By Patricia Fulmer, OD
When I opened my practice in 2020, I knew that I wanted aesthetic services to be part of the clinical and business model from the very beginning—a decision that initially raised a few eyebrows among my colleagues.
In optometry, aesthetics is sometimes viewed as separate from traditional clinical care, but I’ve never seen it that way. As primary eyecare providers, we evaluate the entire periocular region, diagnosing and managing conditions that affect vision, ocular comfort, eyelid function and ocular surface health. In daily practice, it becomes difficult to separate how the eyes function from how the surrounding tissues age and change over time.
That perspective has only strengthened with experience in practice.
SEEING THE FULL PERIOCULAR PICTURE
It’s nearly impossible to ignore how often cosmetic and functional concerns overlap.
Patients regularly present with issues like fine lines, hooding, under-eye bags, rosacea or eyelid laxity, whether or not they bring them up directly. These changes are often viewed as purely aesthetic, but they usually reflect underlying tissue changes such as loss of collagen, decreased elasticity and reduced muscle tone.
These same changes can influence eyelid function. Impaired blinking, lower lid laxity and upper lid hooding can contribute to ocular surface disease and, in more advanced cases, may even impact the visual field.
In our practice, we incorporate advanced, in-office treatments like OptiLift’s dynamic muscle stimulation technology (DMSt). This device allows us to tighten the undereye area non-surgically while improving facial muscle tone, skin quality and periocular structure in a way that complements both aesthetic goals and functional eyelid support. Treatments such as this sit at the intersection of improving how patients look and how comfortably their eyes function.
It is because of this overlap that I’ve come to think less in terms of “aesthetic vs. medical,” and more in terms of a single periocular system that we’re already responsible for evaluating and treating. In many cases, we are not choosing between aesthetic and medical outcomes—we’re addressing both simultaneously.
PATIENTS ARE MORE OPEN THAN MANY EXPECT
One of the more common misconceptions I hear from colleagues is that patients won’t be interested in aesthetic services or won’t be willing to pay for them out of pocket. However, that hasn’t been my experience.
Patients across all age groups and demographics are more aware of these concerns than we sometimes assume. When the conversation is introduced in a natural, low-pressure way—framed around non-invasive options for improvement and prevention rather than criticisms of their appearance—they’re often receptive and curious.
Not every patient proceeds with treatment, but enough do to meaningfully impact both patient experience and practice growth.
Accessibility also matters. Offering payment plans has made a noticeable difference in helping patients move forward with treatments they are interested in but might otherwise defer.
PATIENT LOYALTY AND WORD-OF-MOUTH GROWTH
One of the most unexpected benefits has been the strength of patient loyalty.
Patients who engage in aesthetic treatments tend to become highly consistent with follow-up care. Many return regularly for maintenance treatments and develop a strong connection to the practice over time.
That engagement extends outward. Aesthetic patients frequently refer friends, family members and coworkers. Word-of-mouth has been one of the strongest drivers of growth in this area of the practice.
We’ve also seen aesthetics introduce new patients who may not have initially come in for a comprehensive eye exam. Once they establish trust with the practice, many transition into full-scope patients for glasses, contacts and medical eyecare.
In that sense, aesthetics becomes less about a single service line and more about expanding how patients enter and engage with our practice as a whole. It broadens access and entry points into comprehensive eyecare.
INTEGRATING AESTHETICS INTO WORKFLOW
From an operational standpoint, success with aesthetics depends just as much on implementation as it does on interest.
One of the most important early steps is ensuring the entire team understands why we are adding these services and how they fit into the daily workflow. In my practice, we reviewed indications, scheduling and pricing before launch, so my staff felt confident discussing the services with patients.
Next, staff training is just as important as provider training. We relied on a combination of manufacturer education, on-site support and hands-on learning to build confidence across the team.
One simple but effective tool for patient implementation that we have integrated into our check in process is adding a question on our intake paperwork which asks if the patient would like a complimentary aesthetics consult and has check boxes for the conditions we treat (e.g., redness, fine lines, hooding, etc.). This small change has helped open conversations that otherwise might not have happened.
A SHIFT IN HOW PRACTICES DIFFERENTIATE THEMSELVES
From a broader perspective, aesthetics also plays a role in practice identity.
In an increasingly competitive and reimbursement-challenged environment, many optometry practices are looking for ways to differentiate themselves. Aesthetics offers one pathway to do that through the type of experience and care model it supports.
It allows practices to create something patients remember and brings in those who may not have otherwise engaged with eyecare services at all.
Over time, that helps build a diversified patient base and a more resilient practice model. It also shifts the perception of what an eyecare practice can offer, expanding it beyond traditional refractive and medical services and into a more comprehensive wellness experience.
WHERE I SEE AESHTETICS HEADING NEXT
More colleagues are seeing early adopters succeed, and continuing education opportunities in this space are expanding. As comfort grows, I believe more doctors will begin to view aesthetics as a standard component of comprehensive eyecare rather than a niche service offering.
There is also increasing interest in how light-based and energy-based therapies may evolve to serve multiple indications, beyond ocular surface disease. It will be interesting to see how those technologies continue to develop and potentially converge.
For me, the most meaningful part of incorporating aesthetics has been simple. It’s watching patients feel better about how they look while also improving the way their eyes’ function. When those two outcomes align, it reinforces why I believe aesthetics belongs within optometric care.
Featured photo credt: Westend61, Getty Images
