Optometrists don’t see themselves in a power position, but any profession that sees 88% of all comprehensive exams, in this case eye exams, wields considerable power. And with an election that will focus on healthcare, 2020 will be a critical year for optometry. It’s time to embrace this position and use it to serve our patients—and our practices—better. A significant part of doing that is recognizing disruptors in the field and adapting to stay ahead of the inevitable changes.. 

Test Drive the New Model

Today, 120 million people are in their 40s, 50s and 60s, and more than 38% of them have significant astigmatism. Those 32 million patients need a multifocal contact lens with astigmatic correction, yet most of them believe they are not candidates for contact lenses because of presbyopia, astigmatism or both. 

Bausch + Lomb’s new Ultra Multifocal for Astigmatism contact lens now provides an easy in-office option. This lens provides a high DK/t (163), high water content (46%) and a high modulus (70). It has parameters from -6.00D to +4.00D, around the clock in 10° steps, three cylinder powers and two add powers. In clinical trials, 92% of patients said they could shift naturally from near to far throughout the day.

Upgrade Your Tech Package

Another valuable addition for your patients—and your bottom line—is in-office, patient-pay procedures. Until insurance covers these, doctors can set pricing to appeal to patients while also maintaining a healthy margin. One essential in-office treatment is BlephEx, because removing the biofilm from the lashes and lid margins for patients with meibomian gland dysfunction (MGD)/blepharitis can significantly improvement signs and symptoms. Many patients state that their eyes have not felt this good in decades.
Another important in-office procedure is thermal pulsation with LipiFlow (Johnson & Johnson Vision), iLux (Tear Film Innovations), TearCare (Sight Sciences) or, soon, Ocusoft’s eyelid warming device. Intense pulsed light (IPL), with either the Eye-Light IPL (Lombart) or Lumenis’s IPL, is another in-office option for most ODs. I recently purchased an Eye-Light IPL system and treated 50 patients with it in the first six weeks. We’ve been very impressed with its ease of use, the patient experience and the results. Most patients require only two treatments and I can see a significant improvement in telangiectatic vessels and overall inflammation in the eye.  Patients have noticeable improvements in symptoms. 
Many patients who have delayed treatment of their MGD or dry eye will require a combination of all three in-office procedures. When combined with dry eye therapies and at-home care, these procedures may solve the complex puzzle of dry eye for many patients.

Upgrade Your Tech Package 

Patients trust the provider they have seen for the last two, or 20, years more than someone they meet for 15 minutes before a procedure. That’s why ODs should be integral to the IOL or MIGS selection process. 

By the end of the year, RxSight will introduce the light-adjustable lens. I’ve seen the adjustment process first hand, and most patients with an adjustable light lens had uncorrected distance vision of 20/12 or better. We will be the doctors determining the optimal refraction post-surgery, whether that’s with monovision, full distance correction in both eyes, astigmatism modification or, one day, presbyopic correction designs. Our involvement is key to alleviating the demand on surgeons, considering that the need for cataract surgery will exceed the supply of surgeons within the next seven years. That means we need to handle more of the care, including comanagement and, when we can, laser procedures. ODs can also look into working with surgeons with in-office surgical suites to offer more advanced procedures and help meet the growing needs of patients. 

When you control the majority of all comprehensive eye exams and are more than 40,000 strong, you can be disruptive for the betterment of patients. There are many opportunities to choose from—make sure you aren’t the one being disrupted.

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