Have you ever played a game in one of those modern VR headsets? To the outside world it appears you are swinging wildly at ghosts because on the inside you are swinging wildly at ghosts?!

Well, get ready because VR headsets have become mainstream in optometry offices. The greater mobility of the testing equipment has led to potential for better office and workflow efficiencies and greater patient accessibility.

In the Lane Testing

Having multiple exam lanes for each optometrist improves patient flow, reduces patient waiting times and allows for greater efficiency at deploying medical personnel. Instead of the optometrist waiting for a patient to be “set up” in the exam room, the doctor can be examining a patient in the other room. This efficiency translates to better revenue per doctor day (and improved compensation) as well as improved bottom line net profitability. With the advent of in-lane VR headset testing a patient can “start” the pre-exam testing in the comfort and privacy of an exam lane.

Consistency and Reduced Staff Time

The VR headsets allow for a “virtual” technician that guides the patient through the testing process. This provides a consistent process with consistent education and testing instruction provided to each patient. A patient can be “left” in the exam room and run the testing on their own. As patient testing autonomy becomes more commonplace, the process will become an expected part of the testing and patient education during the eye exam. In many multi-doctor optometry offices, the pretest room has become the bottleneck for office patient flow. The advent of advanced scanning such as OCT and super wide-field fundus photography has changed the optometrist’s role from data gathering to data analysis and treatment plan formulation.

AI and Data Analysis

With the advent of artificial intelligence and machine learning, the opportunity to provide AI Insights for optometric practitioners is now here. Universal VR testing platforms can easily send data and testing results to cloud based telehealth platforms for analysis and AI insights as a adjunctive practitioner support to the patient treatment plan. RetinaLogik is a Canadian based VR headset that is using AI to support practitioners in the care of their patients.

Cloud-based data management companies can further provide objective feedback and AI insights. Care1 is a Canadian telehealth company that has developed objective drusen volume computations. This will allow for treatment analysis as new technologies for the treatment of dry AMD become available for patients inside optometric settings.

Binocularity for All with Marketing Support

Neurolens has recently launched their mobile VR headset N3, which provides the ability to run phorias and fixation disparity via a VR headset. The interesting aspect to their set up is that optionally the patient can learn more about solutions and opt in to further discussions with their optometrist and optometric staff. This makes the sales process more streamlined and consistent. One of the powerful realizations of VR testing is the “wow effect” that patients experience during the testing process. This increases the perceived value of the eye exam and improves capture rates and patient retention.

Future Applications

Many of the software companies that offer virtual reality testing are using the same hardware headset. This may lead to future consolidation so multiple pre-exam tests can be provided without changing headsets. The potential for patients to further streamline the examination process exists in that patients could come in for technician standalone pretesting to improve the exam day workflows. Testing remote populations and at-home testing are becoming a likely outcome with these new mobile technologies. In our offices we see the opportunity to reduce patient logjams in pre-exam on the fly. Technicians can decide to run visual acuity testing, visual fields, colour vision, and other testing away from the pretesting room to reduce patient wait times. The time to welcome VR testing in our optometric offices has arrived!


Dr. Miranda is a partner in a multi-doctor, five-location practice on Vancouver Island.

He is a strong advocate for true Independent Optometry.

As a serial entrepreneur, Trevor is constantly testing different patient care and business models at his various locations. Many of these have turned out to be quite successful, to the point where many of his colleagues have adopted them into their own practices. His latest project is the Optometry Unleashed podcast.


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Opportunities & Options for New Optometrists

On the evening of March 29, young Canadian Optometrists and Optometry students will gather simulataneously online and in person for a unique hybrid event. The event will be live at University of Waterloo, School of Optometry and Vision Science and livecast via ZOOM to an online domestic and international audience. Click here for more information about this event.  The event is co-presented by Bausch + Lomb Canada and Eye Care Businesss Canada.

