The Optical Metaverse in Omniverse City

In 1999, selling websites to Optometric practices was a very tough gig! “Who needs a website, we have the “yellow pages!” was a common refrain. I know this because it was my personal experience.

Well, history proved the naysayers wrong, and “web 1.0” technology, for better or worse, prevailed and is still an omnipotent force for any (serious) eye care practice or optical industry player. Then web 2.0 came adding with interactivity (like Virtual Try On)  and e-commerce with the same observed development curve from naysayers to advocates to an essential element for business and interactive “Omnichannel” everything.

Today the buzzword is “metaverse” and the technology confuses and confounds many, including me, I confess. Some call it Web 3.0 to dumb it down for those who like simple concepts. Guilty again.

Why do I need to be “on the Metaverse? 
I am not going to answer that question (because I honestly don’t know), but metaverse developments at large and within the optical and eye care world do require all forward thinking individuals and companies to keep a watchful eye.

No one in our optical world is more attuned to this future than Charlene Nichols, passionate founder of The Optical Metaverse, a  new platform which is built on a metaverse engine called The Omniverse City. Through the Optical Metaverse, Nichols is creating a path for the optical industry to go along for the journey.

“The Optical Metaverse is designed to unit individuals, businesses, and organizations within the optical industry to create a shared virtual space. This space enables stakeholders to connect and collaborate in a way that has never been possible. Through this platform, industry players can share ideas, innovations, and solutions to create a more sustainable future for the industry,” says Charlene.

“I strongly believe that the Optical Metaverse represents a significant development for the optical industry, and I encourage you to explore this exciting platform further,” says Nichols.  And on that I agree.

She adds,  “… if you’re an eye care provider and you’re not a part of that direct-to-consumer messaging channel, then you’re missing an opportunity to properly educate. Not only are you missing out on an opportunity to make money, you’re missing out on an opportunity to provide people correct information.”

Stepping Into a New World
As part of her “next”, Charlene is taking The Optical Metaverse and The Omniverse Village to the BREATHE! Convention which will demonstrate the utility of Web 3.0 technology in daily life.

Exhibiting at The Omniverse Village grants access to participate in pitch sessions, meet other insiders, and grow audience reach and influence. Companies in the Web3, optical, and eye care industry will benefit from direct exposure to over 5,000 professionals looking for solutions, tools, and innovations.

BREATHE! Convention is set to provide a historic, native Web3 experience, with 5,000+ anticipated attendees, 200+ brands, 150+ media partners, 100+ exhibitors, and 80+ speakers. The attendees will comprise 70% founders and C-level executives. BREATHE! Convention is the first of its kind featured directly on the show floor at the Las Vegas Convention Center.

For more information on The Omniverse City, visit: https://theomniverse.city/ Contact info@theomniverse.city

For exhibiting and sponsorship opportunities with BREATHE!, visit the BREATHE! website and book a call at: https://breatheconvention.com/ 

With the launching of The Omniverse Village, Web3 adjacent eye care and optical projects and companies have the opportunity to exhibit at BREATHE! at a group rate, allowing brands to bring innovative new use cases and applications that revolutionize the optical and eyecare industry.

Even if you choose not to participate at this time in Web 3.0 you do need to track developments.

Click here to view the full Press Release.

David Pietrobon

David Pietrobon

President | Publisher

David is the President of VuePoint IDS, Publisher of the Optik, Eye Care Business Canada and CRO – Clinical & Refractive Optometry and IMAGINEM, an independent eyewear fashion magazine.

Prior to founding VuePoint, David was an executive in several large International eye care companies in ophthalmic lenses, contact lenses and pharmaceuticals. He founded/co-founded  several information technology start ups providing services to Eye care Professionals.  He’s worked in 5 countries in over 30 years in the optical industry.


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Do resmues tell the truth?

Talent acquisition is challenging these days! And while many positions in our industry do have specific degree or licensing requirements, it is not always the case. And even in the scenario where a specific license is required, e.g. Optician or Optometrist, the following scenario applies.

