Demand for eye exams is softening, patients are behaving differently, and the numbers inside your practice may not be telling you the full story.

At first glance, things might look fine.

Revenue might even be up.

But when you start digging deeper, into demand signals, patient behavior, and what’s actually happening inside the practice… a very different picture starts to emerge.

And it’s one that requires action.

In this episode of Power Hour, host Eugene sits down with Dr. Jason Lake, General Manager of PERC & Opti-Port for another Metric of the Quarter, and this one hits differently.

Some episodes give you ideas. This one gives you numbers you can’t ignore.

Demand Is Changing

The first signal is happening before patients ever step into your office.

Search data shows that demand for eye exams is down, tracking roughly 9% below previous years.

At the same time, patient behavior is shifting in a way that’s hard to ignore. Searches for affordable or discount glasses are up 50%, and interest in buying glasses and contacts online is up 40%.

Patients still need care. That hasn’t changed.

But how they choose to spend (and where they choose to spend) is clearly evolving, and that shift is starting to show up in ways that impact both volume and revenue inside the practice.

Where Revenue Is Quietly Being Lost

Even when patients are coming in, practices are losing more value than they should.

One of the clearest indicators is exam-only rate, which has steadily climbed from around 55% to nearly 59%. That means close to 6 out of 10 patients are leaving without purchasing anything.

What makes this tricky is that many practices don’t feel it right away. Revenue can still look stable, often because of price increases. But underneath that, the fundamentals are shifting:

• Fewer patients coming in.
• More patients walking out without buying.
• And longer gaps between visits.

Those trends don’t stay small for long.

The Operational Gaps

When you look closer, the issues aren’t solely external. There are internal breakdowns that are amplifying the problem.

• Staffing and Time Constraints: One of the most overlooked metrics is staff hours per exam. When that number drops below ~4 hours per refraction, staff don’t have enough time to educate patients, product conversations get rushed or skipped, and capture rates decline. Even a small drop in staffing efficiency can reduce conversion by 5–10%.
• Not Maximizing the Patient Visit: Practices are working harder than ever to get patients in the door, but not fully capitalizing once they arrive. Small breakdowns such as rushed doctor handoffs and limited product explanation lead to missed opportunities. As Jason puts it, “The hardest part is getting the patient in the door, and then we let them walk out.”
• Product Strategy That Doesn’t Match Patient Behavior: Patients are signaling they want value, but many practices aren’t structured to meet that demand. Without a clear mix of premium, mid-range and value products, patients default to leaving and purchasing elsewhere. And once they leave, you’ve lost both the sale and the relationship opportunity.

What Actually Moves The Needle

The solutions are not complicated, but they do require attention and consistency.

Reactivation continues to be one of the strongest levers available. Practices that actively bring existing patients back into the schedule tend to see meaningful growth, often faster than those relying solely on new patient flow.

There are also simple execution gaps that have an outsized impact. Up to 25% of patient calls go unanswered during business hours. That’s demand already in your funnel, simply lost due to execution.

And finally, it comes down to visibility. Tracking the right metrics such as exam volume trends, exam-only rate, staff hours per refraction and patient reactivation cycles gives you a much clearer picture of what’s actually happening in the business.

If you’re not looking at the data, you won’t see the problem until it’s too late.

The message from Q1 2026 is clear:

This isn’t a year where you can rely on momentum.

It’s a year where attention to detail, execution, and decision-making will determine outcomes.

The opportunity is still there, but it’s going to go to the practices that understand the data, adapt to patient behavior, and act early.

The warning signs aren’t hidden.

They’re already in your numbers.

Eyecare BOSS Live Summit

If you’ve been to conferences before, you’ve probably left with many great ideas and intentions, and then when you get back to your practice, nothing actually changes.

Eyecare BOSS Live is designed specifically with that in mind so you can not only know what to do to reach your goals, but also have the tools, strategies, and plans to implement lasting changes once you’re back. to change that.

This is a 2 and a half-day, invitation-only event (September 16–18 in Cleveland) designed specifically for practice owners who want execution, not just inspiration.

Inside the room:

• 200 growth-focused operators
• Peer-level masterminds
• Real conversations around revenue, staffing, leadership, AI, and specialty growth

And everything is built around one outcome:

You leave with a 90-day plan you can actually implement.

If you want to be considered, click the link below:

• Demand Is Shifting | Learn why exam demand is declining while interest in affordable and online options is rising, and how this impacts your growth strategy.
• Exam-Only Rates Are the Hidden Problem | Understand why nearly 60% of patients may be leaving without buying, and how that quietly erodes profitability.
• Staffing Directly Impacts Revenue | Discover how staff hours per exam influence patient experience, education, and ultimately your capture rate.
• Reactivation Is the Fastest Growth Lever | See how bringing existing patients back into the practice can drive immediate and measurable results.

Connect with Dr. Jason Lake

Dr. Jason Lake is the General Manager of PERC and Opti-Port, and a recognized expert in practice performance, metrics, and operational optimization in eye care. He works closely with practices across the country to analyze real-world data and identify the specific drivers of growth, efficiency, and profitability. Known for his practical, no-nonsense approach, Dr. Lake helps practice owners translate complex metrics into clear, actionable strategies that improve both patient experience and business performance.

• LinkedIn: https://www.linkedin.com/in/jason-lake-od/  
• Website: https://eyecarespecialties.biz

Connect with Eugene Shatsman

Eugene Shatsman is Host of Power Hour, Managing Partner of National Strategic Group, Co-Creator of The Eyecare BOSS, and a TEDx Speaker. A growth strategist and consultant to hundreds of optometric practices nationwide, Eugene specializes in scaling independent eye care businesses through structured strategy, marketing science, and operational clarity.

• LinkedIn: https://www.linkedin.com/in/eugeneshatsman/ 
• Website: eugeneshatsman.com