“Do we need more optometry schools?” asked then-president of the American Optometric Association Kevin Alexander, O.D., Ph.D., in 2007. “Based on what we actually do know about the numbers of optometrists today and what it costs to start a new school, the answer is ‘probably not.’”

Then again, Dr. Alexander wrote, given that future demand for eye and vision services will increase, do we need more optometrists? “The answer is ‘possibly’—if the current trend continues.” Even if we do need more O.D.s, he wrote, the existing schools and colleges of optometry could expand without the need to open new ones.

That said, three new colleges of optometry opened their doors in September, and they already appear to be flourishing. Each is different, but they have a few common features that they bring to optometric education:

First-year students at Western University College of Optometry began delivering patient care services—such as infant eye exams—by week four of the curriculum.
• Optometry students take classes with students from other professional health care disciplines.
• Colleges stress outreach to provide eye care services to the local community (with an emphasis on Spanish-speaking patients).
• Curricula emphasize early hands-on clinical care integrated with didactic course work.

Western University
Western University of Health Sciences College of Optometry is located in Pomona, Calif., less than 20 miles away from Southern California College of Optometry.

• Facts and figures. The inaugural class includes 78 students; 56 of them (72%) are women. Faculty currently includes three O.D.s as chief administrators, 10 faculty instructors in the college of optometry, as well as two other faculty members jointly appointed from Western University’s College of Osteopathic Medicine of the Pacific. Tuition for 2009-2010 is $27,700.

• Curriculum. The curriculum involves patient care right from the beginning, interdisciplinary education, as well as an emphasis on optometric rehabilitation. Students apply didactic learning immediately to clinical care.

Western University will open a new Health Education Center in December. It includes classroom and lab space for optometry, dentistry, podiatry and osteopathic medicine.
“Our first-year students began delivering patient care services in week four of the curriculum,” says Elizabeth Hoppe, O.D., M.P.H., Dr.P.H., the college’s founding dean. The college of optometry has partnered with the Pomona Unified School District to create a program for early identification of school children at risk for academic difficulty due to vision-related learning issues. “By the end of the semester, we will have provided a comprehensive battery of screening tests to over 2,000 children living in Pomona,” Dr. Hoppe says.

Also, optometry students learn alongside students of other disciplines. “Our first-year students are currently participating in joint coursework in the basic sciences with the Colleges of Osteopathic Medicine, Podiatric Medicine and Dental Medicine,” Dr. Hoppe says. “When I first became involved with the university, I thought, ‘Won’t it be great for our optometry students to learn from physicians, pharmacists, researchers, which will enhance our knowledge base and broaden our perspective,’” she adds.

“Now I define our goal more clearly,” she says. “Our goal is not just to provide an outstanding educational experience and to graduate skilled optometrists, but our ultimate goal is also to educate every student enrolled in each of the 19 programs offered by the university about the role of optometrists in the delivery of health care.”

In other words, every health professional who graduates from the university will understand the scope of practice of doctors of optometry, and that doctors of optometry will participate as full members of the health care team, Dr. Hoppe says. Starting in January, for example, optometry students will participate in case-based, small group interprofessional seminars and interprofessional service learning courses.

In addition, Western University’s College of Optometry emphasizes optometric rehabilitation in patient care and research. “Our first-year students are being introduced to concepts and skill sets in the areas of low vision rehabilitation and vision therapy in preparation for their clerkship assignments,” Dr. Hoppe says. “Beginning in January, students will apply this knowledge in the private practice setting and other clerkship locations, including Casa Colina Rehabilitation Hospital.”

The unmet need for vision rehab services is only growing, Dr. Hoppe says. A significant percentage of elementary school students require special education and help with learning disabilities (most of which are reading disabilities). Also, millions of traumatic brain injuries occur each year, underscored by the number of head trauma patients returning from military duty in Iraq.

• Building and facilities. A new, state-of-the-art, 180,000-square-foot, four-story Health Education Center opens in December, including new classroom, laboratory and study space for the colleges of optometry, dentistry, podiatry and osteopathic medicine.

In addition, an 80,000-square-foot, three-story Patient Care Center, slated to open in December or January, will house a pharmacy, optometry clinic, dental clinic and outpatient clinics in osteopathic and podiatric medicine.

