Ophthalmological services bounce back

KLAIPEDA - Still gripped with the slowly retreating downturn, money-conscious Lithuanians often procrastinate not only in fixing an aching tooth, but also in seeing an eye specialist. Overall, all ophthalmological clinics and smaller vision correction offices claim that the economic slowdown has significantly affected the medical sector. However, with the economy bouncing back, even the most crisis-stricken people ponder seeking ophthalmological assistance.

Eye clinic Lirema, the biggest eye-care facility in Lithuania, provides a wide range of ophthalmological services, including multiple procedures of vision correction, eye surgeries, consultations, medical examinations and other multifaceted services. “Lirema singles itself out with the abundance of provided services, when it comes to diagnosing and treating eye illnesses. We are the only eye clinic in the country to offer various vision correction solutions, including not only the use of eximeric laser for removal of atherosclerotic plaques and treating other vision deviances, but also intraocular correction and  surgeries of crystalline lenses. Besides, on a daily basis we perform surgeries treating cataract, squint, shortsightedness and farsightedness, and correcting eyelids. Importantly for our patients, we offer flexible and acceptable service costs and payment conditions. This complex approach does create an added value for our patients, which is something that makes us stand out in the market,” Mindaugas Socevicius, Lirema director, pointed out to The Baltic Times.

When it comes to surgery at Lirema, the price-list includes, at its lowest point, a 400 litas (120 euros) State Patients Funds’ partly sponsored cataract surgery for  retirees, while, at the highest price-range, a cataract surgery with implantation of bitoric lenses, which allows for quality eyeglass-less vision, costing 5,500 litas. However, this is not the costliest procedure as, for example, for surgery replacing a lucid crystalline lens with the implantation of bitoric lenses with fine-tuning, the patient will be charged 8,000 litas.

While 90 percent of all medical services in private medical institutions, due to much-criticized legislature, are not entitled to reimbursement by the State Patients Funds (SPF), Lirema is one of the few to receive the institution’s money. “Since SPF covers some ophthalmological services completely or partly, some of our services are free or cost considerably less for our patients than elsewhere. Therefore, our services are accessible for most residents,” Socevicius emphasized. Though the ophthalmological services market, Socevicius admits, is not very large in Lithuania, competition is “tangible.”

“Still, it [competition] allows for the successful functioning of several large ophthalmological clinics in the country,” the Lirema director claimed. He asserted that private eye-care establishments “suffer” from state regulations, which arise from the state’s unequal approach to private and state-run vision-care institutions. “Though some of our services are covered by the State Patients Funds, it is not enough, as the state discriminatorily allocates funds for private ophthalmological institutions, which is not an issue for a state medical institution. Though it is a widely acknowledged disparity, it is quite complicated to change the plight, as legislative initiatives in the Ministry of Health are being heavily influenced by influential heads of state-run medical facilities,” Socevicius maintained.

Speaking of the retreating downturn, he notices that until now, the clinic “managed” to cope by slightly decreasing service prices and exerting more marketing effort. “Speaking of economic results, we have compensated losses due to lower service prices by delivering larger service quantity. Therefore, even in the worst years of the crisis, we managed to edge up, ending our annual reports on a positive note,” Socevicius admitted. He is convinced that the eye clinic does not lag behind similar clinics abroad in any sense. “We are running ophthalmological facilities that fully correspond to world standards of these kinds of services. Besides, our high-skilled specialists constantly improve their knowledge both in Western Europe and the United States, which guarantees the highest quality of our services,” the Lirema director reiterated.

Almantas Makselis, the head of Laserview eye clinic, says that his clinic specializes in the field of laser vision correction, especially focusing on laser treatment of shortsightedness, farsightedness and astigmatism. “Since our clinic is not large, we orientate to middle-class people, accordingly matching prices of our ophthalmological services. Undoubtedly, it is hard to compete with larger, similar medical establishments in the field. However, due to our size, we are able to react and adapt faster to the ever-changing economic situation in the country. Thus, it all boils down to our ability to provide the highest quality services for the least prices of these kinds of services in the market,” Makselis pointed out to The Baltic Times.

He describes average clients of the clinic as “someone in his or her middle thirties, energetic and purposeful. For the specifics of the segment, expectations of the clients are generally higher than usual; therefore, the ratio of service quality and result has to be maximum. Older patients and seniors are less frequent visitors to our clinic as, generally, this is attributed to the older generation, as they tend to seek assistance in state polyclinics and other state medical institutions,” Makselis said. He points out that in such cases, the patients, as a rule, are enrolled in a long waiting list to see an eye-doctor, which results in exacerbation of existing medical conditions. The so-called waiting lists are a widespread practice in state medical institutions when it comes to narrow specialization doctors, like ophthalmologists. “Most importantly, those people who shun seeing an ophthalmologist in a private clinic, do lose money at the end, are forced to spend much more for a full-blown medical condition,” Makselis warned.

