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Build the Perfect Ocular Aesthetics Team

Collaboration with dermatologists can address patient needs and ensure comprehensive treatment.

According to a 2017 survey of cosmetic dermatologists by the American Society for Dermatologic Surgery,1 nearly 12 million medically necessary and cosmetic procedures were performed in 2017. Of those, 3.2 million were laser-, light-, or energy-based procedures, 2 million were wrinkle relaxers, and 1.6 million were soft tissue fillers. Of the last two categories, nearly half were performed on patients younger than 50 years.

Nearly three-quarters of patients responding to a consumer survey by the same society reported that “they are bothered by the lines and wrinkles around and under the eyes.”2 This complaint ranked second only to complaints about excess fat on any part of the body.

Why do I cite these statistics? Because they underscore the need for optometrists to know about the latest procedures in aesthetics. Aesthetics topics come up daily, especially at the end of exams when I ask patients if they have questions about the treatment plan for their vision and eye health. One common question is, “What can I do about my bags, wrinkles, and dark aging spots?” Many of these patients have seen me annually for years—some for 2 decades—and they trust that I will send them to someone who can address these issues.


With so many beauty and medical spas offering discounted injections and fillers, it’s very difficult for patients to discern whom to trust and what qualifications to look for. I see it as my responsibility as a clinician to find the most experienced dermatologist or plastic surgeon for patients interested in facial or ocular aesthetics procedures.

To Whom Do I Refer?

In Houston, I refer patients to Paul M. Friedman, MD, for dermatology and laser resurfacing skin care needs. I also refer patients to Sanaz Harirchian, MD, a facial plastic surgeon who specializes in cosmetic and reconstructive plastic surgeries.

I scheduled an appointment with each surgeon to see what the patient experience will be like. I also used that time to introduce my practice to them so that they could in turn refer patients to me.

I encourage readers to find one or two such specialists. Engaging the community of surgeons may take time but can benefit both patients and practices.


Many patients who present to your practice likely belong to demographic groups that are interested in aesthetic services. Knowing who they are may help guide your conversations with these patients.

Generation X (ages 40-50 years) and young boomers (ages 50-59 years) are commonly interested in wrinkle reduction and soft tissue fillers. They tend to be patients who are interested in contact lenses or refractive surgery for vision correction. Many of them present with presbyopia, dry eye disease, or ocular fatigue symptoms.

Nearly 90% of patients seeking injections and fillers are women, many of whom wear eyelash extensions. These women tend to present with red or dry eyes, burning or watery eyes, blepharitis, Demodex infestation, and/or ocular dermatitis.


Optometrists who already collaborate with ophthalmic surgeons are primed to expand their collaboration to include other types of surgeons. Optometrists play an important role in helping patients see, look, and feel their best, and working with a dream team on ocular aesthetics can grow your practice and help your patients.

Bridgitte Shen Lee, OD
  • Cofounder and CEO, Vision Optique, Houston, Texas
  • bshenlee@sbcglobal.net
  • Financial disclosure: Consultant (Alcon, Essilor, Eyevance, Guardion Health Sciences, Johnson & Johnson Vision, OCuSOFT, Shire, Sun Pharma)
  1. American Society of Dermatologic Surgery. ASDS Survey on Dermatologic Procedures. www.asds.net/Medical-Professionals/Practice-Resources/ASDS-Survey-on-Dermatologic-Procedures. Accessed November 28, 2018.
  2. American Society of Dermatologic Surgery. 2017 ASDS Consumer Survey on Cosmetic Dermatologic Procedures. September 17, 2018. www.asds.net/Medical-Professionals/Practice-Resources/ASDS-Consumer-Survey-on-Cosmetic-Dermatologic-Procedures. Accessed November 28, 2018.
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