With the recent slump in the market, nearly everyone is making some adjustments to their list of prioritieswhether it is to stretch two-week disposable contact lenses to last for three weeks, or to put off the family cars regular tune-up for another 1,000 miles. This rearrangement has even affected vision care appointments, where patients are now trying to get the most bang for their stretched buck, or to decide if the bang is worth it at all.

This is typically a slow month for refractive surgery anyway, says Joseph P. Shovlin, O.D., of Scranton, Pa. But, if we look at our appointments in August, as well as our appointments for October, theres no question that were down anywhere from 10% to 15%.

Paul M. Karpecki, O.D., of Edgewood, Ky., agrees. Ive seen a significant decrease in LASIK and refractive surgery volume as patients opt to remain in current corrective options. Currently, patients are taking a very cautious approach to spending money, and this has rippled through everything. I dont recall seeing this level of anxiety in my career.

Christine W. Sindt, O.D., of Iowa City, Iowa, notes another effect of the economic downturn: There is also a push from patients to do more at each visitperhaps because of the price of gas.

Patients are putting off high-ticket items in favor of basic necessities, explains Dr. Shovlin. We had a fellow the other day who was scheduling a [refractive surgery] consultationhe called back later and said, My wife has talked me into postponing this because we dont know what the cost of fuel will be this winter.

These are some of the patient concerns about refractive surgery that no amount of schooling can teach optometrists to manageespecially given the current economic climate.

This month marks Reviews 14th Annual Refractive Surgery Report. Refractive surgery, even in the best of economic times, can still make some patients a little nervous.

Our report includes When Cataract Develops Long After LASIK, by Louis J. Phillips, O.D. (page 69). Dr. Phillips explains that, because eight million Americans have undergone LASIK, more of them will be presenting with cataract as they age. How can these patients eyes and corneal powers be measured accurately for IOL implantation?

In the Optometric Study Center, James D. Colgain, O.D., presents Practical Points on Patient Expectations for Laser Vision Correction (page 98). Dr. Colgain discusses other patient concerns that only experience can illuminate. As he says, There are no mulligans in surgery. Before patients undergo laser vision correction, they have to understand not only the financial obligation involved, but also the potential outcomes. And, patients preoperative fears need to be addressed as well. Its perfectly normal for patients to be nervous, even rather squeamish, says Dr. Colgain, and they may need your reassurance that their fears about the surgical procedure are perfectly normal.

But what about their fears regarding the economy? What about your fears regarding the economy?

Some aspects of practice have not been affected as directly, notes Dr. Karpecki. Contact lens dispensing has changed a little, but it has not been affected as muchthere may be fewer patients opting for daily wear lenses, for example.

Still, patients fears about the economy may result in their not showing up for appointments, says Dr. Shovlin. I think that right now, the uncertainty is whats bothering most people.

But, theres always room for a little optimism. As we recover over the next six months to one year, though, Dr. Shovlin says, I think well be back to where we were.

Dr. Karpecki agrees. The good news is that nearly all of these patients, when surveyed, state that they are only delaying surgerynot deciding against it, meaning that, at some point, there will be a significant backlog of patients who want refractive surgery.



Leah M. Addis

Associate Editor


Amy Hellems Editors Page will return next month.

Vol. No: 145:10Issue: 10/15/2008