LASIK basics
How laser surgery can actually increase --not decrease--dispensing dollars
By Erinn Morgan

Do you have any patients who are white females between the ages of 18 and 29 with an annual household income between $40,000 and $75,000 (for two people in the household with no children) and who does not have a college degree? If so, then this particular customer very well may be considering laser surgery.

According to a recent nationwide survey conducted by the Vision Council of America, this is the typical person considering laser surgery. The study surveyed 1,000 consumers, of which nine percent indicated they were considering having laser eye surgery some time in the future. (See sidebar below for more information.)

Does the fact that she--and others like and unlike her--may undergo laser surgery mean that you will lose patients and business? Will you see a decrease in dispensing dollars coming into your business as post-op patients have fewer optical needs?

Absolutely not, say some industry experts who are combating laser surgery losses with products to serve the post-op patients' needs. "What could be lost to laser surgery can and will be made up with sales of reading glasses and non-prescription sunglasses," says Myles Zakheim, an OD in practice in Southern California. "We have to be a part of the process and not be afraid of losing our patients."

For sure, certain product categories--ready-made reading glasses, plano sunwear, progressive readers, and fashion eyewear--can spark post-op consumers' interests into a sale, even though many can see clearly, almost.

Interestingly, the laser surgery industry has been struggling quite a bit itself lately with both procedures and prices spiraling. "There is a whole crunch going on in the industry," says Josh Josephson, owner of five Josephson Opticians stores in Toronto.

"Our business has increased in the face of refractive surgery, and that to me in and of itself is an accomplishment. We are upper-end, and our clients can afford laser surgery, so I consider it even better. It's been healthy for us, so long as it continues," he says.

Some, however, do say that laser surgery has made its impact on their business. "To sit here and say it hasn't affected our business would be crazy," says Jack Erker, Jr., owner of Erker Optical chain, with five locations in St. Louis, two in Denver, and one in Dallas.

"To say what level of effect it has had is hard in light of the recession and the [September 11] disaster. How much is directly related to laser surgery is hard to know."

Some choose to simply stock an excellent array of products that are desirable to the post-laser surgery patient. Others work with existing patients to co-manage their laser surgery experience and ensure they will return to their dispensary for post-op needs. Both choices are viable options for maintaining a strong dispensing business in today's business climate with laser surgery still a competitor.

"Our stores have been around for a very long time," says Erker, "When contact lenses came about we had the same concerns, but that fear was not realized. We have decided not be concerned about it, but aware of it."

WHAT WILL THEY NEED?

All post-surgery patients will either immediately or eventually require some form of eyewear, even if that is non-prescription sunglasses. Many will actually need some additional vision correction, even if slight. Others will find reading glasses necessary.

Regardless of the type of person, every post-op patient could find a justifiable reason to purchase eyewear.

The bottom line is that they will purchase it from you or they will purchase it somewhere else. You will help them make that decision in the way in which you market and merchandise your eyewear assortment.

"Independent opticians are smart to get into selling more readers and plano sunwear because they have to make up lost business from laser surgery," says Erker.

PALs can be an option. Also, reading glasses, according to many dispensers, can be one of the simplest product categories to add.

"Laser surgery actually increases reading glass sales because of patient's needs after the surgery," says Erker, "And people want to wear nicer readers than they can purchase at Walgreens."

Erker notes that reading glasses are such a strong category that the company plans to open a reading glass store, called C2, in April in St. Louis' Galleria mall. "We found that this customer [the post-op laser surgery patient] is searching for a place to buy them," says Erker,

"Not a day goes by that readers are not sold in our optical stores. It's a test for us to see how it works. We are in the best mall in the Midwest. Further expansion will be dictated by how successful it becomes," he notes.

Erker adds that he hopes to cut laser surgery's effects off at the pass with this store concept. "Every laser surgery that is done to one of my patients is going to cost me $1,000 in sales per year since we are a high-end operation. Can we offset that? It's tough," he says.

So tough that the firm is moving boldly ahead to explore new areas that could make up for losses.

