Optical Forum Flipbook Issue 4. June 2021.

1. In this
Issue
Two Blacks Don’t
Make White
Young Leaders in
Optometry
Optometry Online
Learning
Twenty most read Blog posts from June 2021 with Instagram
Story Answers
2021 World
Orthoptic
Day
Become a Patron:
https://www.patreon.com/opticalforum
June is
Fireworks
eye Safety
and
Cataract
Awareness
Month
Optical Forum 4
June 2021
Making an Impact
ISSUE
Blog
Flipbook

2. Optical Forum
Blog flipbook
Making an Impact
Young Leaders in Optometry-
Page 10
Two Blacks Don’t Make White-
Page 6
Optometry Online Learning-
Page 13
2

3. News and editor’s
perspective
n June the 20th six new board members of the “Syndicat des
Opticienset Optometristes au Liban SOOLB” were elected in an
election that witnessed an unprecedented number of voters. Tuesday the
22nd Mrs. Nisrine Achkar was elected by the new board to serve as the
new president of the guild; Becoming the first female to be elected for
this position and the first President to be supported and backed by Aloo
(Association des Opticiens et Optometristes au Liban).
On June 25th the Mediterranean Council of Optometry was held in Dubai,
and the new administrative board elected Mr. Ahmed Al-Tairi from Saudi
Arabia as “President” and Mr. George Al-Hawat from Lebanon as "Vice
President“.
June is Fireworks eye Safety and Cataract Awareness Month. It was a
busy month that started with Vision Expo East re-opening its doors on
the 2nd of June, MIDO presenting a digital edition, the World Orthoptics
Day on the first Monday of the month, followed by the International
Albinism Awareness Day on June the 13th, and National Sunglasses Day
on the 27th.
Cataracts are one of the world’s leading causes of preventable
blindness. The American Academy of Ophthalmology (AAO) has
declared June is Fireworks Eye Safety and Cataract Awareness Month.
Cataracts account for more than forty percent of all cases of blindness
worldwide.
During June new original content was posted on daily basis and we
invited readers to frequently participate and engage by commenting on
posts and through the “Answer & Insights” section in Instagram stories.
This month’s topics revolved around Cataract, Eye Health, Technology,
along with other topics of entrepreneurship, leadership, marketing, etc…
We invite every one of you to share his or her story with Optical Forum.
Discuss your insights become an author and get heard. You are all
invited to accompany us in this journey by sharing your insights, stories,
posts, and articles at feedback@opticalforum.space or by filling the form
at https://opticalforum.space/contribute/
Gilbert Nacouzi, BSc, MBA, DBA, EIC 3
B y G i l b e r t N a c o u z i , B S c , M B A , D B A , E I C
O
Gilbert Nacouzi

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amet, consectetur
adipiscing elit. Lorem
ipsum dolor sit amet,
consectetur adipiscing
elit.
Sports Eye Safety
4
Enjoy reading our
insights related to
the Eye Care
Business
This Blog is like
the “Agora” in
Ancient Greek
which means “To
Gather Together”.
Like Homer, we
characterize a
community without
an Agora as such
as that of the
Cyclopes, as
lawless
Optical Forum Blog
Contact us:
The Editor:
admin@opticalforum.space
Feedback:
feedback@opticalforum.spa
ce

5. Contents
Optometry
Online Learning
Build Trust Through
Character and
Commitment
Young Leaders
in Optometry
6 Managing
Yourself
Helps you in
Exploiting
Opportunities
Two Blacks Don’t
Make White
1
0
1
3
5
Pareto Efficiency and Optometry 27
What to do When You Have Tons of Ideas 31
Legal Entities in Optometry
32
Marketing Research for Optometrists 34
Alcon Total30 36
Motivating Employees 37
Fireworks Eye Safety 39
Level 5 Leadership 40
New Test to Assess Keratoconus Risk 42
The Power of Leading With Questioning 44
What Does it Take to Become a Great Leader
46
June is Cataract Awareness
Month
8
Leadership and Management
Roles in Optometry
14
Signs That Your Strategy is not
Working Well 16
Optometry PEST Analysis
During COVID-19
17
Scenario Planning in Optometry
19
The Risk of not Taking Risk 21
Decision-Making Style in
2021 World
Orthoptic Day
2
9
Understanding
Andragogy Helps
Online Learners

