Perennial Allergy Relief: A Practice Builder

Spring brings seasonal allergies, but it also is important to provide eyecare for patients with perennial allergies unrelated to seasonal changes. You will be rewarded with loyal patients who let others know of your services.

Allergies related to the change of season in the spring and fall is so common that many think exclusively of it when the topic of ocular allergies comes up. Providing for seasonal allergy patients is essential, but don’t overlook another segment of allergy suffers–those with allergies unrelated to these common factors. Here are key points to keep in mind to serve patients with allergies that don’t go away with the passing of spring or fall.

May Be a Systemic Reason for Allergies

Most nonseasonal, ocular allergies are associated with dust or dust mites, animal dander or mold. Another chronic ocular allergy called vernal conjunctivitis worsens in warm weather, but is not due to typical seasonal triggers such as pollens. Instead it is an IgE mediated mechanism found in some patients who also have a family history of other atopic diseases such as asthma, eczema or hay fever. GPC (giant papillary conjunctivitis) may also result as a form of ocular allergy to long-term buildup of deposits on contact lenses worn for a prolonged period of time. Acute reaction to some forms of cosmetics is also not uncommon.

Bill Medical, Rather than Vision, Insurance

The amount of reimbursement varies from one insurance company to the next, but you would generally receive approximately $90 to $110 for the initial visit and $39 to $65 for each follow-up visit. You should typically see the patients an average of three times to diagnose, begin treatment and follow up until their symptoms are resolved and they are stable, and then again several months later to make sure they are still OK.

A Potentially Significant Group of Patients

The more severe cases are chronic allergies. Chronic allergies often can be inherited and/or the patient has a history of hay fever, asthma or eczema. Patients are typically younger–early 20s or younger. It is more common in males than females. Many of these cases are children. Practicing in the tropics also had an impact with warm weather often worsening the symptoms. Long-time contact lens wearers who wore extended wear lenses without frequent replacement, who then developed GPC, also were common. Middle-age females would account for most of the cosmetic reactions leading to allergies.

Know the Signs of Non-Seasonal Allergies

Most of the time these patients would come in complaining of discomfort and show clinical signs such as moderate to severe injection, minimal to moderate lid edema or just heaviness of their eyelids. Other common signs of  this form of allergies include mucus discharge, itching and/or burning eyes. At times these patients also would experience concurrent rhinitis. Other times they would complain of contact lens intolerance and come in wanting a new contact lens prescription thinking that is what they need.

Prepare to Treat Non-Seasonal Allergies

There is no special equipment beyond the typical instrumentation needed to diagnose this form of ocular allergy. Most of the examination can be done directly and with the aid of a slit lamp. Corneal dyes are often used to aid in the examination.

Understanding the pathology and clinical picture of these conditions and the differential diagnoses is important. Along with taking advantage of ocular allergy learning opportunities at conferences, keeping up with the related medical literature is also extremely helpful.

Educate Your Patient

Helping the patient understand what is happening to their eyes and explaining both the realistic short- and long-term expectations are what most patients want, in addition to the most rapid relief possible. This will provide the patient piece of mind. If there is something the patient can do to improve their situation and prevent issues in the future, such as more frequent replacement of contact lenses (like daily replacement), then explain why this change is necessary and how a change in their contact lens routine may lead to greater comfort.

Post-LASIK Education: Let Patients Know They Still Need You

Providing ongoing care for post-LASIK patients keeps them in your practice and ensures that they receive the services and products they need.

LASIK has become a common procedure improving the lives of many of those who undergo it, but many of those same patients don’t realize that they still need to visit their eye doctor annually. In addition to co-managing pre- and post-operative care for LASIK patients, ODs need to educate these patients about why they still need to visit for a comprehensive exam each year. Education also is needed about which products, such as sunwear, are still beneficial, and why a successful LASIK procedure doesn’t mean a patient won’t need to address presbyopia.

Vision and Eye Health Could Change

Although patients can now see well, they need to be examined on an annual basis. For those getting close to presbyopia, they may need reading glasses in the near future and need to continue monitoring their eye health for such issues as glaucoma, cataracts and macular degeneration. Other LASIK patients are very non-compliant and literally disappear after their surgeries, either showing up rarely or never again.

Monitor and Treat LASIK-Related Dry Eye

Many LASIK patients are people who have had dryness issues that affected their ability to wear contact lenses and require treatment methods for anyone who has dryness including lubricants, Omega 3 supplements and punctal plugs when necessary.

Educate On Added Need for Sunwear and Driving Eyewear

LASIK patients are more prone to glare problems after surgery, especially at night. Many patients have LASIK with a monovision modality, so their eyes are unbalanced for distance vision and these patients can often benefit from night driving eyeglasses, as well, that balance both eyes to distance.

Monitor Eye Health Long-Term

Continue to monitor post-LASIK patients for the same medical eyecare problems that can affect anyone such as glaucoma and cataracts. Also monitor the cornea for any signs of a condition called ectasia, which is an abnormal thinning and bulging of the cornea. Since the surgery leaves the cornea thinner, this can happen, although it is uncommon.