Optometry Students and recent graduates will hear from both industry experts and recent graduates about their various career experiences, exposing the young ODs and students to the opportunities and options that are available to them. The evening will be co-hosted by NextGEN OD ambassadors, Jenny Lee (OD-4 UW) and Nyah Miranda (OD-1 NECO).

The live portion of the event will begin at 7:30 PM (EDT) with light fare/refreshments. The remote attendees will join in at 8:00 PM for the guest presentations (See details here). The presentations will be followed by a  Q&A session and prize raffles for attendees. Nearly $1000 of value prizes will be awareded.

Interested persons should reserve their place soon as soon as possible due to space limitations for the live event.  There is no cost to attend, but available reservations will be made on a first-come first serve basis.

Other sponsors of the event include FYidoctors, IRIS Group, Bailey Nelson, ROI Corporation, Eye Recommend and CRO (Clinical & Refractive Optometry).

Registration is now open for both the live and online event. See you there on Wednesday March 29th.



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By Dr. Trevor Miranda. 

Dr. Miranda contributes his thoughts and perspectives on the topic of Independent Eye Care Practice in Eye Care Business Canada. Check out all of Dr. Miranda’s articles in Independent Insights category.

If you are a practice owner then you are a leader.

It is important to embrace this role, learn to excel as a leader and create future leaders in your organization. Too often the owner abdicates the leadership responsibility and, as a result, the void is often filled by dysfunctional power grabbing protectionist team members looking to control everything and limit the growth of others.

Driving the Bus
As a leader, you need to be able to lead from the front.

This component of leadership is tasked with the awesome responsibility of “being awake at the steering wheel”. This means being ready to make turns to keep the bus on the road to business prosperity, to deftly dodge the potholes (like the Pandemic) and knowing when to stop, rest and refuel.

The driver of the team understands what it takes to do each job to keep the team moving forward. Valuing each job is crucial to engaging the entire team to keep their eyes on the road so they can also catch threats that may end in disaster.

At the Back of The Bus
I remember road trips with soccer and hockey teams growing up.

Only the “cool kids” got the back seats. The cover of invincibility and greatly reduced accountability made the back of the bus the most coveted locale.

A great leader lets others drive. Encouraging and fostering leadership skills in others will incubate a culture of empowerment. Great leaders can sit at the back of the bus and enjoy the fun and reduced stress that comes with that.

These special leaders are in tune with the heartbeat of the team. Make sure you take time to have fun!

No Back Seat Driving
Great leaders let others lead.

The bus of business is on the road 24/7. You can’t be a good driver all the time. Encouraging other team members to lead perhaps by running a meeting, hiring new staff, creating training plans for each team member or investigating new product solutions are all key to fostering a Leadership Culture.

It is important to let the driver in training make decisions such as where to turn without constant direction. Don’t be a backseat driver! Emerging leaders of organizations need some room to FAIL (First Attempt in Learning). Crucial to a learning organization is that reviewing where we are and how we got there brings new insights.

All drivers in training need to know when they take a suboptimal route and understand ways to improve on a go forth basis.

Under the Bus
The concept of throwing a teammate under the bus needs to be revisited.

Taking team accountability for mistakes such as a missed order, incorrect Rx, or any other perceived patient slight allows the patient community to recognize the team care they are receiving.

As a leader, you should always be “under the bus” with the entire team. If we are attached together we cannot throw anyone under the bus without ourselves coming along for the ride.

The Wrong Bus
Sometimes passengers on your team bus may experience motion sickness or do not appreciate the direction the bus is going.

In your company analogy, these passengers are wishing they weren’t even on your bus. They want to fly first class (who wouldn’t?!). It is crucial that the leaders identify these team members and ensure they fully understand the direction of the organization and exactly what roles they are expected to undertake.

If that is unsatisfactory then stop the bus and exit this employee. Perhaps a different journey is more suitable for them and it’s time for them to find a different bus.

It’s better to be honest and frank in these conversations but remember to be kind.

Driving Standards
There are certain attributes that good leaders value including honesty, trust, hard work and kindness.

