By April L. Jasper, OD, FAAO
Offering Ortho-K provides your patients with a premium service that can build your practice. When presented well, the Ortho-K option is of great interest to families where kids may be experiencing myopic creep.
We prescribe the spectacle lenses and lens treatments we know provide the best vision for our patients and the best drops for our patients’ dry eye and glaucoma, so it is only natural that we would take it to the next step and prescribe for our patients contact lenses that not only provide them with the opportunity to do away entirely with corrective eyewear during the day but also has been shown to slow the progression of myopia in many patients. Ortho-K, which reshapes the cornea with the patient wearing a contact lens overnight, to provide temporary correction to vision, is an option I feel must be offered to every patient when their prescription is appropriate. Not only is this an increasingly popular vision correction option that my patients appreciate. It also is a practice-builder with the potential for revenue generation. This is a part of vision correction that our patients need and want, and a wonderful way to create distinction in your practice.
The average number of Ortho-K patients that most primary care optometrists will fit are about two per month. In a contact lens-only practice that number will be more and the numbers will increase as the office becomes more familiar with OrthoK and the referrals start to come in. Financially, Ortho-K can be very worthwhile to the practice.
The average OrthoK fees nationwide are between $1,000 and $2,000 depending on difficulty of fit.
Once-in-Lifetime Chance for Parents
OrthoK is for patients of all ages, but in children OrthoK has been shown to slow the progression of myopia. This ability gives me the chance to help a parent change the future of their child’s vision. When parents have an opportunity to see the change in their children’s vision after just one night with Ortho-K they are extremely grateful many times to the point of tears. No parent is happy to see their child become progressively more myopic and Ortho-K lenses allow them to finally intervene in what used to be the inevitable.
The fees for Ortho-K are much higher than the fees for regular contact lens fittings because this is not an ordinary contact lens. Ortho-K lenses are custom designed for each patient and require appropriate care by the patient and the practitioner. As I mentioned, Ortho-K is financially beneficial for the practice, but in my mind, it is not about the money. It is about having a once-in-a-lifetime chance for a parent to be able to slow the progression of myopia in their child. What could be more important than that? I truly believe that I am not doing my best for my patients if I don’t offer them this option because of the life-changing effects it can have.
But Ortho-K for Adults, As Well
Corneal reshaping lenses can be used by all ages. Children are extremely fun and easy to fit because they learn quickly and the myopia control possibilities are exciting. Adults can be very motivated to get rid of daytime vision correction, as well, so I find that it is best not to try to figure out who your best candidates will be based on age but present the option to anyone with a refractive error you feel comfortable fitting. With all products and services in my office I ask myself not who deserves this opportunity but who doesn’t deserve it (which of course is no one). Once I understood the benefits in terms of convenience and possible myopia control I felt obligated to discuss it with every patient with the right prescription.
Ortho-K Growth Potential
I have seen steady growth in this area of my practice in the past four years. This growth is due not only to my commitment to provide this option to all of my patients but also the result of referrals from raving fan patients. My current Ortho-K patients are a tremendous source of referrals to the practice. Even if these referred patients do not move forward with Ortho-K they become loyal patients to the practice.
Invest in Necessary Instrumentation
Most ODs who offer Ortho-K in their practice will agree that a topographer is a necessity. I like my OPD 3 by Marco because it is also an auto-refractor (and a very accurate one) and links with my automated phoropter, so I not only gained topography with this purchase, but also a more efficient system for doing refractions. I would have purchased this unit even if I were not going to do OrthoK, so the cost was negligible.
Doctor and Staff Education Necessary
Most of the companies that sell OrthoK lenses do online certifications, so it is very simple for anyone to get started with Ortho-K. The learning curve is not that steep either because of the excellent consultants each company provides. I would highly recommend Paragon and their CRT lenses as they are easy to fit and don’t require a fit set if you do not want to make that investment initially. Eventually most doctors will want to have a fit set so they can have a much faster dispensing system and an easier time determining the initial lens.
Most of the staff training can also be done by webinar. It is wise to have one staff member who is your primary resource for patients on training and frequently asked questions, especially pricing. I have found it helpful to take that staff member with me to annual meetings to learn more about corneal reshaping and to help keep us both on the same page with our strategy for growing our Ortho-K practice.
Educate All Patients About Ortho-K
Patients don’t usually bring up Ortho-K themselves, so it is important that I educate patients and parents about this option.
The goal in my practice is to be certain patients and parents learn about all of their options for correction of their refractive error. I explain eyeglasses, contact lenses, LASIK, and when talking about corneal reshaping, I emphasize that not only will they not have to wear eyeglasses or contact lenses all day, but also in many cases, Ortho-K will slow myopia progression.
5 Steps to Offering Ortho-K
1. Buy a topographer, which can be purchased for $7,000 to $8,000 depending on the number of features and software that is purchased with it.
2. Buy a fitting set, which is usually around $2,000.
3. Only fit the easy patients for the first few fits.
4. Charge enough to keep from being frustrated. Look at the number of visits (chair time). Calculate your chair costs and charge to cover that. This also explains why fees vary.
5. Offer Ortho-K to everyone whom you know you can successfully fit.
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April L. Jasper, OD, FAAO, is the owner of Advanced Eyecare Specialists in West Palm Beach, Fla. She was featured in a cover story in the Spring 2012 issue of MBA Insights. To contact her: firstname.lastname@example.org.