6. Two Blacks Don’t
Make White
Answer & Insights
MANAGING YOURSELF HELPS
YOU IN
True
False
Exploring and Exploiting
Opportunities
Occupying Positions

7. Two Blacks Don’t Make White
Peter Drucker emphasized the
importance of being able to manage
ourselves in the present world where
the career paths that companies offer
or make available to their employees
are not as fulfilling as the careers
employees can build by preparing
themselves to opportunities.
Companies try to avoid hiring
celebrity leaders and prefer leaders
who come from inside because they
know that great companies have their
leadership come from inside. Highly
compensated executives don’t
necessarily transform the company
from mediocre to great.
When starting your business you
should answer first who is going to be
on the bus and later think of what
they will be doing. Joining together
people of big mediocrities never
makes one great team. A good team
often focuses on what not to do rather
on what to do to become successful.
Being able to say “no” is the team
that implements and executes a
strategy that shows what to stop
doing.
The same thing with technology and
information systems. You will never
get the right workload by simply
adopting
and employing technology. All what
technology does is accelerate
business but it cannot cause the
business to happen. Technology
cannot explore new opportunities or
new challenges to take.
Decisions that lead to building a great
company don’t come on their own
and are not expected to happen
quickly. There are transformations
and transitions that the company, the
employees and executives should go
through that translate into a
revolutionary leap in results and not
in the level of executives or
technology hired to do the job.
What pulls you forward toward
improvement, comes with the desire
to grow and to make an impact on the
community you belong to.
Transitioning into leadership position
should not come from a desire to
escape or the result of being bored
from the current position. Because in
transitioning there is a trade-off and
therefore there should be different
possibilities that you should evaluate
to be able to make the right choice.
You should expect to make a rapid
change during transition because
transitioning into leadership position
that makes an impact is not a function
of circumstances, but rather is matter
of conscientiousness and conscious
choice.
Companies try to avoid hiring
celebrity leaders and prefer
leaders who come from inside
because they know that great
companies have their
leadership come from inside.
7
What pulls you forward
toward improvement, comes
with the desire to grow and to
make an impact on the
community you belong to.

8. June is Cataract
Awareness Month
June is Cataract Awareness Month
Cataracts are one of the world’s
leading causes of preventable
blindness. The American Academy of
Ophthalmology (AAO) has declared
June is Fireworks Eye Safety and
Cataract Awareness Month. Cataract
accounts for more than forty percent
of all cases of blindness worldwide.
The number of cataract cases is
projected to increase as the
population continues to age. A
cataract is treated through surgical
intervention. It leads to blindness in
case it was not treated. The surgery
becomes difficult and the success of
the surgery and the chances of
restoring high vision after the surgery
are reduced if the cataract is left
untreated longer than a certain
period.
Cataracts do not show redness or feel
pain. They are characterized by
clouding of the eye’s crystalline lens
altering and blocking light to getting
into the eye to the retina and resulting
in a blurred Vision. Surgery is the only
treatment for cataracts, it is one of the
safest and effective eye surgeries,
and it consists of replacing the
crystalline lens with an artificial lens
called an implant or intra-ocular lens.

9. 9
Congenital cataracts are rare conditions where babies are born with
cataracts that can be due to infections during pregnancy. Smoking
doubles the risk of developing nuclear sclerotic cataracts and triples the
risk of subcapsular cataracts. Ultraviolet (UV) radiation from the
sun increases cataract development. UV light penetration into the eye is a
significant influential factor in the creation of cataracts. Aged people
develop cataracts, however, young adults too can develop cataracts due
to Heredity, disease, certain medications, and eye injuries. Wearing
proper eye protection can prevent many types of injury-related cataracts.
Choosing a healthy lifestyle and not smoking can slow the progression of
cataracts. However, age-related cataracts are not preventable.
During June, the AAO reminds eye care providers and the public of the
early detection and treatment of cataracts for the purpose of restoring high
visual acuity after the surgery.
Answer & Insights
CATARACT IS AMONG THE MOST
COMMON CAUSES OF BLINDNESS
True
False
True
False

