By Jason Miller, OD 
Advances in daily replacement toric lenses allow you to improve the vision of contact lens wearers with even small amounts of astigmatism.
Doctors and more and more patients know daily replacement contact lenses are the best choice for comfort and eye health. Until recently this option was not available to patients with an astigmatism who required toric lenses. That is no longer the case. I am finding success–and a practice builder–moving astigmatic patients into toric daily replacement contact lenses.
A vast majority of my patients have at least a small amount of astigmatism. Clinically significant astigmatism starting at about -0.75 DC affects about 35 percent of my patients. There are about 2,000 patients with clinically significant astigmatism in my practice. The only barrier to tapping this market is misconception. Many patients with astigmatism had negative past experiences with an eyecare provider who told them they could not wear contact lenses or they would be more difficult to fit in contact lenses due to their astigmatism. With today’s technology, there are very few astigmatic patients I can’t fit into contact lenses. Here is how I move astigmatic patients into daily replacement contact lenses, why this is such a good opportunity and how to make the most of it.
Maybe Even More Profitable Than Other CL Wearers
Astudy about the value of contact lens wearers by Mark Ritson, PhD, of London Business School, shows that contact lens wearers are 4:1 more profitable to an optometric practice than spectacle-only wearers over time. That is a big number to me! If it was a closer margin, the results could be questioned, but this creates such a large, overwhelming reason to fit all patients in contact lenses.
I propose a next phase of this comprehensive business study, which could offer an analysis of spherical patients to astigmatic patients to presbyopic patients. My guess is that astigmatic and presbyopic patients are even more profitable than spherical contact lens wearing patients to an individual practice. Not only are they going to come in more frequently to see me, they are going to be more profitable to my business. In addition, daily replacement wearers are significantly more compliant than two-week and one-month wearers. It is a win-win! Patients love the convenience of daily replacement and the practice is more profitable.
A comprehensive business analysis of the different modalities and which patients are more profitable would be helpful to us all. My guess is that astigmatic patients are more likely to purchase contact lenses from their eyecare professional because their prescription is more specialized. We should each take time to analyze the business performance of the different modalities of contact lenses that we prescribe and look for trends over time to aid our financial and inventory planning.
Greater Loyalty and Opportunities for Referral
Focus on astigmatic contact lens patients because they are more loyal to their eyecare professional who can fit their prescription successfully. They will often refer more of their friends and family to you because of that perceived “extra care.” In general, contact lens patients come in more frequently and have a stronger relationship with their eyecare professional–a fact that is even truer of astigmatic patients who finally are able to wear the contact lenses they always wanted to wear. When patients note how much more clearly they see with their daily replacement toric contact lenses, I reinforce that impression. I tell them that the clear, stable view they notice should last the whole day without any fluctuation, thanks to their new contact lenses.
Have the Conversation with Patients
With the enhanced wear-ability of daily replacement contact lenses, the greatest challenge is getting patients to give them a try. Here is what I might say to an astigmatic patient to get them to give daily replacement toric lenses a try: “Have you ever considered wearing contact lenses? You are an excellent candidate for contact lenses! In addition, we have the newest option available in your prescription with daily replacement lenses for patients with an astigmatism. They may not have been available in the past, but now we can successfully fit your eyes with one of the healthiest types of soft contact lenses.” I am going for the excitement level. I want to get my astigmatic contact lens patients excited to try something new and involved in the fitting process. Given the chance to try daily replacement toric contact lenses, most of these patients become long-term, enthusiastic wearers.
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Jason R. Miller, OD,has been in practice 11 yearsand is in a partnership private practice with Tamara M. Kuhlmann, OD, MS, atEyeCare Professionals of Powell, Ohio. Contact: jasonrmiller@columbus.rr.com.
