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“ 7 Best Practices in
Contact Lens Management”
Laurie L. Sorrenson, O.D., F.A.A.O.
Austin, Texas
LakelineVision.com
Sorrenson@att.net

% of Gross Income
AVERAGE
• Professional fees 35-40%
• Spectacles 40-50%
• Contact lenses 15-20%
16%
• Other sales 1-2%
Source: MBA Key Metrics

30%
Percent of active patients who wear contact lenses, even part time.

$64
$110
$135
$158
$174
$201
$221
$255
$298
$478

SCL gross profit margin
Low Average High

Contact lens exam fees
New Spherical Contact Lens Patient:
Lowest Next 20% Median 20% Next 20% Highest
$120 $153 $181 $221 $274
Established Contact Lens Patient:
Lowest Next 20% Median 20% Next 20% Highest
$95 $112 $139 $167 $215
Definition: This is the normal, undiscounted fee for a comprehensive eye exam and lens fitting for spherical new
contact lens patients, or the normal, undiscounted fee for a comprehensive eye exam for existing contact
lens patients not requiring refitting. Source: MBA, 2008

The profitability of contact lenses for
European eye care practitioners 2
ECPs
<
1.5x
2. Ritson M. Which Patients are More Profitable? Contact Lens Spectrum March 2006:38-42.
2007-05-0535

“In the time that it takes me to fit a
patient for contact lenses I could
have sold two pairs of spectacles…”
2007-05-0535

ONLY
3. McLean K. Best of Both Worlds. Eyecare Business, April 2006.
4. Goldberg L. Contact Lens Prescribing Revisited. Ophthalmology Management April 2006.
XM =
2.5 Years
2007-05-0535

5. Nowak J. Business school studies contact lens profitability. PCONSuperSite.com April 2006.
6.Goldberg L. Contact Lens Prescribing Revisited. Ophthalmology Management April 2006.
7.McLean K. Best of Both Worlds. Eyecare Business, April 2006.
XM =
15 Months
Examination Fee
2007-05-0535

60%

Conclusions
8. Ritson M. Which Patients are More Profitable? Contact Lens Spectrum March 2006:38-42.
2007-05-0535

Contact Lens
Patient
Spectaclesonly
Patient
(2.4 yr. purchase cycle
@ $242 per sale)
6 year value of contact lens and
spectacles patients
6-year
CL Revenue
($119/year)
6-year
# of Full
Exams
Median
Exam Fee
Revenue
6-year
Spectacle
Revenue
6-year
Patient
Revenue
$714 4 $480 $484 $1,678
$0 3 $270 $606 $876
Contact lens patients generate 91%
greater revenue over 6 years!
Source: Practice Advancement Associates estimates based on CL industry audits, CIBA Vision wearer model, Jobson Publishing frames and lens estimates. 2007-05-0535

Discount on Back Up Glasses?
–10%? 20%? 50%?
–Free Frame?
–Free Lenses?

SunGlasses
Consider sunglass display in
contact lens dispensing area

30%
Percent of active patients who wear contact lenses, even part time.

Positive Correlation
Percentage of contact lens patients
and…
... annual gross revenue
per active patient

How can we increase % of
Contact Lens Patients?
STUDY
32% MORE $
21

Proactively present CLs
to glasses patients
(Dailies for frame styling)

Same Day = Exam + Fit + Dispense
Staff = CL insertion
Staff = Scribing
Staff = CL Review
Staff = CL orders

Follow-ups

Delegation

#3
“fine”

How are you doing with your
contact lenses?
“Fine / OK”
“OK” - all right;
satisfactory or under control;
adequate but unexceptional or
unremarkable;
tolerable 9
9. http://dictionary.reference.com/browse/ok
2007-05-0535

"How are your contact lenses?"
“Oh, they’re adequate.
Kind of unexceptional,
you know, tolerable…”
2007-05-0535

“My patients will tell me if they
are not happy”
WRONG!
2007-05-0535

Total SCL
Dropouts
Went to Eye
Doctor to Solve
Problem Before
Dropping out?
Yes
46%
No
54%
Tried any different
brands/types prior
to dropping out?
Yes
9%
No
37%
Less than 50% even saw an ECP
Only 9% tried a different brand
before dropping out
CIBA Vision data on file, 2006
2007-05-0535