The Obvious Choice

Consider this – you are hiring for an Operations Manager position in your practice and have two candidates filter to the top. The first person has a college degree and ten years of progressive experience working in a comparable partice within the industry. The second candidate also has a degree but a bunch of blind spots on the resume – points in time that are unaccounted for or filled in with part-time consulting.

The first candidate is the best choice, of course. Clearly, with a degree and all that experience, they must be able to hit the ground running. Right?

Maybe. They certainly have the experience asked for in the job description and have been with your competitor for a decade. If they’re so good, though, why are they moving on? They may be looking for advancement or simply not loving the job anymore. They may be faltering, know layoffs are coming, or just be looking for a change. Or maybe there’s no more room to grow there. Will you ever know for sure? These questions won’t have obvious answers on a resume and will only get you well-rehearsed responses in an interview.

If you dig a little deeper, you may find that the second candidate’s resume is slightly irregular because they traveled to some interesting places and explored the world for a little bit. Maybe they did some humanitarian work. You might also find that they took some time to stay home with newborn twins during COVID while also providing care to an aging parent!

These things might be considered vague on paper and get them black-listed by most Applicant Tracking Systems, but they may make a well-rounded individual that could actually be much better suited for the position. They are clearly curious and responsible. They show dedication and commitment and can manage multiple challenges simultaneously.

Skills Based Hiring

Skills-based hiring is a hot topic of conversation right now, and we’ve been talking about it for decades. Hiring based on skills is all about looking beyond the surface and exploring what unique talents are not immediately visible and certainly not emphasized on a resume. Experience and education don’t always translate to job performance, and you may overlook game-changing candidates who don’t fit the mold. If only there were a way to see the person’s potential, not just their pedigree.

Oh, wait. There is.

It’s shockingly accurate and allows employers to change the narrative and transform their workplace.

If you are at all familiar with us, you know that we preach the importance of looking beyond the resume, to better understand the essence of the person behind it. Resumes can be crafted exceptionally well and, with the advent of rapidly advancing AI like ChatGPT, may not have even been written by the candidate at all. The advantages and benefits of skills-based hiring are numerous but boil down to a simple approach that can change the world for all involved.

Using skills-based hiring you can reduce or eliminate bias in the hiring process. The content of a resume is open to interpretation and bias, and education and experience don’t necessarily equate to performance. Candidates with the skills to complete the job may not have taken the traditional path in developing their talent and likely won’t always have a formal education.

However, just because someone didn’t attend a cordon bleu culinary program doesn’t mean they can’t cook spectacularly. Spending years in a family restaurant business or even in your grandma’s kitchen may not land well on a resume, but that doesn’t mean there isn’t a Michelin-star quality chef in there.

Finding the Right Fit

So, how do you find these amazing people? By looking below the surface. Fit First Technologies uses patented, science-based technology to truly understand who a person is, how they tick, and what they are best suited for. Looking beyond the words on the resume gives you a deeper and far more valuable understanding of what a person is made of, how they will fit in your business and click with co-workers and your company. Employees that are happy, fulfilled and able to make a contribution to their company will ultimately onboard faster, perform better and stay longer.

What this all boils down to is a candidate’s potential vs. their pedigree. When you look beyond the narrow, myopic focus on education and experience, the talent pool will naturally widen to include people who are exceptionally great candidates who don’t meet the traditional criteria. “Great people, in surprising packages”, as one client put it.

Everyone knows that grandma’s cooking is the best, and those recipes, traditions and values are learned –  not through formal training, but through immersion in the experience and love for the process (and the delicious outcome).

TIM BRENNAN

is Chief Visionary Officer with Fit First Technologies Inc, the creators of Eyeployment, TalentSorter and Jobtimize.


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Adulting

As I sit here in the airport between flights, on my way home, from speaking with the students at the University of Waterloo, School of Optometry & Vision Science, I’m still running on the high of their energy and enthusiasm for the future!

So, in the spirit of the presentation, this two-part article is a great summary for everyone who wasn’t able to make it, and for those who would just like a brief recap!

