What’s that I said? Esthetic optometry? I realize that you’ve probably never heard those two words used together, but trust me, over the next few years you will be hearing a lot about esthetics and optometry. In fact, I predict that this practice niche will help save and redefine our profession, keeping it relevant despite an onslaught of well-financed and carefully contrived media assaults on traditional optometric practice.

So, what exactly is esthetic optometry? It is the practice of enhancing the appearance and related function of our patients’ eyes. While it’s not plastic surgery in the contemporary sense, rapid advances in technology and new medications will likely have a very positive impact on our ability to make our patients’ eyes look as good as they see.

With my focus on ocular surface disease, and more and more patients suffering the effects of “dry eye” and digital device overuse, I see this coming like a runaway freight train. Every week, the number of patients complaining of cosmetically objectionable red eyes steadily increases. While some issues are the result of the “dry eye” triad—discomfort, diminished and unstable vision, and conjunctival injection—for many patients, red eyes are their primary complaint.

The good news is that we are on the edge of new and more effective treatments for these patients. In addition to managing lid disease and bacterial overpopulation, new eye whitening drops, like B+L’s long-awaited Luminesse, will hopefully be approved by the FDA in the near future.

A variety of energy forms including intense pulsed light (IPL) and radio frequency-based Thermi treatments have been proposed as therapies for MGD. They also tighten and smooth periorbital skin. In some states, ODs are already licensed to use these technologies and perform procedures. Even in restricted states, working with an MD or DO medical director, or hiring a laser/IPL-certified aesthetician can immediately propel many practices directly into esthetics.

Perhaps the most compelling reason to get involved is the economics. At a time of diminishing reimbursement and increased competition for traditional sources of optometric income, virtually all esthetic procedures are out of pocket. All require human-to-human contact and can’t be performed online, and, as has been generally true for investments in most advanced technology, the return on investment is usually both rapid and rewarding. All of that said, we need to get involved in this area of practice because it is something that our patients want. Esthetic optometry is clearly part of our future.

Arthur B. Epstein, OD, FAAO Chief Medical Editor artepstein@optometricphysician.com

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