The Role of Aesthetics in an Optometric Practice

Tailoring response to each patient yields positive results.

By Milana Matz, OD; S. Barry Eiden, OD; and Kathleen Albrecht, MD

The demand to address aesthetic concerns is at the forefront of medicine today. Billions of dollars are spent annually on cosmetics and skin care products and services in the hope of preserving youth, although not all products and services are created equal. Nevertheless, many women and men are willing to do and spend whatever it takes to hold on to their youthful appearance.

Aesthetics has always been a part of the culture in the eye care setting, although mostly in conservative ways. Eye care providers have traditionally focused on ocular health management and vision correction involving the use of elaborate designer eyewear and contact lenses, but we have been known to shy away from significant appearance-enhancing services and products. Injectables, lasers, facial chemical treatments, and skin care seem like a foreign land to many practitioners. But why should they be, when we spend our days looking at and evaluating the face and facial features?

In our practice, we have recognized the demand for aesthetic enhancement and rejuvenation, and we have focused our attention on the ocular and facial anatomy as well as visual and functional changes that happen with age. We started having discussions with our patients about their likes and dislikes regarding their appearance, and we found that we were able to help in more ways than one. This article details some of the aesthetic products and services we offer to patients—products and services that you, too, could offer to help improve the appearance and well-being of your patients.


Colored contact lenses and prosthetic lenses are the simplest ways for patients to visibly enhance or alter their appearance. Specialty lenses can mask anatomic irregularities, whether congenital or trauma-related. These lenses can truly change a person’s life, making way for improved self-confidence, better social acceptance, and enriched quality of life. For some patients, such lenses may mean job opportunities in the creative arts, while for others they may simply be used as a vehicle to enhance overall appearance or achieve a desired look.


Frequently, during a slit-lamp examination, we may note various anatomic irregularities in a patient’s globe, eyelids, adnexa, or orbit. Some findings may be blatantly obvious, such as lumps and bumps on the eyelid. Others may be health-threatening. Still others may be cosmetically unappealing, such as ptosis or asymmetry of lid position, eyelid hooding and dermatochalasis, or pronounced festoons. Subtler findings that we may have to make an effort to look for can include lateral canthal lines; loss of bone or tissue density around the orbit, promoting an aged or fatigued appearance; glabellar folds; and others.

Some of these findings may affect function, and others may be merely distracting in appearance. Whatever the case, these characteristics affect each individual patient in his or her own way. If patient and physician agree, an intervention may be necessary. If the use of botulinum toxin, facial fillers, laser treatments, or surgery are deemed necessary, referral to a specialist is advised.

Figure 1. Patient before the initiation of an in-office chemical peel (Left). The same patient, 1 week later (Right).

Another option is to incorporate an oculoplastic surgeon as part of the team, as our practice has done. We have been fortunate to incorporate a trusted surgical subspecialist in our optometric practice, allowing us to provide seamless coordinated care for our patients. The subspecialty training of oculoplastic surgeons is focused specifically on the area around the eye, which is a key factor in achieving the best structural and most visually appealing outcomes for the patient and the practice.


Offering skin care treatments has been a huge game-changer in our practice. These treatments can be used in management of ocular disease, in addressing contact lens intolerance, in attempts to reduce visible signs of aging of the face and eyelids, and prophylactically to address aging changes before they occur.

Gentle in-office chemical peels are performed by our licensed aesthetician to address facial rosacea, fine lines and wrinkles, and hyperpigmentation (Figure 1). They can also be used to prepare patients for surgical treatments or injections, to optimize results, and to rev up the healing process.

Figure 2. Patient before Oxygenating Trio (PCA Skin) facial treatment (Left). The same patient moments after application (Right). Note the smoother and brighter appearance of the skin.

We also prescribe various formulations of facial washes, creams, hydrating serums, retinols, and sun protection factors to allow patients to manage blepharitis, ocular or facial rosacea, and various aging concerns through at-home care (Figure 2). In addition, we address lid hygiene with facial and lid care to improve contact lens tolerance and increase patients’ hours of comfortable contact lens wear time.


By offering each patient a custom-tailored, comprehensive in-office and at-home treatment plan that yields visible results, we have experienced tremendous success, not only in managing the specific conditions for each patient, but also in improving patient compliance. This allows us to build a greater platform of trust and commitment for ongoing care with each patient.

Milana Matz, OD
• optometrist, North Suburban Vision Consultants, Deerfield, Ill.
• financial disclosure: none relevant

S. Barry Eiden, OD, FAAO
• president and medical director, North Suburban Vision Consultants, Deerfield, Ill.
• financial disclosure: none relevant

Kathleen Albrecht, MD
• ophthalmic plastic surgeon, North Suburban Vision Consultants, Deerfield, Ill.
• financial disclosure: none relevant