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How to Incorporate Scleral Lenses Into Your Practice

Turning your interest in scleral lenses into a successful practice-builder requires more than just knowing how to fit them.
By Stephanie L. Woo, OD

1/15/2015

With scleral lenses increasing in popularity, more practitioners than ever are considering how to incorporate them into their practice. So you’ve attended the workshops, seen the lectures, browsed through articles and maybe invested in a scleral lens diagnostic set. But, how do you bring this new modality into your practice so that it enhances rather than disrupts your office? Here are some points to consider in developing the best method that works for your patients and your practice.


Using Social Media to Market Scleral Lenses
By Aliza Martin, Associate Editor
Of all the technological advances made in the last few decades, social media has been one of the most disruptive forces that’s reshaping how companies—from huge multinationals to small medical offices—conduct business, promote their brand and engage customers in the 21st century. Of course, many companies that adopt these methods sell products with wide appeal, which makes the mass audience of social media an ideal way to communicate. So, how can eye care providers use these techniques to engage scleral lens wearers, who make up only a portion of contact lens patients?

More reach, less effort. Traditionally, companies often spent big bucks developing blanket-advertising campaigns in an effort to reach as many customers in as many different ways as possible—choosing, in effect, quantity over quality of interaction. Typically, the amount of money spent was proportional to how far the message was spread; thus, smaller companies were often at a disadvantage. Social media, however, levels the playing field for companies of different sizes while simultaneously aggregating a wide variety of users in a single medium and collecting data on what makes each unique. Users can be targeted on Facebook, for example, based on location, demographics, interests or behavior, so try using this tool to target contact lens wearers in your area who may have previously searched for specialty lenses online.1

Make conversation. The next step after finding the potential customer is to engage them. Social media has given users more control over choosing what they do or do not want to see while browsing. Thus, building a good one-on-one relationship with the customer is key: someone who feels respected, listened to and valued is more likely to maintain brand loyalty and share their positive experience with others, instead of simply ignoring a post or even clicking “unfollow.” So, engage your scleral patients online. Invite them to “like” your page and post a review, and be sure to respond to their comments. Post contests and other interactive content on your page to encourage conversation. Continually adding new information to your page will help keep patients involved and aware.

“Today, you need to think social media at all times,” says Jack Schaeffer, OD, head of Schaeffer Eye Center in Alabama. Have videos on your website that discuss the advantages of each product category you offer, including sclerals, so that patients can view, comment and share, he suggests. Dr. Schaeffer encourages his scleral patients to “go on Facebook and talk to other people, so it will be a word of mouth-type marketing campaign that would come basically from the patient, not from the practice.”

Pick the right medium. Social media and the Internet in general have had a significant impact on the average attention span, as we are constantly bombarded with information. The latest statistics place the average attention span at eight seconds in 2013, down from 12 seconds in 2000.2 In line with this trend, short Facebook posts, tweets and six-second video clips have largely supplemented and in some cases replaced newspaper, radio and television ads, as well as older forms of online advertising like website banners. These small campaigns can be quickly and easily shared and “reshared” between hundreds of thousands of social media users, creating a ripple effect. 

Try getting your staff involved in creating and distributing videos or tweets for your practice to raise patient awareness. Many marketing research firms and social media giants like Twitter have published studies on, for example, how to best construct posts and when to send them.3

Tweak your website. In this day and age, your website is just as important as the receptionist sitting at your front desk. Many prospective patients may visit your site well before calling to schedule a consultation. As this is their first impression of your practice, make sure your website is clean, easy to navigate and as informative as possible.

“Our website is a big tool for us,” says Jason Jedlicka, OD, at the Cornea and Contact Lens Institute of Minnesota. “We make sure to have a page devoted to scleral lens information.” He points out that he and his colleagues named their practice expressly to focus on their contact lens expertise. “We are not a routine eye care practice that happens to have a scleral lens fitting set—we are first and foremost there for the patients that need specialty contact lenses. Patients will see our name and know what we are about.” 

