Add a Specialty

How three optometrists successfully incorporated niches within their practices

Visual Generation/

So, after careful consideration, you’re looking to add a specialty to your practice. Now, you need to figure out how to find patients to fill the slots; how these patients will fit in to your schedule; what equipment you need; and how to stay on top of trends in the niche. Here, three optometrists who have added niches provide their insights on these items.


Adam Clarin, O.D., of Clarin Eye Care, in Miami, added vision therapy and sports vision specialties. To find patients for these specialties, he says he initially informed current patients about the new services via e-blasts and social media. Now, he says he tells patients about them during office visits, and office signage promotes the niches.

“People play sports year-round in South Florida, so every exam is an opportunity to discuss current sports,” he says.

To do so, he says he asks patients lifestyle questions: “When they mention playing sports, it’s an opportunity to delve into how their vision plays a role.”

Dr. Clarin says he usually begins the conversation by reviewing how important patients’ eyes are to everything they do. Then, he mentions how every play in sports begins with what they see and how fast they process visual information.

It’s also important to mention that both sports and vision are learned skills, he relays. “Just like you’re not born knowing how to shoot a basketball or swing a bat, you’re not born with perfect eye movements,” Dr. Clarin will say. “But unlike sport skills, eye movement skills develop earlier, and any bad habits get reinforced day in and day out. So just like training a swing, we can train the eyes to move more efficiently and work better.”

“If you’re serious about your game, you need to maximize your training,” he continues, with patients. “Sports vision can be the edge that takes you to the next level.”

The best external marketing has been through networking with current patients, Dr. Clarin adds.

“After discussing what sports vision training is with a patient, they usually know a coach, trainer or team and set up a connection,” he explains. “When I first became serious about sports vision training, I was showing a longtime patient the types of activities we use.

“The father brought in and connected me with his son’s hitting coach. Since then, I’ve developed a relationship with the coach, and I brought in vision training to strengthen his hitting facility.”

Dr. Clarin says he meets one-on-one with coaches and trainers to explain the concepts and benefits of sports vision training. He adds that he speaks with primary care physicians and neurologists, who provide referrals, about concussions and neuro-optometric rehabilitation.

“Just talking about my passions in the exam room pays off,” he says. “One of my patients is a local pediatric emergency room physician. After discussing neuro rehab with her, she asked me to speak to a group of pediatricians at her hospital. Since then, I’ve been getting more referrals from those doctors.”

Thanh Mai, O.D., F.S.L.S., of Insight Vision Center Optometry, in Costa Mesa, Calif., whose niches are myopia management and scleral lens fits, says his practice also educated current patients about these specialties. (As a brief, yet related, aside, Dr. Mai says to consider a niche that is prevalent among your patient population.)

“We informed current patients when we added the specialty, and they told others about us,” he explains.

Maria Richman, O.D., F.A.A.O., director of low vision services — her specialty — at Shore Family Eyecare, in Manasquan, NJ, says she also reaches new patients by having other doctors, such as other optometrists, other specialists (i.e., retinal specialists, neuro-ophthalmologists and occupational therapists) and primary care physicians, as well as state agencies, refer them to her practice.

“I educate referring doctors about the importance of functional vision services in patient summary reports,” she explains. “When a patient has a positive experience, they tell others with similar struggles about how I helped them.”

“We’ve been fortunate to receive referrals from other doctors who see the value in managing myopia beyond a pair of glasses,” Dr. Mai says.

Specifically, doctors go on site visits to referring optometrists.

“I have found that the best approach has been taking referring doctors out to lunch and also dropping by their clinics and having a community presence,” he says. “Bringing sweet treats is always a staff pleaser on site visits.”

Insight Vision Center Optometry has also been able to acquire myopia patients via its partnership with Treehouse Eyes, a vision care center that treats children who have myopia, Dr. Mai relays.

“Their team has been instrumental in helping us write marketing materials for our emails and website,” he says.

Marketing messages focus on managing myopia to prevent long-term ocular complications, rather than just focusing on achieving clear vision.


When Insight Vision Center first opened, Dr. Mai says the practice reserved Tuesday and Thursday afternoons for patients requiring specialty care, because those days seemed to work best with patients’ schedules.

