Differentiate Your Practice With Specialty Lenses

I have a passion for specialty contact lenses and have been working with them for more than 6 years. After completing my residency, I built a specialty lens service within a group private practice. In August 2022, I opened my first cold start practice, Elevate Eye Care + Eyewear, in Rochester Hills, Michigan, where specialty lenses are my primary offering, although I provide primary care services as well. Working with these lenses allows me to spend more time with my patients and differentiates my practice from other, more generalized providers in my local area.

Training

After I earned my doctorate degree, I did a yearlong residency in cornea/contact lenses at Indiana University, and I became a fellow of the Scleral Lens Society. The scope and depth of these trainings gave me the confidence to fit specialty lenses successfully for a variety of conditions: corneal transplants, post-refractice surgery patients, keratoconus, corneal ectasia, and severe dry eye disease. I also specialize in designing orthokeratology lenses for adults as well as myopia management in children. Even in the 5 years since I left residency, specialty contact lenses have evolved significantly, so I keep abreast of new developments in the industry by attending conferences and webinars.

Strategies for Building the Specialty Lens Practice

When I began working at the group practice after residency, I was brand new to the area and did not have any referral sources. The office was not providing many specialty lenses at the time, so I met with local ophthalmologists and optometrists to tell them about this new service.

When I opened my private practice, I was fortunate that many patients followed me, but I also reached out again to local practitioners. I visited with doctors face to face to describe the services I provide. Both ODs and MDs need to be educated about all the indications for specialty contacts, because many indications are often overlooked. For example, many providers think that scleral lenses are only for the treatment of keratoconus. Most practitioners have been receptive and appreciate having a local source for these lenses, especially for their challenging cases.

Building and Maintaining the Referral Network

My best advice to optometrists who want to launch a specialty contact lens practice is to not steal your referred patients. Send them back to their referring doctors for follow-up, so they can tell those practitioners what an amazing experience they had with you (and so those doctors can evaluate your work). I do not offer referred patients primary or routine care, examinations, or glasses. Also, I make a point to visit these local practices quarterly to check in and get to know their staff. This habit builds good working relationships and keeps me in the front of their minds for referrals.

It is important to describe your specialty lens services on your website so that patients who are researching doctors for their condition can read about your experience with specialty lenses before they even make an appointment. People who need these lenses have fewer options for providers, and they appreciate being able to read about your experience and reviews. I have had patients drive farther to come to my practice because of my positive reviews.

What Does it Take to Launch a Specialty Practice?

To begin offering specialty lenses, it is imperative to have a good corneal topographer. I personally have never used a scleral profilometer, although I’d like to add one in the future for challenging eyes. My preferred style of fitting specialty lenses is diagnostic with trial lens fitting sets. I like to have two or three scleral lens fitting sets, because not every patient is going to be able to wear the same lens. Some eyes need different diameters and different geometries, and having just one set would limit how many eyes I could successfully fit. Personally, I would not want more than three sets so I can master the ones I have and limit how many labs I order from. My advice is to dive in and really become an expert at one design before trying to learn multiple designs at once.

Practice Flow

When a patient is referred from another office, we request their records to be sent over so we do not have to repeat a complete examination, especially if the patient just had one done a week or so previously. Once our receptionist checks the patient in and does all the intake, I immediately start with pretesting, topography, and checking their best-corrected vision against whatever they are currently wearing, if anything. Next, I discuss the patient’s options. I explain what I’ve found during testing and what correction I recommend, and I go over their insurance coverage and any out-of-pocket expenses they may have. I like to be upfront about the investment; I don’t want patients to be surprised by unexpected fees after they have committed to a specialty lens.

If the patient decides during this visit to proceed with a scleral lens fitting, which happens more often than not), then I begin the fitting. I place a diagnostic lens on the eye, let it settle, take the measurements, and order the lens. Usually, the lens arrives within 2 weeks, and the patient returns for a dispense appointment and to be trained on application, removal, and cleaning. I have a cross-trained optician who performs this training. I do not have a technician at this time at my cold start, but in a busy office it is imperative to have a technician to assist with specialty patients. 

Appointment Times

My initial appointments usually take about 45 minutes. For those who want to accommodate specialty lenses into primary care scheduling, it is possible to apply a diagnostic scleral lens on an eye, see a routine patient in another lane while the scleral lens is settling, and then come back and take the measurements to keep the schedule moving.

Likewise, we set aside approximately 45 minutes for follow-up appointments, although they often don’t take this long. I don’t want patients to feel rushed, especially when they are new to contact lenses. I apply the lens on the patient’s eye, let it settle for 15 to 20 minutes, and measure to see if any adjustments are needed. Often at this visit, the patient has questions he or she did not think about previously. Once we are both happy with the fit, the patient sees our optician to learn how to use their lenses.

I usually schedule one more follow-up appointment 1 to 2 weeks after the patient receives the lenses to see how they are fitting and feeling. At the follow-up visits, I can answer questions or concerns and make adjustments if needed.

For most patients new to specialty lenses, I tell them to plan on the initial fitting visit, a dispensing visit, one follow-up, and possibly additional follow-ups if necessary. The number of visits depends on how complex the patient’s condition is. More complicated eyes take a bit more designing on my part and more modifications to the lenses.

Where Do Specialty Lenses Fit?

Any type or size of practice can offer specialty lenses. Specialty patients require more chair time, but the revenue per patient is so much higher than it is for routine patients that oftentimes, seeing one specialty lens patient is more profitable than seeing a dozen routine patients. When I ran my new practice’s metrics, my top-selling contact lens was a scleral lens, and I could not be happier about that. I like spending more time per patient and delivering a high level of service.

Growing and Sharing

Working with specialty contact lenses is rewarding and creates happy, loyal patients. They will send you their friends and family members, and they will do video testimonials to promote your practice. Patients are very grateful when a scleral lens can provide them with a quality of vision they have not had in years; I’ve had patients cry in my office with joy and I will always remember those moments.

For the foreseeable future, I will keep focusing on these lenses. Eventually, I’d like to teach optometric student externs who want to learn how to offer specialty lenses in a private-practice setting, because I think there’s a great need for this service and would love for the industry to continue to grow.

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