Nearly 80% of the patient base at NYC Pupil is pediatric patients. Photos courtesy of Dr. Gelfond-Polnariev.
Creating impact through leadership, purpose and giving
By Ilana Gelfond-Polnariev, OD, FOVDR
July 22, 2026
When I opened my practice nearly a decade ago, I had a clear vision for what I wanted to build. Taking that leap of faith was not easy, but it has been one of the most rewarding decisions of my professional career. I wanted to create a practice that allowed me to focus on the areas of optometry I am most passionate about while creating an environment where both patients and colleagues could thrive.
My journey has reinforced an important lesson: There is no single “right” way to practice optometry. The key is finding the practice model that aligns with your values, strengths and the type of impact you want to make for patients. For some, that may be private practice ownership. For others, it may be academia, a group setting, research, industry or another path. The most important thing is finding where you can be fulfilled and contribute your talents.
At NYC Pupil, we focus on pediatric eyecare, vision therapy for children and adults, neuro-optometric rehabilitation and all modalities of myopia management, including specialty contact lenses. We have built a practice centered around providing care that is often beyond what is addressed in a traditional eye examination.
SPECIALTY CARE WITH INTENTION
It is incredibly rewarding to see the difference we can make in patients’ lives. While approximately 80% of our primary care patient base is pediatric, we welcome patients of all ages. Our youngest patient was just 4 days old, and we continue to care for patients well into adulthood, oldest thus far is 104 years young.
With children, a routine eye examination may not always reveal the challenges they are experiencing. We look beyond visual acuity and evaluate skills such as tracking, focusing, eye teaming and visual processing. These are areas that can significantly impact learning, development and daily performance. Often, children do not realize they are seeing differently because their visual world has always been their “normal.”
With adults, particularly those recovering from concussion, traumatic brain injury or neurological conditions, the experience can be very different. They remember what normal vision felt like and are searching for that quality of life again. Helping patients regain function and confidence is incredibly meaningful.
Although we do not have a traditional optical department, we continue to provide comprehensive eyecare and offer a wide range of contact lens options, including specialty lenses for myopia management and other visual needs. We are fortunate to have developed strong relationships with many excellent opticians and optical professionals across different regions, allowing us to help patients find trusted resources when needed.
The NYC Pupil practice has grown through relationships, referrals and the trust of our patients, families, specialists, educators and colleagues. Patients travel from throughout the region and beyond because they are seeking specialized care and expertise. Most of our patients come from word of mouth, referrals from leading specialists and school principals. The practice is about 30% local and 70% travel from outside Staten Island, including patients as far as California, Canada and Florida.
I have also learned that building a successful practice requires investing in your team. Creating a positive culture does not happen by accident. After several years in practice, I hired a consultant, Bethany Fishbein, OD, with the goal of strengthening our office structure, improving team culture and creating a sustainable model for associate doctors with fair and competitive compensation. These efforts also produced measurable results. We have experienced steady annual growth, including a 41% increase in practice revenue over the past three years, driven by thoughtful improvements in office efficiency, workflow, strategic participation with insurance plans and stronger alignment with our patient population.
That process helped us better define roles, expectations and opportunities for growth within the practice. It also helped the practice achieve important financial goals, as well as maintaining excellent employee retention and a stronger team environment. To me, success is not just measured financially; it is measured by creating a workplace where people want to stay and where everyone feels valued.
SEEING HOW LUCKY WE ARE PRACTICING IN THE U.S.
A speaking opportunity abroad shined a light on opportunity in the U.S.
I do not take lightly the privilege I have had to practice optometry in the United States. Recently, I had the opportunity to lecture at the European Academy of Optometry and Optics (EAOO) Conference, where I led a workshop for optometrists from across Europe. The 20 attendees represented 10 different countries, and the experience was a real eye-opener.
One of the things that struck me most was learning how limited the scope of practice is for many optometrists across Europe. In many countries, optometrists have little or no authority to use diagnostic or therapeutic eye drops, prescribe medications or independently manage ocular disease. I also learned that in some regions, even prescribing prism for patients with binocular vision disorders or diplopia falls outside an optometrist’s scope of practice. Those conversations gave me an even greater appreciation for the privileges we have as optometrists in the United States—not only to prescribe and treat, but also to diagnose and manage ocular disease.
The experience also reminded me how fortunate we are as optometrists in the United States. Our profession has fought hard over many decades to expand our ability to diagnose, treat and manage patients. The level of trust and responsibility given to U.S. optometrists is something we should appreciate and protect.
Sometimes we focus on the areas where we still want to grow, but international conversations reminded me how much our profession has already accomplished. This is also why involvement in organized optometry is so important. Since graduating from Pennsylvania College of Optometry in 2002, I have remained actively involved in organized optometry through the American Optometric Association, my state associations, and organizations such as OVDRA.
Our profession is strongest when optometrists come together. Advocacy, education, leadership and mentorship all depend on participation. Whether through membership, volunteering, attending meetings, presenting, mentoring students or simply supporting colleagues, each of us has a role in strengthening the future of optometry.
We benefit from the work of those who came before us, and we have a responsibility to continue building the profession for those who come after us.
PASSING IT FORWARD WITH PURPOSE
My journey through optometry has taken me from being an associate in a large practice to becoming a practice owner, educator and mentor. One of the greatest lessons I have learned is that there is more than one path to a fulfilling career.
I especially encourage my female colleagues to recognize their value and consider all of the opportunities available within optometry. For many years, large practices and leadership positions were often led primarily by men, and many women hesitated to speak up or pursue ownership and leadership roles. Creating spaces where women have a voice, feel supported and recognize their ability to lead is something I believe is important for the continued growth of our profession.
I welcome conversations with colleagues who are exploring their next steps, whether that means taking the leap into practice ownership, developing a specialty area, improving patient care or simply finding a better fit within optometry.
I know what it feels like to want something different and to wonder whether taking a new path is possible. My hope is that sharing my journey encourages others to explore their own possibilities and continue contributing to this incredible profession.
Giving back also means investing in the next generation. I enjoy welcoming shadow students into our practice so they can experience firsthand the many opportunities within optometry. It has been incredibly rewarding to stay in touch with many of those students as they completed optometry school and became colleagues. I hope more optometrists will consider mentoring and hosting shadow students. Small investments in future generations help strengthen our profession for years to come.
 |
Ilana Gelfond-Polnariev, OD, FOVDR (FCOVD), is the founder and owner of NYC Pupil, a pediatric and neuro-optometric practice in Staten Island, New York. She is also an Associate Clinical Professor at SUNY College of Optometry, where she enjoys teaching and mentoring future optometrists. A graduate of Pennsylvania College of Optometry (Salus at Drexel University) in 2002, Dr. Gelfond-Polnariev has remained actively involved in organized optometry throughout her career. She has volunteered with the AOA’s InfantSEE® program for more than a decade and served as Chair of the International Examination and Certification Board (IECB). Dr. Gelfond-Polnariev has lectured nationally and internationally on pediatric eye care, vision therapy, neuro-optometric rehabilitation and myopia management. She is passionate about advancing the profession through education, mentorship, advocacy and service. To contact here: IlanaGelfond2020@gmail.com |
