THE IDEA
Special Eyes’ origins are traceable to a particular patient. In late 2014, Dr. Cathy Doty examined an 18-month-old boy who arrived at Family Eye Care in New Bern, NC, with an untreated strabismus that had notably delayed his general development. Troubled by the fact that his parents, as members of a public health scheme, had been forced to wait three months to see her — one of the few doctors in the area who accepted their coverage — Doty made the decision to dedicate herself to pediatric and special-needs optometry. Her partners were agreeable, and by May 2015 she had opened the business’s children’s facility, Special Eyes Pediatric Vision Clinic.
THE EXECUTION
Doty sees patients up to age 16 and special needs patients of all ages, offering comprehensive exams and emergency visits. “No two days are the same. Some patients come in on gurneys from residential facilities,” she says.
Staffing a niche practice presents unique challenges. “There are definitely some people who enjoy working with children, and the children can tell. I have provided some in-service training, and have put together [fitting] guidelines for our optical staff.”
Exam rooms are set up for comfort and fun. The décor draws largely on Doty’s own parenting experience, and audiovisual and sugary treats are deployed at strategic points throughout the process. “It is rare for us to need more than three adults to help us hold the child, but it has happened… I will do as much as the parents want me to do.”
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Doty has made it a mission to drum home to parents the link between vision health and behavioral issues. “Parents still believe when their children pass vision screenings at school and the pediatrician’s office, that their vision is fine. I see the ‘jaw drop’ reaction almost every day. Many of them have behavioral diagnoses and take heavy medications for issues that may have been related to their +6.00 OU prescriptions. If there are two things that I hope I can help change in this world, it would be: 1. All children deserve to have at least one comprehensive eye exam before they start school; and 2. Comprehensive vision exams should be part of the overall health evaluation of a child before they are labeled as ADD, ADHD, ODD, OCD, autism spectrum disorder, speech-delayed, or behaviorally disabled and placed on medications.”
THE REWARDS
Getting Dr. Doty to discuss herself is a challenge; this modest but highly accomplished and dedicated professional will turn the conversation back to the “critical issue of vision correction for the most vulnerable.” But she concedes being “blessed beyond measure to have a supportive husband, partner, amazing staff, and community.” She took a leap of faith, she says, “and God has provided. I can’t even put a price on what this has all meant to me personally.”
PHOTO GALLERY (14 IMAGES)
Do It Yourself: Pediatric and Special Needs Optometry
1. TR GO NICHE. . Make contacts with pediatricians, therapists, school systems, and other eye doctors, Doty advises. “They will ALL be happy that someone is taking the lead to focus on children and/or special needs patients.”
2. AS Set the scene. Parents of kids and special needs patients like to be reassured they will have a caring experience. Special Eyes created a Google tour on its Facebook page, showing exactly what patients can expect during their visit.
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3. COA spoonful of… The No. 1 attraction in Doty’s exam rooms is the treat drawer, which helps her gain leverage. Special Eyes also has movies loaded on its M&S charts, and the children pick what they want to watch during retinoscopy and dilation.
4. CIMom’s the word. Nine times out of 10, says Doty, “Mom is the medical decision maker for the family. An OD who is willing to see their baby, free of charge, and provide good preventive care has won the family in most cases, whether or not the doctor takes their insurance.”
5. GO Soft touch. Frame selection is key, of course. Special Eyes carries Kids Bright Eyes, Dilli Dalli, Miraflex, and Solo Bambini. “We also love Gwen Stefani, Funoogles and Lindberg which allow older children to personalize their looks,” she says.
ONLINE EXTRA: Interview with Dr. Cathy Doty
To start with, what is the relationship between New Bern Family Eye Care and Special Eyes Pediatric Vision Clinic? How many ODs and/or opticians does Special Eyes itself employ?
DR. DOTY: My husband, Dr. Shawn Doty, and I are partners with Dr. Mark Leary. The three of us owned two freestanding offices, Pamlico Family Eye Care and New Bern Family Eye Care, up until three years ago. We hired an associate in 2011, Dr. Kim Oncavage. So, there are four of us. We have two optical staff in Pamlico and four in New Bern.
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What was your motivation for moving into this niche?
As the practice grew and our doctors were booked months in advance, a little patient changed my life. This article ran in my local paper, and The Associated Press picked it up: www.washingtontimes.com
Your practice accepted InfantSEE patients prior to the opening of Special Eyes, is that correct?
Yes.
What were the factors in your deciding to join this program, and why don’t more practices do so, in your opinion?