• Mission. “We strive to always embody Western University of Health Sciences’ core values of caring, humanism and scientific excellence,” Dr. Hoppe says. “We are creating an environment where our faculty and students are expected to exhibit the core values, and we seek to recognize the examples that occur.”

Why Do We Need More Optometry Schools?
• Elizabeth Hoppe, O.D., M.P.H., Dr.P.H., Dean of Western University of Health Sciences College of Optometry:
“An increased demand for eye care will come from the aging of the overall U.S. population as a consequence of expected age-related changes in eye health and visual status. Many states are also enacting initiatives requiring vision examinations for children prior to school enrollment. With eye care services mandated, the public’s need for optometric care will continue to increase. The incidence rate of diabetes, and diabetic eye disease, has risen to epidemic status in the U.S. … All of these factors indicate a growing need for eye care services.”

• Hector Santiago, O.D., Ph.D., Dean of Midwestern University Arizona College of Optometry: “We still have significant underserved areas in the state of Arizona—two-thirds of all optometrists are concentrated in five cities, and more than half of cities and towns have no eye practitioner at all. So, as we graduate optometrists throughout America, a significant number of them will distribute into these communities where there’s a need for eye care yet there is none. Nationwide, there are 45 to 46 million Americans who are not insured. As these people come into the health care system, there will be increased needs to serve these populations. So, I see that in the future there will be greater needs for optometrists.”

The 34,000-square-foot Midwestern University Eye Institute of the Arizona College of Optometry is under construction and scheduled to open by summer 2010.
Midwestern University
Midwestern University Arizona College of Optometry is located in Glendale, Ariz., in the Phoenix metro area.

• Facts and figures. The inaugural class includes 53 students. In contrast to other colleges of optometry, less than half (21, or 40%) are women. Faculty currently includes three administrators, five full-time instructors and five adjunct (part-time) instructors in the College of Optometry, as well as 30 faculty members who teach the integrated (interdisciplinary) science course. Additional faculty members are still being hired. Tuition for 2009-2010 is $27,500.

• Curriculum. In the first year, the curriculum features an interdisciplinary health care course in which optometry students learn side-by-side with students from the colleges of Health Sciences, Osteopathic Medicine, Dental Medicine and Pharmacy, to teach all students about health care using an interdisciplinary approach to patient care.

“In this course, students from all colleges take class together, they learn what each profession is devoted to, what the importance is of each profession, and how to refer to each profession,” says Hector Santiago, O.D., Ph.D., founding dean of the Arizona College of Optometry. “We are creating the new generation of practitioners for the future who will be able to work together with each other for the benefit of the patients.”

Midwestern University is training optometry students to provide primary eye care in Arizona’s under-served rural areas and for its growing older population.
Also, this multi-module interdisciplinary course is structured on organ systems—nervous system, musculoskeletal system, lymphatic/immune system, cardiovascular system, respiratory system, gastrointestinal system, epithelium/connective tissue/blood, and other systems. So, basic knowledge of anatomy, histology, biochemistry, physiology, pharmacology and pathology are applied to each organ system, rather than separated out into individual courses.

In addition, clinical cases are coordinated with this interdisciplinary course. “Students have case studies, using actual cases, and they have to apply the knowledge they gain in their courses to the cases, plus do research on their own,” Dr. Santiago says. “In addition, students make a presentation on those cases, and are then tested based on those cases.”

First-year students are already applying their knowledge in the real world as they perform vision screenings in the Glendale community, Dr. Santiago says. By their third year, they’ll have thorough hands-on clinical experience in the university’s new Eye Institute.

Another innovation: Some of the elective courses reflect the need to address the “changing face” of America, as well as the needs of the population specific to the Southwest. Specifically, one-third of the population in Arizona is Hispanic, Dr. Santiago says. So, the college offers a cultural competency course to prepare students to meet the needs of many different cultures and ethnicities. And, the college offers two conversational Spanish language courses to help optometry students to better serve the needs of the growing Spanish-speaking population.

