Practice Management

The Practice Setting Empowering My Teleoptometry-Based Practice

Dr. Goldstein delivering a teleoptometry-based appointment. He says that the ability to deliver high-quality, efficient remote care will only grow in importance.

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By Leonard Goldstein, OD

Oct. 19, 2022

The pandemic changed consumer expectations. Many have become more accustomed to virtual interactions. Besides the change in expectations, some less-populated areas have reduced access to eyecare. I had the opportunity to launch a teleoptometry practice over the last two years.

My practice expands access to care while allowing me to build a practice aligned with an exciting new way of providing quality care. My three independent practices (one fully in operation and the other two on the way) are located adjacent to Walmart Vision Centers. This has given me the support I need to successfully launch a forward-thinking method of practice.

A New Perspective on Practice Growth
I’ve had an opportunity over the years to practice in a variety of ways. I’ve had a solo private practice for 32 years, was a military OD, developed one of the first retail optical websites, created a large-scale skilled nursing home practice in 1993, and for the past 14 years, have practiced as an independent optometrist, most recently with offices adjacent to Walmart Vision Centers.

I’ve always tried to be ahead of the curve in the industry, and the emerging modality of remote eye exams is of great interest to me. During the pandemic, the need for remote care became obvious, but as I delved further, I realized the need was greater than that. I realized there were many other reasons this modality made sense, including staffing utilization. Supply and demand!

Optimizing the Advantages of Teleoptometry With Right Support
Teleoptometry does more than just fulfill new consumer expectations; it provides significant additional advantages. Among those advantages, teleoptometry allows for multiple locations in smaller markets, adding up to as full a patient load as you desire. When you combine that with the key advantage of having an independent practice adjacent to a Walmart Vision Center you have a winning formula.

Walmart often makes adding advanced instrumentation easier. I am able to rent the technology I need from Walmart at fair market value, rather than buy it myself.

Some offices adjacent to Walmart even receive clerical and technician support at reasonable fees.

Having an independent practice adjacent to a Walmart Vision Center, where many visit to shop for groceries and other items, allows for a large population that may warrant my vision care services. They see our independent optometry practice and then look us up online. When they schedule an appointment, they learn that their visit will be handled in a way that may be new to them.

Most Patients Are Open & Ready for Remote Care
We don’t want any surprises. I advise patients what to expect. Our receptionist lets patients booking appointments know that they will get a comprehensive eye exam, but that the doctor will not be in the exam room with them. Of the 300 appointments we have completed via the use of teleoptometry, only one person was not open to the new format.

When patients arrive, they are given a tablet to complete patient demographics and history. My technician then pre-tests and takes photos with our OCT and retinal camera.

The patient is taken to the exam room, which has a 50-inch screen that allows the patient and I to interact remotely. I review the findings revealed by the OCT and retinal camera images and do the refraction myself. There is a camera that allows me to look closely at the patient’s eyes, similar to the image produced by a slit lamp.

I educate the patient about any diagnoses I have made, with instructions for any follow-up care that is necessary. A button is pressed to print out the patient’s prescription for glasses or contact lenses. The patient is given their Rx, which can be filled at the optical shop of their choosing, including a Vision Center if they elect.

The Right Time & Practice Setting for Teleoptometry
Teleoptomery has blossomed like a rose, but one with potential thorns. We’re still defining best practices for teleoptometry in eyecare to consistently offer the highest quality patient care and patient experience. Walmart is the perfect model for teleoptometry. Many stores are located in rural settings, and the opportunity often presents to acquire the necessary technology.

Teleoptometry is the wave of the future, and I’m glad to be a part of it with my private practices adjacent to Walmart Vision Centers. I’m proud to have expanded access to care while staying ahead of the curve in a modern eyecare practice.

Leonard Goldstein, OD, has created a consulting practice to help others move ahead in this exciting field. is a fee-based service for that purpose.

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