Referring Physicians

Why Refer to Michigan Contact Lens?

Your patients deserve more than “there’s nothing more we can do.” We specialize in the complex, hard-to-fit cases that general optometry and ophthalmology refer out — keratoconus, irregular corneas, post-surgical and post-transplant eyes, and high or unusual prescriptions that standard lenses cannot correct.

Led by Dr. Shira Kresch, OD, MS, FAAO — trained at Columbia University and the Kresge Eye Institute — our practice brings academic-level expertise to every fitting. We use advanced corneal mapping and Eaglet Eye profilometry to design custom scleral and specialty lenses with a precision most practices are not equipped for.

We diagnose the problem, design the solution, send you a full report, and return your patient to you for their primary eye care. Your patient stays yours — we co-manage, we do not poach.

Conditions We Commonly Co-Manage

Each links to what we do for that condition, including what decides candidacy and what you get back.

• Keratoconus and corneal ectasia
• Post-LASIK and post-surgical ectasia
• Pellucid marginal degeneration
• Corneal transplant — fitting over a graft
• Corneal dystrophies, including Fuchs’
• Corneal scarring
• Irregular astigmatism and high or unusual prescriptions
• Sjögren’s, ocular GVHD and Stevens–Johnson syndrome
• Neurotrophic keratitis and exposure keratopathy
• Severe or refractory dry eye and ocular surface disease
• Contact lens intolerance and failed prior fittings
• Prosthetic and cosmetic lenses for disfigured or light-sensitive eyes
• Paediatric myopia management (Ortho-K, MiSight, atropine)
• Paediatric aphakia and specialty paediatric fittings

The Patients Who Benefit Most

Consider referring any patient who:

• Has been told they “have to live with” blurry or unstable vision
• Cannot achieve clear vision in glasses or soft lenses due to corneal irregularity
• Has keratoconus that is progressing or difficult to fit
• Had a corneal transplant, RK, LASIK, or other surgery leaving irregular astigmatism
• Has chronic dry eye or ocular surface disease limiting contact lens wear
• Needs a prosthetic or cosmetic lens for a disfigured or light-sensitive eye
• Is a child who would benefit from myopia control

Cross-Linking Co-Management

We do not perform corneal cross-linking — Dr. Kresch is an optometrist, and CXL is a surgical procedure. What we do is both ends of it, and that is usually where these patients fall through the gaps.

Before referral for CXL: the question that decides candidacy is whether the keratoconus is documented as progressing, not simply whether it is present. We establish that with serial corneal topography and Eaglet Eye profilometry, and send you the comparison. A meaningful number of patients referred to us as urgent turn out to be stable, and some presenting as routine are not.

After CXL: cross-linking stabilises the cornea without smoothing it, so the irregularity that was blurring the patient’s vision is still there afterwards. Most of these patients need a specialty lens to see, and many are never fitted for one. We refit or fit from scratch once the surgeon confirms the cornea has settled — see vision after cross-linking.

If you already work with a corneal surgeon, we fit alongside them. If you would like a referral pathway, we can point you to surgeons we work with regularly.

What You Get Back

Every referred patient generates a report to you, not just a note in our file:

• Corneal topography and profilometry maps, with the clinically relevant findings called out
• Whether the disease appears stable or progressing, and on what evidence
• The lens design fitted, its parameters, and why that design over the alternatives
• Corrected acuity achieved, and what limits it if anything does
• Ocular surface findings, since these frequently change the lens decision
• Our recommended follow-up interval, and what we will be watching

On documentation: keratoconus is coded in the H18.6 family, and the code turns on whether the disease is stable or unstable as well as on laterality. That distinction is the same one that decides cross-linking candidacy, so our progression assessment supports the coding as well as the clinical decision. Post-transplant and post-surgical status codes apply separately. We supply the diagnostic documentation; your billing team should confirm the specific codes for your own claims.

How to Refer

Submit a referral using the form below, call our office at (248) 545-2800, or fax your referral to (248) 581-4074. We will take it from there — scheduling your patient, completing the specialty evaluation, and coordinating their lens design — and we will keep you informed every step of the way.

Your patients come back to you. We make sure they come back seeing clearly.

Online Referral Form

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This form is not for medical emergencies. For urgent concerns call 248-545-2800.