In the same way that we follow “the rules of the road,” great leaders don’t cut corners when it comes to “doing things the right way.” Crucially fostering other leaders is very important.

We have created a pathway or “journey” for each team member by overlapping training and compensation so that each employee feels some control of the direction that the team is heading.
Great execution relies on an amazing team all driving in the same direction!



Dr. Miranda is a partner in a multi-doctor, five-location practice on Vancouver Island.

He is a strong advocate for true Independent Optometry.

As a serial entrepreneur, Trevor is constantly testing different patient care and business models at his various locations. Many of these have turned out to be quite successful, to the point where many of his colleagues have adopted them into their own practices. His latest project is the Optometry Unleashed podcast.


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By Dr. Trevor Miranda. 

Dr. Miranda will be regularly contributing his thoughts and perspectives on the topic of Independent Eye Care Practice in Eye Care Business Canada.

In life and at work, we can often think it is easier not to think of something to avoid having to use the scarce resources of time and energy to properly deal with the task at hand.

For me, it’s organizing my closet or cleaning the garage. I cope by putting it off but every time I open my drawers I am reminded that it needs my attention (I finally did tidy the garage and I feel so much better!).

My stress could be reduced by just stopping the avoidance of these tasks!

Multi-tasking Owners are Challenged

Independent optometric owners have to juggle many responsibilities. Marketing, human resources, inventory management, cash flow, financial statements, scheduling, tax planning, budgeting, equipment purchasing and maintenance, product information, staff training, patient experience, E-Commerce and many other duties can easily overwhelm the minds of optometric owners.

Beyond that, the responsibilities of continuous learning on glaucoma, macular degeneration, vision therapy, low vision, myopia management and primary eye care further compete for optometrists’ time and energy.

Wearing all these hats is very challenging and often leads to avoidance coping.

Avoidance coping is a maladaptive form of coping in which a person changes their behaviour to avoid thinking about, feeling, or doing difficult things.

Stress Management versus Stress Avoidance

Avoiding stress might seem like a great way to become less stressed, but this isn’t necessarily the case.

More often than not, confronting a problem or dealing with a stressor is the only way to effectively reduce the stress it causes.

We strive for “stress management” rather than “stress avoidance”. Usually, procrastination or trying not to think of the stresses leads to further stress and increased frustrations. Actively managing stress is a more healthy and productive strategy.

Ways to Manage Stress

Delegate (don’t abdicate):
Delegation of duties is an effective way to distribute responsibility and accountability.

Effective delegation requires structure and training. It is important that there is oversight of delegated tasks.

This means using “SMART” goals: Specific, Measurable, Attainable, Realistic, Timelines.

As an owner, it is important to be briefed regularly on the status of a particular portfolio. For instance, delegation of marketing in your practice should include a regularly updated budget and a yearly marketing plan with regular reviews at predetermined intervals.

There are task management applications that can assist in overseeing these delegated tasks; examples include Monday.com and Trello.

Delegation of tasks can be divided among the entire team rather than residing as the responsibility of the office manager. For instance, one staffer can be in charge of outstanding accounts; another in charge of ordering supplies.

We utilize Slack to assign tasks that combine communication to both assignee and assignor until task competition. The management of outstanding tasks allows compartmentalization of these potential stresses and combats avoidance.

Cultivation of empowerment in each team member to be part of the solution is important to stress reductions and better office functioning.

The culture of not passing the buck or saying “that’s not my job” is crucial to a shared responsibility and accountability. This helps reduce the burden and decrease potential stress.

Leaders guide their businesses in a directional way. Avoiding micromanaging will reduce stress.

It is important to quickly address large issues but avoid managing each and every mistake. Resist the urge to point out every mistake as this can be demotivating and depressing while adding stress on both sides.

If something is particularly bothersome, ensure you are not actively frustrated and address the issue in private with the appropriate compassion and honesty. Collaborate on ways to improve with training and feedback. Getting buy-in is crucial.

