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A N.C. Eye Doc Passionate About Vision Health for Kids and Special Needs Patients

The vision health of children and those with special needs receives devoted, undivided attention at Special Eyes Pediatric Vision Clinic in New Bern, NC.

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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.”

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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.

After years covering some of the farther flung corners of the world of business journalism, Heath has more recently focused on covering the efforts of independent eyecare professionals to negotiate a fast-changing industry landscape. Contact him at heath@smartworkmedia.com.

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This California Lens Lab Has an Inspiring Recovery Story

They were burned to the ground in last year’s wildfires. Six months later, they’re thriving.

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SOMETIMES, THE THINGS that make you the best of the best are born of tragic necessity. On Nov. 8, 2018, the Camp Fire, the deadliest wildfire in the U.S. in a century, raged through the Northern California town of Paradise, destroying it entirely. Eighty-six people died in the blaze, which destroyed more than 18,000 structures. Among them was Paradise Lens Lab, which the day before had just celebrated its seventh anniversary.

THE FIRE

“I was headed to work a little before 7am,” recalls owner Gary Bates of that day. “It was a clear day but off to the side, where the sun was coming up over the hill I could see either clouds or smoke around the sun.” After about an hour at work, Bates headed to a lookout point 200 yards away. “The flames … were racing up the hill towards the back of the lab.”

A brief discussion about what they might be able to save was soon abandoned. “The Fire Department was telling people it was time to run.” There were five staff including Bates working that day; all got out, but all lost their homes. A few days later it was confirmed that the building and all its equipment was lost.

The rebuilt Paradise Lens Lab in Chico, CA. ‘It took us about three weeks to get our first edger and start the buildout,’ says owner Gary Bates.

THE REBUILD

That weekend, Bates and wife Tammy’s first thought was to move to Oregon. “But we just decided we had too many people relying on us. We had to give it a shot. That day we were out looking for commercial real estate” in Chico, CA, 15 miles west of Paradise.

Already reeling from the loss of his business, a second shock followed: “I thought I was insured fully, you know, rookie business owner.” Bates’ insurer informed him that on the $400,000 worth of equipment and stock he’d lost, he was covered for just $3,500. Help was at hand, however. Prior to opening Paradise Lens Lab, Bates, who’s been in the optical industry since 1989, had worked at Coburn Technologies. He was able to marshal some contacts there to get some edgers delivered within a matter of weeks. Later, Satisloh came through with a donation of brand new digital equipment. And a group of local doctors he does a lot of work for gave Bates $50,000 to help him start back up. “The generosity and kindness was amazing right after the fire,” he says. Most importantly, Bates’ customer base came through, pledging to stay with him.

Not everyone was so helpful, though. According to Bates, one major industry player “actually tried to poach my business. They went into all my shops, and promised them all this awesome pricing to ‘help them out.’”

Thankfully, things moved fast. “It took us about three weeks to get our first edger and start the buildout.” He was able to take some customers back almost immediately, though some were asked to be a little patient, as he didn’t want to underserve anyone. “Within a month and a half we were able to get them all back and provide excellent service for them all.”

THE POSITIVES

Many in this situation would see it as an insurmountable setback. But the Bateses have been rewarded for their determination. He says that whereas before Paradise Lens relied on conventional surfacing, with the new equipment, they can now process digital freeform lenses. Amazingly, business is actually up about 32 percent from before the fire. “We’ve gotten more customers; people have reached out to us wanting to give us their business.” And while they still live in their travel trailer, because of a post-fire housing shortage, they’re philosophical. “At least we have a travel trailer,” Bates says.

The rebuild at Paradise is now fully finished. “We’ve been complete for about three months now. It took us just a little over three months to build out and get all the equipment, get everybody trained and up to date,” he says.

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Let This Texas OD Tell You About a Way to Serve Underprivileged Patients in Your Area

Helping kids see has never been easier.

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IT’S A SIMPLE, sad fact that in this country millions of children are dependent on charitable organizations, and the doctors who work with them, for their vision exams and eyewear. On the local level, many practices encounter community members in need, and even if the ODs are willing to donate their time, providing the hardware — like frames, lenses and finishing —is a hurdle that is hard to overcome. Luckily, there are resources to tackle just this problem, and doctors making the most of them, like Dr. Jerry Gundersheimer, owner of Eye-Do Optical in Sherman, TX.

THE IDEA

Gundersheimer has been a member of the Sherman Noon Lions Club for 25 years, and has been providing free eye exams and eyeglasses to needy schoolchildren in Grayson County, Texas for the vast majority of that time. His optical manager, Albert Yougas, got wind of the Changing Life Through Lenses Program from the non-profit Essilor Vision Foundation (EVF) via Eye Do’s Essilor rep (you don’t have to be an Essilor customer to join the program; see below). This created an opportunity for the club to save the expense of the lenses, frames and lens finishing, the cost of which is now picked up by EVF. They have been doing so for at least six months now.

THE EXECUTION

The partnership has been highly successful, according to Gundersheimer, who has seen about a hundred kids or so since it began. With its help, he has also been seeing adults on behalf of the Sherman Evening Lions Club. “The Essilor Vision Foundation has been a dream come true for us. They are so easy to work with. The lenses they provide are of superior optical quality, too.”
According to Gundersheimer, Essilor will walk you through the steps it takes to send the glasses in for Rx-ing. “It’s a no-brainer,” he says.
EVF also has programs for optician-owned boutiques, including See Kids Soar, an in-office donation campaign that gives optical staff the tools they need to raise funds for underprivileged kids who are going without eyecare.