• Building and facilities. The Midwestern University Eye Institute (situated alongside a new dental medicine clinic) is under construction and scheduled to open by summer 2010. “That building will accommodate our third-year classes as well as our main clinic. It is a 34,000-square-foot facility, with 50 examining units and state-of-the-art equipment,” Dr. Santiago says.

“Besides the primary care units, it will house our specialty clinics, which include a low vision rehabilitation clinic, a pediatrics and vision training clinic, an advanced contact lens clinic, an electrodiagnostic clinic, and also a sports vision clinic.” It will also include another unique clinic: a prosthetic eye clinic.

• Mission. One of the core elements of the college’s mission is to prepare students to provide care for the changing population of America. “Right now, about 13% to 14% of the American population is Hispanic. Within 30 to 40 years, one of every four Americans will be Hispanic,” Dr. Santiago says. Similarly, “here in Arizona, 5% of the population is Native American. So it’s important we prepare our students now with the cultural competent skills, and the sensitivity and the knowledge to serve those populations in the near future.”

 New Optometry School Coming to Iowa?
Des Moines University is deciding whether to open Iowa’s first optometry school. The university already has programs for osteopathic medicine, podiatry, physician assistants and physical therapy. So, an optometry program is not a stretch. The university has undertaken a feasibility study and senior university leaders are currently reviewing the results. They will take into account funding requirements, facilities, staffing, and the number of prospective students before making any recommendations to the university board. No date is set on when they’ll reach a decision.

One of two proposed eye care facilities at the University of the Incarnate Word. 
University of the Incarnate Word
The University of the Incarnate Word School of Optometry (UIWSO) is located in San Antonio, about 200 miles away from the nearest optometry school, the University of Houston College of Optometry.

• Facts and figures. The inaugural class includes 62 students; 35 of them (56%) are women. The class is 71% minority. It’s also 12% Hispanic, which is four times the national average. When fully staffed, the program will eventually have about 45 full-time positions spread over some 60 faculty members. Tuition for 2009-2010 is $27,000.

• Curriculum. The optometry program offers a highly integrated clinically-based curriculum with early exposure to clinical applications and patient exposure. Also, to help students get a leg up on entering the “real world,” business courses cover practice management and coding/billing.

UIWSO also offers students the option to pursue a certificate in Spanish, “which will help fill a void for the Spanish-speaking residents of this region,” says the school’s founding dean, Hani. S. Ghazi-Birry, O.D., M.D., Ph.D. The language barrier impedes care for many Texans, especially those in rural areas.

The university, in conjunction with the optometry program, has also launched an Honors Bachelor of Science degree program in Vision Science. In this program, high school graduates can carry out their undergraduate education through the School of Optometry. The program’s curriculum, structure and content provide undergraduates with the requirements to qualify for optometry school or other health-related professional programs. The program also incorporates a two-year rotation through the optometry clinics. Thirty-five freshman and sophomore undergraduates are currently enrolled in this program.

• Building and facilities. The optometry school’s facilities will be housed in two locations—one onsite and another to serve economically disadvantaged and minority citizens of San Antonio. While each location will offer a wide range of clinical optometric services, they will also have a special commitment to pediatric eye care and low vision services.

The primary 68,000-square-foot location will be housed in the San Antonio Medical Center. It will include the academic headquarters, research facilities and one of two clinical facilities.

The second location will be a 30,000-square-foot clinic on San Antonio’s East Side. “The East Side clinical facility is, in my opinion, what constitutes the jewel of the clinical program,” Dr. Ghazi-Birry says. “We are able to serve a significant population of the underserved and underinsured. We are also able to expand the mission of the university in terms of social justice, community service and the provision of healthcare.”  

• Mission. The school’s mission is to educate and prepare future leaders in optometry through excellence in education, patient care, vision research and public service within a context of faith and personal development.

UIW is a Roman Catholic institution, and its optometry school is the only faith-based program in the United States. However, there is no religious requirement for the professional degree. Still, the evidence-based curriculum aims to reflect the university’s mission by emphasizing medical ethics and morality.

“Everyone at UIWSO is committed to fostering academic and clinical excellence, professional growth and community outreach,” Dr. Ghazi-Birry says. “Our clinical facilities are also committed to serving a significant population of the underserved and uninsured and expanding the mission of the university in terms of social justice, community service and the provision of health care."