At A Glance

  • Risky contact lens behaviors can lead to potentially devastating ocular complications, such as corneal ulcers, neovascularization, corneal edema, and conjunctivitis, among others. 
  • Setting the tone correctly regarding contact lenses from the beginning allows optometrists to work with their patients to ensure success.

According to a survey conducted by the Centers for Disease Control and Prevention, between 80.9% and 87.5% of patients admit to having at least one risky behavior regarding their contact lenses.1 These behaviors include swimming in lenses; sleeping in lenses; storing or rinsing lenses in tap water; not replacing lenses, solutions, or cases in the recommended interval; and not visiting the eye doctor at least annually. These risky behaviors can lead to potentially devastating ocular complications, such as corneal ulcers, neovascularization, corneal edema, and conjunctivitis, among others. Additionally, only 65.4% to 68.0% of patients purchase their lenses from their eye care providers. This opens the door for companies to switch out lens brands, materials, and even prescriptions in some cases.1

Although it is impossible to stop all risky behaviors in every patient, setting the tone correctly during the first contact lens consultation can play a determining factor in your patients’ compliance and purchasing decisions. In this article, I review some tips and considerations to help make that first impression a positive and impactful one.


It is important to remember that almost all visits—even red eye appointments—can turn into contact lens consultations. With new technology making soft lenses more comfortable, breathable, and moisturized, younger and more complex patients are able to wear lenses successfully and should not be counted out before trialing.

Let’s suppose a patient comes in for a problem-focused visit and is diagnosed with severe dry eye. In addition to providing therapeutic treatment, you might find that this patient is a great candidate for Dailies Total1 (Alcon) lenses, which utilize SmarTears Technology to help stabilize the lipid layer of the tear film.2 Or, the patient might be right for a scleral lens that can protect the damaged ocular surface.

Specialty lenses such as sclerals, hybrids, and rigid gas permeable lenses have become much easier to fit. These modalities create opportunities for patients previously unable to achieve great vision. You and your staff should always be prepared to introduce the idea of contact lenses to your patients and consider using them in more medically driven and unique cases when appropriate.


During a patient’s time in an optometric office, he or she will interact with the staff for a much longer amount of time than he or she will interact with you, the doctor. This means that your staff has the opportunity to introduce and discuss contact lenses and answer many questions before you enter the room. For this to be successful, the staff must understand which lenses you prefer to fit, which patients are appropriate and which are poor candidates, which rebate options and lenses are carried in the office, and what patient complaints might be remedied through contact lenses.

An example might be a new presbyopic patient who can no longer read fine print but who does not want to use her reading glasses daily. An educated staff member might hear this patient complaint and ask the patient if she has considered multifocal contact lenses. If the patient has not, this query plants the idea and gives her time to formulate questions before the clinical exam begins. If the patient has thought about these lenses and already has questions, the team member may be able to answer them and also give the doctor insight before the exam into the patient’s thoughts and preferences.

Keep in mind that not only your clinical staff (technicians and scribes) should be fluent in contact lenses. Receptionists, opticians, and other employees throughout the office will also encounter patient questions, and they should be able to answer most of them to ensure that your patients have a positive contact lens experience.


One of the biggest deal-breakers for new contact lens wearers is unmet expectations. This can be the case both for patients who have never worn contact lenses and for established wearers trying a new modality. Remember to educate your patients regarding the reasons you are choosing a particular lens for them, but do not over-promise. Instead, make sure that you set realistic expectations.

For instance, if the patient has dry eye, educate her about potential signs of dryness with the lenses and give recommendations for alleviating those symptoms before they occur. If the patient is a new multifocal or monovision wearer, inform him that he may still need reading glasses in some circumstances, particularly when lighting is poor or the print is very fine. The more the patient understands about a particular contact lens—including its strengths and its potential challenges—the more likely he or she is to be a successful wearer.


Make sure to discuss the cost of contact lenses up front with your patients. By doing so, you prevent future sticker shock and open the door for conversations regarding your prices versus those of competitors. Make sure you know the rebate options for the lenses you prescribe, understand how the patient’s insurance may factor into purchasing, and become familiar with your most common competitors’ pricing in order to have the most successful financial conversations with your patients.

In addition, inform patients of other services you can provide, if they purchase through your office, that online retailers will likely not offer. These may include providing trials when required or replacing unopened boxes of lenses if the patient’s prescription changes before the next annual appointment.


Compliance with contact lens wear is a daily challenge in optometric practice. Lack of compliance can lead to vision-compromising conditions for your patients. It is our responsibility to inform patients of the risks involved with use of these medical devices.

As previously mentioned, more than 80% of patients admit to breaking compliance in some way. This means that more than 80% of contact lens wearers are putting themselves at increased risk for complications. Through proper education and tools, we can attempt to curb this probability.

Eye care providers should give patients clear instructions regarding handling and care, replacement schedules for lenses and lens cases, and symptoms of problems that should be reported. Providing samples of recommended solutions is an effective way to educate your patients on proper lens cleaning and to equip them for success.


Contact lens fitting is an exciting facet of optometric practice that allows us to improve our patients’ daily lives. If you implement the tips laid out in this article, you will help patients leave your office educated, prepared, and excited about their new contact lenses. By setting the tone correctly from the beginning and making sure your patients know that you and your staff are available when needed to troubleshoot any issues, you will ensure their long-term success while simultaneously building and growing your practice daily.

  • 1. Cope JR, Collier SA, Nethercut H, Jones JM, Yates K, Yoder JS. Risk behaviors for contact lens–related eye infections among adults and adolescents — United States, 2016. MMWR Morb Mortal Wkly Rep. 2017;66(32):841-845.
  • 2. Dailies Total1 Water Gradient Contact Lenses. My Alcon website. Accessed February 14, 2019.