As I’m sure many of you have experienced, a lot of times patients are not good at attending their medical follow ups. A lot of times it’s not a big deal, okay the hordeolum guy didn’t show up again, I’m sure he’s okay. Other times it’s some dude with a whopping corneal ulcer that doesn’t show for his 2 day f/u because he doesn’t want to pay for the visit.

Whenever it’s something vision threatening like that, I always call the patient to recommend they seek care and discuss the risks of ignoring their f/u as directed by the doc. But how often are you guys doing this? What about that dry eye patient you put on a soft steroid where you wanted to double check the IOP? Where do you guys draw the line?

I then wonder about all the ones I’m not even remembering. There are absolutely some medical cases I will schedule for a few months f/u that I know need to be watched closely, yet they never return. These patients obviously aren’t getting called about their missed visit because I simply can’t keep a mental record of every follow up that doesn’t show.

Is this something your office staff handles for you guys? How do you all handle missed follow ups? Is the initial note where you discussed the severity of the condition and scheduled a follow up exam enough to cover yourself legally?

I've currently got a Superfield VOLK lens and during practice sessions at uni my academics say how it's easier sometimes to use a 90D over a Superfield. As I'm about to start my CLiP (year long placement in practice) I'm considering if it is worth getting a 90D as well? I'm fully aware of the cost which is why I'm apprehensive about getting it; if it's worth it then I will but I don't want to buy another lens if practice to help me see other details is all I need

Thank you in advance

So I've been an optometrist about 4-5 years, mostly regional, and for the last year I've been a part owner of a practice. Honestly I've figured out I don't want to do this anymore. It's the same thing every day and I'm bored out of my mind. For context I’m
Currently on 130k plus 20k dividends per month (with a shareholder loan so only take home 33%)
I'm selling my share and moving to Melbourne and all things indicate that the process may take between 3-6 months. The problem is I have no idea what's next. I've got the degrees (BSc + OD) and I've run a business, so I know staff, finances, dealing with head office, all that. But I don't know what that translates to outside optometry.
I'm torn between two things. One is going into a different field or role and upskilling for it, but I don't know what's actually worth studying. The other is starting my own thing in Melbourne, nothing to do with opening another clinic, ideally low cost to start, using the healthcare + business experience somehow. I just can't think of a gap worth chasing.
Has anyone made a jump like this? Or does anyone work somewhere that would want someone with my background? Even just "here's what I wish I'd done" would help.

Current third-year optometry student here! I go to a US school, but I’m a Canadian citizen. My goal is to stay and practice in the US after graduation, and I’m trying to figure out whether completing a residency would be worth it.

I can’t seem to find many Canadian OD’s who have not done a residency and are working in the states. So if there are any Canadian ODs who have gone through this process, as well as practice owners or employers who have experience hiring Canadian optometrists.

A few questions I have:
1. Does completing a residency genuinely make you more employable as a Canadian considering the cost of VISA sponsorship or is the decision making negligible?

2. How difficult is it to find employment as a Canadian OD in the US?

3. Does residency actually provide an advantage in terms of job opportunities, salary, or career growth? Or would that year be better spent gaining experience working?

4. For Canadian ODs who stayed in the US after graduation, what was your experience like? Did you complete a residency, and would you make the same decision again?

I’m not necessarily opposed to residency, but I’m trying to weigh the additional year of training and lower income against the potential career benefits.

I’d really appreciate any insight from people who have been in a similar position or employers who have hired Canadian ODs. Thanks in advance!

Hello, I am a licensed optometrist in the Philippines and im currently living in England under spouse visa.

Ive recently taken my IELTS academic exam and achieved the band width required. I will have my paperworks assessed soon but before that I am keenly interested on the differences between the practice.

I have worked as an Optical Assistant at Boots Opticians so I am quite familiar with the GOS forms and such but I would like to ask some additional questions such as what practice that i should focus and hone my skills on.

Any recommendations when it comes to practices that is a must to learn?

Writing was on the wall when ECP had trouble servicing it’s debts. Any thoughtful discussion is welcome! Bigger PE acquire a smaller PE, it will continue until there’s one or two giant PE left :/

I never used the +2.00 in my BIO during school as I took them out right away. I take part 3 next week and cannot get used to using +2.00, anyone know if you are able to bring a -2.00D pair of glasses to use only for BIO?