Plano sunwear is also an area that targets the needs of post-op patients. Those optical shops that focus on the category with prescription eyewear in the background say they have not lost business to laser surgery. "We haven't felt much of an effect," says Marvin Freeman, owner of 10 Davante optical shops, located in Las Vegas, Rancho Mirage, Calif., and Palm Desert, Calif.

"Maybe this is because we sell 30 percent prescription eyewear and 70 percent plano sunwear. If they have had laser surgery, we may not even know it because they might buy a pair of plano sunwear and not mention that they've had the procedure."

Still, other patients will require eyewear with a slight prescription.

"It's not terribly uncommon after six to eight months that a person's eye has a predisposition to go back to a curvature that it was before," says Rick Hogan, owner of Optical Designs in Santa Monica, Calif. "Then there will be a little residual prescription."

One of Hogan's customers was a minus 11 prior to laser surgery and a minus .75 and minus 1.0 post-surgery. "He came in for an exam and realized he could see better with a slight prescription," he says.

"It was nothing he had to be dependent on, but he saw the difference. He will wear his new glasses at night for plays and driving, plus sporting events. The surgeon told him he could do a 'touchup' but the patient said he wanted to wear glasses occasionally," Hogan says.

Another interesting trend mentioned by many dispensers is that post-op patients often come in requesting that their old eyeglasses be made into readers, plano sunwear, or even clear, non-prescription eyewear.

"Many are bringing in their old prescription glasses and putting plano lenses into them after the surgery," says Erker.

"They are putting plano clear lenses in because they still want to wear eyewear occasionally. Some also put reading glass lenses in them," he notes.

While this may sound like another lost sale for dispensers, some ingenious optical experts say it actually serves as an excellent marketing tool.

"We encourage them to turn the eyeglasses they were wearing into reading glasses or sunglasses so they don't forget who and where we are after the procedure," says Hogan.

"We definitely don't want them to forget us," he adds.

Other areas which remain somewhat exempt from the reaches of laser surgery--such as children, sports, safety, and computer eyewear--are viable options to increase business, even if in smaller ways.

Many say these are niche businesses, less profitable than plano sunwear and readers, that only make sense if you have a current customer base that is interested in those products.

CO-MANAGEMENT AS AN OPTION

While increasing certain product offerings will give post-op patients more options, this alone may not be enough to make up for lost business.

Some experts say co-managing your patients with a local refractive surgeon or laser center can ensure that they return to you for their eyewear needs.

"A lot of people feel if your patient is leaving to have laser surgery, you are losing a patient," says Zakheim.

"What you are really losing is a single-vision prescription eyeglass sale. They still need reading glasses, sunglasses, and post-op care." And PALs are still a lens of choice for many entering presbyopia.

Thus, some optometrists chose to align themselves with laser surgeons to ensure that their patients keep coming back to their dispensary.

"You don't want to lose that patient and they become Dr. X's patient," he says. "To make sure that I don't lose a patient, I will visit them post-op, even out of the office if necessary."

Many resolve themselves to the mindset that those patients who want to have laser surgery will do so regardless of whether or not their practice is part of the process.

"If they are going to have the surgery, you want to make sure they get it done with the best surgeon for the best possible fee," says Zakheim. "And you hope they have a husband or wife who does not want laser surgery whom they refer. This is where your new and incremental business will come from."

Though on the decline, co-management fees still bring in good money, and, just as important, this patient is guaranteed to return to your office for post-op care.

"We do pre- and post-op care for our patients who have laser surgery," says Pam Weddle, an optician with Optiks in Bloomington, Ind.

"We align with a local laser center. They come here first, then they go to the laser surgery center, then come back for post-op care and follow-up visits. Some don't need prescription eyewear, but many do and sunglasses as well. A lot of older people also want another pair of reading glasses," Weddle says.

Overall, many dispensers agree that laser surgery is not the death knell for dispensing that some have predicted it would be. In fact, it can actually be a boon to eyewear sales--if you make a variety of products available to your post-op patients and customers.

"The issue is that these are people who are not happy with contact lenses or eyewear under any circumstances, and the surgery for them is purely elective," says Zakheim.

"The point is, if you get involved and help them get it done the right way, and handle it with the right protocol, you can maintain their business. But it's got to work for everybody."