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Are you just another Refractionist? Part 2

In part 1 of this article series, Mr Prasad Sawant has defined in detail the role and focus of optometry. In this part, he will pen down his observations on setting up one’s own optometry practice.

Owning an optometry clinic – the edge

Having an own optometry clinic is the dream for most of us. However, it is not often the first choice as it needs experience, confidence, capital investment, impressive location and finally good patient base to run the show. Owning an Optometry clinic- job satisfaction is its greatest edge. Even while performing a simple procedure like refraction, we can do wonders. Additionally, complicated manual refractions, cycloplegic refractions in children, refraction in patients with inoperable media opacities or any other pathology could set you apart from other routine optometry practices.

Make your patients believe in your skills

Once people realize that you are skillful professional in their visual rehabilitation, they will start showing faith in you and consequently increases the footfall in the clinic. Let your clinical skill speak for you, rather than your clinic premises or the set up. It also automatically increases the respect and awareness amongst surrounding ophthalmology practices.


Build healthy relationship with your ophthalmologist friends

It is always good and ethical to meet neighboring ophthalmologists within your practice location and introduce yourself with your specialized areas of practice, which will help to increase referrals to your practice from them. An informatory and easy-to-read brochure with all your services listed on it, should be handed over to these eye doctors when you meet them personally as it creates impact over verbal communication. The most ethical thing to do is to refer back the patient to that ophthalmologist who has originally referred the patient to you for your optometric eye care. This helps in building a professional and trustworthy relationship between you and the ophthalmologist, resulting in a very healthy and strong bonding between these eye care professionals.

Offering specialty services

One very thing that sets your practice apart from the other is the specialty services that you offer.


Contact lens services: In the recent past, the regular contact lens practice has been a piece of cake for everyone including under qualified opticians. Therefore, think outside the box. Offer contact lens services, but that makes you stand out of the crowd. So offer contact lens fitting services for irregular corneas and dry eyes. I have seen a lot of patients with irregular corneas in quest for ideal visual correction. Along with best possible refraction, you could always fit them with specialty lenses that might include specially designed spherical GP lenses, reverse geometry lenses, hybrids or even with scleral lenses.


Low vision services: Low vision examinations and dispensing of devices are another social and value added services that will help you to build up the personal relations with patients who are visually impaired. Vitreo-retinal surgeons would always like to work, hand-in-hand with optometrists who have low vision care at their disposal. Many of their patients would need low vision examination and devices at end of their clinical procedures. You can also work as a Contact lens and/or low vision specialist to nearby eye institute and let me tell you it is a situation with mutual benefits. It will also be a wonderful learning opportunity.



Pediatrics: Collaborations with Pediatric Ophthalmologist are another a great option, where an Optometrist builds his/her image as a Pediatric Optometrist. Diagnosing and treating cases of various forms of binocular anomalies, correction of accommodative convergence squint, latent hyperopia, refractive amblyopia, automatically builds the confidence and faith of respective Ophthalmologist on your practice. Parents are the most responsible media for word-of-mouth publicity in both positive as well as negative way. So you have to be very careful in handling pediatric cases. Always make sure the diagnosis and line of treatment is going in proper direction. It is always good to refer the child for second opinion to pediatric ophthalmologist with whom you can create professional collaboration. If the child comes back confirming your line of treatment is accurate then slowly your pediatric age group population becomes an important segment in your practice. Always remember one thing, all these categories of patients are not single patients; they come along with great opportunity of multiple dispensing bundle with them for their families, relatives and friends.

Diagnostics: Diagnostics is another area where you can always create an impact. A-Scan, B-Scan, Topography, Tonometry, Perimetry and Fundus cameras are the best diagnostic instrument options to choose from. Having one or more these instruments at your clinic strengthens your practice reputation. It is a win-win situation for you and the referring ophthalmologist and most importantly for patients who benefit out of the use of advanced technology. If you use these diagnostic instruments, remember not just to wait for the referrals to do the test but use your discretion, to conduct these tests based on the case history and examination. Do the required diagnostic tests and then refer those patients for further consultations to respective specialties with the interpretation reports. This will project your knowledge and expertise, area of interest and accuracy in diagnosing the condition. It automatically creates an impact on the referring doctor and it sets you apart from the routine practice.

Fair pricing

Charge your consultation fees even for routine refractions, contact lens examinations and follow-ups to every procedure you do. Never underestimate yourself for the professional fees. That builds your image and increases the value and respect. Always remember free has ZERO value in life and shows you are under qualified or inexperienced.


Challenges in establishing own practice

The first challenge is the initial investment, which includes investment for the clinic space and the instruments, establishing the initial stock and inventory of frames, lenses and contact lenses.


Second challenge would be organizing the clinic, selection of appropriate staff and training them to meet your requirements so that they will assist in the prosperous operation of the clinic.


Third and the most important challenge is usage of ophthalmic drugs while practicing. The purpose of these drugs may be either to perform invasive procedures such as tonometry, during cycloplegic refractions or conducting certain clinical examinations. We, as optometrists in India are ethically and legally not allowed to use and prescribe ophthalmic drugs. However, it is impossible to complete certain eye examinations without their usage.


To summarize the article I would say, ethical and experienced testing strategies coupled with proper communication and explanation with patients makes a greater positive impact on your practice. The professional collaborations’ with local ophthalmologists will help in establishing and managing a successful clinical practice.

Mr Prasad Sawant is ‘not just another optometrist’, he established himself from an amateur to a revered professional. During his journey he associated himself with other eye care professionals, academics and also international organizations and associations. 

Prasad started his optometry career by completing a Diploma in Optometry from the Municipal Eye Hospital, Mumbai. Later, he completed Bachelors (2001) and Masters (2005) degrees in optometry from Bharati Vidyapeeth School of Optometry, Pune. Between these two academic degrees he obtained a clinical optometry fellowship from LVPEI (2002). After his post-graduation he also obtained a Fellowship in Scleral Lenses from Boston Foundation for Sight, USA (2008) and British Contact Lens Association Fellowship (2014). 

Lens Educators, Australia (2011) and was on faculty panel of Johnson & Johnson as the Vision Care Institute speaker (2010-2014). In addition to presenting in national and international Optometry conferences, Prasad is a guest faculty and external examiner at Bharati Vidyapeeth School of Optometry, Pune. Lotus College of Optometry, Mumbai, Manipal School of Optometry, Manipal, and Nagar School of Optometry, Ahmedabad.

Prasad is practicing Boston Scleral Lenses as a Clinical Associate for the PROSE Clinic (Boston Foundation for Sight), India at The Eye Super-Specialties, Ghatkoper-Mumbai.  Also he is an accredited Fellow of International Association of Contact 

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