10. Young Leaders in Optometry
In this post, we’d like to share a
lesson from John Calvin Maxwell
about leadership for young leaders
and how they get buy-in when they
still don’t have a successful record. It
is almost impossible for young
leaders eager to share their
knowledge, thoughts, ideas, and
vision to find people and followers to
immediately join their team and help
to accomplish those ideas. The
reason is not that they are not rightful,
it’s because they don’t have enough
credibility and their work and
accomplishments are not known. At
this stage, what they need is to earn
people’s trust through character and
competence. And how they build
these will determine their leadership
success or failure.
We often hear successful
Optometrists speak about their early
days as cold starting a practice with
few to no patients per week. When
young leaders start a new position
with new responsibilities the
temporary trust they obtain is a
function of the culture of people they
are interacting with, the credibility of
their predecessor, and the influence
of the people who put them into this
position or endorsed them to this
position; In optometry, their alma
mater, their internship, their specialty,
and their social circle, connections,
and friends.
No doubt, if the environment and the
culture are negative young leaders
will have a hard time penetrating and
getting accepted. If the environment
is more positive and the culture is
10
will be easier for them to prove
themselves because during this early
period what they say and what they
do and accomplish weigh more than
who they are and who their
connections are. And if they can
demonstrate character and
competence their credibility and their
reputation will grow to the point when
who they are will eventually have
more influence than what they say.
John Maxwell emphasized that for
young leaders to demonstrate
competence at their start, they should
embrace working hard, thinking
ahead, demonstrating excellence,
and following through. And to
demonstrate character young leaders
should first and foremost care about
the people they lead, make things
right, and always tell the truth
demonstrating consistency between
words and actions. This way followers
know they can trust them as young
competent leaders and they will never
lose faith in them.
Young Leaders in
Optometry
John Maxwell emphasized
that for young leaders to
demonstrate competence at
their start, they should
embrace working hard,
thinking ahead,
demonstrating excellence,
and following through.

11. Young Leaders
in Optometry
Answer & Insights
TO GAIN TRUST, YOUNG LEADERS
IN OPTOMETRY
Good
Bad
Need to demonstrate
character and competence
Need to show-off and
influence followers

12. Become a Patron
of Optical Forum
Become a Patron of Optical
Forum
Optical Forum is now on Patreon.
https://www.patreon.com/opticalfo
rum
We thank everyone who reached
out to us and wanted to support us
right from the beginning. Now we
are making this possible on
Patreon. We found Patreon to be
the most appropriate way to
receive support but also to launch
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model where we can provide extra
personalized content, books,
courses of Optometry
management, and one-to-one
consultancy.
Now you can become a Patron at
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Thank you once again for
accompanying us in this wonderful
journey to discover our purpose as
eye care providers.

13. Optometry Online
Learning By Dr. Gilbert Nacouzi
If blended learning
has its importance
during the pandemic,
there are innovation
requirements to meet
up demands in
learning and
assessment.
Optometry Online Learning
COVID-19 has impacted Optometry
colleges among other education
specialties. The first reaction of all
Optometry colleges was to shift to
blended or online learning
programs. Scholars argue, If blended
learning has its importance during the
pandemic, there are innovation
requirements to meet up demands in
learning and assessment. Ramani
and Hussaindeen (2021) proposed
tools and strategies that could
support optometry educators to
establish and expand networking to
rebuild the mindset and the education
system. They emphasized educators
need to consider the new national
educational strategy while restoring
the curriculum, pedagogy, and
assessment in optometric education.
Online learning systems have no
doubt benefitted optometry students
and help them complete their
programs with minimal damage.
However, the most
successful online experience in
Optometry education has been
relevant to Optometrists more than
students. This is being demonstrated
through online continuing education,
webinars, conferences, and online
courses. Those who haven’t
previously taken online classes, may
not be aware of some foundations on
online learning. Those foundations
are based on the Andragogy theory
about adult learners provided by
Malcolm Knowles who was the
foremost expert and authority on this
learning style. This learning theory
pertains to settings that are different
than face-to-face classroom teaching
that is normally based on pedagogy.
Andragogy is grounded on the
premises that adults learn with
independent self-directed self-
concept, they apply their experience
and critical thinking to solve
problems, they are ready to learn with
ready questions, oriented to learn by
immediately applying rather than
procrastinating, and motivated to
learn moved by intrinsic motivating
factors as they grew and matured.
This explains why in some places
while Optometry students struggle to
attend online classes, we find
Optometrists actively searching for
the latest zoom conferences and
online continuing education courses.
If students are struggling to learn and
understand online class materials and
assignments, their dominant learning
style is most probably anything other
than visual learning that is at the