“My patients will tell me if
they are not happy”
WRONG!
% experiencing
at appointment
% telling
the doctor
Eyes dried out when wearing CL’s 81% 44%
Contact lenses felt uncomfortable at EOD 73% 34%
Eyes felt irritated when wearing CL’s 60% 26%
Ability to see changed throughout the day 52% 18%
Among patients switching to another brand of lens at last appointment
CIBA Vision data on file, 2007.
2007-05-0535

Are they telling us?
Eyes got red 48% 16%
Vision was blurry or hazy
after sleeping in lenses 39% 7%
Cleaning and disinfecting
too much of a hassle 36% 3%
Contact lenses required
% experiencing at
appointment
% telling the
doctor
too much effort 35% 4%
Among patients switching to another brand of lens at last appointment
CIBA Vision data on file, 2007.

How are you doing with your
contact lenses?
“Fine / OK”
Getting past
"Fine"…
9. http://dictionary.reference.com/browse/ok
2007-05-0535

Case history – ask probing
questions!
"Comfortable ALL DAY?"
"…change ONE thing…"
2007-05-0535

Case history – ask probing
questions!
Sleep??
Nap??
2007-05-0535

Don’t want to sleep in
their lenses
54%
Sleeping??
25%
21%
Want to sleep overnight
in their lenses on a
regular basis
25%
21%
Want to sleep
overnight in their
lenses occasionally
Source: CIBA Vision, data on file, 2005.

Ave. = 21 nts/mo.
41% > 7 nights
–28% not approved
for such use
66% accidentally
Sleeping in lenses
fall asleep/nap
(Source: CIBA Vision, data on file, 2005)

Case history question of the day
Tired?
Red @ End of
Day??

Limbal hyperemia
•“… significant decrease in limbal hyperemia within one month …” 3
“Bulbar and limbal hyperemia decreased significantly …
The reduction … occurred mainly between the baseline and 1 month visits. 4
3. Dumbleton K. Daily wear performance of Silicone Hydrogel Lenses. www.siliconehydrogels.org June, 2005.
4. Dumbleton et al. Redness, dryness and comfort following refitting long term low Dk hydrogel lens wearers with silicone hydrogel lenses. Optometry and Vision Science 81
(12S):31. 2005-12-0640

Ordinary hydrogel lens N&D contact lens
Limbal Redness
Localized Oxygen Transmissibility
at Lens Periphery
Vascularization
Bulbar Redness
Limbal hyperemia is directly related …oxygen transmissibility in
the peripheral… area of the lens. 6
The minimum Dk/t necessary to avoid limbal hyperaemia in
daily wear = 125. 5
5 Papas, E. On the relationship between soft contact lens oxygen transmissibility and induced limbal hyperemia. Exp Eye Res
1998;67(2):125-131.
2005-1-0005

Dangerous Attitude??
My patients
are satisfied!
2007-05-0535

#4
Same Products

The two most powerful words in
your vocabulary…
"I recommend"
2007-05-0535

2 - 3 Years
2007-05-0535

Daily
2-week
Monthly
Replacement Schedule
5.7% replace “every couple of days”
0.5% replace up to a week
18% replace every 3 weeks
23.1% replace every month
3.8% replace every 4 to 6 months
47.6% replace every 2 weeks
28.3% replace every 2 to 3 months
66.2% replace every month
93.8% replace
every day
0% 20% 40% 60% 80% 100%
Source: Bailey, GM. Shovlin, JP. Compliance and Contact Lenses.
Review of Cornea and Contact Lenses March 2006:2–3.
2007-05-0535

0.75 Cyl
Spherical
Equivalent
Specs??

Keys to Success
Enthusiasm
2007-05-0535

#5
Not charging

Review

Basic
Complex
Specialty

"What contact
lens exam?"

Recommendation from
Clarke Newman, O.D., F.A.A.O.
• Pick five specialty lenses
• Learn them "inside out"
• "Don't worry about making
money on your first few patients
because it will make you a lot of
money in the long run."

#6
Annual supplies

Make it easy

Review
Annual
Supplies

Laurie Sorrenson, OD, FAAO
Sorrenson@att.net
www.LakelineVision.com
Austin, TX