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The Value of Referring to a Surgeon

Is the surgeon a competitor or a partner?

Many optometrists have a fear that is articulated like this: “I’m worried about losing a patient if I refer him or her for refractive surgery. Why would I ever do it?”

This view, although commonly held, fails to include the whole picture. Sending a patient to a refractive surgeon does not necessarily close the door to future patient interactions. Some patients may be lost, but the majority of them will return (with confidence in your clinical skills, no less) when new treatment options are available. Acting purely in your patient’s best interest establishes a level of trust and professionalism that will benefit your practice in the long run.

Patients naturally seek clinicians who embrace the latest technologies. Millennials in particular equate the use of high technology with doctor competence. Optometrists who strive to provide comprehensive examinations but fail to discuss refractive surgery have incompletely assessed their patients.

Withholding information about the potential benefits of refractive surgery is unethical, and doing so misleads patients who might benefit from surgery. Highly myopic patients, for example, may not be aware of phakic IOL technologies, such as the Visian ICL (STAAR Surgical). Patients with an incipient cataract may not be aware of refractive lens exchange options. Taking profit margin out of the equation—that is, not concerning oneself with the potential for lost revenue—allows the optometrist to provide the most complete care.


Historically, many optometrists have shied away from referring to refractive surgeons out of fear that refractive correction with LASIK, phakic IOL, or premium IOL surgery could eliminate the need for patients to return to the optometry practice. These optometrists have seen refractive surgeons as competition. In reality, the true competitor is the retail chain next door that sells contact lenses at wholesale prices and offers “buy one, get one” deals on spectacles. The optometrist who performs a thorough eye examination and refraction is forced to hand over a prescription that results in no revenue, and the retail chain reaps all the benefits.

Refractive surgeons, on the other hand, can help generate revenue for the optometric practice. Surgeons generally refer nonsurgical candidates back to the optometrist for specialty contact lens or spectacle fittings. Postoperative care, future annual eye examinations, and other medical eye examinations will likely be performed by the optometrist.


Transparency with patients wins true loyalty and trust. New relationships develop and new doors open, both of which help keep your practice thriving. Aspire to keep patients abreast of the latest technological advancements, and watch the benefits flow into your practice.

Anar Maurya, OD
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