14. online teaching and learning. For
those struggling with online learning,
it is recommended to learn adaptive
strategies to compensate for the lack
of a visual dominant learning style. A
good
14
way is to review Andragogical
learning rules and principles and how
to acquire specific skills related to this
learning theory.
The leadership of an Optometrist is
not dependent on the factors, traits,
and skills (this explains why both men
and women make great Optometrists)
that the Optometrist has but rather
from the situations that the practice
has been through and the decisions
he made that drove the practice
throughout the situation in a particular
way. Therefore, an Optometry
practice over time will go
UNDERSTANDING ANDRAGOGY HELPS
ONLINE LEARNERS
True
False
Leadership and
Management Roles in
Optometry
Leadership and Management Roles
in Optometry
There is a great emphasis on the
roles of leadership and management
in Optometry as a small business.
Optometry practice owners and
practice managers must understand
the relationship between the role of a
leader and a manager when
operating an Optometry practice.

15. through many stages (for example the
launching or start, the growth, the
maturity, and decline) and the
decisions that the Optometrist makes
driving the practice through these
stages will determine the type of
leadership he is. Depending on the
situation the practice is in, determines
the type of leader the Optometrist is.
The managerial role of an Optometrist
relies more on consistency and
certainty. The Optometrist should be
able to process and obtain a full
understanding of planning and
implementing strategic plans by
contributing their knowledge and skills
in this field. Technical Optometric
expertise is required to give the
practice a competitive advantage and
to be able to produce enough returns
to cover
15
salaries, bonuses, and new positions
within the practice. He should
demonstrate effective skills for
presiding over daily medical and
business operations and settings as
well as achieving short-term goals.
Both leadership and management in
Optometry use guidance to achieve
goals either through influence or
planning. While leadership is
constantly behind the creation of new
ideas, management is behind
creating processes that put ideas at
work. The manager’s role is to keep
employees in line with the practice’s
jobs and responsibilities while the
leader Optometrist enables them to
be unique and distinctive entities
within the practice.
LEADERSHIP RESULTS FROM
SITUATIONS AND NOT TRAITS
True
False

16. Signs that your
Strategy By Dr. Gilbert Nacouzi
16
in the market conditions and is not
providing or developing a competitive
advantage over the near and
immediate future. In terms of
perpetual motion, the practice is not
being able to constantly change and
adapt to the changing nature of the
market.
The strategy is not unique and it is
based on technological competencies
and productivity effectiveness. Those
characteristics can at any time be
copied by the competitors.
Technology can be acquired by any
Optometrist and productivity based on
staff skills can be achieved by any
practice. In this case, the strategy is
not working because the practice
does not have a clear and sustainable
competitive advantage that provides a
higher performance over
If your strategy is not
working well, your
practice will not be
able to compete in
the current and
future market
conditions and your
mission will
eventually end in a
short period of time.
Signs that your strategy is not
working well
Optometry practices offer new
advantages by focusing on niche
markets and providing high levels of
patient services that constantly
respond to new market opportunities
and patients’ conditions and needs.
Like all small businesses, many
Optometry practices do not survive
past the first five years of providing
services to the market. If your
strategy is not working well, your
practice will not be able to compete in
the current and future market
conditions and your mission will
eventually end in a short period of
time.
Three important signs that your
strategy is not working well:
The strategy is not working at either
one of three levels internally,
externally, and in perpetual motion.
Internally, the strategy is not
becoming part of the culture and staff
are not adopting an organizational
behavior that increases team
productivity and practice process
efficiency. Externally, the practice is
not being able to compete
is not working well