Asked to evaluate the ophthalmological market in the sense of supply and demand, he said that when it comes to laser vision correction, supply, most often, matches or sometimes exceeds demand. “It is estimated that for optimal functioning of a ‘laser eye office,’ roughly from 750,000 to 1 million people should be available. Currently, in Lithuania, we have four eye clinics. Obviously, because of that, competition in the market is perceptible, as every patient is very precious to us. Briefly, it induces service quality and, most importantly to patients, decreases service prices. However, on a wider facet, ophthalmological services are easily accessible only in the largest Lithuanian cities while, often in smaller settlements and towns, there are no steadily practicing eye-care specialists,” Makselis maintained.

Remembering the grip of the crisis, he says that, since its start, people started saving at the expense of their health, vision included. Eye specialists felt the saving mode not only in private medical institutions, which, generally, are seen to be pricier, but also in state-run polyclinics. “Frankly, the impact of the crisis was severe, as the flow of our medium-income patients has petered out approximately 30-40 percent. In the higher-than-average-income-segment, the plummet was not so drastic, averaging 10 percent. Besides, we have seen considerably less numbers of Lithuanian emigrants, who make up a significant part of our clientele. Responding to the shrunken income of our visitors, we had to slash our service prices, which, eventually, resulted in lesser salaries for our doctors. However, as we run a small clinic, we were quick to adapt to the changing situation. As for the current situation, we have been experiencing a certain enlivenment in the market for over half a year.

However, many people who walk in want to just check out our services and prices. So far, most of them are determined to wait for ‘better times’ to realize their dream – to see the world without glasses or contact lens,” Makselis said.
He finds it interesting that, during the crisis, a sheer majority of patients opted for settling bills by paying in cash, instead of paying by installments. “Obviously, people avoided undertaking any financial commitments,” Makselis inferred. In addition, he notices that more foreigners have started coming to the Laserview clinic. “The flow of foreign visitors makes up the loss due to the crisis. Service quality and skill-wise, we do not yield to our Western counterparts in any sense. What matters most, we can offer a 2-4 times lesser price than that in Western Europe. It makes a big difference to many,” the Laserview director maintained.

Alvydas Paunksnis, director of Stratelus Ophthalmology Clinic, says that the clinic’s activity is oriented in three directions; first, running a “traditional” eye clinic in Kaunas; second, delivering remote consultations developed in the telemedicine network and, third, performing eye screenings in Lithuania’s regions and companies. “Our uniqueness lies in providing ophthalmological services both on primary, secondary and tertiary levels, as well as combining very strong technical facilities and medical research. Thus, Stratelus coordinates an EU-financed project, which is aimed at creating an appliance allowing more accurate diagnostics of eye tumors,” Paunksnis said to The Baltic Times.

He is not concerned about the competition in the ophthalmological market, asserting, “Eye illnesses do not recede. On the contrary, because of the technological advancement, we observe a rise in technology-related eye illnesses. Generally, due to a large number of ophthalmological offices, competition is high. However, as we are focusing on exclusive fields, such as telemedicine, specialization in ultrasound differential diagnostics of inner eye tumors, it does not frighten us. In addition, we spearhead expansion of innovative digital diagnostic technologies and implement international projects with partners from Kaunas Technology University, Sweden and Finland. One of the projects has resulted in the creation of a non-invasive expert ultrasound-optic system for differential diagnostics of inner eye tumors. All this is cutting-edge innovative advancement, allowing us to be ahead of others at many points.”

Vytautas Jasinskas, a distinguished ophthalmology professor at Kaunas Clinics Eye Illness Clinics, points out that Eye Clinics performs some procedures and surgeries that are not being carried out anywhere else in the Baltics. He prides himself on the fact that lately, hopeless eye illnesses have been on the decline. “While private eye-care institutions tend to be non-complicated cases, for example non-complicated cataracts, our Eye Clinic performs even the most complicated and sophisticated surgeries, such as vitrectomy, a surgery to remove some or all of the vitreous humor from the eye,” Jasinskas revealed to The Baltic Times. He asserts that the downturn has not affected the patient flow and ophthalmological service spectrum provided by the University Clinic, which is the only one of its kind and accredited by the European Ophthalmologist Council.