Avoiding difficult conversations will only add to stress levels. It is better to act like the CEO of your optometric business. Guide the ship through small directional maneuvers rather than being stuck in reflexive reactions in day-to-day events.

Another way to help manage the myriad of responsibilities is to outsource to experts.

Companies offer marketing, human resources, accounting, and even optical dispensary management where experts take on the responsibility and reduce the owner’s stress load.

Don’t avoid the necessary time it takes to manage these areas properly. Use outsourced experts that are accountable for results and preset timelines.

I remember when I started my first clinic. I answered the phones, did the accounting, cleaned the office and helped in frame selection.

All of these duties are currently not my direct responsibility. It is important that you change as you grow.

Learning the business by doing it yourself is great if you’re capable, enjoy that aspect of business and have the time to do it.

As your business grows your management techniques need to adapt. With five clinics and a growing team, I know that I must adapt to actively manage stresses rather than avoid them.



Dr. Miranda is a partner in a multi-doctor, five-location practice on Vancouver Island.

He is a strong advocate for true Independent Optometry.

As a serial entrepreneur, Trevor is constantly testing different patient care and business models at his various locations. Many of these have turned out to be quite successful, to the point where many of his colleagues have adopted them into their own practices. His latest project is the Optometry Unleashed podcast.


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End of Time

By Dr. Trevor Miranda. 

Dr. Miranda will be regularly contributing his thoughts and perspectives on the topic of Independent Eye Care Practice in Eye Care Business Canada.

Time may be our most precious resource. Time has a finite and infinite horizon depending on the reference point. We all know and understand the saying “time flies when you’re having fun!” When you can’t wait until the end of the day rolls around, time seems to go slow, punishing you for watching it, agonizingly; seemingly consciously slowing the seconds down.

When it comes to time at work, most of us spend half our waking day “making a living”. It is estimated most people spend one third of their life at work.

There are those that dread these work hours. They work to have time off. They don’t enjoy work and their time at work brings them stress, anxiety and lack of fulfillment.

Then there are those of us that enjoy working. We choose an attitude and a mindset by embracing the day at work with excitement and anticipation. In this way, work is not so much about time as it is about the individual interactions and experiences that every day brings.

Slow Down Doc!
In my early career as an optometrist, I would fret about being late for my next patient. I was worried about the emergency “fit -in” that would distract my mind from the patient right in front of me.

One patient told me to slow down. It made me realize I was doing it all wrong. I still really like running on time but now I give 100% attention to my current patient.

I started using a chair-side assistant that scribes my notes so I can give full time eye contact to my patient, engaging with them on a deeper level. Rather than having to turn my side to them and type notes (I use the hunt and peck typing method), I can now pick up general body language and nuances to ensure my patient understands and can comfortably ask all their clarification questions.

I won’t leave until all questions are answered. I use videos to send information about disease conditions and invite follow-up dialogue if required. I page my optical experts to be present in my exam lane to enable a seamless hand off resulting in increased confidence in my recommendations that are reviewed by the opticians. This in-lane hand off produces greater optical capture rates and improved compliance to treatment plans.

Saving Time
Being time efficient or “lean” is something that can pay off both financially and in providing more time for other options. I calculated that saving two minutes per patient would equate to 16 days of time off or extra patient slots (based on 16 full exams over 48 weeks).

This can be done by delegating contact lens trials, utilizing a scribe, in lane handoffs, using multiple exam rooms, having scans and phoropter prepared for the patient in advance and many other ways to improve patient flow and efficiency.

Once you have saved the time you can decide if you want to use it to buy more time off or to see more patients.

So next time you are thinking why is the day dragging on, change your perspective and enjoy and be thankful for every minute of your day!

Quality Versus Quantity
It is not the amount of time that you spend with the patient that matters; it is the quality of that time.

Important to ensure you maintain as much eye contact as possible while the patient is speaking. It is challenging to look away and make notes and still have that patient know you are listening.

Delegate data gathering to techs and use the doctor’s time to listen, recommend and customize solutions for your unique patient.

