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Best Practices | Oct 2016

Breaking Down Barriers to Offering Aesthetic Services

Are optometrists limiting their own success?

Despite numerous opportunities for interested optometrists to add aesthetic services to their practices, for some, getting started is a large obstacle. Perhaps it is the opportunities themselves that become barriers. So much is potentially at stake—money, reputation, time—that one wants to get it absolutely right from the start. The benefits of adding such services, especially in light of declining reimbursements, are obvious. Diversifying one’s patient base is certainly important, and beyond that, a cosmetic focus may be a natural evolution of where optometry is going. Many practices are gravitating toward a wellness model, which is complemented by aesthetics. Wellness is not only about feeling great, eating healthfully, and exercising. It is also about looking good, which can be extremely important for patients’ self-esteem.

What I sense from conversations I have had with colleagues is hesitation or unease with finding an “in” to get started with aesthetics. Are some of these barriers self-imposed? Are some interested optometrists over thinking things?


One of the questions I am asked about aesthetics is some variation on the following: “Are there patients in my practice who might be interested in aesthetic and cosmetic services?” The answer is likely yes, and the population may be larger than expected.

I see a lot of patients with dry eye disease (DED), and these individuals may be more inclined than others to ask about wellness and health as an adjunct to their eye care needs. DED patients tend to be amenable to conversations about ocular health and are interested in strategies and approaches that will benefit their ocular surface while also yielding a cosmetic improvement. They are attuned to quality-of-life issues as a consequence of ocular discomfort. In general, these patients are frustrated by their inability to read without glasses or look at their phone comfortably, so they are receptive to solutions—including cash-pay services—that provide lifestyle enhancements in addition to addressing their medical problem. Conversations about lid scrubs and hygiene, for example, are a natural fit. From there, talking about the health and appearance of the skin around the eye follows easily.

Providers who successfully prescribe multifocal contact lenses are treating patients who are making a cosmetic choice to get out of glasses and are willing to pay a little more for the convenience of correcting their presbyopia. Not coincidentally, the largest population of multifocal contact lens wearers is patients in their 40s who may be experiencing their first encounter with signs of aging. Talking about presbyopia can lead to conversations about other facial signs of aging.


Classically, the population in search of the magical elixir that will turn back the hands of time has been older women, but that is not the sum total of the aesthetics market. Patients are thinking about health and wellness products earlier in their lives. Aging signs like wrinkles and frown lines may show up later in life, but they are preventable if corrective behavior is started earlier. Although older women are still the most likely candidates for aesthetic services, more than ever, men and younger individuals of both sexes are also seeking ideas to keep them looking youthful and vibrant.

In terms of approaching men versus women with advice and education about cosmetic and beauty products, how the message is delivered is important. In my experience, women are willing to listen to beauty-centered conversations that convey aesthetic outcomes, whereas men want reasons why they should change their behavior. I find that women generally want to understand how a product will make them feel or look, whereas men may need a more linear connection between using a product and the benefit it will provide. In some respects, men may be more willing to listen to conversations about health and wellness in the setting of an optometrist’s office, where the environs are more medical in nature, versus a spa or retail distributor of beauty products.

Comfort in the aesthetics realm is also necessary on the provider’s side. I am comfortable leading and participating in conversations about aesthetic services. I have, however, spoken with some peers—both men and women—who are afraid of offending a patient if they say the wrong thing. These individuals could consider assigning this role to a staff member, one who has been trained and who may feel more confident about approaching patients.


Another commonly cited barrier to integrating aesthetics is how difficult it might be to provide training and resources to ramp up capabilities. The level and extent of ramping up will mostly depend on what services one plans to provide. Some providers may be surprised to learn that many of the core necessities are already in place.

Offering a product line, such as the various formulations with retinyl palmitate and hyaluronic acid to help smooth out wrinkles, is a relatively low-risk way to dip a toe in the aesthetics market. From there, medically oriented products, such as those designed to treat rosacea, are a natural extension. The next layer of involvement would be equipment based, such as intense pulsed light therapy or radio frequency to treat wrinkles.

Regardless of the optometrist’s level of involvement, resources are available. Many manufacturers of skin care lines provide training in the office, which could be especially valuable to providers who intend to rely on staff to engage patients. On the other hand, for someone interested in offering platform-based services, it is incumbent on the provider to become the expert. As a person gets more sophisticated in his or her intended offerings, the need for and intensity of training will increase.

Many practitioners may be surprised to hear that they may already have a framework upon which to add wellness services. Those who have a high-end optical boutique or who do a lot of LASIK shared care, for example, are already active in services designed to enhance patients’ experiences, a principle that is central to health and beauty offerings. Equally applicable to aesthetics offerings are many of the principles that drive success in these lifestyle services, including consistent messaging and engaged patient encounters with well-trained staff from the front desk all the way to billing and support members.

That said, something that I have found in my encounters with eye care practices is that there may be a lot of people on the bus but that not all of them are in the right seat. My advice to anyone thinking about adding aesthetics would be, before even thinking about making a capital investment in this arena, to talk with the staff, decide how to get them excited about and involved in this new service, and make sure everyone is on the same page.


I think that many of the perceived barriers for entering the aesthetics market may be self-imposed. Sure, the process can be tricky and difficult, but there are ample opportunities in lifestyle services for those interested. I believe it may be a matter of motivation more than anything else. Most optometrists would be surprised at the number of patients already in their practices who would be interested as well as how easy it could be to attract new patients. Successfully adding health and wellness services to an already busy practice may require a new way of thinking and a new vocabulary, but many principles we already use in patient encounters may be applicable. As in many things in life, fear of the unknown may be the greatest barrier to success.

Whitney Hauser, OD
Whitney Hauser, OD
  • assistant professor at Southern College of Optometry, Memphis, Tennessee
  • (901) 229-2137; whitneyhauser@sco.edu
  • financial disclosure: board member for Paragon BioTeck and TearLab; speaker for and/or consultant to Akorn, Allergan, BioTissue, Lumenis, NovaBay, Science Based Health, Shire, and TearScience
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