Anticipate the Rare Poor LASIK Outcome

In most of these cases, the problems were not medical, but a result of a patient with unrealistic expectations. Some patients who had the oldest refractive surgery, radial keratotomy (RK) have had massive shifts in their refraction over the years, ending up extremely hyperopic. In addition, their best corrected visual acuity is often not correctable easily to 20/20 vision.

Generate Post-LASIK Patient Referral

Ask for referrals of the patient’s friends, family and co-workers who may be interested in LASIK surgery. Often, the patient’s happiness and enthusiasm is highest right after the surgery, so this is a good time to ask for referrals. The referred patients will not necessarily be excellent candidates for surgery, but will then continue coming to our office for their eyeglasses and contact lens needs.

Are Eyeglasses More Fashionable Now than 5 Years Ago?

Most eyeglasses wearers (66.9%) recognize that eyeglasses are more fashionable now than they were 5 years ago. Only 1/7 of those who currently wear eyeglasses believe that eyeglasses are not more fashionable now than they were 5 years ago, according to The Vision Council VisionWatch Fashion vs. Function Eyewear Report.

When compared to other eyeglasses wearers, women, younger Americans, eyeglasses wearers from higher income homes and eyeglasses wearers who also use contact lenses were all relatively more likely to believe that eyeglasses are more fashionable now than they were 5 years ago. Also, it is interesting to note that the same demographics that view eyeglasses as more fashionable now are also the same consumer demographics that did not slow their purchases of Rx eyeglasses during the recession and weak economic recovery; their sustained purchasing activity has helped minimize the overall industry losses from 2008 through 2010.

In the average practice, the optical shop represents 60%-70% of the dollars coming through the front door. We need to pay attention to this area of the practice. Generally, our first thought about the optical side of care is to promote function over fashion. Our typical focus is to make sure the patient is able to function maximally at work, home, school and play.  But, the Vision Council Vision Watch Fashion vs. Function Eyewear Report reminds us to not forget fashion.

This Vision Council Vision Watch Fashion vs. Function Eyewear Report gives us valuable information. Fashion is important to our patients. It needs to be important to us as well. Based on this we need to question how well we manage fashion marketing in our opticals.

Fashion marketing goes beyond just merchandising. Fashion marketing involves positioning, branding, marketing mix, and, yes, merchandising. From the perspective of fashion marketing, go back and look at your optical and answer these four questions:

    1. Where have you positioned your optical?
         -High dollar
         –Medium dollar
         -Low dollar

     2. Have you branded your optical?
          -Do you have recognizable brands in your optical?
          -From just visuals, can a patient successfully navigate your optical?
          -Is there a theme in your optical?

    3. Do you manage your marketing mix?
          -Do you show the same frames as other opticals in town?
          -Do you have a minimum of 25 frames in each brand on the frame board?
          -What do you do with your non-performing frame lines?

    4. How well does your optical manage frame merchandising?
          -Do you highlight brands?
          -Are your displays focused (i.e.: not too many products on one display)
          -Are your best sellers at eye level?

Don’t just think about this, instead walk into your optical and ask yourself if you’ve achieved the fashion marketing objectives described above. Do you have room for improvement? Create a fashion marketing plan today to make your optical the best it can be.

Tap Opportunity: Daily Replacement Lenses for Astigmatic Patients

Advances in daily replacement toric lenses allow you to improve the vision of contact lens wearers with even small amounts of astigmatism.

Doctors and more and more patients know daily replacement contact lenses are the best choice for comfort and eye health. Until recently this option was not available to patients with an astigmatism who required toric lenses. That is no longer the case.  

A vast majority of patients have at least a small amount of astigmatism. Clinically significant astigmatism starting at about -0.75 DC affects about 35% of patients. The only barrier to tapping this market is misconception. Many patients with astigmatism had negative past experiences with an eyecare provider who told them they could not wear contact lenses or they would be more difficult to fit in contact lenses due to their astigmatism. With today’s technology, there are very few astigmatic patients who can’t fit into contact lenses.  

Maybe Even More Profitable Than Other CL Wearers

A study about the value of contact lens wearers by Mark Ritson, PhD, of London Business School, shows that contact lens wearers are 4:1 more profitable to an optometric practice than spectacle-only wearers over time. If it was a closer margin, the results could be questioned, but this creates such a large, overwhelming reason to fit all patients in contact lenses.

In addition, daily replacement wearers are significantly more compliant than two-week and one-month wearers. It is a win-win!  Patients love the convenience of daily replacement and the practice is more profitable.

A comprehensive business analysis of the different modalities and which patients are more profitable would be helpful to us all. The assumption would be that astigmatic patients are more likely to purchase contact lenses from their eyecare professional because their prescription is more specialized. We should each take time to analyze the business performance of the different modalities of contact lenses that we prescribe and look for trends over time to aid our financial and inventory planning.