Creating an amazing experience requires the team to be able to flex around each individual patient’s needs. I don’t like to see patients “waiting”.

I would rather the patient’s perception be of a new experience. Techs let the patient know that the exam is starting with some testing before they see the doctor. Perceived wait times are minimized by “pre-shopping” for glasses and education via videos on conditions and solutions which are chosen based on the patient’s profile.

The Acceleration of Time
As we get more mature in our work lives and the years pass by, we often lament that the years are going quickly.

This usually comes with the realization that time is precious and we don’t have an infinite amount of time left on this earth.

I find myself full of gratitude for each day; it’s a blessing to have the privilege to go to work, walk the dog and learn new things.

After 27 years as an optometrist, I am hoping for 27 more but thankful for each one!



Dr. Miranda is a partner in a multi-doctor, five-location practice on Vancouver Island.

He is a strong advocate for true Independent Optometry.

As a serial entrepreneur, Trevor is constantly testing different patient care and business models at his various locations. Many of these have turned out to be quite successful, to the point where many of his colleagues have adopted them into their own practices. His latest project is the Optometry Unleashed podcast.


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By Dr. Trevor Miranda. 

Dr. Miranda contributes his thoughts and perspectives on the topic of Independent Eye Care Practice in Eye Care Business Canada. This post is his first contribution to the series. Check out all of Dr. Miranda’s articles in Independent Insights category.

Today’s term “Independent Optometrist” has been hijacked by almost every form of practice.

Practitioners next to Lenscrafters, inside of big box stores and practicing in solo and group practices all have seized the phrase “independent optometrist” to describe their mode of practice. I would like to think I am an independent optometrist. Free to practice how I see fit with the equipment, products, staff, fees and culture that I feel suits my practice preferences.

What does it mean to be “independent”? What are the benefits and risks of being truly independent?

Dealing with Complexity
As a parent of three adult children, my goal has always been to raise independent kids. Today’s world is intricate and complex, full of nuanced relationships and global challenges. Might a better goal be to raise children that are capable of independence through interdependence? By this, I mean being stronger as an individual by learning and collaborating with others.

Can we apply the same goal to our optometric professional careers? Learning, collaborating and networking are basic tenets of excellence. In my career, I have learned processes and skills from those practitioners that have consistently shown excellence in their practice and personal lives. Learning is important but implementation is even more important to benefit from the learnings.

How to Collaborate
There are many ways to collaborate within the profession. Join your provincial and national professional associations. Be an active member and take on committee chair or Board positions. Join a buying/training network; I am part of Eye Recommend and have consistently gleaned practice management nuggets from my peers during an ER conference or get-togethers. Join a small business optometric group; I am part of a “mastermind” type group called Quantum where we share professional and personal challenges and collaborate with best practices and share the “group mind”. I am also part of our regional “BIG” (Business Influence Group). This group discusses all matters of optometry from HR and staffing issues to tricks and tips to maximize opportunities and practice enjoyment.

Today’s uber-competitive retail environment requires independent practitioners to collaborate with manufacturer suppliers. Choosing such partners requires careful consideration. Does an independent optometrist fit all contact lenses? Does the clinic deal with multiple spectacle lens companies? Does joining a buying group reduce the cost of goods and improve choices? These questions need to be answered but the most important question is what is best for the patient?

The Role of Bias
 It has always amazed me when one clinic can sell one brand of glasses and a clinic across the street feels like that frame line “doesn’t sell”.

Even at the same store, different opticians may have a bias towards certain products which can result in vastly different styles and designs of optical products that are sold.

Most professional sales personnel don’t usually have such a wide choice of similar products to choose from. For instance, a car salesperson for Lexus has a limited product offering and must understand and highlight the features and benefits of Lexus, not Mercedes.

Choose Your Supplier Companies Carefully
Limiting the product offering to excellent products and allowing very occasional ‘off menu’ choices in exceptional circumstances can improve staff product knowledge, increase supplier investment in your clinic and reduce costs in shipping and reduce costs of goods.

