When mivision asked me to write an article about setting up a contact lens practice, I quickly jotted down everything that came to mind. Those who know me, know I don’t mind a chat, but this was going to be one long article. So instead, I’ve broken my list into three key tips to help you get underway.
Nobody sets up a contact lens practice without a desire to grow their practice and help more patients. Doing so is a significant investment in time, money and brain space, so you don’t want to waste the opportunity.
With this in mind, my top three tips for getting started are:
- Work collaboratively with ophthalmology,
- Educate yourself, and
- Train your team.
Once one doctor expresses their confidence in referring patients to you, their colleagues will feel comfortable referring their patients to you for contact lens services as well
WORK COLLABORATIVELY WITH OPHTHALMOLOGY
Patients require the services of a specialty contact lens practitioner for various reasons. Perhaps they have keratoconus; they have had previous corneal graft surgery; corneal dystrophies; or have experienced post refractive surgery ectasia; they may have suffered a corneal trauma resulting in scarring; or be a child with progressing myopia.
Each of these patients will have seen an ophthalmologist; perhaps even several over many years. They may currently be under the care of an ophthalmologist who has referred them to you for comanagement. Either way, it’s likely that you will find yourself working closely with ophthalmology, so one of the keys to setting up a successful contact lens practice is to work collaboratively with the relevant ophthalmologists in your area. These are likely to be:
- Paediatric ophthalmologists who refer progressing myopes,
- The ophthalmologist on call at the hospital (emergency department staff) who refers corneal trauma patients, and
- Corneal specialists who will refer corneal disease patients.
Before any medical practitioner refers their patients to you, you will need to earn their trust. It stands to reason that they will want to know you have necessary clinical skills and expertise to help their patient, that you keep up with the latest research, and you fit contact lenses based on clinical evidence. I also believe they will want some reassurance that you are a nice human, a good optometrist, and most importantly, that you will take care of their patients.
The only way to establish this level of trust and confidence in your ability is to get to know them – and ideally, to get to know them personally. I realise this is easier in a regional area than in a city location, but irrespective of where you practise, at least find a way to introduce yourself.
One way to do this is to attend their education events – many ophthalmologists host CPD seminars for optometrists.
The best way to build confidence in your expertise is by sending thorough patient reports back to the referring ophthalmologist. As well as being a professional courtesy, it is in the patient’s interest for their referring doctor to be kept updated on their condition as they may see the patient for a future consultation. In your initial report, include information about the contact lenses you intend to fit the patient with, and the reasons for your choice. Once you start the fitting process, write to them with the lens details and provide an update on how the patient is going with the appropriate lens modality.
Some optometrists fear disclosing lens information to colleagues. I’m not suggesting you describe the specifics of the edge lift and material – simply identifying the lens type and providing the basic parameters will demonstrate a willingness to share information. Remember that ophthalmologists don’t fit contact lenses; in fact, they know very little about them generally… and while I don’t think it’s a niche they are going to advance into anytime soon, I have found that they are interested in, and reassured by, the customised solutions I prescribe to meet the needs of their patients.
When writing to paediatric ophthalmologists who have referred patients for myopia control, I always describe the myopia control modality I have prescribed and include the latest evidence to support its use. Spectacle and contact lens modalities for myopia control are not typically those prescribed by ophthalmologists. Although they may be attuned to the latest research on these modalities, it’s possible they haven’t done all the reading and learning that you have.
Getting to know your local ophthalmologists is personally rewarding. You don’t have to get to know everyone, but it’s worthwhile making the effort to get to know a few. Like optometrists, ophthalmology is a small and close profession. Once one doctor expresses their confidence in referring patients to you, their colleagues will feel comfortable referring their patients to you for contact lens services as well.
EDUCATE YOURSELF
I’m not sure what your experience was like, but I don’t believe I graduated my optometry degree with many specialty contact lens skills. Instead, I learned the required skills on the job, through trial and error, by committing to lots of reading and attending conferences.
Specialty contact lens conferences are exceptional, with days filled with contact lens lectures on topics ranging from theory to practical workshops and new research. These long days are followed by themed gala dinners and time spent networking with colleagues. Getting to know fellow contact lens optometrists is helpful to you, your patients, and your business.
In Australia, there are two unmissable contact lens conferences; the International Cornea and Contact Lens Congress (ICCLC) by the Cornea and Contact Lens Society of Australia (CCLSA), and the Orthokeratology Society of Oceania (OSO) conference. Held on alternative years, these conferences are the highlight of my professional calendar.
Outside Australia, there are several other great contact lens conferences on offer. I attended Vision By Design in Houston, Texas, a few years back, and ended up touring New Orleans with a group of optometrists I met there. Many of those optometrists have become life-long friends; we lean on each other for support and help whenever needed.
Beyond conferences, it’s possible to network and advance your skills by joining Facebook groups and by attending supplier information events.
Supplier information events are an excellent way to maximise the potential of available equipment. Understanding, for example, how to take excellent topography maps and interpret them; learning how to use contact lens simulation software; and having a solid understanding of your contact lens fitting sets will save you time and optimise patient outcomes. When it comes to custom contact lenses, there are a vast number of lens choices and fitting sets to choose from. My suggestion is to learn to use three fitting sets well, and then expand your repertoire with more choices over time. Ideally, we want to be the master of our tools.
Over time, your skills will improve and your knowledge will advance. The more you know, the more you will be able to explain to your patients, and the easier it will become to answer their questions. As a consequence, your patient will be reassured of your expertise and more likely to comply with your clinical recommendations.
TRAIN YOUR TEAM
As the owner of an independent practice in Newcastle, New South Wales, I admit that I couldn’t run our practice without excellent support staff.
I have a team of wonderful humans to help me with all my specialty contact lens work. They support our optometrists by performing a great range of pre-testing before our consultations. They support our patients by teaching contact lens insertions, application and removal techniques, taking topography maps, performing optical coherence tomography imaging over scleral lenses, and measuring corneal thickness in those with corneal scarring.
While all of this is patient-facing work, the harsh reality is there’s also a lot of behind-the- scenes work that comes with running a contact lens practice. Contact lenses from the fitting set need to be cleaned and sterilised, custom orders need to be placed with the laboratory, then checked and verified on arrival. I often get emails or messages from patients during weekends, but on weekdays, it’s my clever staff who help answer patient emails and phone calls, and help triage complex cases.
While I know contact lens practice isn’t for everyone, I do think it’s a highly rewarding way to practice.
Heidi Hunter is the practice owner of Custom Eyecare in Newcastle. After graduating in optometry from the University of New South Wales (UNSW) in 2000, Ms Hunter spent time consulting with a local ophthalmologist, a laser refractive surgery clinic, and many optometric practices in the Newcastle region.
As well as looking after patients, Ms Hunter lectures about eyes and vision to university students, school teachers, GPs, nurses, and pharmacists; and she is a clinical supervisor of optometry students for Flinders University, Deakin University, and UNSW. Ms Hunter is on the national board of the Cornea and Contact Lens Society of Australia and a NSW/ ACT board member of Optometry Australia. She has lectured at conferences throughout Australia on various clinical topics.