17. other competitors in the same
specialty.
The strategy is not producing high-
performance levels of sustainable
competitive advantage and
profitability. If your practice is not
remarkably outperforming others it
will never gain a market share that
will
17
establish strong operations and
product niche. Low productivity, low
return on investment, low patient
retention, low patient development
related to new and specialty
conditions, low revenues are all signs
of a stalling strategy.
related to factors at the internal level,
external microeconomic level, and
external macroeconomic level. A
SWOT analysis is employed to
understand the internal level factors,
the Porter Five Forces model is used
to understand the external
microeconomic level factors, and the
PEST analysis is used to understand
external macroeconomic
A UNIQUE STRATEGY CANNOT
BE COPIED BECAUSE
It is based on high levels of
investment in technology
It is based on a sustainable
Competitive Advantage
Optometry PEST
Analysis During
COVID-19
Optometry PEST Analysis During
COVID-19
A PEST analysis is used as a
management framework and strategy
diagnostic tool. It helps understand
the effect of external factors at the
macro economical level on the
company’s strategy and decision
making. Strategy tools that impact
decision-making are

18. level factors.
PEST is an acronym for Political,
Economic, Social, and Technology.
PEST is frequently replaced by
PESTLE which is an acronym for
Political, Economic, Social,
Technology, Legal, and Environment.
The aim of conducting PEST or
PESTLE analysis is to gain insights at
the macroeconomic level and to
analyze its impact on decision-
making. COVID-19 pandemic has an
effect on all external factors.
Political factors affecting Optometry
are related to government decisions
on lockdown, loan forgiveness,
telemedicine and telehealth
expansion, and vaccine.
Economic factors affecting Optometry
are related to employment or labor
availability, unemployment rate,
18
inflation due to quantitative easing,
economic stagnation, supply chain
disruption, exchange rate fluctuation,
interest rates, cost of living changing
with the changing consumer spending
habits, as well as the effect of
businesses looking for ways to
compensate for the reduced working
hours in affecting pricing and
products availability.
Social and socio-cultural factors
affecting Optometry are related to
changes in trends in consumer
behavior for shopping, lifestyle
changes, affected cultural norms,
customers are becoming more price-
sensitive, and expectations of career
attitude and work-life habits have
dramatically changed. Practices in
large cities are less frequented due to
the demographic shift toward inner
cities and suburbs; consumers are
fleeing large cities and preferring not
to visit crowded places and waiting
rooms.
Political factors
affecting Optometry
are related to
government
decisions on
lockdown, loan
forgiveness,
telemedicine and
telehealth expansion,
and vaccine.
Social and socio-
cultural factors
affecting Optometry
are related to
changes in trends in
consumer behavior
for shopping,
lifestyle changes,
affected cultural
norms, customers
are becoming more
price-sensitive …

19. Technology factors affecting
Optometry are related to the
advancement of telecommunication
and internet-based telehealth.
Teleconferencing is disrupting annual
meetings and exhibitions. The
depreciation of equipment for eye
diagnostic and lab machinery has to
be revised with the
19
reduced utilization.
Once all the factors in a PEST or
PESTLE analysis are identified the
next step would be to assess its
impact on the micro economic level
and the internal level of your practice
as well as making decision related to
the overall strategy.
technology and since we grew our
practices to paperless practice and
electronic medical records, the
access to data and the extraction of
insights have become common tasks.
We gather data, prioritize
investments, link the commercial
results to what data insights inform
us, and incorporate everything into
the overall strategy of the practice.
In the middle of those stages,
A PEST OR PESTEL ANALYSIS
HELPS UNDERSTAND
Internal Factors affecting
decision-making
External macroeconomical
factors affecting decision-making
Scenario Planning in
Optometry
Scenario Planning in Optometry
We’re always obsessed with
measurements and scales because
we want to be in control and because
we have a hunger for managing
things around us. If you want to
manage, you have to be able to
measure; those are words we often
hear repeated by optometrists or
even sometimes: you cannot manage
what you cannot measure. Today’s
advancement of

