact lens technologies and trends,” Campbell says. “This includes training sessions and encouraging staff to stay informed about industry advancements. Staff are involved in complex fits, including assisting with insertion and removal of lenses, conducting scans, and teaching patients.
“By educating both our staff and patients about the benefits and advancements in contact lens technology, we can address misconceptions and highlight the practical and lifestyle advantages of contact lenses.”
Boneham says practices should have staff meetings every week to discuss topics such as new lenses or new packaging of disposables.
“I’ve been in the game for 40 years, and you can see it’s getting better and it’s going to be better in another five years. The range available to us now is fantastic,” he says.
A positive contact lens culture should emanate throughout the entire team – from the front desk to the consultation room. Training staff and having them acquire the right qualifications to alleviate some of the work with contact lens education for patients is one step to achieving this.
By investing in staff, Robinson says that practices can cultivate valuable resources.
“If you have a support staff member that’s trained on it, they’re upskilling which means they’re really motivated, and it gives them time to shine. Why not make the most of those staff and utilise them in that way?” Robinson says.
“They can also be trained on insertion and removal instructions and talk about contact lens care practices.”
This can also be invaluable when optometrists are short on time with a full appointment book.
“You’ve got to have an idea about how you manage contact lenses in a busy practice and that means having a support team member that’s dedicated to this area. They might look after all contact lens ordering as well, for example,” Robinson says.
Informed decision making also empowers patients, equips them with the knowledge to select options that are best for them and increases satisfaction. With this is mind, Boneham makes it a priority to inform patients of the risks and benefits.
“We should be suggesting it to patients; let them make the choice,” he says.
Robinson suggests having staff wear contact lenses. Ideally, this would include a variety of age brackets and different types of lenses to model as many options as possible to patients.
“I had a practice manager who wore soft contact lenses for a very long time,” he says. “She had intolerances and other problems so we put her into dailies, and that’s what she would tell patients when we got her to talk to them about contact lenses.”
Beyond education, the CLI’s report cites product accessibility – especially access to fit sets – as the chief component of a positive contact lens culture. Robinson recommends having trial lenses ready to go as availability and timely delivery are important.
“Quite often they will be happy with the result of that trial,” Robinson says.
“I’m happy to do trials for people for one week with a cheaper, generic contact lens and then one with a better lens and almost always those trials come back with significantly happier patients with the better contact lens.”
However, once a trial is initiated, it’s imperative to take the time to have conversations on how to properly handle contact lenses as well as following up to seek the patient’s feedback.
“You should be managing your patients if you’re doing new fits with them. You should be getting them back for reviews and not just giving them a trial and setting them up,” Robinson says.
Engaging the entirety of a practice
The CLI’s report also unveils the power of dual wearing opportunities. It revealed 20% of glasses-only wearers considered purchasing contact lenses as well if they were bundled with the glasses at a discount.
Meanwhile, 80% of respondents cited the importance of developing unique offerings and purchasing incentives for prospective contact lens patients.
“Some of our past research showed that dual wear – prescribing both glasses and contact lenses – is appealing to patients and is very good for practices. It is important for eyecare professionals to raise this, since many people believe it’s a one or the other proposition,” Andrews says.
“Our latest work on culture also indicates talking about what’s new in contact lenses works, including advances in materials and designs that allow wear by a much larger number of people than ever before.”
Practitioners can provide customised solutions by trying to understand each individual’s needs. They should ask open-ended questions and discern what is suited to their lifestyle.
“We leverage the potential of dual wearers by understanding their lifestyle and vision needs, offering them the flexibility of both contact lenses and glasses. This approach helps them appreciate the benefits of each option in different scenarios,” Campbell says.
Robinson cites dispensability as another important factor. If a practice has sufficient stock on hand, then it would be worth their while to discount contact lenses when sold in bulk. Although discounts can undermine practices’ bottom line, selling in bulk is advantageous.
“I tell patients that this is the price for three months, but if you want to buy for six months, it’s this price, and if you want to buy 12 months, it’s this price. So, you can afford to offer some discounts on a bulk buy,” he says.
Technological investments can also be invaluable to increasing contact lens penetration, according to Boneham. For example, he invests in OCT with anterior imaging to optimise contact lens fitting.
“Always keep the patients informed about the latest technologies but also invest in contact lens related technology,” Boneham says.
“You have to always be investing in the latest technology so you can fit the best lenses for your patients. That’s what it’s all about – looking after them and getting them seeing as well as you can.”
Patients may also be concerned about factors such as makeup and makeup removal while wearing contact lenses. Robinson ensures he mitigates concerns by consciously stocking the appropriate products and educating patients on safe makeup use.
“We sell ocular surface safe makeup and makeup removal products. I talk to people about makeup use, especially mascara use because it’s the most dangerous for the ocular surface,” Robinson says.
“I also have my staff try the makeup so that they can also talk to patients about it.”
Andrews emphasises the transformative role contact lenses play and the profound, untapped potential an expanded scope-of-practice can offer staff and patients.
“Contact lenses play an incredible role in the lives of millions – with the potential to do the same for millions more. By engaging the entirety of a practice, we can find ways to embrace a positive contact lens spirit and convert those views into actions tailored for each setting and patient,” she says.
More reading
How optometrists can cultivate positive contact lens culture
The power of dual contact lens and glasses wear
Finding your niche with a specialty contact lens clinic