Choose your contact lens, spectacle lens and frame manufacturers carefully. Which companies support your independent practice ideals? Do these companies compete with your clinic at a retail level? Do they have products available online at a retail level? Do they help keep repeat orders through your independent OD channels?

The inter-dependence of suppliers and independent optometrists relies on careful consideration on choosing your supplier partners. Every purchase you make from a supplier is a proxy for your future success.

I recommend picking two suppliers in each category and deepening your partnerships. This existential dilemma will only increase as manufacturers continue to supply optometrists on the wholesale side while attempting to compete for our patients on the retail side.

Next Level Collaboration
Might the future survival of truly independent practices rely on cross-equity partnerships where independent clinics own pieces of other independent clinics? Might this joint ownership model allow for better pricing through a master account so independents can compete on a level playing field with corporate accounts to lower product acquisition costs?

I am a big believer in the future of independent optometry. Independents can truly keep the patient’s best interests at the top of the pyramid while curating partnerships with industry and partnerships with other like-minded clinics. Independence through interdependence!



Dr. Miranda is a partner in a multi-doctor, five-location practice on Vancouver Island.

He is a strong advocate for true Independent Optometry.

As a serial entrepreneur, Trevor is constantly testing different patient care and business models at his various locations. Many of these have turned out to be quite successful, to the point where many of his colleagues have adopted them into their own practices. His latest project is the Optometry Unleashed podcast.


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Career Pathfinders

The employment market in eye care has always been a challenge but today, catalyzed by the new opportunities from eyecare organizations eager to acquire new talent, the challenges, options and opportunities are greater than ever.

An overview of the employment situation will be shared with attendees as well as some sage advice from employment gurus.

Hiring organizations will provide insights into their culture and benefits. Attendees will be able to meet with the leaders behind Canada’s largest organizations and get first-hand perspectives. OD members of the Canada’s largest optometric buying groups share their perspectives on independent optometry. 

This interactive event is ideal for early career stage eye care practitioners looking to chart their course and those, at any career stage, considering upon a change in direction.


  • Tim Brennan, Chief Innovation Officer, FitFirst Technologies
  • Dr. Michael Naugle, VP Optometric Partnerships, FYidoctors
  • Dr. Daryan Angle, VP Business Development, IRIS Group
  • Dr. Laurie Lesser, Eyecare Director,  Canada/UK, Bailey Nelson
  • Nicholas Perry, Cofounder & Managing Director, Canada/UK, Bailey Nelson
  • Dr. Kyla Hunter, Aurora Eye Care, Grande Prairie, AB , Eye Recommend
  • Dr. Trevor Miranda, Cowichan Eyecare BC
  • Dr. Maria Sampalis, Founder & Owner, Corporate Optometry
  • Naomi Barber, BOptom, Director of Optometry, Specsavers

All events will be hosted and moderated Roxanne Arnal, OD, Certified Financial Planner. Dr. Arnal brings a unique combination of experience as a former independent practice owner and certified financial planner to the proceedings.

Mingle with your colleagues and presenters in conversation rooms following the presentations.


  • Presentations and Moderated Panel discussions
  • Private Video Chat tables
  • Interactive Text Chat
  • Direct Links to valuable information

Event registration is now open. Click Here for Details. 












Events in the Series:  

Registration for the first event Monday October 25th,  “Technology Drivers of Change” is still open. Click here for detailed information on this event. 

Registration for the second event Monday November 1st,  “Selling & Buying a Practice” is still open.  Click here for detailed information on this event. 

Click here to register for any of the Changing Landscape Events 


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Buying & Selling a Practice

The second event of the “Changing Landscapes: Opportunities & Options for Canadian ECPs” will focus on Selling & Buying a Practice and will be held Monday November 1st (7:30 PM Eastern).

The Canadian market has experienced transformational change in the past year.

Major players have had substantial capital injection and new Canadian market entrants are making their play for market share, creating more opportunities and options for Canadian ECPs.