THE REWARDS

“As optometrists,” says Gundersheimer, “we took an oath to make certain that no individual in our community lacked for proper vision care.” The Changing Life Through Lenses program, he says, “helps each of us to fulfill that portion of our oath.” He adds that it has created goodwill for his practice throughout his community via word-of-mouth, and the satisfaction that comes from serving those we live with who can’t otherwise afford their vision care needs.
Gundersheimer says there may be financial benefits in the form of others hearing about his benevolence, and thus widening his paying patient base, “But truthfully, if this is the motivation for entering into this particular public domain, you are doing it for the wrong reason! The benefits are more emotional, and that is far more rewarding, in my opinion.
“We will continue to avail ourselves of this relationship as long as the Essilor Vision Foundation will continue to provide this amazing program.”

Do It Yourself: Partner with Essilor Vision Foundation

  • CALL YOUR REP. “My advice to anyone who wishes to utilize this program,” says Gundersheimer, “is to contact your Essilor rep and see how easy it would be to help those very deserving individuals out.”
  • NO REP? NO PROB. You don’t have to be an Essilor customer to participate. Create an account here: changinglifethroughlenses.org
  • NOT AN OD? Essilor Vision Foundation’s See Kids Soar program can help your optical retail biz raise funds for kids who can’t afford vision care: evfusa.org/get-involved/see-kids-soar-enrollment
  • TESTIMONIAL. Watch Dr. Gundersheimer discuss his experience with the program here: invisionmag.com/051901
  • SMALL PRINT. EVF will ask you to sign an agreement; among the requirements are an NPI or license number. Patients must be at, or below, the poverty level and without insurance to qualify.

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An Iowa OD Who Developed an Industry-Leading Neuro Rehab Specialty

Offering glasses just wasn’t enough.

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DR. DEANN FITZGERALD STARTED practicing optometry in Cedar Rapids, IA, in 1984. In 2006, she founded the non-profit Spanda, Inc., which combines optometry with other healthcare specialties and took her as far afield as Kenya. Soon, she decided to expand Spanda’s activities to her own community. Spanda opened Cedar Rapids Vision In Motion (CRVIM), a vision wellness and rehab clinic, in 2007. What started as a 1,600-sq. ft location with an occupational therapist and a single employee now occupies 6,000 sq. ft and employs two athletic trainers, seven therapists and two ancillary staff.

THE IDEA

A Door Opens

Vision therapy was on Fitzgerald’s radar screen from her earliest days in optometry, but it took some time for her to embrace it. “I originally went to school with the thought of providing therapy but Cedar Rapids was very medically oriented, with the University of Iowa just 20 minutes away. Which made it very difficult at first to want to do therapy.” But by the 1990s — the “decade of the brain” — she sensed a door opening.

THE EXECUTION

Bridging the Gap

Dr. DeAnn Fitzgerald

CRVIM deals with a larger variety of diagnoses and issues than we can list. The services Fitzgerald’s team have developed bridge “the gap between assessment and treatment” for patients of all ages who experience visual processing dysfunction. In other words, “It’s a brain thing,” as the practice’s mantra states. Since 2010, CRVIM has also been teaching, offering instruction to OTs, PTs, ATs and others, passing on Fitzgerald’s “Train your brain to see again” gospel.

Patients find CRVIM in a variety of ways. “We have the general practice so sometimes people come in for routine care and find out that we do other services to help with various problems.” Of course, there’s word of mouth, as well as the training conferences to which the CRVIM team are now often invited as experts. “I have patients come from a nine-state area for our services. With the training conferences, we try to collaborate with other OTs and PTs.” Among the many hats Fitzgerald wears, she is vice president of the Neuro-Optometric Rehabilitation Association (NORA), an inter-disciplinary industry group whose mission is to see that patients with physical or cognitive disabilities as a result of an acquired brain injury get full ocular health evaluation and optimum visual rehab services.
Fitzgerald doesn’t have the luxury of patterning CRVIM after anything in the industry, “because it doesn’t exist. But I look at what’s possibly working and couple it with things that work — multi layered therapy or integrated therapy for quicker recovery — so we combine vision vestibular and auditory and proprioception all together for a more intense and passive therapy that works well.”

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THE REWARDS

‘The Last Resort’

Fitzgerald finds working with neurologically challenged patients — “giving them back their life,” as she puts it — hugely rewarding, but along with the highs there are tough moments. “These patients have a lot of depression and emotional issues that you have to cut through to get them better.”
Fitzgerald established baseline testing for 1,400 metro youth football players over a period of three years. At first many parents didn’t see the need, but by year three every one of the players came in to get tested. She eventually donated seven laptops so these schools could do their own testing. The Pop Warner youth football league last year rated these schools’ testing system as the best it had seen.
It’s an anecdote that illustrates the complexity, and the importance, of CRVIM’s activities. “We do get very complex patients,” says Fitzgerald, “because sometimes we are the last resort.”

Do It Yourself: Develop a Niche Rehab Practice

  • BONE UP. Be prepared to learn on the fly. Says Fitzgerald: “Optometric education provides the avenues to do rehab, but I have logged countless hours in classes and reading … on … concussion and brain injury.”
  • LOOK AROUND. Fitzgerald advises finding someone who is doing what you want to do­—and learning. “It’s the quickest way to get where you want to go…We have a lot of doctors visit our clinic.”
  • BE USEFUL. Get into the community, says Fitzgerald, and “instead of telling people what you do — ask them what they need. Then help make it happen — often that is the ‘in’ to getting partnered with them.”
  • HIRE CAREFULLY. Fitzgerald says one of her biggest challenges has been finding staff that are competent but also compassionate.
  • PREPARE YOURSELF. Rehab can be taxing for both patient and therapist. Fitzgerald says of her patients: “They have a brain injury. We have to gently get them out of their own way so they can recover.”

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