Part 1: Setting up your Life and Career

The Infinity Circle that is Your Financial LifeThe Infinity Circle that is Your Financial Life

It all starts with You! You will earn an income – You will have expenses, and the greatest of these over your life will be TAXES (search YouTube or Facebook for the fun 30 second clip of Dony playing Monopoly). The goal is to keep your expenses less than your income so you can generate excess cash.

Excess cash that can then be used to purchase businesses. Businesses like your own clinic, commercial property, or profitable, well established market investments. These businesses will also earn revenue and manage expenses to create excess cash that can be used to reinvest in the business and provide you with an income such that, over time, the circle on the right replaces your need to actively work. That is what we call Financial Freedom.

Earning an Income and Contracts

Most young ODs will start their career as associate doctors. When reviewing various contracts, it’s important to be aware of some key questions to ask and terms to negotiate:

  1. When and how often are you expected to be present to see patients?
  2. How are patients going to be booked with you? Are you given all new patients? Is your schedule filled only after the senior doctors are fully booked two weeks out? Are the support staff eager and encouraged to book appointments with new doctors?
  3. Are there any dispensing or product sales quotas or targets?
  4. How is your renumeration calculated? If you elect to have a future ownership stake in the practice, will you be given any goodwill credit?
  5. Are there current and past contracted doctors that you can speak with? You will want to know the ease with which clinical days are filled with patients, what kind of patients, and any other expectations that they discovered while working there that weren’t discussed ahead of time.
  6. Are there any non-solicitation clauses on exit regarding patients and staff? Do you understand them and the penalties that would apply if broken.
  7. Are there any non-compete clauses? In most cases where you will not have an ownership stake in the business, these are often removed or restricted to a small and reasonable area and time frame as many have been challenged in court.

Sweetening the Deal

Often today you will see signing enticements such as a “golden handshake”, “loan forgiveness” programs, moving allowance, etc. You can negotiate these, but you should also understand when such payments will be received and any repayment terms if the relationship doesn’t work out.

I want to remind you that nothing is ever free – so be sure you understand the strings attached.

It’s Not Work-Life Balance because it’s all Your LIFE

I’ve never been a fan of the term work-life balance. It’s all your LIFE – so it should bring you joy.

We have created a Lifestyle Desires Checklist specifically for young ODs that takes a deep dive into your personal wants for your life (as you see it now), your professional wants, and then you will need to prioritize them.

The checklist also covers off considerations around different geographical locations and what they have to offer based on what you love to do, such as mountain biking, kayaking, attending the ballet.

And lets not forget to cover off how you ideally want to practice; everything from the number of hours you want to commit to clinic time, as well as ease of vacation opportunities and future education.

This checklist* is designed for you to get clarity on what is truly important to you as you head out into that Adult World!

*To download the checklist, please visit our website @ c3weatlhadvisors.ca. It is located under the resources tab.

Practice Culture and Locale Lifestyle

Consider spending some time at practices you are considering joining. Culture matters and you’ll want to get a good feel for the community.

  1. How do team members interact?
  2. What types of patients are typically seen at the office?
  3. How does the office handle patient needs that are beyond a “basic eye exam”?

It is important to understand the community into which you are choosing to practice and are considering living in, as this will enrich your life outside of the clinic.

Related Read
This is a two-part post. Here is part 2.

Adulting 101: Part 2


Advisory

As your Chief Financial Officer, I am here to help guide you through the various adult decisions you will need to make and the next steps you will be taking. Helping you understand your money and assisting you in making smart financial decisions about your debt repayment, insurance protection, tax management and wealth creation, are just some of the ways that I work as your fiduciary.

Have more questions than answers? Educating you is just one piece of being your personal CFO that we do. Call (780-261-3098) or email (Roxanne@C3wealthadvisors.ca) today to set up your next conversation with us.

Roxanne Arnal is a former Optometrist, Professional Corporation President, and practice owner. Today she is on a mission of Empowering You & Your Wealth with Clarity, Confidence & Control.

