Michael Mayers, OD, Mayers Eye Solutions, Powell, Ohio, examines a contact lens patient.
By ROB Editors
Asking your patients the right questions about their contact lens use and care will help you pinpoint discomfort that will otherwise lead them to drop out. Contact lens patients, whose return visits to the office are more frequent than those of eyeglasses-only patients, are highly valuable to the practice long term, so reducing dropouts is a key practice builder.
for CL Patients
1. Anything about your contact lenses that you wish was better?
2. Which contact lens solution do you use? Please point to the solution in this picture (of various solutions) that you use.
3. What contact lenses are you wearing? The same as what I prescribed for you last year?
4. How comfortable are your contact lenses at the end of the day? As comfortable as they are in the morning?
5. Do you do a lot of computer work? How do your eyes feel after several hours of detailed work on your computer?
Probe Details on Comfort
“Many ECPs ask, ‘How are your contacts going?,’ which is not a far departure from asking someone how their day is going,” says Michael Slusky, OD.”Think about it, how many people will really get into it with you? How many will simply say ‘fine?'” Instead, Dr. Slusky recommends more targeted questions that encourage patients to be specific in describing their contact lens comfort level. “What if we were to ask the right question: ‘Is there anything about the contact lenses which youhavebeen wearing that you wish was better?’ Now we have an open-ended, effective case history to guide us through the examination,” he says.
Michael Slusky, OD,
Halsted Eye Boutique
Dr. Slusky says he is careful to also ask about the solutions the patient is using. “The medical history questionnaire asks the patient to list the solutions they are currently using,” he says. “This has been an effective means of opening up a conversation about contact lens solutions,” Dr. Slusky says. “For those with electronic records where the patient does not fill out a medical history form, try asking the simplequestion, ‘Tell me, what contact lens solution are you currently using?'”
Put Risks in Understandable Terms
“I am aware of the dangers of patients self-prescribing solutions, and inform them of the risks associated with mixing less compatible lens materials and solution chemicals,” Dr. Slusky says. “This is a strong driving point that resonates well with patients. Although they don’t need a biochemistry degree, many people understand the concept of not mixing chemicals. It is common knowledge that certain household cleaners should not be mixed, as it is common knowledge that water and oil do not mix–so that’s the way to phrase it: ‘Although there are many contact lens solutions on the shelf, and they share a common purpose of cleaning contact lenses, the technology of contact lenses and contact lens care has been optimized to enhance the safety and comfort of wearing your lenses. It is for this reason, I am prescribing you OPTI-FREE RepleniSH to maintain your eye health, reduce the risk of contaminants, and improve the comfort of your lens wearing experience.”
Dr. Slusky says detailed communication between doctor and contact lens patient is essential to the long-term success of contact lens wearers. “If the eyecare professional is not able to build loyalty though effective communication, and manage their patient’s contact lens needs, that ECP will probably not be the selected source of future medically necessarycare for that patient.”
Michael Mayers, OD
Mayers Eye Solutions
Cold; 3 years ago
Annual CL patients
Visit office every
14 to 16 months
Paint a Picture for the Patient–Literally
“When a patient comes in for a contact lens exam, I do a review of records and a review of their compliance with their current prescribed lenses and solutions,” says Michael Mayers, OD. “I talk about the lenses themselves and ask if they’re wearing their prescribed lenses from last year. Lots of times they will order online, and end up wearing something different from what I prescribed. I also ask them which solution they buy when they go to the pharmacy. Since, most of the time, they don’t know, I have pictures of solutions to help them identify which one they’re using.”
After verifying that patients are still in the same lenses he prescribed and–with the help of pictures–that they’re using the same solution he recommended, Dr. Mayers asks patients specific questions about their contact lens comfort throughout the day. “I ask them about their end-of-day comfort,” he says, “and ask if they do a lot of computer work, and if they do, whether they feel their eyes drying out. I then ask if there is anything about their lenses they would like to improve or change. After getting this feedback from patients, Dr. Mayers opens the conversation to the patient, asking if there is anything he hasn’t touched on about their contact use that they would like him to know.
Just as patients often don’t know the lens or solution they’ve been using, many also are unaware of all the other eye products they are using. For that reason, Dr. Mayers advises ODs to ask patients, when they schedule their appointment, to bring in all the eye care products they are using, including rewetting drops, and any drops they may be using to, say, reduce redness.
Listen to How Patients Want the Information
When presenting patients with their contact lens prescription, Dr. Mayers not only gives detailed directions on replacement schedule and the preferred solution to use–he asks if the patient would like the information written down, or if the directions along with a sample kit featuring the recommended solution is enough. “If the patient wants it written down, I write it down,” he says. “I also try to make a connection with the patient when I hand them their starter kit. I give them one great reason I have prescribed their lens and solution,and tellthem not to switch without talking to me first.”
For More Reading on Reducing Dropouts: