Contact Lenses

4 Ways to Prevent Contact-Lens Dropouts

By Susan Resnick, OD, FAAO, FSLS

Dec. 2, 2020

Patients have high hopes and expectations for their contact lenses. They want lenses that deliver on vision, comfort and ease of care and handling. When one or more of these fails to meet their needs or expectations, they will often reduce their wear, or even worse, abandon the lenses entirely.

As a contact lens specialty practice, with 60 percent of our gross revenue generated from contact lens fitting fees, materials fees and follow-up care, keeping contact-lens dropouts to a minimum is especially important, but for any practice, limiting contact lens dropouts will have a positive impact on patient care and profitability.

My practice’s dropout rate is around 5 percent, mostly stemming from older presbyopic patients dropping out due to inability to adapt to multifocal contact lenses. A well-known study on contact lens dropouts by Sully et. al. showed a typical dropout rate of 20 percent, occurring most often among wearers in their first year in contact lenses.

Contact lens dropouts have significant implications for practice success and growth. It is well established that contact lens patients are more compliant with annual vision and eye health evaluations than eyeglasses-only patients, generating consistent and reliable revenue from both the contact lens evaluation and lens sales. With the advantage of these additional touch-points, comes the benefit of an improved bottom line through increased sales of prescription and non-prescription eyewear.

Here are four key steps to take to make contact lens dropouts much less likely in your practice.

Get Patients Off to the Right Start in their Lenses
Aim to exceed expectations from the outset to set the patient on a path to success:

  • A comprehensive pre-fitting evaluation is critical to assess refractive requirements and ocular surface health.
  • Understanding the patient’s goals with their lenses is the best guide to selecting lens modality.
  • Working with a wide range of designs improves our ability to successfully meet the needs of a greater number of patients.
  • Develop a sound clinical rationale for lens selection and clearly explain to the patient why you are prescribing a particular lens.
  • Avoid giving choices or using the word “recommend.” Rather, outline your plan, informing the patient of alternatives should you need to change course. This bolsters patient confidence in you as the professional, as well as supporting their understanding that contact lens fitting and prescribing is a process.

Tap Your Whole Team to Support the Contact-Lens Wearer
Be sure to provide clear and concise verbal and written instructions to new wearers. In our practice, we follow-up with all new dispenses three days after their visit. Our technicians call to be sure the patient is succeeding in insertion and removal. They also do a quick phone triage to be sure the vision and comfort is acceptable. The follow-up appointment is confirmed. If a patient requires re-instruction on lens handling, they are scheduled for an interim visit with the technician. Non-urgent clinical issues are noted in the patient’s records and discussed with the doctor to determine if an earlier follow-up visit is warranted or any additional lenses need to be ordered.

Ramp Up Recall
Ongoing follow-up care for our contact lens patients is guided by their visual needs, type of lens worn, frequency and duration of lens wear and any underlying corneal pathology. We pre-appoint visits within a three-month window for final follow-up on new visits and refits. Our recall for six months and beyond is done via e-mail. If that appointment is missed, a reminder card is sent by traditional mail. Our administrative team will subsequently phone the patient if they have not been seen within 18 months. E-mail reminders are generated one week prior to the patient’s scheduled appointment. Finally, patients receive a text message the day before their visit to confirm their appointment.

Provide Ongoing Education & Outreach
As a contact lens specialty practice, our practice’s success and growth hinges on our proactive approach to patient education and communication. Our internal marketing strategy has proven to be the most effective means of fostering patient confidence in our services and loyalty to our practice. At each visit we discuss new technologies that might benefit the patient. We maintain an up-to-date, informative web site and we publish an annual newsletter to detail current and future products and services.

Successfully caring for contact lens patients is not only clinically rewarding, but is an important component for practice growth and profitability.

Susan Resnick, OD, FAAO, FSLS, is president of Drs. Farkas, Kassalow, Resnick & Associates in New York City. To contact her:

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