This article is an excerpt from the Changes & Challenges report.
Seeing the Previously Unseen
Noelle Tchang, OD, walks over to her standing desk in her home office, which is thoughtfully arranged to ensure patient privacy, faces the windows looking out at the Arizona landscape and logs onto her computer to join her first video conference call of the day.
Dr. Tchang, a graduate from Southern College of Optometry with a background in public health says, “During the pandemic, we were exposed to telehealth, and I realized what an excellent modality of care it is to help more patients and expand access.” In 2021, Dr. Tchang joined 20/20NOW Eye Exams, PC, a teleoptometry and technology company. Bilingual in Spanish and English, Dr. Tchang started with the company by providing direct patient care to patients across the country. She says she kept volunteering as new opportunities arose, and today, Dr. Tchang is the company’s senior director of professional services.
MISCONCEPTIONS
She explains that telehealth in optometry often faces misconceptions. “Some people think it’s just a patient on the phone at home,” she says. “But that’s not our model. We perform comprehensive vision evaluations with a remote doctor.” Patients visit a physical location where they undergo standard pretests and imaging. Depending on state regulations, a certified technician may gather preliminary refractive data for the doctor. From there, the patient’s synchronous two-way audio and video tele- health consult with the doctor begins.
Dr. Tchang outlines the importance of staying patient-focused in this modality. “There are tele-eligibility gates,” she says. “The first gate is during intake, ensuring patients meet telehealth requirements, such as no new onset of double vision or recent eye injury, for example. Secondly, if we cannot obtain the necessary images or tests to properly evaluate the patient’s ocular health, then they’re not a good candidate for telehealth. The final gate is the doctor; their clinical judgement and expertise must always be respected and honored. Sometimes, patients disclose something during the exam with the doc- tor that requires further care. We’ll refer them to an in-person provider if needed or provide some bridge service.”
Dr. Tchang’s home office is designed for efficiency, equipped with a laptop, two additional monitors and proprietary software that cues up patient charts. An AI-driven algorithm assigns patients based on factors like licensure, wait times and vision insurance. “It’s all about keeping the process smooth and efficient,” she says. “The goal is to free up doctors’ time so they can focus on providing quality eye care services.”
INCREASING ACCESS
As a public health advocate, Dr. Tchang says that this is where teleoptometry’s promise shines. “The number of eye care professionals is not keeping up with patient needs. Many patients haven’t had access to a provider in years, and telehealth often identifies issues that require referral to local providers.”
She highlights telehealth’s ability to fill gaps in care, especially in underserved or slower locations where staffing can be a challenge. Hybrid opportunities are also emerging, allowing doctors to split their time between telehealth and in-person care.
“Telehealth isn’t replacing in-person care,” she says. “It’s creating opportunities to reach patients who might otherwise go unseen.”
OD Discovers the Richness of a Career in Nonprofit Sector
Karen Slate, OD, found her calling in the nonprofit world, a path she hadn’t considered in her early career. For 12 years, she thrived in a medically oriented private practice. But the pandemic prompted a re-evaluation of her goals. “I loved my work, but my mission was to help the most people,” she says. “I felt like I was missing that.”
Leaving her practice was agonizing, but Dr. Slate knew she needed to dive fully into her mission. Her first step was senior care. She now spends three days a week at a Delaware nonprofit offering vision, dental and hearing services to low-income seniors. “I immediately fell in love with the nonprofit model,” she says.
She also joined Vision to Learn, traveling to schools across Delaware in a van outfitted for exams. “We see kids from K-12 and provide glasses or referrals,” she says.
Additionally, she conducts disability exams for veterans. “These patients are medically complex. I spend more time with them, and I feel like I’m truly making a difference.” Dr. Slate says this work has transformed her. “I didn’t know this kind of career existed, but I’m so grateful I found it.”
A “Regular” Practice and a “Specialty” Practice
Janelle Davison, OD, faced a challenge. At Brilliant Eyes Vision Center in Smyrna, Georgia, her growing dry eye services were complicating workflows and creating confusion for patients and staff. “Patients coming for refractive care didn’t understand why they were seeing me for medical services, and referrals blurred lines with my primary care practice,” she explains.
To simplify operations and protect relationships with referring ODs, Dr. Davison made a bold move. In 2024, she opened the Visionary Dry Eye Institute of Georgia, a standalone center in Marietta, exclusively dedicated to dry eye treatment.
Located in a medical complex, the institute underscores its role as a specialty care provider. Patients are referred through a formal process, even those from Brilliant Eyes. “We use a referral pad and fax every referral, ensuring clarity for patients and consistency for staff,” she says.
The center offers advanced treatments like intense pulsed light, radiofrequency and punctal plugs in a spa-like environment featuring dark gray walls, mustard-yellow accents and vibrant artwork. Patients appreciate the calming atmosphere and amenities like a hydration station.
With no eyeglasses on display, the institute reinforces its sole focus: managing dry eye disease. Meanwhile, Brilliant Eyes continues thriving with an associate OD, dedicated to refractive and routine care. “It’s a move that has streamlined care for patients and strengthened my referral network,” Dr. Davison says.
Saying Yes Opens Doors
When Jessilin Quint, OD, MS, MBA, FAAO, was completing her residency in ocular disease and primary care, a mentor gave her a simple piece of advice: Be open to new opportunities. For nearly 10 years, she’s followed that advice. “I just keep raising my hand and saying yes,” she says. That mindset has helped her cultivate a collaborative “say yes” environment at Smart Eye Care that has led the team to open new locations and add new team members in this rural Maine practice.
Even before she went to optometry school at Indiana University, she had earned her MS and MBA in health care management. But she hasn’t stopped learning.
She’s received her Fellowship and Clinical Investigator Certification through the American Academy of Optometry, and she’s a Diplomate with the American Board of Optometry. She’s currently president of the Maine Optometric Association and a member of the Intrepid Eye Society.
Her willingness to at least be open to “yes” extends to her embrace of technology as well. “Technology is an incredible differentiator,” Dr. Quint says. “Our responsibility as providers is to stay open to these advances and integrate them thoughtfully into our practices. Patients deserve the best care, and technology helps us deliver that.”
 |
| DOWNLOAD HERE |
She adds that patients are open to technological advances. “Think of a smartphone. The technology there makes our lives easier in ways that we had not even imagined. Tech advances in eye care can do the same for doctors and patients,” she says. “As a doctor, I feel it is my responsibility to be open to these advances. I am not going to adopt every technology advancement, but I will talk with representatives and colleagues and read journal articles to see if it’s a good fit.”
The Changes & Challenges report is supported by Alcon.
