How Satisfied Are Patients With Exams at Independent OD vs. Chains?

Independent ODs are leaving a more favorable impression with patients than corporate-owned optometry chains, according to Jobson Optical Research’s 2012 Adult Consumer Eye Exam Experience. Fewer consumers who had an exam at a chain in the last six months strongly agreed with the statement that overall they were satisfied with the eye exam experience compared to those who had an exam at an independent in the last six months (45.3% and 58.1% respectfully). Indeed, just under half of those consumers who had an eye exam at a chain in the last six months (46%) said the exam was thorough, compared to 58.9% of those consumers who had an eye exam at an independent in the last six months.

Among consumers who had their eye exam at a chain in the last six months, 53.4% said they were extremely likely to return to the same place for their next eye exam. By comparison, 70.7% of those who had their eye exam at an independent in the last six months said they were extremely likely to return to the same place for their next exam.

Of the respondents who had their exam at an independent in the last six months, 63.5% reported that they are currently covered by a type of managed vision care or vision insurance plan. This is greater than the 53.9% who have a vision plan and chose to have their eye exam at a chain in the last six months.


New Revenue Stream: Lubricating Eye Drops

Offer lubricating eye drops as part of a treatment plan for dry eye and LASIK co-management patients. Patients enjoy convenience and avoid brand confusion at retail outlets, while your practice adds a new revenue stream.

Instead of giving patients a prescription to hunt on their own for the eye drops, you could offer exactly what they needed right in our office. In the process, you also could build revenues. 

Sell Branded Eye Drops for Slightly More than Pharmacy

On average, the lubricating drops you can sell cost $10 to $15 in a pharmacy. In exchange for the patient’s convenience and the added sense of security that comes from getting the drops directly from you, you can sell the product for slightly more than that.

Keep Inventory Simple

You should only invest in selling one brand of eye drops in three different versions–preserve, non-preserve and gel.

Doctor Prescribed and Sold

Like eyeglasses, contact lenses or any other product you would prescribe for a patient, it is best when selling eye drops to write down your prescription, and hand it to the patient or to the person who will conduct the transaction. Since most of our patients opt for LASIK procedures, you can make the eye drops a standard part of the preoperative and postoperative regimen for every patient. This is an approach that any OD who has a LASIK co-management specialty can emulate. It also works if you are able to make the eye drops you sell a standard part of a treatment plan for patients with dry eye.

Enable Patients to Use Flex-Spending Dollars on Drops

Be sure to write out a prescription for the eye drops so patients can use their flex-spending account dollars to pay for them. When you hand the patient off to the front desk for check out and purchase of the drops, remind them that they can use their FSA dollars.

Display at Front Desk

Make sure all of your patients know they can purchase eye drops from you-and can use their FSA dollars to do so–with a product display at your front desk and a sign that explains the product and the ability to use FSA.

Can PlusoptiX Replace Cycloplegic Exams in Young Children?

Pupil dilation lengthens exams, but also increases the cost of the exams. The plusoptiX photoscreener is a noninvasive digital infrared device linked to software. It takes multiple photographs in 3 different meridians in just a few seconds. The plusoptiX screens both eyes simultaneously for refractive errors, pupil size, and gaze deviation in patients as young as 6 months. Results are displayed immediately as a pass or refer. Pupil size, corneal reflexes, and refraction are measured and compared with referral criteria; if readings are outside age-based limits, a refer recommendation is displayed

The researchers who presented at the American Association for Pediatric Ophthalmology and Strabismus 38th Annual Meeting, conclude that a normal plusoptiX result, combined with normal alignment/motility evaluation and normal visual acuity, has a 98% negative predictive value for ophthalmologic pathology.

Topical Anesthesia Preferred for Cataract Surgery

Worldwide variations in the use of anesthesia for cataract surgery are underscored in a Chinese meta-analysis of published randomized clinical trials that did not consider the most popular method applied in the United States. Ophthalmologists at the Shanghai Jiao Tong University School in China evaluated 15 randomized clinical trials comparing the performance of topical and regional anesthesia during phacoemulsification with lens implantation, study published in Ophthalmology.

The study concludes that topical anesthesia falls short of matching the ability of regional anesthesia (including retrobulbar and peribulbar anesthesia) for sparing patients from pain. But overall, the clinical trials indicated the topical approach led to similar clinical outcomes, eliminated injection-related complications, and mitigated patients’ fears about needle injections near the eye and orbit.

Thus, the findings suggested that topical anesthesia before cataract surgery is an inevitable trend for ophthalmology and its use will grow because of improved performance of phacoemulsification machines, better surgical techniques that lead to reduced incision sizes, and effects on the anterior chamber and iris. There were less frequent anesthesia-related complications such as chemosis, periorbital hematoma, and subconjunctival hemorrhage.

By contrast, intraoperative and postoperative pain was higher in the topical anesthesia group, compared with regional anesthesia. Also, inadvertent intraoperative ocular movement was observed significantly more often among patients who received topical anesthesia than among patients in the retrobulbar group and those in the peribulbar group. Those in the topical anesthesia group more often needed an additional intraoperative dose. Still, patients far more often preferred topical anesthesia over other pain-stopping options and the meta-analysis uncovered no significant differences in the surgical complication rate for the topical and injected regional approaches to anesthesia.

These findings do not reflect how phacoemusification is performed in the United States. The standard of care here has involved topical anesthesia supplemented by intracameral lidocaine for more than a decade. The protocol calls for the injection of a slightly dilute solution of nonpreserved lidocaine and epinephrine, which facilitates pupil dilation into the anterior chamber immediately after incision to instantly anestehtize the eye internally.

Give Your Office Environment a Multi-Sensory Analysis

Smell: When a patient–especially a new patient–enters your practice, what do they smell?  The smell of professionalism? Whatever you think it is, make sure it’s inviting.

Sight: What a patient sees when they enter your practice contributes heavily to the first impression. This includes making sure your front desk stays impeccable at all times. A well manicured carpet, a squeaky clean pre-testing room and contact lens room, as well as a spotless exam room, are all important.

Feel: The educated customer can then make an informed decision–hopefully that the designer frames are worth the added cost. In addition to the feel of your frame board offerings, patients notice how your dispensing table and chairs feel when they touch them. The same holds true for all the ophthalmic instrumentation you examine them with. So be sure to sanitize all instrumentation prior to each use.

Hearing: What patients hear when they enter your office is another factor that will determine how loyal they stay to your practice.  

Taste:  Last, but definitely not the least, is the taste of a practice. A patient’s experience at your practice can leave a taste-hopefully a great one-behind in their memory. 

Recognizing and understanding the senses of your practice is a recipe for long-term success. Both you and your patients will appreciate an improved office environment, increasing the chances that your patients become patients for life.