Join leaders and spokespersons from the world of independent optometry supported by B+L and major eye care groups/organizations including IRIS, FYidoctors, Vision Alliance Corporation, OSI/SOI, Eye Recommend and, new to Canada, Specsavers. ROI Corporation, Canada’s leading health practice brokerage will also share their experience.

This event is a must-attend for any practitioner looking to exit their business, start a new practice or formulate a strategic partnership.

Speaker List Includes:

  • Jackie Joachim, Chief Operating Officer, ROI Corporation
  • Dr. Daryan Angle, VP Business Development, IRIS Group
  • Dr. Wes McCann, Central Optometry, ON, Eye Recommend
  • Dr. Michael Naugle, VP Optometric Partnerships, FYidoctors
  • Gord McFarlane, Managing Director of Corporate Development, FYidoctors
  • Dr. Skylar Feltis, YXE Vision Group, SK, OSI Group
  • Dr. Warren Toews, YXE Vision Group, SK, OSI Group
  • Dr. Trevor Miranda, Cowichan Eyecare, BC, Independent Practice
  • Dr. Robert Allaway, Chief Optometry Officer, Vision Alliance Corporation
  • Mike Protopsaltis, Partnerships Director, Specsavers 

The event series will be moderated by Roxanne Arnal, OD and Certified Financial Planner (TM), bringing an informed and unique perspective to the events.

Event registration is now open. Click Here for Details. 





Digital ECP  

Follow up Events: 

The final event in the series will be held Monday November 8th  7:30 PM (Eastern). 

Career Pathfinders| Making Informed Choices (November 8th)  
Career options and opportunities for both young and experienced ODs have never been greater as new organizations offering unique business models enter the market and established entities respond to the changing environment.
Click Here for Detailed Information.

Registration for the first event Monday October 25th,  “Technology Drivers of Change” is open. 
Click here for detailed information on this event.  

Click here to register for any of the Changing Landscape Events 


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Growing an Independent optometry pPractice Toronto

Jaclyn Chang graduated from UW School of Optometry in 2018. In 2019, less than two years after graduating, she took the plunge and purchased an existing independent practice in an urban setting with plans to grow. She shares her story below.


By Jaclyn Chang, OD

I bought the practice in the middle of November, 2019. It was not a decision I made lightly.

The owner of one of the clinics that I was working at as an associate, in mid-town Toronto, was ready to retire and offered me the opportunity to buy the practice from him.

He had been working as an optometrist for over 38 years and had been in the office’s current location for the last 18 of them.

The equipment was original to the practice’s current location and was in need of an update; this meant that I would essentially be taking over an existing patient base, paying one lump sum for the patient records.

The office sold contact lenses but there was no dispensary or any auxiliary testing available.

With a deadline, I had to consider my options and get back to the owner with my decision.

Because I had been working in the practice a few days per week over the previous year, I knew the patient demographic, staff, schedule, and location very well – a huge advantage as I was making my decision.

I liked the idea of building on a smaller existing practice as opposed to starting from scratch or paying a higher price for a larger practice.

There would be patients walking through the door on day one but I would still be able to put my stamp on the practice and really make it my own.

Ideally, I wanted to provide patients with more technology, including a retinal camera, OCT, and visual field. With this equipment, I would be able to continue to grow my skills as a practitioner in treating and managing disease.

Eventually, I would also want to give patients the convenience of having access to a dispensary in my own clinic – something which would not be possible at the current location.

As a newer practitioner, I was also limited financially and by the amount of business knowledge and experience I had.

I would have to figure out what equipment to purchase, how to finance it, and decide on the new fee structure for patients.

I would have to go through the process of creating a dispensary and hiring and training staff.

By adding new revenue streams that previously did not exist for this practice, there was no reference as to how the patient base would respond.

I worried about how long it would take to get to the stage I wanted and whether or not I would be able to afford it.

An Opportunity
Then, another opportunity came up for me to move the practice into a nearby clinic with the technology and dispensary that I was looking for.

