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By D. Penn Moody, OD

Trial contact lenses offer several key advantages. First, you can utilize them to overcome patient hesitancy, then readily evaluate their success with your lens recommendation. Further, if you simplify your inventory of trial lenses and offer direct delivery for purchased lenses, you can lower your often overlooked staff costs of maintaining inventory and transacting lens sales and delivery.

When prescribing contact lenses to patients, or asking them to make a switch to another type of contact lens, the doctor must overcome patient apprehension. One way to do that is through trial lenses. Most doctors use trial lenses to some extent in their practices, but in my practice, we make them a cornerstone of our contact lens strategy. The key advantages of trial lenses are many: they eliminate the patient’s stress over buying lenses that might not work well, maximize office efficiency in staff resources, time and cash flow and limit the investment in stock lenses for resale.

[FREE RESOURCE: click HERE to download a copy of Dr. Moody’s Contact Lens Evaluation and Follow-up Form]

Here is how we use trial lenses to their full capacity to increase our patients’ comfort and our profitability.

Fitting and Direct-to-Patient Shipping

I believe in using trial lenses for fitting and then direct-to-patient shipping for delivery of revenue-generating boxes. This reduces our transaction costs and inventory costs tremendously–costs that often are overlooked. In particular, it reduces employee time spent on “mail room” activities so they can concentrate on patient care. We fit nearly 50 percent of our contact lens patients in daily replacement contact lenses; since these come in 90-lens packs, it also saves inventory space.

Create a Trial Lens Room

When we remodeled our office, we created a separate “trial lens room” located between the front desk and the exam rooms. This makes it accessible to the doctors and clinic or the front desk staff. Typically I will have one of the assistants pull trial lenses, but sometimes I will. It depends upon patient flow at that particular moment. I tell patients: “We are going to give you trials to put on. You don’t have to order lenses until we finalize the fit and your vision.” I believe in keeping instructions simple versus long explanations with suggestions.

Give Patients Guidance Before and After Trying Out Lenses

I often get asked “what’s the best lens?” My answer is: “My favorite lens is the daily replacement lens. You get a fresh lens everyday and you don’t have to clean it, so you’re not putting chemicals in your eyes.” Usually this is enough, but sometimes we will have a more in-depth discussion of lens modalities. I will tell them there are three criteria for “the best lens”: comfort, vision and health. I want a lens they can wear comfortably, can see well out of, and that doesn’t adversely affect the health of their eyes.

When patients come back for a follow-up, we always have them fill out a short questionnaire on their wearing experience. There are many schools of thought, but I subscribe to the “if you mention it, you will put it in their minds,” so I describe very little in the way of expected symptoms. I find their comments and my further questioning will elicit what I need to know and what they want to tell me. Another aspect of this is patients will ultimately wear what they want to wear regardless of what we think is best for them. They will find a “reason,” “symptom” or “issue” to lead us to change the lenses to one they want to wear.

Patients commonly make two “heads up” comments that the lenses are not right for them: They have blurred vision or heightened awareness of the lens (particularly as the day wears on). Obviously, anything I see with the slit lamp, whether or not it’s symptomatic, also can be an alert. I discuss anything I notice with the slit lamp further with the patient first, and then proceed from there. The patient may have symptoms they don’t think are important that actually are. They also might be wearing the lenses too long, not cleaning them correctly, or need a different lens design.

Give Patients Just One Type of Lens to Try

Usually I only give the patient one type of trial lens based on our discussion and what the patient prefers. Sometimes I will give them two, but never any more than that. The reality is most lenses work for most patients so why spend an inordinate amount of time going through similar products or performance? One thing I tell many patients: “I don’t want to see you anymore than I have to, but I want to see you every time I need to.” They have busy lives, too, and get this message.
I believe they appreciate choice with direction (taken from Great by Choice by Jim Collins and Morten T. Hansen). I would say the most common two trial lenses in my office are daily replacement and the patient’s previous lenses (so they don’t feel pressured).

Wandering through the trial lens room trying to decide what to fit a patient in is a waste of everyone’s time, and it brands you as indecisive. Don’t fit what the patient is wearing just because they “like” their lenses. Bring them up to speed on what’s available and how it will benefit them.

Create Follow-Up Protocol: Enable Commitment to Lens

In my practice, follow-ups after initial contact lens fittings are a judgment call supported by a protocol:

All new patients are scheduled for a follow-up.
All patients with a change in modality are scheduled for a follow-up.
Previous patients with a similar Rx and lens modality are told to call us to (1) order lenses or (2) schedule a follow-up if they have any questions.

Supply Patients Amply

I generally provide enough trials to carry patients until their next follow-up. Since I fit a lot of daily replacements, and they come in five- or 10-lens sleeves, I generally give them 10 lenses per eye. With any two-week or one-month lens, I give them one pair. My typical follow-up is in one week, variable to fit their schedule.

Allow Patients to Return Unopened CL Boxes

Our number one goal is “An Exceptional Experience for Every Patient.” We will always accept unopened boxes of lenses for credit within 30 days, almost always within six months, and not often after that (although we have done this). We find our fitting process usually eliminates the need for returns, so the cost to the practice is negligible when compared to the goodwill. Even if we just throw away the “trade-ins,” we’re in the business of creating exceptional experiences, not selling products, so we will do this. Some of our high usage lens vendors will support us in this way.

Manage Re-Stocking of Trials

We have a jar by the sink where the patient puts on the trials. They put the cover foils in this jar and we reorder trials generally two times a week. If we give them lenses without a try-on that day we put a note in the jar to reorder trial lenses with those parameters.

Limit Number of Trial Lenses in Stock

One of the greatest mistakes many ODs make is having too many types of trial lenses. It makes the trial lens room cluttered and it makes no sense to have every lens you might fit immediately available. I fit a limited number of lenses: Proclear 1-Day, Clearsight 1-Day, B&L Daily, Biofinity (sphere, toric, multfocal) and Alcon Multifocal. I keep nearly the entire parameter range of trial lenses for these brands in stock. I stock trials in the most common ranges for the brands and types of contacts I prescribe less frequently. Periodically I go through my trial sets and discard (yes, throw away) the sets we don’t use. For example, I threw away my Avaira trials because we switched to a daily-monthly modality focus.

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D. Penn Moody, OD, is the owner of Moody Eyes, in Indianapolis, Ind. To contact him: penn@moodyeyes.com.