These articles are for information purposes only and are not a replacement for personal financial planning. Everyone’s circumstances and needs are different. Errors and Omissions exempt.

ROXANNE ARNAL,

Optometrist and Certified Financial Planner

Roxanne Arnal graduated from UW School of Optometry in 1995 and is a past-president of the Alberta Association of Optometrists (AAO) and the Canadian Association of Optometry Students (CAOS).  She subsequently built a thriving optometric practice in rural Alberta.

Roxanne took the decision in  2012 to leave optometry and become a financial planning professional.  She now focuses on providing services to Optometrists with a plan to parlay her unique expertise to help optometric practices and their families across the country meet their goals through astute financial planning and decision making.

Roxanne splits EWO podcast hosting duties with Dr. Glen Chiasson.


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Let’s be real. Have you ever stretched the truth on a resume? Maybe nudged your marks a bit higher or embellished your job responsibilities just a smidgeon to add some flair and polish? Chalk it up to being aspirational, perhaps. Jobseekers view the job market as an audition, and they know that putting their best foot forward may require some creative optics (pun intended).

These flourishes are far more common than you may think. HRDive found in one study that a third of Americans admitted to lying on their resume, while other studies estimate the actual number is higher. The reality is resumes are marketing tools designed specifically for self-promotion. Jobseekers can craft and draft content around what they think an employer wants to hear to give them an advantage over other potential candidates.

The Truth about Resumes
Here’s the real issue. Even if a resume is 100% accurate, the information in it is the statistically weakest predictor of someone’s likelihood of success in the job.

A resume is simply not a good reflection of a person. It is just a tailored list of education and experiences. It’s a brief snapshot that doesn’t shine a light on the truly important stuff – how a candidate makes decisions, manages change, or deals with disagreements. All the stuff you really need to understand.

Credentials may be qualifiers for very specific positions as is often the case when seeking a particular qualification such as an optician or optometric assistant. However, those qualifications aren’t reliable predictors of how an employee will integrate with your team, how they will perform or how long they will stay. Here’s the secret – you need to invest in resources that focus on finding people who will fit in your reality, not people who have the best resume writing skills.

Understanding a candidate better through an assessment can save you a lot of time in the hiring process and money in the long run. Spend more time on the right candidates and less time filtering through stacks of resumes. When you hire for job fit you are more likely to hire an engaged and passionate employee. Not only that – you may be very surprised to find your next superstar was hidden by barriers well beyond their control.

Fit First Technologies helps you see the real person behind the resume. Looking beyond the resume is exactly what you need to do to hire the right fit.

TIM BRENNAN

is Chief Visionary Officer with Fit First Technologies Inc, the creators of Eyeployment, TalentSorter and Jobtimize.


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If you are anything like me you probably can’t imagine a world without some form of vision correction – whether it be glasses, contact lenses or even refractive surgery. Personally, I have been wearing glasses for myopia since the fourth grade. I didn’t realize I had a problem with my distance vision until my first eye exam; this was the first time I could literally “see” the difference placing a plastic lens in front of my eyes could have on my perception of the world.

Refractive error, as it pertains to the human eye, describes an aberration in the visual system that produces unclear or blurred images. There are many types of aberrations that may occur in one’s visual system and traditional lenses are limited in the degree and type of aberrations which they can correct. Additionally, disease, infection or functional abnormalities may also affect visual acuity and are important aspects to investigate if one’s vision is poor.

Today it is easy to undergo an eye exam and obtain spectacle lenses to correct for one’s own unique visual impairments. With the use of the phoropter and a systematic methodology combining both objective and subjective data, an optometrist can diagnose their patient’s refractive error with great accuracy in a relatively short period of time. This methodological process is termed Refraction, and is best described as both a science and art.

Refraction is Both Science and Art

The science of refraction involves the ways in which a lens placed in front of the eye may alter the quality of the images produced by the brain. The art of refraction involves providing a patient with a prescription that considers their specific and unique visual issues and aids in improving their vision by correcting for those unique issues.