As with any practice purchase, patients would experience a doctor change, but if we moved, we would also be putting patients through a physical location change and switching to a very different way of practicing suddenly.

However, it would also mean that I would be able to practice the way that I wanted to, with the equipment I wanted, immediately.

My Decision
I knew there was extensive work to be done on the practice and a steep learning curve to becoming a practice owner, but this was an opportunity that I could not turn down.

By December 2nd, 2019, I had moved the practice into the new office and had officially seen my first patients as a new independent practice owner.

This process did not happen the way I would have ever imagined, but now that one year has passed, I look back on it proud of the progress we have made and am excited to continue sharing my story with you!


Editor NewOptometrist.ca

Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with NewOptometrist.ca.


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TAYE Think About Your Eyes is a USA national public awareness campaign, presented by The Vision Council and the American Optometric Association, designed to educate the public on the benefits of vision health and promote the importance of getting an annual comprehensive eye exam.  Click here for more information and a full list of the participating organizations.

A strategic weakness of independent optometry that rarely gets discussed is fragmentation; an industry condition in which the providers function as individuals instead of as a collective or aggregate. An extreme result is the condition of each practice as out for itself, rather than as part of an industry that needs to unite to preserve itself. By noting this weakness, we may be able to find ways to work together to overcome it.

The egg, beef and milk industries all experienced fragmentation, and successfully addressed it. These are industries that produce products to be sold, rather than licensed professionals who provide services, but we can still use their example to give us ideas of what we in eyecare could do. The independent growers and purveyors of the egg, beef and milk industries committed to national advertising to support their collective need, and eyecare can do it, too.

Consolidation in the pharmacy and real estate markets, which have experienced a roll-up process similar to what is beginning in eyecare, were capitalized upon because of their fragmentation.

TAYE Is a Good Start, But More Is Needed
Can you imagine how hard it would have been in 1985 to get ODs to contribute money to a national marketing campaign like Think About Your Eyes? TAYE is making significant inroads to educating the public of the services independent optometrists provide, but it’s still an uphill battle convincing ODs to pitch in contributions to a marketing campaign benefiting independent optometry as a whole, rather than just their individual practices.

Despite the relative success of TAYE, after 50 years of interaction with my colleagues and friends, I see the odds of a successful collective response as slim, meager and none. Added to the challenge of fragmentation is the mass retirement of Baby Boomer ODs, who are looking for their personal best exit, with understandably greater concern for their own finances than the state of independent optometry.

Personal Cost and Effort, Not Just Legislation, Is Required
As difficult as it will be, it is not too late to consider a collective strategy to preserve independent optometry. The counter-measure will require increased personal cost and effort, and must represent a much stronger counter-fragmentation strategy. The strategy needs to be a business strategy, in which independent ODs are shown that it is in their personal financial interest to come together. A legislative or legal strategy having no sound economic value is doomed to failure.

Consolidate While Maintaining Independence
The individual independent practitioner will do well to continue to look for the ability to gain the benefits of a consolidated aggregate buyer and seller of care while maintaining their independence.

Join Alliances, Buying Groups and Optometric Associations
There’s never been a more important time for participating in buying groups, management groups and professional associations that can, while avoiding anti-trust laws, improve the ability to buy and sell care like an aggregate. This is a sound strategy for maintaining independent ownership. Think regionally when joining together with your colleagues to form operating collectives for the most manageable and effective outcomes.

What ideas do you have for how independent practice owners can join together to preserve independent optometry?



 is co-founder and chief clinical and regulatory officer with Innovega Inc. He is the co-founder of SynergEyes Inc and co-inventor of Paragon CRT. Dr. Legerton was the managing partner of a seven-doctor, four office, multi-specialty practice in San Diego. He holds 52 issued U.S. patents, and has 70 pending applications registered in more than 45 countries. Products flowing from these patents enabled eyecare practitioners to earn more than $1 billion in fees for services and lenses in the last 15 years. Contact : jlegerton@aol.com.


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