Greater Loyalty and Opportunities for Referral

Focus on astigmatic contact lens patients because they are more loyal to their eyecare professional who can fit their prescription successfully. They will often refer more of their friends and family to you because of that perceived “extra care.” In general, contact lens patients come in more frequently and have a stronger relationship with their eyecare professional-a fact that is even truer of astigmatic patients who finally are able to wear the contact lenses they always wanted to wear.

Have the Conversation with Patients

With the enhanced wear-ability of daily replacement contact lenses, the greatest challenge is getting patients to give them a try. Given the chance to try daily replacement toric contact lenses, most of these patients become long-term, enthusiastic wearers.

HOYA North America Launches HOYAVision.com

HOYA Vision Care North America announced the launch of its new consumer web site, developed after a yearlong market research study to better understand how consumers approach buying premium spectacle lenses. The new site is designed to empower eyecare patients with easy‐to‐understand information about the latest advancements in vision correction, offering straightforward explanations about the differences between HOYA lenses and other lens brands.

This approach is in direct response to research findings that consumers are focusing more on their lens treatments and frames than on what they actually see through. “After quantitative and qualitative studies, we found the vast majority of eyecare consumers don’t care about their lenses,” says Ron Barnes, director of project marketing at HOYA North America, “because they don’t understand our industry jargon. That’s why so many patients still think lens brands are all the same, just commodities. So they base their purchase decisions on price alone.”

In addition to the educational benefits for patients, the new site can be used as a preemptive sales tool by eyecare professionals–a way to give their patients a head start in learning about their premium lens options before their next appointment. Detailed overviews about the advanced nature of HOYA lens products and technology, combined with general overviews and explanations about vision correction itself, invite eyecare consumers to be a part of their treatment and better inform their questions prior to their office visits.

“This is about shifting paradigms,” says Barnes. “The new site will let patients know they can wear a premium lens brand, not just designer frames. And just as important, we’ll let them know the most advanced prescription eyeglass lenses on earth are only available at independent eyecare practices.”

The new HOYAVision.com is also designed to make finding HOYA premium lenses easier for consumers. By simply entering their zip code in the “Find a Provider” section of the site, eyecare patients can locate their nearest HOYA-authorized practice.

Partner with a CL Distributor to Make Reordering Convenient and Simple

Use a contact lens distributor to maintain your inventory and streamline patient reorders. The payoffs: Less work for you, and you retain valuable CL patients.

You may use ABB CONCISE’s contact lens distribution services and be able to offer enhanced contact lens services to patients. You may decide to use a distributor to reduce the number of individual contact lens companies you deal with. That way you can have one bill for all of the contact lenses that you order. The key advantages of ordering through a distributor are: enhanced customer service, availability of all of the contact lenses that you fit, fast turn-around time (if the order is placed before 3 p.m., Monday through Thursday, you can have the lenses in your office the next day), your reps from all of the contact lens companies receive “credit” for the orders you place through ABB CONCISE and you always have trial lenses available.

In turn, using the full range of services of a contact lens distributor allows you to better the patient experience:

Set Up CL Patients to Order on Practice Web Site

By setting up all of your soft contact lens wearers to order their contacts on your web site via ABB CONCISE’s online contact lens ordering system Yourlens.com, you would be reducing your ABB CONCISE bill, and increasing the size of the check you will receive mid-month, which represents “profit” on the sale of contacts from your practice. There is a Yourlens.com a direct link on our web site so patients can order online themselves. You may also have a link to Yourlens.com on your Facebook page. That way you can make sure that every new and existing contact lens patient is set up to order off your web site, and you can send a confirmation e-mail to them while they are still here in the office. 

Ordering via Distributor Web Site Enhances Compliance

You can encourage patients to order their year’s supply or select the “auto ship” feature when placing their contact lens order to ensure compliance with the wearing and replacement schedule of their contact lenses. The key advantage of Yourlens.com is the ease of use. You should be able to better serve your patients by not only providing them with comprehensive eyecare (evaluating the fit of their contact lenses and the health of all of the ocular structures,etc.) but also educating them on the importance of the proper care and replacement schedule for their contacts, and sending them a link to order their supply. In many cases, patients order while they are in your office from their smartphones or as soon as they get home.

Market Contact Lens Services Using Multimedia

The marketing of these CL services may be done in your print ads in U.S. 1 newspaper and Town Topics in a syndicated column that appears every other week in both papers, and through e-mail blasts with Websystems III at your office. 

Optimize Relationship with Distributor Rep

Your ABB CONCISE rep, should make him/herself available via phone, e-mail and regular visits to your office. Reps can put together laminated sheets that you can use as a tool to educate patients about the savings they will realize when they order a year’s supply of their contact lenses. The quarterly report of contact lenses that ABB CONCISE compiles would help to keep you cost-competitive with your online pricing. In addition to these reports that are produced for you,you are able to go online to the ABB CONCISE web site to track your contact lens inventory finances yourself-making the service a win-win for both you and your patients.