20. specifically, when we try to link the
commercial results to what the data
insights inform us, we need to make
sure that the data provide good
insights that inform the future
strategy. A way to do this is to test
those insights using scenario
planning. Basically, what is done in
scenario planning is first a “what
would you need to believe” analysis,
followed by “what conditions would
need to be true for X to be a good
idea”?
Being able to ask these couple of
questions returns a set of potential
hypotheses which lead to different
scenarios and different outcomes. We
should be able to determine each
20
scenario strengths and weaknesses.
One scenario may return high
rewards for higher risks, while
another scenario would yield
completely different rewards at low
risk. We often hold on to the most
credible hypothesis and the most
probable scenario to achieve the best
outcome. Accordingly, the practice
strategy will be gradually shaped
making assumptions based on those
different scenarios. Using scenario
planning will help us test and
understand what the outcomes will be
without having to completely
implement the strategy and risk
wasting time and energy.
SCENARIO PLANNING IS A WAY TO USE
DATA RESEARCH INSIGHTS
To understand credible
hypotheses & future strategies
To priorities investments
“The essence of strategy is choosing
what not to do.“ Professor Michael E.
Porter

21. The Risk of Not
Taking Risk By Dr. Gilbert Nacouzi
21
Risk aversion is highly influenced by
the rationale that makes people cling
to loss aversion. People chose to
settle down and live as their fathers,
mothers, and grandfathers. Very few
would want to take risks and get into
new undertakings.
Don continues to portray America as
a country that has always been about
risk-taking from its very beginning.
“From Columbus to Jamestown to the
Second Continental Congress and
Thomas Jefferson’s eloquent
Declaration of Independence, this
nation has been built on one risk after
another. We are the descendants of
tough, resilient risk-takers who put
everything, including their lives, on
the
“Loss aversion”
actually runs the
opposite way risk-
taking goes. Risk-
taking is at the basis
of success in
entrepreneurship…
The Risk of Not Taking Risk
In a previous post, we jotted down
“loss aversion” as one of the barriers
to growth in Optometric marketing
strategy. The “loss aversion” notion
was interpreted by Kahneman and
Amos Tversky in the 1979
paper “Prospect Theory, Analysis of
Decision under Risk”. It consists of
the belief that a person has in his
mind that losses are perceived as far
greater than the equivalent gains.
“Loss aversion” actually runs the
opposite way risk-taking goes. Risk-
taking is at the basis of success in
entrepreneurship. A common hard-to-
take risk, we often learn about among
a startup entrepreneur is that he
mortgaged his house and everything
he owned to try his new idea.
Don Keough former president of
Coca-Cola Company wrote “The Ten
Commandments for Business
Failure”. He placed “quit taking risks”
at the top of the list. He emphasized
that risk aversion has always been
the prevailing mood for most of
mankind’s history.

22. line and survived almost
insurmountable odds.”
Optometry in itself is about risk-
taking; the profession’s origins date
back to antiquity and the science of
optics. The Greeks 400 years before
Christ, had some knowledge about
optics and myopia. Throughout
centuries risk aversion limited getting
into new undertakings.
The invention of Optometry came as
an American product that is based on
risk-taking. Charles F. Prentice called
the “Father of Optometry” was himself
a risk-taker. He enticed the public to
conclude that he had the
qualifications that authorized him to a
fee for advice.
22
And that was at the time the biggest
risk that an optician would take.
Despite opposition from the medical
society, he and his colleagues were
able to submit a bill to regulate the
practice of Optometry in the state of
New York.
In 1904, the terms “Optometry” and
“Optometrist” were adopted and they
were popularized by a consecutive
campaign. In 1908, and after 12 years
of continuous effort, the New York
Legislature passed an Optometry law.
In 1919, the American Association of
Opticians changed its name and
became the American Optometric
Association.
What would then be the Risk of not
Taking Risk?
THE WORDS “OPTOMETRY” AND
“OPTOMETRIST” WERE ADOPTED IN
The antiquity and among early
Greek
1904 in the USA
“The biggest risk a person can take is to
do nothing.“ Robert T. Kiyosaki

