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Optometrical Practice Management Newsletter - Tips & Reviews. Volume 1. March 2008

Therapeutic Review: Global Keratoconus Conference 2008

I just got back from Las Vegas, which is the conference capital of the world.  One of my optometry passions is keratoconus, so I had to go to the Global Keratoconus Conference. This was held at the Bally’s Casino in late January, which is across the road from the famous Caesar’s Palace and Bellagio Casino’s. If you got bored of the keratoconus, there was always Texas Hold'em or Craps.

There were a number of take home points:

  • Inflammation must be kept to a minimum
    • Non-steroidal  anti-inflammatory and steroidal drops need to be used
    • Recommend protective sunglasses
    • NO rubbing of eyes
    • Poorly fitted contact lenses abrade the cornea and cause progression
    • Topical anti-oxidants will be developed in the future that will also be useful.
  • Paradigm shift in managing the keratoconus patients.
    • Contact lenses are still the mainstay
    • Synergeyes hybrid technology is a tremendous option for keratoconus patients - this will discussed in detail in a future issue.
    • Scleral lenses are making a comeback
      • Don Ezekiel of Gelflex laboratories recognized in the early 1980’s that these lenses could be made of gas permeable materials. Finally after more than 20 years a number of laboratories are making these very useful lenses.
    • Collagen Cross-linking via Riboflavin and UV light needs to be offered earlier rather than later.  The cornea needs to be at least 400 microns otherwise damage to the endothelium can occur.
    • Intacs often offered with collagen cross-linking can be a viable option if contact lenses prove to be too uncomfortable. Intacs originally could only reduce the corneal power by 4D which limited its application. The new innovation is the Kera Ring, which can drop the apical radius by more than 8D sometimes.


Business Tip: Selling to existing patients (Part 5 of Excellence in Optometry)

The average dollar spent per patient consultation is a very important key practice indicator (KPI). During an optometrical consultation we have the patient's attention 100%. Many of us miss this unique opportunity that will not arise again for another two years.

Rather than use all the time collecting data, a lot of the time is better spent having a one on one discussion around the patients life style and any eye problems that are tangible or intangible.

At The Eye Practice most of the technical part of the consultation is completed before the patient even sees the optometrist. Many patients have very specific eye health concerns that need alleviating such as a family history of glaucoma or macula degeneration. These issues must be put to rest before we can discuss optical solutions.

By having advanced diagnostic instrumentation such as digital retinal cameras and corneal topographers, every consultation can increase income from $60 to $150. Currently in the Australian optometrical market the average sale per consultation is around $400. By doing a more technologically advanced eye test you immediately increase your income by over 20%. At this point we have not even got into the consultation room.

Virtually every patient that requires an optical correction is being under sold to. We need to mention the need for prescription sunglasses, separate computer spectacles, does every spectacle lens have a multicoat?

The key here is that every consultation is an opportunity to improve a patient's vision and their quality of life. By making a concentrated effort it is easily possible to increase the average spend from $400 to $600, most of which will be profit, straight to the proprietors bottom line.

In the next newsletter due in June 2008, Dr Anthony Maloof will return and I will continue on with the Excellence in Optometry program.


Email me if you would like to implement

"Excellence in Optometrical Practice" into your business








Email me if you would like to implement

"Excellence in Optometrical Practice" into your business

A cost effective program of hurdling the challenges of optometrical practice and rekindling your passion for your profession is only an email away.

You can email me at:










Information Technology & Optometry

If you want to invest in new technology you must have a solid computer system to make sure that the use of the technology is efficient. Having a solid computer network for an optometry practice is way beyond the average optometrist's skill set. That's where Richard Rees comes in.

Richard Rees works for They are specialists in Information Technology solutions. Phone Richard on

1 300 553 559

Visit Lookup for all your IT needs                           






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