A tall and burly man entered optometrist S. Moshe Roth’s Old Bridge, N.J., practice wearing the type of dark sunglasses one would expect to see on a movie star or a secret service agent. But this gentleman was neither. Instead, the sunglasses masked heterochromia caused by trauma. Today’s visit: An evaluation for prosthetic contact lenses, as the man divulged feeling self-conscious about his all-the-time sunwear.

“Within 20 seconds of inserting the prosthetic lens that matched his other eye and provided his original iris’ color, he became a different person: He sat up straighter, and he had a huge smile,” explains Dr. Roth. “This is what drives me: transforming self-esteem and quality of life.”

Research on prosthetic contact lens wear supports Dr. Roth’s experience with this patient. Specifically, such contact lenses significantly improve both the well-being and social relationships of patients who wear them, according to an Eye & Contact Lens study.

In addition to the altruistic rewards of helping such patients, Dr. Roth, among other doctors who prescribe cosmetic contact lenses, describe reasons optometrists should consider providing these lenses and advice on getting started.

ADDITIONAL REASONS

Those interviewed cite:

• Practice differentiation. “In addition to providing primary eye care, I provide specialty contact lenses, vision therapy and vision rehabilitation, all of which have helped me to differentiate the practice and attract and retain patients,” Dr. Roth explains.

• Patient variety. Elise Kramer, O.D., of Miami Contact Lens Institute, in Miami, says fitting cosmetic contact lenses keeps the practice of optometry interesting and fun because an array of patients can benefit from these fits. (See “Cosmetic Contact Lens Applications,” p.23)

For example, Mitch Cassel, O.D., of Custom Color Contacts and Studio Optix, in New York City, provides cosmetic contact lenses for the entertainment industry.

He says he fit Leonardo DiCaprio with special effect custom contact lenses that made the actor look inebriated (bloody eyes) as “The Wolf of Wall Street’s,” greedy, philandering addict Jordan Belfort. Other clients include Glenn Close in “Fatal Attraction” (convulsed eyes due to strangulation); Tom Cruise in “Days of Thunder” (subconjunctival hemorrhage, due to car accident); and, most recently, Robert DeNiro in “The Irishman” (eye color changes to age the character).

• Patient dedication. Because cosmetic contact lenses are, well, for aesthetics and tend to be an out-of-pocket cost, those interviewed say patients who wear them are typically more compliant with the prescribed wear and care schedule than those patients who wear standard contact lenses.

“When someone has a scarred or disfigured eye, they want to look as normal as possible on a daily basis,” explains Dr. Cassel. “When they are given contact lenses to do that, it makes sense that they’d be sure to take good care of them.”

Dr. Kramer points out that she sees the same dedication in patients she fits in colored contact lenses, yet require no functional vision change.

“Most of them view going in public without their lenses as analogous to going out without makeup, in that they don’t want to have to do it,” she explains. “That color, whatever it is, is a part of them, and that’s a powerful thing.”

ADVICE ON GETTING STARTED

Those interviewed recommend the following:

• Seek education. The optometrist should conduct online research on available CE and eye care trade shows, such as the Global Specialty Lens Symposium,* where cosmetic contact lens labs have booths to visit. This way, O.D.s can pick the brains’ of the lab consultants, recommends Dr. Kramer.

“If the O.D. is still in optometry school, he or she should investigate doing a residency with a corneal specialist who can also provide experience in fitting scleral lenses and orthokeratology lenses,” she adds.

• Start basic. “I think one of the easiest ways to get started here is to just work on changing patients’ eye colors with off-the-shelf colored contact lenses,” suggests Scott Edmonds, O.D., F.A.A.O., of multiple-Philadelphia-area practice, Edmonds Eye Associates. “The fit is pretty easy, and in a lot of cases you’re correcting the refractive error too, so this is a great starting point to test one’s comfort level and then, perhaps, work their way up in to some more challenging cases.”

• Acquire equipment. In addition to a slit lamp and phoropter, those interviewed recommend a topographer (for acquiring pupil size and corneal measurements), an HVID rule (to measure diameter when designing a custom cosmetic contact lens), high-resolution digital imaging (to acquire an image of a healthy eye to send to a contact lens lab for a customized lens) and a robust trial fitting set.

“The O.D. will need to obtain trial lenses from the different cosmetic contact lens manufacturers, so he or she won’t be ‘shooting from the hip’ with fitting, which can be a time-consuming endeavor and result in an unhappy patient,” Dr. Edmonds explains.

• A cosmetic contact lens fitting mindset. Drs. Cassel and Edmonds define this as patience, should the optometrist opt for the customized cosmetic contact lens route, and knowing when to refer.

“As rewarding as fitting customized cosmetic contact lenses is, it’s important to understand that it can be very time consuming too, in that, there is a learning curve, and there can be several re-dos,” Dr. Cassel explains. “As a result, the O.D. who takes this on needs to be passionate about getting it right and determined to make a difference in these patients’ lives.”

When it comes to knowing when to refer, Dr. Edmonds says this is contingent on the O.D. having a realistic idea of his or her skillset and identifying patients whose level of expectation exceeds what the optometrist can provide.

• Marketing. Drs. Kramer and Roth say the best form of marketing is word-of-mouth referrals.

“If you can improve a patient’s physical appearance with a contact lens, they’re going to tell everyone they know about it,” Dr. Kramer explains. “But, it’s also important to mention here that, sometimes, you need to be the one to bring it up because the patient is either embarrassed, or they simply don’t know such contact lenses are available.”

Dr. Cassel says he did just that when working with rock icon David Bowie on the “Little Wonder” music video. According to Dr. Cassel, Mr. Bowie was concerned with light sensitivity (secondary from his iris being severed from a childhood accident), so Dr. Cassel mentioned he could custom make a contact lens design that would relieve the light sensitivity and match his non-injured eye.

“He thanked me for the offer, but said he preferred ‘the Bowie look,’” remembers Dr. Cassel.

For external marketing, the doctors suggest advertising via the practice website, showing before-and-after photos on the practice’s social media channels — with the patient’s permission, of course — and reaching out to local ophthalmologists via letters or lunches where the O.D.’s education and skill in this area are mentioned to garner patient referrals.

FULFILLMENT

“When you’re giving someone their life back through a service you can provide, it’s just so fulfilling,” Dr. Roth says. “I don’t expect to retire; I just love what I do, and I may die in my exam room. My wish is that other doctors feel just as professionally fulfilled as I feel I have been fortunate to be.” OM

* Global Specialty Lens Symposium is a PentaVision meeting. PentaVision is the publisher of Optometric Management.