At Thanksgiving, the youngest of my three brothers, Steve, told me he was thinking of undergoing LASIK.

Considering that Steve routinely wears his soft contact lenses way past their lifespan, and he consistently rewets them by popping them into his mouth, swishing them around for a second and reinserting them into his eyes (despite horrified pleas from everyone to stop doing this), he might benefit from LASIK. At least he wouldn't abuse his eyes so much.

The late adopters

As a 30-year-old single guy who has a good disposable income, Steve definitely represents the largest and fastest-growing category of potential LASIK patients � the late adopters.

Many O.D.s and M.D.s are betting on this huge potential market of patients to send the numbers of LASIK procedures sky-high.

Howard Gottlieb, O.D., president and CEO of Eye Care Consultants Limited, a company that provides consulting and network services, spoke about this influential category of people at the recent American Academy of Ophthalmology meeting.

The market is shifting to late adopters, Dr. Gottlieb says. These well-educated people are usually aged 30 to 50 and represent 65% of all refractive patients, he explains. Also, they're more affluent, and care about state-of-the-art equipment, convenience and personal attention.

Basically, they want a high-touch, high-tech experience at a good price.

Where managed care comes in

Needless to say, the competition is clamoring to tap this huge pool of potential LASIK patients.

Advertising has become more aggressive and corporate involvement is on the rise � even managed care is getting into the game.

How? Within the last few years, a definite trend has emerged, says managed care expert Gil Weber, M.B.A. "We've seen an increase in prominent vision care plans teaming with corporate LASIK vendors to provide LASIK at a discount."

According to Weber, author of this month's cover story, this trend "ultimately could exert profound, negative change on the 'friendly' dynamic between O.D.s and several of the traditional vision plans."

As far as comanagement of LASIK patients under these discounted arrangements, continues Weber, "it isn't necessarily clear how things will shake out over the next year or 2. Discounts and enforced protocols may not be conducive to co-managing your patients."

For more on this trend and its potential impact on co-management relationships read page 26 of our magazine or look for �Blending LASIK With Traditional Vision Plans� in our Current Issue Highlights.

Co-managing relationships

Considering the uncertainty over whether this trend will be favorable to those of you who co-manage, many of you may be glad to know that Steve is staying with his contact lenses (hopefully, with better care habits) � at least until presbyopia sets in.