The rise of “content marketing” has also impacted the way businesses reach customers and so should be taken into account when designing a website. Content marketing, or the distribution of media and written content with the intent of influencing consumer behavior, is a good way to educate scleral lens candidates while also making them aware of your practice in particular. Posting a small article on the benefits of wearing scleral lenses or useful tips to keep in mind on your practice’s website may also help boost patient confidence and trust. Additionally, writing or contributing to articles published elsewhere can also enhance patient referrals. 

“We have written many articles on scleral lenses and it is amazing how many patients find us by searching the web for information,” Dr. Jedlicka says. Patients “stumble across an article we wrote about how we fitted someone like them in sclerals and helped them, and they call wanting to know if we can do the same for them.”

Employing search engine optimization (SEO)—the process of improving a website’s natural search engine ranking using a combination of certain keywords, images and other components—can also make the content on your site appear higher in search results, helping to drive web traffic to your website and increase awareness of your practice. Google offers a guide for getting started with SEO.4

Combine social media with other platforms. Although social media has in many ways revolutionized marketing, more traditional methods like television and radio still hold significant cultural weight. In fact, cross-platform advertising may be the most effective way to market your practice. Research by Nielson and Google found nearly 75% of consumers remember an ad when viewed across all media platforms, compared to just 50% when viewed only on TV.5 A separate Nielson study in 2013 found many marketers still view television as the most effective way to reach customers, but also noted that Internet advertising jumped by more than 32% in a year’s time.6  

“In our practice, we try to do public relations-type stories on patients who are in keratoconic lenses,” for instance, says. Dr. Schaeffer. Local news media in his area have featured representatives of the practice discussing new treatments for keratoconus and other corneal diseases. “And of course that’s where we talk about the advantages of scleral lenses.” Consider taking out an ad on a local television channel or in the newspaper. 

Don’t forget the original social network: word of mouth. “I market specifically to corneal surgeons,” says Shelley Cutler, OD, founder of Scleral Lens Associates in Pennsylvania. “I started out with a letter. I went through the phone book and online to find as many corneal-trained doctors in the Philadelphia area, and Delaware and New Jersey, and I sent them out a letter and some business cards, then I followed up with a postcard maybe four to six months later.”

Derek Louie, OD, of Casey Eye Institute in Oregon, uses similar methods. “I speak to other practitioners in the community and let them know we are using these types of lenses frequently and have [the] familiarity to help their patients. Internal marketing to our existing patients also works if someone is struggling or looking for something different than their current contact lenses.”

1. Facebook. How to target Facebook Ads. Available at: www.facebook.com/business/a/online-sales/ad-targeting-details. Accessed on December 3, 2014.
2. Statistic Brain. Attention Span Statistics. Available at: www.statisticbrain.com/attention-span-statistics. Accessed on December 3, 2014.
3. Twitter. Tweet tips: Most effective calls to action on Twitter. Available at: https://blog.twitter.com/2013/tweet-tips-most-effective-calls-to-action-on-twitter. Accessed on December 4, 2014.
4. Google. Search Engine Optimization Starter Guide. Available at: http://static.googleusercontent.com/media/www.google.com/en/us/webmasters/docs/search-engine-optimization-starter-guide.pdf. Accessed on December 11, 2014.
5. Nielsen. Nearly 75% of Consumers Remember an Ad When Viewed Across All Media Platforms. Available at: www.nielsen.com/us/en/insights/news/2011/nearly-75-of-consumers-remember-an-ad-when-viewed-across-media-platforms.html. Accessed on December 11, 2014.
6. Nielsen. TV Remains the Reigning Champ, But Display Internet Ads are the MVPs of 3Q. Available at: www.nielsen.com/us/en/insights/news/2014/tv-remains-the-reigning-champ-but-display-internet-ads-are-the-mvps-of-3q.html. Accessed on December 11, 2014.