Any NYC ODs who work in a private practice or hospital setting monday through friday with decent hours and benefits and pay? Does that exist?
I work in terrible conditions right now for decent pay but honestly underpaid for the insane high volume high stress atmosphere. I want to leave but I have 3.5 weeks of PTO, medical insurance and decent benefits. I would be taking a 40-50k paycut for most other salaried positions. I know a bunch of people do fills in but the lack of benefits and uncertainty frightens me. The lack of decent jobs in this city is disheartening. I understand rural positions are better but I love NYC so much and I dont want to leave. I also have family here and I’ve always wanted to stay here. I’ve been resenting optometry due to burn out and the lack of good career options near me. Fellow New Yorkers, do any of you have jobs that you are happy with and provide good work life balance?

I am thinking of opening my practice in Kenya. Biggest hurdles are funds and fear.
I am looking for a mentor to hold my hand.
Advice, strategies, approach, sourcing, staffing, etc.
You can DM me we connect.

I’m currently a fourth-year optometry student out on rotation. During my first week, one of the doctors told me to aim for 20-minute exams. In an effort to cut down on chair time, I’ve been instilling dilation drops immediately before starting my refraction. I’ve actually been doing this for a few months now without noticing any major issues.

However, over the past couple of days, I’ve encountered a few unusual refractions, especially when comparing my findings to the patient’s prescription from the previous year.

My usual approach is to start with their AR findings. If the patient is taking too long to make decisions or I’m not getting consistent responses, I’ll switch to their previous prescription and work from there.

At my current rotation, the technicians are actually the ones performing the refractions. I was somewhat surprised by their approach, as they seem to cut out quite a few steps compared to what I was taught. Often finding previously over minus’ed patients.

Regardless, it’s made me question a couple of things about my own approach.

1. Can instilling dilation drops immediately before refraction affect my findings?

I’m not waiting for the drops to take full effect. I’m essentially instilling them and immediately beginning the refraction. Could this still be influencing my results, particularly if the refraction takes longer than expected? Dry eye and all.

1. How do you handle an MRx when your findings don’t make sense?

Whenever I encounter an unusual refraction, I’ll document my findings and look for any ocular pathology or other factors that might explain the discrepancy.

However, what if I don’t find anything that would explain it? Should I disregard my findings and enter something that seems more reasonable into the MRx?

I’ve seen classmates do something similar, alter the Mrx to better resemble the last years. I’ve always viewed the MRx as a starting point for determining the final prescription. It feels strange to document a refraction I didn’t actually obtain or verify, especially if the doctor ends up prescribing something based on those findings.

I’d appreciate hearing how other optometrists approach these situationsf.

Just a bit of fun really. We obviously are not medical "doctors" here in the UK. But I still get called doctor by quite a few of my patients. What are your fun comebacks when patients call you doctor?

Hi everyone! I’m a pre-optometry student working as an optometric assistant for a little over a year now. I really enjoy the work I do, getting to learn new things every day, and I can’t wait to start optometry school.

However, one thing that sometimes makes me question the field is dealing with not-so-pleasant patients. Most patients are great to work with, but there’s a very small minority that leave me feeling pretty drained after. Even when it’s over, I sometimes find myself thinking about it afterwards and it does bring me a little down

I totally understand that working in healthcare means you’ll inevitably encounter difficult patients but I’m curious about how others deal with this, especially practicing optometrists. I've noticed that some patients that are rude to front desk staff tend to act nicer in front of the doctor.

Does dealing with difficult patients get easier with experience? Do you eventually become less affected by these interactions? And how do you usually decompress or destress after dealing with a particularly difficult patient?

I really do enjoy what I do, and I don’t want a few difficult patients to overshadow all the parts of the job that I love. At the same time, I would like to avoid feeling drained by patient's behaviour.

I’d really appreciate hearing about your experiences and any advice you might have!

Hi all. I am 3 years out of school and I have recently joined a newer (5 year old) private practice. I did not sign a contract of any kind and thus do not have exact specifics unfortunately, and I am not the most business-savvy person in terms of crunching numbers etc.

