What Do Online Searches Tell Us About the LASIK Market?

Potential patients search for information differently than in the past.

By Conni Bergmann Koury, Editor-in-Chief, AOC

We wanted to understand how consumers research information about eye surgery, what the current state of the LASIK market is, and whether LASIK volume can rebound, so we interviewed Ron Walker, publisher of AllAboutVision.com. AllAboutVision.com was launched in January 2000 to provide consumers with an unbiased, easy-to-understand source of trustworthy information on eye health and vision correction options. The website is operated by Access Media Group, and the company’s founders have been involved in eye care journalism since 1977.

AOC: A big question currently in ophthalmology is how the industry in general—and refractive surgeons specifically—can reboot the LASIK market. What do the data you have regarding activity on your website say about consumers’ interest in LASIK?

Ron Walker: During the first 5 months of this year, compared with the same period last year, we have experienced a 26% increase in page views of articles about refractive surgery.

The “LASIK & Vision Surgery” section of the site is an encyclopedic collection of articles that discuss everything that a patient might want to know about LASIK and related procedures. We recently added a LASIK frequently asked questions (FAQ) section that answers many very specific questions people have when researching the procedure. It is important to note that the site has more content than in the past, which certainly contributes to the increase in activity.

Our site encourages consumers to learn everything they can about their options. Traditionally, our most popular articles are ones that explain how LASIK works and what to expect before, during, and after the surgery. Patients search for answers to questions like “What are the risks?” “What does it cost?” and “Which laser is the best?”

The FAQ section is very specific. For example, we have an in-depth article about the recovery period in general, and then an FAQ might be, “Can I drive home after LASIK?”

AOC: Providing answers to specific questions is in sync with how people use Google.

Mr. Walker: Exactly. This is how people search for information. All of these topics were covered in one way or another on the site, but now the LASIK FAQ pages address them all in very specific terms.

We find that, when we add a new FAQ, we often rank No. 1 for that particular query very quickly, which then in turn increases our traffic. Our LASIK section is up about 400,000 page views in the first five months of this year, with about two-thirds of that attributable to the new FAQ section.

AOC: Can we extrapolate what this means?

Mr. Walker: This tells us that there is more interest in LASIK this year than there was last year. Certainly the market is nowhere near what it was in the LASIK heyday, but we are seeing a recovery in terms of the trough that we recently experienced. The extent of this recovery remains to be seen, and I am sure that surgeons view it quite differently than we do as providers of information.

A 26% increase in page views is a very big jump for our website, but for a surgeon it’s not bringing back the procedure volume that once existed.

AOC: One thing I have taken away from the ongoing discussion of how we can reboot the LASIK market is the perception of an imbalance of information. What I mean by this is that the negative LASIK information and sensationalistic websites seem to keep hanging around, but newer data, meta-analyses, and true statistics on safety seem to not gain as much traction. Maybe this even means that surgeons are not taking control of the conversation and ensuring that the true data is published and accessible.

Mr. Walker: One of our primary objectives is to give people current information. Especially from a consumer standpoint, there is a lot of old information hanging around the internet. There certainly exists some fear-mongering on the topic of LASIK, and there are sites that are run by people with an axe to grind for one reason or another.

One problem with internet health information in general is that it is often hard for consumers to discern how up-to-date it is. We hope that by providing current information and offering very specific answers to common questions that people really have, we can help consumers to become more knowledgeable. The more familiarity people have with something, the more comfortable they are going to be with it. We can provide patients a powerful educational experience by answering all of their questions in one place—even questions they did not think of.

AOC: Going back to Google and how patients search for information, it seems that, if outdated or overhyped LASIK risk information is still online, those results should not appear as high in search results as more current information.

Mr. Walker: That is an interesting point. Google often presents results in terms of what is the most popular, not the most recent. When I Google the term “LASIK,” the prominent results tend to be ads and then practices. Google essentially treats LASIK just like it would treat pizza. If you search “pizza,” Google thinks you are looking for a pizza place, not a website to learn about pizza.

