Having practised in some of the oldest and leading contact lens practices in South Africa and New Zealand, Alan Saks is passionate about the topic of contact lens practice building.
One way to get into contact lens fitting and management is by joining a leading contact lens speciality practice. There you’ll have the specialised equipment, trial lenses, and mentors you need to establish yourself in the field. However, such an ideal situation is not always possible. You may find yourself in a practice that does not yet have all this
in place, or in a solo practice, a group general practice, a commercial chain or a greenfield startup. If you’re keen to develop your contact lens skills, I wouldn’t let any of these environments hold you back. Indeed, I have experienced some of these scenarios myself.
It was a privilege to spend two decades in our family practice in Pretoria, South Africa, with the best you could get. My dad was a globally recognised contact lens pioneer from the 1950s. He taught me how to mould and manufacture scleral lenses, and how to modify, repower, re-edge, and polish contact lenses. We made our own contact lens polishing units and constructed areas for contact lens instruction sessions, spending many weekends on such projects. I could measure base curves on a radiuscope and determine diameter, thickness, optic zones and much more before high school, and was ahead of the game at optometry school.
You can have all the toys, the best skills and more, but without quality and service you’re less likely to succeed.
Establishing a great contact lens practice with a loyal following and plenty of referrals from optometric and ophthalmology colleagues was satisfying and rewarding work.
However, when I migrated to New Zealand in 1994, things were a little different. My first job in optometry was in Hamilton in the North Island, working in a dispenser-owned practice. It was new, modern, and minimalistic. So new, in fact, that on arrival for my first day of work, the owner sheepishly showed me my consulting room. It was a bare office!
We were still installing equipment and building the consulting room right up to the first booking at 11am on day one. The chair and stand were still in transit, from Italy; we used office chairs, a desk, and I performed trial frame refractions. Despite this rocky start, we got on really well. The owner gave me free rein to build a contact lens practice and practice optometry as I saw fit. In under two months I had re-established myself and we were fully booked. I was fitting soft and rigid gas permeable lenses, including the first quadrant-specific, asymmetric lenses in New Zealand, ordered in from Switzerland.
What Drives Success?
There are not too many new practices that are fully booked so early on in the game… so what made us so successful?
To start with, we had three highly motivated individuals – a Kiwi, an Austrian, and a South African. We were outgoing, engaging, and skilled at what we did. The practice was well presented. We delivered excellent service, and quality products with skill, knowledge, and style.
Right there you have two of the cornerstones to successfully building a practice: quality and service. You can have all the toys, the best skills and more, but without quality and service you’re less likely to succeed.
Another great practice builder is word of mouth referrals. A happy patient drives 10 more. Unhappy patients are bad for business. Pure and simple.
All this was in a time before the internet had taken off. Google ratings, reviews, and social media hadn’t been invented yet. We didn’t benefit from the immediacy of positive reviews, but neither did we suffer the panic that comes from negative reviews exacerbated by the internet.
Instead, we used some radio advertising to get a few people through the door then relied on referrals from happy patients to lead the way. Later, I pioneered optometric websites, which helped us convert to daily disposables in the late 90s. We dispensed thousands of 30-packs in our first year.
Enthusiasm is another infectious quality that patients appreciate, along with subtle confidence. My colleagues in the practice were only too happy to discuss contact lenses and make bookings. Sometimes they were a bit over the top… In one case they wanted me to fit a new wearer into disposable lenses on a Saturday morning. He had an important cricket game to play that day. There was no time to do insertion and removal training, so we had to stay open until after his game to remove the lenses. I warned him that the lenses might affect his judgement and perception, due to image size and so on, relative to his spectacles.
He returned in the afternoon with a smile from ear to ear. He’d played his best game ever, taking a record number of wickets. Many referrals flowed from that one.
The team also offered a pair of disposable contact lenses, close to a patient’s spectacle Rx, to aid in frame selection. This is a sure-fire way to get contact lens conversions. When a patient experiences the amazing vision and field of view, and finds them more comfortable than expected, they are more often than not, converts.
There were a lot of keratoconus sufferers in Hamilton and we had great success helping them. We had modern equipment but no topographer and built-up trial lenses as we went.
In the end it comes down to good sense: ethics, empathy, enthusiastic quality care, great results, and value for money will help cement your position, retain patients, and drive referrals.
It Takes Time
One of the best ways to grow your contact lens practice is by spending time with patients. In today’s climate, 20-minute eye exams are apparently common. A patient barely has time to express their desires and history. Some patients are told they cannot have contact lenses because they have astigmatism or presbyopia, or that their Rx is too high. Many of these prove to be ideal contact lens patients.
Consider performing diagnostic pretesting yourself. Patients are so appreciative when you take the time to explain in detail what their topography, optical coherence tomography, or images reveal. We obtain added insights into their personality by how they react and respond, and glean additional data observed while capturing the images. We might see distortion on autorefractor/keratometer mires or note early tear break-up or ring jam on placido disc rings, and so on.
If time is an issue, consider making up for time spent on personalised service by using an artificial intelligence scribe.
To promote your practice, go online. An optimised website is beneficial. Online booking systems are valuable, and social media is a great way to maintain engagement with your community. Google Ads can help you reach people who are yet to know you exist (see page 82). People might search Google Maps for ‘contact lenses near me’ and then look at ratings and reviews on what pops up. Important services, like myopia management, are another driver to help build your contact lens practice.
In the end it comes down to good sense: ethics, empathy, enthusiastic quality care, great results, and value for money will help cement your position, retain patients, and drive referrals.
All this leads to enjoyable, rewarding practice.
Alan Saks is a retired optometrist. He is the Chief Executive Officer of the Cornea and Contact Lens Society of Australia, and a regular contributor to mivision.