In most Provinces and Territories, the ability to perform refraction is limited to optometrists, refracting medical doctors and ophthalmologists. However, many opticianry school programs have begun to incorporate both theory classes as well as practical training in Refraction into their programs. The inclusion of such classes will help increase the depth of understanding in dispensing, visual optics and the physiological functioning of the eye among new opticians, while additionally providing novel avenues for potential revenue; especially if there is a change in the opticians’ scope of practice in more Provinces, allowing for stand-alone vision tests similar to British Columbia and Alberta.

Outside of vision testing, knowledge of Refraction may be beneficial to opticians who perform contact lens fittings. A sound knowledge of refractive methodology will make sphero – cylindrical over refraction (SCOR) an easier task and allow the optician who performs it to combat poor acuity, the second most common reason for contact lens drop out, next to comfort, in new wearers. As most practitioners, opticians and optometrists alike, tend to mask astigmatism with a compensated spherical contact lens prescription, those who correct for it, or at least present it as an option to patients will see an increase in both fits and sales.

Astigmatic Correction Often Provides a Noticeable Difference

Arguably it does take time to perform a thorough and complete contact lens fitting with sphero – cylindrical over refraction; as such, it is reasonable to charge a contact lens fitting fee depending on complexity of the fit.

Investing in this process however indicates to your customers a higher level of professionalism and helps build loyalty. Offering contact lens options shows the customer your versatility in fits and demonstrates your concern for their vision quality. Extending contact lens fit over multiple visits to allow for trial lens comparisons is recommended, and the ultimate in interactive patient feedback in healthcare.

Depending on one’s prescription, providing astigmatic correction often provides a noticeable difference in vision quality. Becoming familiar with the lenses that work best for you and your customer demographic will be essential in determining which contact lens manufacturer fit sets you should keep at your location. Having a fitting set onsite reinforces the professionalism and quality of an establishment, given the perception among the public of astigmatism correcting lenses as premium products. Space concerns may limit the fit sets you may be able to keep so reviewing previous sales data is a good starting point.

Paramount in contact lens fitting is setting reasonable patient expectations based on spectacle visual acuity. Achieving a good fit with a toric lens and demonstrating visual acuity enhancement employing the knowledge of Refraction, while performing sphero-cylindrical over refraction, will result in a stronger customer base, greater sales and increased profits.

Dr. Shaun Rawana

Dr. Shaun Rawana is a practicing optometrist with over 15 years of experience in both the United States and Canada. His area of focus has been primary care optometry with interests in cornea/ocular surface disease and contact lenses. Dr. Rawana recently began teaching clinical skills in the Opticianry program at Seneca College and looks forward to contributing his insights into the current Canadian scene through Optik.


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New eye care technology

You have a busy practice and work is going quite well. Your clinic looks great and has a growing patient and revenue base. You initially bought the latest technology to start your clinic. Wide Field Retinal imaging, OCT and perhaps some other great diagnostic or treatment tech. You have paid off some of the scary bank debt and you’re starting to feel like owning your practice actually was a smart idea and a good investment! When is it time to reinvest in your practice? When is it time to buy into new technology? In this article, we will examine some factors to consider when looking at the next tech.

Budget
Cash flow analysis is important. Are debt loads sustainable? Every year we budget for everything. Revenues and expenses are broken down into estimated projections and profitability levels are set and monitored throughout the year. In our clinics, we set 3% of revenues to our equipment expenses. If you are below 3% you may want to consider a reinvestment into the next revenue generating or profit creation technology.

Contribution Margin
The contribution margin is computed as the selling price per unit, minus the variable cost per unit. Also known as dollar contribution per unit, the measure indicates how a particular product contributes to the overall profit of the company. It provides one way to show the profit potential of a particular product offered by a company and shows the portion of sales that helps to cover the company’s fixed costs. Any remaining revenue left after covering fixed costs is the profit generated. I won’t go in-depth here but you can do an analysis to find a break-even point to decide how many units sold will make the purchase of new equipment make sense.

