I enrolled in optometry school because I enjoy working with people and want to help them see better. Is it any less meaningful because my practice is next to a corporate optical?


In Defense of Wal-Mart

I wanted to respond to Dr. Barry M. Lebowitzs letter in your January 2009 issue regarding tuition. Dr. Lebowitz raises a very pertinent issue to todays graduates, but unfortunately misses the mark with his comments.

As an independent Doctor of Optometry who chooses to practice next to a Wal-Mart Vision Center, I take personal offense to his comment that this is not a meaningful career opportunity. I enrolled in optometry school because I enjoyed working with people and wanted to help them see better. That is exactly what I do.

Is it any less meaningful because I choose to operate my practice next to a corporate optical chain? I personally dont think so and Im sure the patients I have helped over the last 10 years would agree with me. I have never been told by Wal-Mart how to practice optometry. I provide the same level of care to my patients now that I did when I practiced private optometry, or as you may term it, meaningful optometry.

While I will agree with Dr. Lebowitz that optometry schools need to behave professionally and ethically and disclose more information about post-graduation career opportunities to students, I hope that same information would never discourage a prospective optometrist. My personal reasons for practicing where I do are varied, but I love my profession and would be happy with it in almost any practice modality. Any future optometrist should consider this when deciding if the debt they incur from school is worth it. For those who enter the profession for the right reasons, you will find your happiness more from the patients you help than from where you are when you help them.

Laura S. Taylor, O.D.

Rifle, Colo.


Regarding the letter by Dr. Barry M. Lebowitz: Whether a new graduate with $150K in school debt chooses to practice his/her profession to the fullest extent of the law at a retail establishment and earn a professional income based on the fee for service OR becomes an indentured servant to an established practitioner to learn how to sell glasses and run a businessshould be up to the individual.

The fact remains: $150K is a lot of money, but still is an excellent value when your return on the investment is an annual income in excess of half your debt. To imply that practicing in a commercial setting is the equivalent to working in a discount department store is misleading, irrelevant and indicative of the identity crisis optometrists have had for many years. I thought we put that to rest last century.

David J. Anderson, O.D.

Freeport, Ill.


Editors note: For more about working in a corporate setting, see Why I Love Wal-Mart, in this month"s issue.


Are Any Groups Left?

I recently read an e-newsletter and learned about the Tear Film & Ocular Surface Society (TFOS). This, in addition to the Optometric Retina Society (ORS), the Optometric Glaucoma Society (OGS), and who knows what other society. I dont neccessarily disagree with Board Certification, but where does the fractionalization end?

Where can I register the Left Eye Society? There are so many O.D.s. Id like to become the first O.S.

S. Moshe Roth, O.S.

Old Bridge, N.J.


ECP for Cataract/Glaucoma

I would like to comment on Dr. Fanellis response to Dr. Sellers Letter to the Editor in the January 2009 issue.

I find patients compliance with their glaucoma medications to be a major issue in treatment failure. This has been recently substantiated in a study by Okeke, et al, which found that adherence to once-daily prostaglandin therapy is not any better than once-daily drops of beta blockers or four-times daily pilocarpine.1 Nearly 45% of patients using an electronic monitoring device who knew they were being monitored and were provided free medication used their drops less than 75% of the time. In addition, neither patient self-reporting nor clinician estimation of adherence accurately reflected the patients true behavior. In other words, both the patient and their doctor are deceiving themselves.

Because of this high potential for poor compliance, I offer endocyclophotocoagulation laser (ECP) to all my glaucoma patients who also need cataract surgery. ECP is a simple and safe laser procedure that often relieves patients of needing to use glaucoma medication.2 The cost savings to the patient has also been shown to be significant.3

Leonid Skorin, Jr., O.D., D.O.

Albert Lea Medical Center Mayo Health System

Albert Lea, Minn.


1. Okeke CO, Quigley HA, Jampel HD, et al. Adherence with topical glaucoma medication monitored electronically. Ophthalmology 2009 Feb;116(2):191-9.

2. Skorin L. Consider ECP for glaucoma. Rev Optom 2008 Nov;145(11):43-8.

3. Uram M. Endoscopic cyclophotocoagulation. Glaucoma Today 2007 Mar/April; 5(2):13.

Vol. No: 146:03Issue: 3/15/2009