Inform Your Staff
Staff members play a critical role in enhancing patient experience, from the receptionist who answers the phone to the technician who works the patient up and the optician who fits the patient with glasses or contacts. Educating your team on the new service you are now offering will better enable them to recommend scleral lens options to patients and answer some patient questions before the patient even sits in your chair. Having knowledgeable staff members also enhances patients’ opinions of your practice.

When you make the decision to start fitting scleral lenses, organize a staff meeting to let them know of this new service. Educate them on what these contact lenses are, how they differ from other types of lenses and which patients are good candidates (i.e., those with keratoconus, corneal transplant, a history of LASIK, extreme dry eye, corneal scarring.). This way, staff members will be prepared when patients inquire about scleral lenses, and possibly even confident enough to recommend that certain patients look into this design for the best possible vision. It will also ensure patients get a consistent message no matter who in the practice they happen to be talking to.

Not too long ago, one of our newest staff members came to my office and said, “There is a patient on the phone and they were wondering if we treat keratoconus?” Imagine the incredulous look I must have given the poor girl! But then I realized this lack of knowledge is my fault; I did not properly train her regarding the services we offered or which patients we could help. Since then, I’ve added an introduction to the practice and an explanation of what makes us different to my new employee orientation. During this meeting, I always mention that our practice has the ability to fit difficult corneal problems and I give examples of various typical cases. I also changed the system of how newly hired employees are trained—now all staff members are well informed of the services that we provide. 

Get the Word Out
It’s important to let people know you’re now offering this new service. Place an ad in the local paper announcing that you can now assist more difficult-to-fit patients, including those with keratoconus or other corneal irregularities, such as irrgeular astigmatism following a transplant or other corneal surgery. 

If you distribute an electronic or paper newsletter, highlight scleral lenses and the kinds of patients you can help in it. And make it personal: tell the story of a successful patient. Avoid overuse of technical terms about the lenses and medical jargon.

Be sure to also update your website, social media pages and any online business listings. You will be surprised at how many people call your office to inquire about the new product and ask if they can try these special lenses. 

Offer Free Consultations
A great way to capture a potential patient’s interest is to offer a free contact lens consultation at your office. When the patient calls to inquire about specialty lenses, have your staff explain the benefits of a free consultation. You can also advertise this service on your social media page or in your newsletter. 

The services included in the consultation depend on what you deem appropriate, so feel free to develop your own. In my practice, we check the patient’s vision, verify their glasses, perform topography and evaluate their eyes briefly with the slit lamp. After this, I spend five to 10 minutes reviewing the findings with them and discussing contact lens options. I also review pricing and go over what to expect during the fitting process so there will be no surprises. 

Typically, when patients are aware of their condition and understand why they cannot wear standard contacts or glasses, they are more receptive to the treatment options that you, as the doctor, recommend. Overall, these consultations have been extremely successful in my practice, and I hope they are in yours too!

Inform Local Doctors
You may think, ‘Why would another eye care provider refer a patient to me? Can’t they just fit the patient themselves?’ The answer is: not everyone wants to fit specialty contacts—many don’t even want to touch scleral lenses! I find this especially true of optometrists who have been practicing for more than 10 years. Many learned to fit corneal GP lenses, and that is what they are comfortable with—which is great for you! As you know, scleral lenses can work for a variety of patients, and, in some cases, are the only viable option. 

If you let other optometrists in the area know that you can fit scleral lenses, many will be happy to send patients your way, especially if you make it clear that you are simply trying to help their patient, not steal them. Many of these ODs have likely already tried other designs that have failed, so they may welcome the assistance. To maintain this relationship, I always make a point to send the patient back to their referring doctor for everything that is unrelated to the contact lens services I’m providing, whether it’s a request for glasses or ocular health issues I observe that may need treatment. This serves as a good form of mutual advertisement—they will circulate your name to patients, and, if you’re so inclined, you can do the same for them.