I knew Dr. [W. David] Sullins, the optometrist and founder of this program. InfantSEE was one of his most important legacies to optometry and public health. I wanted to answer the challenge that former President Jimmy Carter gave to [the American Optometric Association] to end amblyopia. I attended the workshops that were provided at several meetings, and then I began to tell parents about the program. Word of mouth and social media helped grow InfantSEE. I think that it is an amazing opportunity for optometry to do the right thing, and start the conversation with parents about the importance of vision care for children. I may not find any problems with a baby’s eye health or development, but I can educate a parent on the importance of proper follow ups, signs and symptoms of problems, and common myths about “pink eye”, etc. I think that a lot of ODs are uncomfortable examining babies, don’t trust their retinoscopy, or in their mind they just need to fill those appointment slots with “paying patients”. Here’s the amazing thing: Nine times out of 10, it’s mom who brings the child. Mom is the medical decision maker for the family. An OD who is willing to see their baby, free of charge, and provide good preventive care has WON the family in most cases, despite whether or not the doctor takes their insurance. InfantSEE saves vision, saves lives, and can help position a doctor as an expert in their community.
Could you provide a few details about the kinds of patients you see? What sort of services are offered to special needs patients? Are these all children or does this include special-needs adults?
I see pediatric patients (0-16 years old) and ALL special needs patients. We offer comprehensive exams and same day emergency visits with pediatrician referrals. No two days are the same, that is for sure! Some of the patients come in on gurneys from residential facilities.
For a different article, an optician once described the process of fitting a child with frames as (sometimes) being like “wrestling a greased pig”. (She meant it affectionately.) How have you and your opticians learned to cater to kids in the exam room and in the optical? Have you/they received special training in this, or can they learn on the job? Are some people just better at dealing with kids than others? What are the main challenges?
There are definitely some people who enjoy working with children, and what’s interesting is that the children can tell. I have provided some in-service training for my staff at SpecialEyes, and have put together guidelines for our optical staff in the main New Bern office for fitting procedures. In our exam rooms, everything is set up for the comfort and enjoyment of the experience. If you check our Facebook page, you will see photos of the rooms. You can also take a Google tour, which helps families with special needs children to decrease their anxiety about the visit. We have movies loaded onto the M & S charts, and the children get to select what they want to watch while I am performing retinoscopy, or when they are dilating. The No. 1 attraction in my exam rooms is definitely the TREAT DRAWER, and I use it as leverage throughout the visit. It is rare for us to need more than three adults to help us hold the child, but it has happened. My rule is that I will do as much as the parents want me to do. If they are willing to help me obtain the information I need, then we can usually complete the exam.
Judging from what I’ve seen online, your practice goes out of its way to way to provide a comfortable environment for kids. Was this hard to achieve? How do they respond to the experience?
We receive many compliments daily about how bright and fun the office is. The décor was easy to design because I just used a palette of colors and themes that reminded me of when my children were small. After the first visit, they feel at home and know exactly where everything is. They know we are there to provide a thorough examination and serve them and their families.
How about the parents? What are they usually most concerned about? You must have to spend a lot of time educating them about the particulars of pediatric vision care?
I find that parents still believe when their children pass vision screenings at school and the pediatrician’s office, that their vision is fine. I see the “jaw drop” reaction almost every day. Many of them have behavioral diagnoses and take heavy medications for issues that may have been related to their +6.00 OU prescriptions. If there are two things that I hope I can help change in this world, it would be these: 1. All children deserve to have at least one comprehensive eye exam before they start school; and 2. Comprehensive vision exams should be part of the overall health evaluation of a child before they are labeled as ADD, ADHD, ODD, OCD, Autism Spectrum Disorder, Speech Delayed, Behaviorally Disabled, and placed on medications.
Do you sell Tomato Glasses or anything similar? Are you satisfied with what your insurance plans allow you to sell to kids in terms of frames? And what are your thoughts on children’s frames/lenses in general?
In terms of rubber frames, we carry Kids Bright Eyes, Dilli Dalli, Miraflex, and Solo Bambini. We also love the Gwen Stefani’s, Funoogles, and Lindberghs, which allow older children to personalize their looks. I have recently become very involved in our optical because I know what works. I think that insurance plans are not providing enough flexibility with younger patients who are growing so quickly. For example, it would be revolutionary for an insurance company to offer a “growth” flex plan, which allows a child to get new glasses in six months rather than waiting for a year. What 3-year-old child can wear the same pair of tennis shoes for a year? Overall, I am very disappointed with insurance plans when it comes to visual benefits for children and special needs patients.
Could you comment on the rewards for yourself personally, your staff, and the business? Both personally and financially?
As I told you, I am honored and humbled that someone thought I may be worthy of your time and print space. But this article does not need to be about me, or what I have done. Hopefully, this is a platform for more discussion on this critical issue of vision correction for the most vulnerable citizens in our country—children and special needs patients. I am just blessed beyond measure to have a supportive husband, partner, amazing staff, and community that have all supported this endeavor. It was a leap of faith, and God has provided. I can’t even put a price on what this has all meant to me personally.
What comments/advice/suggestions would you have for other independent ECPs thinking about pursuing this niche?
Just do it!!!! Make contacts with pediatricians, therapists, school systems, and other eye doctors. They will ALL be happy that someone is taking the lead in their community to focus on children and/or special needs patients. Who is better trained to take care of the eyes of these patients? NO ONE. Optometrists should be the leaders in this niche, and we need to cheer each other on.