Amortization
I started my first of five clinics in 1997 (okay don’t judge but I still feel like I am just getting going!). I still have functioning equipment from those early days! It is good to amortize the equipment over the estimated life span of that equipment. If you can pay for the equipment slowly over time it is better than fronting that cost. This allows you to reduce the contribution margin and enhance overall profitability along the way.

Professional Fees
I often see optometrists (I am guilty too!) undervaluing their services. One of the first recommendations I make when someone purchases a new piece of equipment is to increase their exam fees even if it means just a couple of dollars per exam. Often this alone can cover loan payment costs for that new piece of equipment.

Choosing the No-Brainer
Sometimes a new technology comes along that allows early adopters a “no-brainer” option. Neurolens is such an option. Neurolens opens up a new category of spectacle wearers (20% of the lenses sold are plano) while providing robust profits for every pair of Neurolenses sold. The NMD2 instrument makes misalignment measurements more accurate and tech driven thereby reducing exam lane time and practice productivity. As a first mover advantage, patients are seeking us out to have this test and gain the benefits of the Neurolens. Patient results have been tremendous and the lenses are fully guaranteed to provide patient satisfaction and symptom relief. Further, the icing on the cake is that the company offers a generous “device rebate” for regular users of the lenses. This helped to make our entry into Neurolens a “no-brainer” and a “slam dunk”.

Would you rather…
My kids used to play the game “would you rather?”. If you are not familiar with this game it goes something like this: “would you rather hug a snake or have a rat run across your face?” or some similar no win scenario that you have to just pick one! The real life game gives me pause. Would you rather invest in Neurolens or IPL? Well, I will take both thank you very much. I can make a financial case for both and carefully lay out a plan to implement both technologies into my clinics in a successful way.

What about you?

 

DR. TREVOR MIRANDA

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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Artificial Intelligence

Absolutely, in both good and not-so-good ways.

On the positive side of the score sheet, there are branches of AI, like ChatGPT, for example, that can and will take pressure off early adopter HR staff by picking up some of the more mundane day-to-day tasks. ChatGPT has been trained with extensive data sets and can generate very human-like responses to requests and tasks. If AI can write job descriptions, answer standard employee questions, and develop contracts and policies, there will be more time for HR staff to focus on bigger issues.

On the less positive side of the score sheet, the rise of AI could be considered another issue on a long list of challenges for hiring managers. If you’re hiring someone based on a well-written resume, you may have more concerns than the typical embellishments. One of the most pressing concerns is the ability of AI to craft convincing cover letters and resumes. So convincing that it could be difficult for hiring managers to distinguish between genuine and not-so-genuine candidates.

If resume-based hiring is your process, be prepared for some surprises. AI is astonishingly more advanced than you think, and its human-like writing can make it indistinguishable from the ‘real thing.’ This evolution of technology is inevitable, but those responsible for hiring must be aware and take steps to make informed decisions. One very effective way is to ensure the resume is only one piece of the overall hiring puzzle and to use other technologies, like behavioral assessment tools, to truly identify a candidate’s qualifications and potential fit for the role.

Measure what really matters. Look beyond the resume (no matter how well it’s written) to develop a comprehensive understanding of a person’s skills, knowledge and aptitude. Shine a light on strengths and weaknesses and discover hidden talents. If you are responsible for hiring, consider options to help you find candidates that are the right fit for the job, the team, and the manager.

Fit First® Technologies, offers a range of tools and services to help employers identify the best candidates for the role and ensure they are a good fit for the organization. Our proprietary assessment platform uses a combination of behavioral assessments, cognitive assessments, and personality assessments to evaluate candidates. This platform can be customized to suit the specific needs of the organization and the role and can be used to assess candidates at all levels, from entry-level to executive.

If you think AI couldn’t fool you, you might be surprised to know this was written, in large part, by ChatGPT and edited by Grammarly.

Even robots can have personalities (if you tell them what personality to have).

TIM BRENNAN

is Chief Visionary Officer with Fit First Technologies Inc, the creators of Eyeployment, TalentSorter and Jobtimize.