Sclerals can also be a great way to establish or strengthen collaborative relationships with local ophthalmologists, especially those who do a lot of corneal and refractive surgery. Some of their patients will need specialty contact lenses after a procedure, and scleral lenses are not always part of the services offered at an ophthalmology practice. It’s to their benefit, and yours, if you know each other’s capabilities.

Overdo the Education 
You can never give a scleral lens patient too much information about their new modality. Most patients have difficulties with their lenses, and many who drop out do so because of simple problems like lens insertion. Providing patients with adequate information—before, during and after the fit—will greatly decrease their chances of dropping out.

After the lenses are dispensed, the patient should be given articulate instructions about insertion, removal, lens care and frequently asked questions. Increase their chances of success by demonstrating a variety of methods for lens insertion and removal (Figure 1). This way, if they get home and one method doesn’t work, they don’t have a panic attack. Also, make sure to provide written step-by-step instructions for the patient to take home—just like a good portion of patients in general, many new scleral lens wearers forget instructions as soon as they leave the office (Figure 2). 


Fig. 1. Give your patient multiple ways to insert and remove the lens.

Fig. 2. Provide your patient with a variety of scleral lens resources, such as an informative DVD and written instructions to take home.

Providing a list of online resources where patients can find information and videos on lens insertion, removal and care is another way to decrease dropout. I recommend www.gpli.info and www.sclerallens.org as good sources for both practitioners and patients. Your staff can also create this content in-house. (See “Using Social Media to Market Scleral Lenses.")

Appoint a Staff Member as Your Billing Guru
You do not need an experienced biller to be successful with scleral lens reimbursement; instead, pick a team member who is committed to finding out the correct answers and willing to to do the research needed. Some practices call the insurance company before the patient is even seen for a consult or their comprehensive exam; others wait until the patient has been seen to report the proper diagnosis and procedure codes. Some insurance companies do not require a preauthorization letter, while others do. If you designate a staff member at your practice to help you with specialty contact lens research, billing and coding, they can help you determine the best approach for your practice, thus making your life easier.


 Many vision insurance companies like Eyemed, VSP, Spectera, Davis and Avesis also have good staff to assist you in determining medically necessary contact lens benefits. Remember that most vision plans make scleral lens fitting very easy to bill. 

Don’t Overlook Your "Regular" Patients! 
Many patients who come in for their routine exam expect to simply receive their annual check-up and an updated glasses and/or contact lens prescription. If you feel, however, that a patient might benefit from a scleral contact lens evaluation, mention it to them! I can’t tell you how many post-refractive surgery patients show up for their routine exam unaware there are contact lens options for them. This is especially true of the early adopter group who underwent refractive surgery using previous techniques that are no longer state of the art, such as radial keratotomy (RK)—it’s likely that they’ve been walking around with unaddressed vision problems for years.

Even if your patient reports seeing relatively well, ask them about dry eye or fluctuating vision. Then, inquire if they would be interested in contact lenses. Many patients will be shocked at the possibility because they are under the impression they could never wear contact lenses again. I challenge you to ask your next RK patient who comes in for their comprehensive exam if they would be interested in contact lenses. You’ll likely be excited by their answer and even more excited to fit them with scleral lenses!

Just Do It
That old Nike slogan applies here: just do it. Scleral lenses are the biggest growing category in gas permeable lenses, and it’s clear to see why. They are comfortable, stable, provide excellent vision and are easy to fit! Scleral lenses have made fitting both the irregular cornea and the normal cornea simple and straightforward. They can be a good source of revenue for your practice, as well as a good move in establishing your clinic as a specialty contact lens resource. 

The patients that you help by offering this service can be extremely rewarding. My favorite part of the day is when I see a scleral lens consult, fitting or dispense on my schedule. Scleral lenses change lives—for both patients and practitioners alike!  
Dr. Woo graduated from the Southern California College of Optometry and completed a cornea/contact Lens residency at the University of Missouri–St. Louis. She is a Fellow of the American Academy of Optometry and a Fellow of the Scleral Lens Education Society. She currently practices at Havasu Eye Center in Lake Havasu, AZ.



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