When you search for “LASIK,” Google will show LASIK surgeons, not necessarily information portals about LASIK. So, if I search right now, for example, I see local results for surgeons and practices, then some results from AllAboutVision.com, and then LASIK.com and Wikipedia. I also see some information from the American Academy of Ophthalmology and a few Yelp reviews. The entire first page does not present any of the sites that are highly negative toward LASIK. This is definitely A change from the past.

AOC: So people do not necessarily see that information unless they search for “LASIK problems,” for instance.

Mr. Walker: Yes, sites that provide information about complications would come up if one were searching for that. The unfortunate part is, as you imply, that a significant amount of the data on complications that exists online is fairly outdated. Patients should be able to access accurate and current data about complications. At least it appears that negatively-biased sites do not rank on the first page when the root term “LASIK” is searched.

AOC: What else can we learn from how consumers search for LASIK information?

Mr. Walker: Ten years ago the most dominant searches in the LASIK area were “LASIK problems,” “LASIK risks,” and “LASIK outcomes.” Today, by far the most popular search related to LASIK is “What does LASIK cost?” That seems to imply that people today are a lot further down the decision funnel before they Google some of their questions. They already think of LASIK as safe, they probably know someone who has had it, they assume they are a candidate, so they are looking for the cost.

Now, of course, this also could mean there is a group of people out there who do not think LASIK is safe or a good option for them, so they are not Googling it at all.

AOC: Just now I typed in “LASIK outcomes.” After the first few results, which are local practices, paid ads, and AllAboutVision.com, I see the US Food and Drug Administration site, data on the PROWL study, and some UCLA data on the percentage of patients who are 20/20 after surgery. This seems very positive. There is also a link to an outcomes study.

Mr. Walker: Your search results are tailored by your previous searches, so you are probably getting scholarly results that others might not see. Your point is good, nevertheless. I do not think we can say that the online discussion is dominated by people who think LASIK is bad, and therefore every time information is searched, negative results show up. In my view, negative information online is not the reason LASIK volumes are down.

AOC: How do you see the idea that wearing glasses with fashion frames is “in,” and that contributes to the overall decline in LASIK? I think that argument, which has been heard in recent years, might be overstated.

Mr. Walker: Glasses have been “in” since the 1970s when manufacturing technologies and designer brands changed the aesthetic appeal and marketing of eyewear. Glasses were “in” when LASIK volumes were much higher, so I don’t think you can cite that as a reason for the decline of procedure volume.

I think the decline we experienced was, to some extent, a function of exhausting the pent-up demand that was exploited in the first decade or so after refractive surgery approval. But I do think that the appeal of eyeglasses has always been a barrier to greater market penetration by both contact lenses and refractive surgery.

I’ve often heard it said that the typical LASIK patient is a dissatisfied contact lens wearer: Someone who cannot tolerate wearing contact lenses any longer or who doesn’t want the hassle of caring for them. Contact lenses have become much more convenient and comfortable over the past 10 or so years, and I see that as affecting LASIK volume.

AOC: As a contact lens wearer, wearing contacts has never seemed like a big deal to me, so I understand the point of view of having no interest in LASIK.

Mr. Walker: This is true in medicine, in general. If a patient can be happy with a nonsurgical approach, he or she does not get surgery.

AOC: It appears as though several factors are at play in terms of the current market and demand for LASIK.

Mr. Walker: That’s right, and I also think it is harder to really discern what proportion each factor contributes to the volume of procedures. It can be difficult to obtain specific data; much of it is proprietary.

The important thing is for refractive surgeons to be savvy in attracting the patients out there who are ready for the procedure, and to realize that there is another group of prospective patients who are “on the fence,” but if they can be educated and have their concerns addressed in ways that are meaningful to them, they will be the incremental group that grows procedure volume. n