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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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Act II

By most accounts, the Canadian primary care optometry practice’s bread and butter is refraction, sprinkled with some management of chronic eye diseases, and the odd acute care case. So, in truth, after such a long period one should expect some degree of monotony. However, how you deal with these feelings may help you progress, expand your footprint, and reinvigorate your passion for the profession.

For me, the COVID pandemic took a lot of the enjoyment out of the practice of optometry. Conversing with patients and exchanging stories during the exam provided me with a constant cultural and culinary education, as well as amazing travel suggestions. Unfortunately, as brevity, sterility and decreased patient interaction became the new norm, I was experiencing increased job dissatisfaction and fatigue.

Burnout

As the pandemic carried on, I struggled with greater responsibilities and increased concern for the well being of my family, staff and patients. I began to realize I was experiencing some of the signs of burnout. I considered trying to keep my head down and just try to plow through until these feeling passed, but knew in truth, this was not a real solution.

By definition, burnout is a condition experienced by workers and professionals in which aspects of their role or workplace induces stress1. This stress results in manifestations of physical, mental and/or emotional exhaustion. Common signs of burnout in the workplace may include anxiety, headaches, insomnia, fatigue and an increasingly cynical outlook on work and life in general 2,3.

burnout, stress

Burnout Can Happen to Anyone at Any Time

There is no defined treatment paradigm for workplace burnout at present. Many people find it helpful to take a leave temporarily, or even permanently. However, identifying the abovementioned signs of burnout and implementing proactive decisions to alter one’s work environment can not only aid in avoiding the symptoms of burnout, but, also open one up to opportunities not previously considered.

Important to realize is that although burnout may be a personal experience it is a community battle. Support from within the workplace, family and friends are integral to overcoming burnout’s depressive cloud. Simply talking to someone about your symptoms or the alternatives you may be considering may help lessen your burden.

Support from Co-workers, Family and Friends is Essential

To avoid burnout myself, the first thing I did was to take a small step away from patient care. I realized that as an optometrist I possessed a narrow academic skill set not easily transferable; however, I also possessed a wealth of life and entrepreneurial experience I could use. I began to think about why I entered the optometric profession, what experiences in my tenure as an optometrist I cherished the most and how I could replicate those experiences. I thought about the personal passions and professional desires I had yet to accomplish or even attempt, and how I may go about doing so.

co-workers

I spoke to several friends and colleagues and found that my experience of burnout, while unique, was not uncommon. This realization gave me some solace. I continued conversing with colleagues and bounced ideas off friends for alternative career paths within the optometric profession. I had often hired students at my office and enjoyed mentoring them as they learned about eye care.

Many of the students I hired went on to pursue careers in the ophthalmic industry. Realizing the desire to impart my knowledge to others led me to speak to a friend who had been teaching in the Opticianry Program at Seneca College. Luckily there was a need for lab instructors, and I was able to provide myself with some variety and a new set of challenges.

I continued to pursue unique experiences and became involved with a community charity project at Seneca. I continued to speak with my peers and colleagues, and sought input on new experiences and opportunities that may be available. It was during one such exchange I was serendipitously surprised to hear of the opportunity to write the article you are currently reading.

As writing has always been a passion of mine, I pounced on the chance to contribute my take on stagnation and burnout in optometry in the hopes it may assist anyone who needs it and provides some ideas of how one may overcome this common condition.

Work Cited:
1 “Staff Burn-Out” Journal of Social Issues. January 1974
2 “Symptoms of professional burnout: a review of empirical evidence”
APA PsycNET. American Psychological Association. 1998.
3 “Health Impact of ThePsychosocial Hazards of Work: An Overview”
World Health Organisation. 2010

Dr. Shaun Rawana

Dr. Shaun Rawana is a practicing optometrist with over 15 years of experience in both the United States and Canada. His area of focus has been primary care optometry with interests in cornea/ocular surface disease and contact lenses. Dr. Rawana recently began teaching clinical skills in the Opticianry program at Seneca College and looks forward to contributing his insights into the current Canadian scene through Optik.


