Best of the Best: Special K

Ortho-K from Dr. Jeff Jeruss

Georgia OD builds practice — and seeks to curb myopia — with orthokeratology.

Dr. Jeff Jeruss has an edge on the competition. It’s orthokeratology, the specialty that distinguishes his Marietta, GA, optometry practice, and one that’s become part of his professional mission. — JESSE BURKHART

This article originally appeared in the May 2015 edition of INVISION.

THE IDEA: Orthokeratology uses specially designed gas-permeable contact lenses to reshape the cornea and reduce myopia, among other refractive errors. For Jeruss, owner of Eye to Eye Vision Center, the specialty helps his practice stand out in today’s sea of “fast-food opticals.” With low markup on contact lenses, “some doctors can’t really support their businesses just by fitting regular contact lenses that everybody else is fitting,” he adds.

A desire to limit myopia in young patients is a powerful motivator for Dr. Jeff Jeruss.
Jeruss also feels personally invested in Ortho-K. He says that myopia is increasing in younger people in part because many eye doctors are not aware of the latest research showing that single-vision contact lenses can increase myopia. Commercial practices try to see as many patients as possible, so Ortho-K takes more time than those practices are willing to invest. “We can stop [myopia from increasing]. That’s the biggest thing about Ortho-K,” he says.

THE EXECUTION: Jeruss has been practicing Ortho-K for 30 years and was among the first doctors to specialize in it. One of the originators of Ortho-K (Stuart Grant) was among his contact lens instructors.

The learning curve is steep, so Jeruss started with easier prescriptions and worked up to more difficult ones. Today he relies on a company called Wave, which makes Ortho-K lenses and custom software that he uses to design his own lenses. A local lab makes the lenses from his designs.

Lenses vary in complexity, he says. “You can start out with the simpler designs and do really well with that. But if you want to take on more difficult prescriptions, then you need to keep on going to the more complicated designs.”

Jeruss says the new design software allows doctors to fit people with much higher prescriptions, and for nearsight, farsight and astigmatism. He says the biggest challenge is managing the expectations of patients, who require attentive follow-up care — usually six appointments in the six months following the original fitting.

“You can’t just fit someone with lenses and say, ‘See ya later. Call me if you need me,’” he explains. “Since the patients will be sleeping in the lenses, we hope that their eyelids will not alter the lens fit while they are asleep. The only way we can determine how a lens is really working is when we perform corneal topography mapping on follow-up visits.”

THE REWARDS: Because of the design work and expertise level required for Ortho-K, the service costs more, so it’s considerably more profitable than standard contact-lens fittings, Jeruss says. Although Ortho-K fittings aren’t covered by insurance, patients can use the contact-lens allowances in their vision plans to help offset the overall cost, he adds.

Aside from bolstering the bottom line, the specialty has turned Eye to Eye Vision Center into a destination. He says most of the practice’s Ortho-K business comes through referrals — the reward from having spent three decades fine-tuning the craft. “I’m known for my experience in this, and I usually don’t have to talk people into it,” he says. “There are still plenty of people who’ve never heard of Ortho-K, but the word is getting out there.”



Consult with peers. Before you dive head-first into Ortho-K, Jeruss suggests talking to optometrists who know the specialty so “you don’t lose your shirt ordering lenses that don’t work.”

Be an advocate. Many people haven’t heard of Ortho-K. By taking time to explain the benefits to patients, you’ll pique their curiosity. Make sure your staff can answer basic inquiries, too.

Keep it simple. Jeruss advises that eye doctors avoid more difficult prescriptions at first, staying under a -4, and getting familiar with just one contact-lens brand.

Charge appropriately. Ortho-K requires multiple office visits and possible redesigning of lenses, so set your fees accordingly or risk losing money.

Make the news: Jeruss says local TV coverage of his practice boosted credibility and resulted in thousands of phone calls. A video of the 2010 story on his website continues to spark interest.