“It was helpful for doctors and, particularly, staff to get into the ‘specialty care mindset,’” he explains. “They worked more efficiently with patients.”

Now that it’s a busy practice, every day is a specialty day, Dr. Mai relays.

At Shore Family Eyecare, a three-O.D. practice, where each optometrist has a primary area of expertise, scheduling is delegated based on patient needs for the specialty: “When a patient calls, staff have been trained to schedule each patient with the appropriate doctor.”

Dr. Clarin says he dedicates one day per week to his specialties. Additionally, he says he allows a sports vision evaluation during a free hour in his schedule or he adds an evaluation after his last patient on primary care days twice a week, because time allows for it.


As Dr. Richman’s visually impaired population increased, the practice’s need for low vision devices and adaptive technology emerged.

“Our practice developed a method for maintaining a large variety of magnification, illumination and glare control options,” she says. Dr. Richman says she purchases devices in volume that she prescribes most often, so they’re always in stock. As such, when a patient successfully completes training, they can take home the device the same day. This is similar to what contact lens specialists do when choosing inventory.

Regarding its technology arsenal, Insight Vision Center uses axial length measurement technology for orthokeratology fits.

“We added it early on because we’re serious about treating myopia correctly,” Dr. Mai says. “We need to know how good of a job we’re doing over time, which makes axial length measurement critical. It is similar to measuring IOP for glaucoma management or taking corneal topographies when doing orthokeratology treatment.”

The practice also utilizes a corneal topographer, he says.

More Tips for Adding a Specialty

OPTOMETRIC MANAGEMENT’s previous coverage has a wealth of tips for adding a specialty:

→ “It helps to identify a need for your niche before starting it. Begin by evaluating the records of your current patients to see whether enough have presented with the ocular/vision need(s) to make adding the niche worth it. Also, ask them, face-to-face, whether they or a nearby friend or family member would be interested in the niche. Further, assess Census Bureau data for the local area your practice resides to make the patient need determination.” — Jennifer Stewart, O.D., in “Niche Necessities,” found at

→ “Communicate your vision with staff. Invite honest feedback of where potential roadblocks will be and how to change the business to accommodate the new niche. Carefully explain “why” you want to add this niche to your practice. Develop a protocol so that the whole team is on the same page. Ensure adequate training is provided for you and your staff. Give staff the tools needed to help you succeed.” — Selina McGee, O.D., in “Leverage Your Passion by Adding a Specialty,” found at

Add a new specialty via the addition of an associate doctor. In such a situation, the senior doctor would need to be prepared to not run the show and to change some of the operations of the practice, such as time slots for appointments and the adoption of new fees and billing procedures, in order to use this business strategy. The new associate would have to be proactive and creative; put plans and ideas in writing and present them to the senior doctor; propose exam templates, fees, patient handouts, polices and more. — Neil Gailmard, O.D., M.B.A., F.A.A.O., in “Tip of the Week:” Adding a New Specialty, found at


To stay abreast of current research and best practices, Dr. Richman says she is a member of the American Optometric Association (AOA) Brain Injury Task Force, AOA’s Vision Rehabilitation Section, the New Jersey Society of Optometric Physician (NJSOP) Vision Rehabilitation Committee, NJSOP Low Vision Committee, the AOA’s Vision Rehabilitation Advocacy Network and the Neuro-Optometric Rehabilitation Association.

Dr. Mai says he attends CE courses and conferences, specifically the Global Specialty Lens Symposium*, The Myopia Meeting and Vision by Design.

Similarly, Dr. Clarin says he attends the International Sports Vision Association annual meeting.

“Presenters do a great job combining the academic and research world with the practical real-life world of building a service niche inside a practice,” he explains. “The meeting offers hands-on workshops with new techniques and ideas and lectures from top researchers.”


When looking to add a niche, Dr. Richman advises promoting what you do in a variety of ways.

“No one knows what you do better than yourself, so it’s up to you to communicate that,” she says.

For an optometrist considering a niche, having a passion for the area is essential, Dr. Clarin says.

“To be successful, make sure you discuss sports vision with every patient,” he explains. “You never know who can recommend a coach or athlete. Furthermore, many patients are intrigued by sports vision and want to know more about it.” OM

* The Global Specialty Lens Symposium is operated by PentaVision Media, Optometric Management’s publisher.