With COVID-19 sending the world into lockdown, the main goal for many is simply survival. Despite high hopes for the year of optometry, 2020 has quickly become the most challenging time the profession has ever faced. 

Hopefully the COVID-19 curve will flatten with social distancing, and several potential treatments are in the works. Optometry practices will survive this period and be stronger because of it, but there is no denying the challenges.

What To Do Now

Back in April, federal crisis relief legislation went into place, including the CARES program, business loans, unemployment and upfront CMS Medicare payments. I commend the AOA on providing timely information and resources on these programs and COVID-19 updates. 

Still, to survive, optometry practices must embrace telemedicine. Optometry has one of the best platforms available through EyeCare Live. CMS and other medical insurance companies pay the same for telemedicine visits as in-office visits. 

But telemedicine is only successful if you already have a medical model. If you don’t, Optometric Medical Solutions (OMS), which specializes in transforming optometry practices into medical eye care practices, is a key resource. Telasight also provides consultative clinical support for those pursuing medical eye care.

A few other tools can help: 

  • Bausch + Lomb can ship contact lenses, for free, to patients’ homes, and it has increased practitioner rebates.
  • Imprimis can ship compounded drops to patients.
  • Allergan has eliminated copays on all of its ophthalmic drugs.

And that’s just a sampling. 

We can also use this downtime to participate in educational webinars, stay in contact with staff and prepare to return stronger than ever.


Optometry will find revenue streams beyond seeing patients in the office. Telemedicine will become part of how we practice, although it will require HIPAA-compliant platforms after the pandemic subsides. A virtual visit can’t replace the initial exam or glaucoma/retina evaluations, but it could be great for a one-month follow-up for a dry eye patient not on steroids, contact lens and prescription refills and many other follow-up exams. 

Home diagnostics will become essential to expanding telehealth. AtHome (iCare) IOP monitoring allows patients to check their own IOP for interim telemedicine visits, and ForeSeeHome (Notal Vision) provides at-home AMD monitoring.  

An online contact lens distribution avenue that generates revenue for the practice will be valuable. Companies with sound online distribution channels (e.g., Hubble) are already successfully partnering with some within the optometric profession. 

Likewise, recurring sales from over-the-counter products is another revenue stream. Companies such as Science Based Health, MacuHealth, Pristine and Pharmanex all have excellent products we can provide our patients. Bruder Healthcare initiated a program for dry eye patients during this downturn. ‘Storefront’ options, such as those offered by Allergan and myoasis.com, allow you to sell over-the-counter products online that appear to be coming directly from your office or website. While these resources won’t replace the revenue from seeing patients, they at least provide some steady income. 

Even where you see patients will change. People are staying away from crowded stores and hospitals, which leads to new Rx opportunities such as LeGrandeRx. Patients will be increasingly hesitant to have cataract surgery in a hospital or ambulatory surgery center, and practices that have office-based surgery suites such as iOR Partners may be a safer option.

Pent-up Demand

The profession must adapt, and the new model will provide eye care differently. For one, ODs should wear surgical masks, even after the pandemic.

The demand for eye care services is currently pent up. By re-positioning our practices, creating new revenue sources and adapting to the changes, optometry won’t just survive, it will eventually thrive.

Note: Dr. Karpecki consults for companies with products and services relevant to this topic.