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Advances in Eye Care

It is such a privilege to practice a profession that can save vision, relieve debilitating symptoms and protect the future of my patients’ vision. I thought it might be a good time to have a retrospective look at some of these amazing advances over my career.

Retinal Imaging
First, it started with fundus camera images where we could visualize and manipulate the retinal image to better understand what we are seeing under the microscope. Soon that evolved into wide angle retinal imaging to be able to get into the mid and far peripheral retina through an undilated pupil. This game changing technology allowed for a more expedient diagnosis (I sometimes make a retinal referral while the patient is in pre-testing and the image shows an obvious retinal detachment). Next came OCT (Ocular Coherence Tomography) which is essentially allowing a cross-sectional look under the retina and between retinal layers. OCT suddenly gave optometry the ability to instantly diagnose many more retinal pathologies with a high degree of certainty.

When we first acquired these technologies, we imaged every patient to better understand what we were seeing. The amount of occult pathology that was present without obvious symptomology made us pause and think.

Finally, we decided on a wellness model. We would image all patients with angle retinal imaging and OCT to screen for all pathologies that would present with symptoms and those that would be lurking as threats in the future.

Glaucoma Screening
Glaucoma is often called the silent thief of sight because there are often no obvious symptoms until vision is lost and major irreversible damage has taken place. Every eye exam looks for glaucoma, usually through intraocular pressure measurements and viewing the health of the optic nerves.

Nerve Fiber Layer (NFL) and Ganglion Cell Complex (GCC) imaging has allowed a look at early cellular changes before functional vision loss takes place. We screen all patients with visual fields, NFL and GCC scanning to set baselines for future reference and to identify glaucomas early in order to intervene and protect the future of our patients’ vision.

Dry Eye Disease
When I started practice, dry eye disease was a “grin and bear it” condition. Practitioners would acknowledge the presence of inflammation and provide artificial tears (usually a sample not a therapeutic course) and not follow up with the patient again until their routine eye examination two years later.

Now we screen for dry eye conditions before the patient arrives with a DEQ 5 dry eye survey and have added lower lid meibography and vital dye staining to every primary eye examination. Treatment advances in Dry Eye therapies abound and include advanced treatments such as Radio Frequency and IPL as well as LipiFlow. Medications that promote corneal healing and better tear production have made significant improvements in the lives of my patients previously suffering through untreated ocular surface disease.

NeurolensNeurolens
Recently we added an instrument that measures binocular dysfunction in a very accurate way through the Neurolens Measurement Device, or NMD. This technician-driven diagnostic test provides repeatable measurements that allow optometrists to prescribe Neurolenses, which incorporate a “contoured prism” to relieve symptoms associated with a proprioceptive conflict between misaligned eyes and the trigeminal nerve—sometimes referred to as trigeminal dysphoria. These common symptoms include dry eye sensation, light sensitivity, headaches and fatigue.

The results so far have been outstanding. Previously we would have to have patients suffer from not loving their progressive lenses and having to just “deal with it”. Patients have been raving! One patient described these glasses as “magic” and having changed her life.

It is rare that in one’s job you can make such a difference so as to evoke an emotional response of tears of joy and gratitude. Neurolens is such a technology, and a new way of prescribing glasses. We have started to screen all patients with symptoms of trigeminal dysphoria as Neurolens moves from being a problem solver to a
problem predictor.

The Rate Change Paradox
They say that change has never been this fast before and will never be this slow again. The rate change paradox requires optometric clinicians to change, learn and improve. As independent clinics, we have the power to instantly change without the required green light from head office that chains or corporate entities may require.
This is both a blessing and a curse. The curse is that nobody is requiring you to change via a memo sent down from the suits in HQ. That fact means that as leaders and practice owners the impetus for change has to come from you!

Embrace it! There will be many advances that will help us make the vision and indeed the lives of our patients more enjoyable. How quickly will you incorporate this into your clinic? The best is yet to come!

DR. TREVOR MIRANDA

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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