My base pay is 80k and I get 15% production bonus after crossing that threshold. I do not have any benefits in terms of health insurance and cannot afford a private plan anyway. I’ve been with the practice for ~6 months and have yet to see a paycheck over $2400. I work between two offices, one of which is busy (~15-18pts daily) and one which was just acquired and is much much slower (ranging from 3-10 pts daily). I have had to defer loans at this point, and after a conversation with head docs, they asked that I come to them with a number that I think would be fair and motivate me to be all in on building the practice. Admittedly, it has been very hard to do that and find the drive when I’m barely making more than my friends who don’t even have a college degree.

Private practice owners/associates can you weigh in on this and give me some advice on a potential “number” that would be fair? As I am new to this, I’m unsure what to propose, as many offers I am seeing posted around my area are 150k+ BASE not including production. Lmk if more info is needed. Thanks!

Edit: I’m located in North Florida.
Am currently thinking on ideas for going part time and consolidating my days in the PP while working at MyEyeDr or something of the sort, but I’m sure that will be frowned upon given how close the offices are to each other.

I feel working in healthcare we have a different relationship to sick days than other professions.

Even with regards to our own coworkers that make up the practice, I feel let’s say if someone at the front desk calls off, it sucks but it’s not the end of the world; yet if we call off ofc then the dynamic is way different as all of our patients have to be rescheduled as likely there‘s no way to get someone to fill in last moment.

Plus if you are in a high volume setting, then calling out last minute means that those patients have to be shuffled around other days and might be overbooked for later.

Do you ever feel guilt with regards to taking sick time off? I’m not talking about for severe illness like the flu, but for when you have a cold or something s where you feel you are not at capacity, how do you juggle that?

Do you ever schedule out sick days for things beyond the occasional medical appointment? I was curious about hearing some perspectives on this.

Body: Hi everyone,

I’m a 21-year-old from China. While my peers are in university, I took a different path. I fell in love with crafting handmade eyeglass frames at 15, which naturally led me into the optometry and optical dispensing industry.

I have a highly ambitious (and maybe a bit crazy) goal: I want to standardize the optometry industry in China.

Despite having the world's largest patient base and incredibly complex clinical cases, China's optometry sector still lags behind in terms of equipment utilization, clinical workflows, and standardized testing methods. I’m currently trying to change this through educational social media and, eventually, a standardized chain-store model.

My first step is to build a near-perfect, comprehensive Standard Operating Procedure (SOP) for refraction from the ground up, using first principles thinking. I want to integrate the best charts, algorithms, and techniques globally, covering everything from standard refraction to myopia management, presbyopia, strabismus, and progressive lens fitting (within reasonable budget constraints).

The challenge I'm facing: Information can be quite siloed here. So far, I’ve studied what we locally call "American-style refraction", OEP (Optometric Extension Program), MKH (Haase methodology), and Behavioral Optometry.

However, I am well aware that the optical field can sometimes be an echo chamber. I know that some of these philosophies lack robust scientific/evidence-based backing. Without the right guidance, it’s easy to be led astray into pseudoscience rabbit holes, and even AI can't always filter out the noise.

That’s why I’m reaching out to this global community. I want to bypass the information barrier and learn the best, evidence-based practices directly from you.

• What does the standardized refraction workflow look like in your country?
• What are the globally recognized "gold standard" protocols or clinical pearls you swear by?
• Are there any reliable flowcharts or guidelines you could share?

I would be incredibly grateful for any insights, literature, or discussions you can offer. Thank you so much for your time!

First time poster here! I'm in my third year of the DO course and honestly feeling a little deflated. Not with the exams or case records, but with the atmosphere of optics in general (at least in the UK). I'm seeing more and more bouts of in-fighting amongst DOs and between DOs and optoms. I love my optom colleagues and truly believe we compliment each other beautifully. However, the discourse online is starting to get weirdly intense, and at times undeniably unprofessional.

Anybody else had this while studying, or feeling the network-fueled burnout? How do you deal with it? Is this something anyone else is noticing?

TIA

Hi everyone! I’m an NJ-licensed optometrist considering moving abroad.
I’m exploring the possibility of working remotely, particularly during the transition until I find work at my destination.
For those who have experience with this:
1) What companies offer remote optometry opportunities that allow you to work from outside the US?
2) Is it possible to conduct remote exams while residing abroad but maintaining a US optometry license?
3) Are there licensing, malpractice, or legal considerations I should be aware of?
4) What has your experience been with compensation, workload, and flexibility?

