Myopia is a common cause of vision loss, with uncorrected myopia being the leading cause of distance vision impairment globally. In 2020, it was estimated that about 30% of the world’s population had myopia, and this number is expected to increase to 50% by 2050.1,2
The World Health Organization (WHO) has identified myopia as the number one vision threat worldwide, and the number of people with high myopia is estimated to be 1 billion people by 2050.2
Fortunately, as primary eyecare providers, we can reduce this number by detecting, managing, and preventing myopia-related ocular complications and vision loss.
Why should you get into myopia management?
The International Myopia Institute stated, “Myopia has been the subject of major international research for decades.”3 If you do not engage in myopia management now, you are losing a significant battle. Before I started my myopia management journey, I had to take a deep breath before facing the parents of patients waiting in the lobby, hoping to hear that there had been no progression.
Although there was nothing I could have done, I felt guilty telling the parents that their child’s eyes had become more myopic each year. One of my young patients, who was an avid reader, became my first orthokeratology (ortho-k) patient when her myopia progressed 2 diopters in 1 year.
The financial rewards of myopia management
We all know the importance of myopia management, and it is worth spending your extra hours and efforts diving into it. About 10 years ago, our office was grossing $1.2 million in a 1,100-square-foot office with one exam room, a tiny lab, and a decent optical space.
At the time, I worked 4 days a week as the practice’s only full-time optometrist, alongside one associate optometrist (who worked 2 days a week) and three staff members. We made a high net profit of over 40%. During this time, I thought I had capped out on our gross income due to our small office size. However, incorporating myopia management allowed us to reach close to $2 million in gross revenue this year—even at the same location.
Further, 3 years after starting myopia management, to expand in this area, I opened a second office from scratch with two exam rooms. Within the first 2 years, I was able to gross close to $1 million by focusing on myopia management. Approximately 10% of our patients come to us for myopia treatment. Additionally, these patients referred us to their family members and their friends, and our appointments started to fill up.
Guidelines for setting myopia management fees
Setting fees can be one of the most challenging aspects of incorporating myopia management. First, consider how many hours you will spend with your myopia management patients in the first year, including your full exams and consultations.
For example, with ortho-k patients, figure in:
- General exam
- Consultation
- Lens dispensing
- 1-week follow up
- 1-month follow-up
- 3-month follow-up
- 6-month follow-up
Tip: Instead of a one-day follow-up, my staff calls the parents of my patients to check on them.
Cost-by-cost breakdowns of myopia management fees
To justify your commitment to myopia management, you should charge the patient a minimum of $1,800 for the first year, with ortho-k patients being charged closer to $2,700.
Consider this myopia management fee breakdown:
- First-year visits: 7 X $150 per visit = $1,050
- Pair of lenses: $250 to $400
- Five axial length measurements: 5 X $39 = $195
- Five topography measurements: 5 X $39 = $195
- Annual retinal imaging: $39
Tip: I keep the axial length, topography, and retinal imaging pricing consistent at $39.
Comparing pricing for different myopia management modalities
I see my Misight patients about four times a year to monitor their axial length, assess their vision, and perform an ocular health exam. I charge the same amount for my ortho-k patients and Misight patients since the former requires a greater time commitment, while the latter is more costly to the practice.
For my atropine patients, I utilize slightly lower pricing because their three to four visits per year are much shorter. During their first year, I see them for an annual exam and a 1-week follow-up after they start atropine to monitor any possible side effects the patient may experience.
My staff check their axial length at 3 months, and I see them for 6-month follow-up. Starting their second year and onwards, I see them three times per year for an annual exam and their axial length measurements.
If your patient searches orthokeratology online, they will find prices anywhere between $1,000 and $4,000. Remember, lower pricing will not necessarily attract more patients. Sometimes, a higher price can signal more experience.
Further, not everyone can afford to pay for myopia management upfront. Offering payment options via CareCredit, Cherry Payment Plans, or PatientFi will provide patients with the flexibility they need to proceed.
Make it easy with a streamlined fee structure
For the past 3 years, I drastically reduced my patient care days to 2 to 3 days a week between two offices, and I needed a simple fee structure for my staff and associate doctors to follow while conducting consultations. If a patient asks about our fees, I provide the information in the exam room. This way, I can screen who is serious about moving forward with the treatment.
My practice has four fee structures for myopia management:
- Ortho-k and soft myopia management contact lens patients
- Atropine patients
- Returning patients for ortho-k and atropine
- Returning patients for soft myopia management contact lens
Our fee includes an annual examination and four to five follow-ups in the first year, as well as an annual examination and two to three follow-ups in the second year and onwards. It also includes one set of orthokeratology lenses, a 1-year supply of soft myopia control contact lenses, or 1 year supply of atropine. We charge one set price for lost ortho-k lenses.
When setting fees, ask your colleagues in your area about their prices. Especially when starting out, think of it as investing in learning a new skill. Set your price where you feel comfortable, and you can always increase your fees as your confidence builds.
On a final note
My conversations with parents of patients emphasize that myopia management could be the best investment they can make for their child’s health. I encourage them to make a decision soon, rather than waiting for another 3 months or another -0.25D change.
As primary eyecare providers, we need to recognize the urgency of myopia management in the next generation. If myopia management is done right, we can be rewarded financially and, most importantly, improve patient care.
