Interest in ocular aesthetics is on the rise, and it will soon play an important role in both the beauty and health care domains. Optometry has a unique opportunity to be a key player in the field of ocular aesthetics. Everyone wants to look his or her best, and the eyes are among the most important aesthetic features of the face. Add to this an aging population, and the world of ocular aesthetics offers vast opportunity in today’s market.

UNDERSTANDING OCULAR AESTHETICS

Historically, ocular aesthetics services have primarily been focused on surgery. Blepharoplasty and other eyelid procedures for ptosis, entropion, and ectropion once defined the limits of ocular aesthetics. However, recently there has been a shift to a more nonsurgical description—one that includes not only the eyes, but also the skin and face.

The Aesthetics–Ocular Surface Connection

Managing ocular surface disease is a critical first step in offering ocular aesthetic services. Thanks to growing research, we know more about dry eye disease than ever before. We know that recommending artificial tears alone is a bandage and does nothing to get to the root of the real problem. We know that dry eye is a chronic problem that affects patients of all ages, races, and sexes. Treating the ocular surface can improve comfort, restore vision, and enhance the aesthetics of the eyes.

Some treatments for dry eye, such as intense pulsed light (IPL), have secondary aesthetic perks. IPL not only decreases ocular inflammation, but it also reduces facial skin redness, telangiectasia, hyperpigmentation, fine lines, and wrinkles. Having IPL equipment in your office to treat dry eye disease opens up many aesthetic options down the road. Perhaps you could start a dry eye and aesthetic clinic that brings in other health care professionals to put your IPL equipment to use in other modalities. Or perhaps you could create an aesthetic clinic that has a culture of eye-focused health. Your aesthetic clinic could hire appropriate health care professionals to perform laser or injectable procedures from a perspective that is rooted in the awareness of how each aesthetic enhancement can affect the eyes.

KNOWLEDGE IS POWER

Many health care providers interested in entering the ocular aesthetics market do not have the eye knowledge or experience that optometrists and ophthalmologists do. Any aesthetic enhancement product or procedure should support healthy eye function, and an eye care professional should be involved in the clinical decision-making process. For example, research shows that a potential complication of botulinum toxin type A injection into the lateral canthal rhytids (crow’s feet) involves disruption of the tear film, causing dry eye.1 If you have a dry eye patient who receives such injections, you should be educating him or her on this risk and working with the patient’s botulinum toxin provider to develop an aesthetic enhancement plan that is not harmful to the health of the eye.

Furthermore, the internet is full of “beauty influencers” giving their opinions about skin care, beauty, and eye products. Many of these influencers’ product recommendations are filled with toxins, allergens, and eye irritants. And their followers tend to take what they say as fact, even when these social media personalities lack knowledge and expertise on how certain ingredients can be detrimental to eye health.

Patients care about ocular aesthetics, and they should be getting their information from knowledgeable, reputable sources. Eye care professionals should be talking to their patients about how makeup, skin care, and beauty products affect the health and functionality of the eyes. Optometrists are the predominant primary eye care providers in the United States, which means our profession has the opportunity and responsibility to talk about eye health in relation to beauty and skin care products.

TIPS FOR OFFERING AESTHETIC SERVICES

How can optometrists begin offering ocular aesthetic services in their offices? In a nutshell, once you have a solid understanding of everything involved, you can spread that knowledge and commit to aesthetics as a practice focus.

Doctor Education

Learn about what ingredients are harmful to the eye (see Ocular Enemies). Be knowledgeable about common preservatives, resins, additives, surfactants, and fragrances in skin care products, makeup removers, and beauty products. Be prepared to answer questions and give advice on how different ingredients and injectable procedures can affect eye health.

Patient Education

Inform your patients that many beauty and skin care products have ingredients that are not always eye-friendly. We are all busy in exam rooms, so create an education sheet that can be handed out to patients when they leave the office. Include basic facts on how some products can clog the meibomian glands and disrupt the tear film, and the consequential effects on the health of the eye. Emphasize the importance of removing cosmetics before bed, and outline proper techniques for makeup removal. Educate patients on how to be mindful of the ingredient deck in beauty products.

Realistically, most patients aren’t going to give up their “ride or die” mascara overnight, but plant the seed. Sometimes it takes hearing a suggestion 10 times before it’s adopted. People care about their health and their eyes. Information on how products used around their eyes can affect their ocular health should come from knowledgeable sources such as their primary care optometrist.

Embrace Dry Eye

Don’t just advise a patient to use over-the-counter artificial tears. Get to the root of why his or her dry eye is occurring and treat it accordingly. Literature abounds on the various causes of dry eye disease and the available treatments. Get up to speed and enlighten your patients. You can boost your practice and improve your patients’ eye health at the same time.

Sell Eye-Friendly Ancillary Products

Consider selling eye-friendly skin care or beauty products in your office. Not interested? Then find out where your patients can find such products and offer them your recommendations.

REWARDING ON MANY LEVELS

The realm of ocular aesthetics is growing, offering ample opportunities for optometrists to incorporate these services into their practices or even carve out a niche in their geographic area. Optometrists who embrace ocular aesthetics elevate the level of patient care and create an avenue for dispensing accurate information to the public. From a practice management standpoint, incorporating ocular aesthetics into your practice could also create new cash-based revenue streams.

  • 1. Ho MC, Hsu WC, Hsieh YT. Botulinum toxin type A injection for lateral canthal rhytids. JAMA Ophthalmol. 2014;132(3):332-337.
  • 2. Chen X, Sullivan DA, Sullivan AG, et al. Toxicity of cosmetic preservatives on human ocular surface and adnexal cells. Exp Eey Res. 2018;170:188-1973.
  • 3. Okereke JN, Udebuani AC, Ezeji EU, et al. Possible health implications associated with cosmetics: a review. Science Journal of Public Health. 2015;3(5-1):58-63.
  • 4. Are some makeup ingredients toxic? Medical News Today. www.medicalnewstoday.com/articles/327318.php. Accessed January 21, 2020.
  • 5. Color additives and cosmetics: fact sheet. US Food & Drug. www.fda.gov/industry/color-additives-specific-products/color-additives-and-cosmetics-fact-sheet. Accessed January 21, 2020.
  • 6. Ethanolamine compounds (MEA, DEA, TEA and others). Campaign for Safe Cosmetics. www.safecosmetics.org/get-the-facts/chemicals-of-concern/ethanolamine-compounds/. Accessed January 21, 2020.
  • 7. Skocaj M, Filipic M, Petkovic J, Novak S. Titanium dioxide in our everyday life; is it safe? Radiol Oncol. 2011;45(4)227-247.
  • 8. The problem with vitamin A. Environmental Working Group. www.ewg.org/sunscreen/report/the-problem-with-vitamin-a/. Accessed January 21, 2020.