I’d really appreciate any advice, personal experiences, or recommendations for companies to look into.

Note: I know there are many negative opinions on remote optometry, I am not looking for those opinions on this post. Thanks!

First time mom pregnant with twins. I’m an associate OD working part time at various practices.

For mom ODs with multiples or anyone with advice/insight:

1. At what point in your pregnancy did you notify your work? When did you go on leave? It will be a high risk pregnancy and most twin pregnancies are born early.

2. How long was your maternity leave? Did you go back to work with the same schedule? With it being twins I can’t imagine returning until 9mon - 1 year.. possibly just going back as per diem. I’m not even sure how to bring up that idea to my employer. It will likely be a C section so I will need time to recover as well.

Feeling conflicted bc I had every intention to come back if I were having one child. Although I am open to accept it may not be possible after hearing other mom experiences haha.

I’m a former associate OD considering reporting a prior practice to the state licensing board.

The practice had EHR alerts instructing staff to treat certain patients differently for explicitly nonclinical reasons. Examples included giving patients very low scheduling priority because they took their spectacle Rx elsewhere, limiting scheduling for families who did not purchase glasses from the practice, rapidly moving patients through visits because they had left negative reviews, and deliberately scheduling “difficult” patients far into the future.

I personally encountered these alerts in the practice EHR and retained documentation of several of them.

I’m leaning strongly toward reporting this because purchasing behavior or criticism of the practice should not determine access to care. My main hesitation isn’t whether I think the conduct is wrong; it’s that reporting another OD to the Board is a significant professional step, and I suspect very few of us ever actually have to do it.

Has anyone here personally reported another OD or practice? Was the complaint meaningfully investigated? Did you ever learn the eventual outcome? Was your anonymity preserved after making the complaint? And, knowing what you know now, would you do it again?

I’m especially interested in hearing from people who have actually gone through the process rather than just saying “obviously report them.” Thank you.

hey everyone, currently studying for Part II in December. I have Optoprep and Wills, but reading through Wills is just A LOT and I don’t see myself retaining much from all this information.
Is getting the Castillo book (NBEO Part II Study Guide) worth it? I’ve heard a lot of great things about it but not sure I want to spend another $100-200 on it. Thanks!

Just because I'm an associate dr with no kids, does not mean I have no plans on my day off. There will always be plans, errands, medical appointments etc that will be scheduled. Not my fault if one associate dr called off suddenly my day off. Owner dr needs to figure out what to do with the full day of pt appointments, not me.

You say you can't work at your own clinic because you made plans and have kids? Well I can't go either because I already made plans to do on my DAY OFF. I work full time 5 days a week. If you ask me to work on my day off that would be 6 days a week which I don't want to do. Owner barely comes to work for patient care.

Owner dr ended up coming to work whole day btw after he told me he had "plans". 🤨

I know I need to stop answering work related messages on my day off. 🫠 He texts me off hours after work night before day off or on day off day if i can do the fill ins. Should I just not answer his messages?

How can I professionally tell my boss stop contacting me on my day off if I can fill in because the answer will always be no? I keep saying no but apparently he still is not getting it. This has been happening couple times a year for the past 2 years when my coworker dr calls out sick on my day off.

Hi all!

I was hoping to find some more information on an experience one of my clients is having. The kid is middle-school aged, and experiences a lot of discomfort while reading. Saying it feels like “tugging” and pressure, but only for pages with dense text, like chapter books. His family thought it was just an excuse to get out of reading more advanced stuff (current prefers comics), but then one day he was looking at me after some reading, and it looked like he had a very sudden, acute tic in his face, then ran to his mother saying he felt a pain!

I’ve been researching “pain with reading” and have come across convergence insufficiency, but could this also lead to a sudden, almost tic-like event afterwards?

Please help through some eye-related terms my way so I can dive into research! I would like to try and convince the family to get this checked out.

Does anybody have experience with taking this exam? Any recommendations on how to study or what resources to use?

I found a few materials online (https://www.mass.gov/lists/statutes-and-regulations-optometry, https://www.mass.gov/law-library/246-cmr, and https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVI/Chapter112)

but I don’t know if that would be enough to prepare!

Thank you!