23. Decision-Making
Style in Optometry
By Dr. Gilbert Nacouzi
23
Strategic decision-making at the
beginning is needed before the
practice launching. You indicate who
should be your co-founders, your
partners, what marketing strategy,
how and where will you practice, what
will be spent on building your
practice, and what equipment will you
lease. All those are strategic decision-
making that rely on research,
analytics, facts, and rationality.
The element of uncertainty in
decision-making makes us anticipate,
plan, and forecast but doesn’t make
us sure. Cash flow forecast, number
of patients, or procedures. Here you
reply on both rational and intuitive
decision-making.
The element of rationality puts limits
…you will also need
intuition and gut to
be able to see, for
example, what the
competition is up to
and where the
market is going…
Decision-making Style in
Optometry
The answer to the question: is
decision-making style in Optometry
analytical or intuitive? is “both”.
Success in Optometry practice relies
on entrepreneurial spirit that relies on
strategic decision-making. In the
beginning, when you have just started
your practice, all decisions are
strategic and rely on rational, complex
yet long-term related decisions. Later
you will also need intuition and gut to
be able to see, for example, what the
competition is up to and where the
market is going.
Strategic decision-making is
characterized by complexity,
uncertainty, rationality, and control. A
strategic decision is complex due to
the tons of facts and research
involved.
You make a market research, you
come up with an idea, you start
evaluating it, you imagine the
concept, develop prototypes, test the
prototypes with customers, and
consider raising funds.

24. on our goals, objectives, and
expansion. What will be the surface of
the acquired facility to transform into
the practice? What will be performed
to achieve the profit formula? What
competitive advantage we have as a
team that allows us to organize our
practice around.
24
The element of control relies on
influence, rationality, own knowledge,
gut, and experience in choosing
among alternatives sometimes in an
autocratic style that speculates mostly
on the short-term. What will be the
decision related to staff issues or
product returns and negative reviews.
DECISION-MAKING STYLE IN
OPTOMETRY IS
Analytical, based on
research, data, and rationality.
Intuitive, based on gut and
experience.
“Truly successful decision-making relies on a
balance between deliberate and instinctive
thinking.” — Malcolm Gladwell —
Both
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of Optical Forum

25. Are You a Problem
Solver or an
Innovator By Dr. Gilbert Nacouzi
25
different processes and as long as
you are providing different value
proposition you cannot mix those into
one business model because you will
never be able to calculate your profit
formula and you will never be able to
determine the overheads of every
transaction.
But for all of that, one thing is true
that we as Optometrists are
consultants and we perform both
problem-solving and innovation. We
should agree that problem-solving
restores performance to past levels.
That is if your vision decreased due to
an increase in myopia we can restore
your past level of visual acuity by
providing you with a new prescription.
Over time problem-solving becomes
routine, and by orienting your
…three types of
business models that
need to be separated
in Optometry: the
value-adding, the
solution shop, and
the subscription-
based business
models…
Are you a Problem Solver or an
Innovator?
When it comes to classifying the
services that eye care providers
deliver to patients, opinions diverge.
For some, by the services we provide,
what we provide is classified as
problems solving for others it is
innovation. But what is the difference
anyway? In a previous post, we
emphasized three types of business
models that need to be separated in
Optometry: the value-adding, the
solution shop, and the subscription-
based business models as defined by
Professor Øystein D Fjeldstad at BI
Norwegian Business School. After
posting this I received many emails
commenting that Optometrists by
nature are consultants and
consultants are problem solvers and
innovators at the same time. How can
we separate those into two different
business models? Well, the answer is
as long as you are using different
resources and

26. practice to performing problem-
solving procedures the best you can
do is catch up with the competition.
Whereas innovation provides a higher
value than problem-solving or
restoring your past levels, therefore
opens new untapped opportunities.
Myopia control management is an
innovation that helps you not just
catch up with the competition but it
creates an important gap between
you and the next closest
26
competitor. Innovation improves your
performance in a way that changes
your patient’s perspective and
increasing his trust in you. One last
very important point is that problem-
solving is based on the decline of the
patient’s performance or the problems
that the patient is looking for solution
whereas innovation is based on the
eye care provider’s initiative.
PROBLEM-SOLVING
Restores Confidence to
Past Levels
Creates new solutions thus
unlimited new Opportunities
“People don’t want to buy a quarter-inch drill.
They want a quarter-inch hole.”
― Clayton M. Christensen, The Innovator's
Solution: Creating and Sustaining Successful
Growth

27. Pareto Efficiency
and Optometry By Dr. Gilbert Nacouzi
27
and the excess in risk aversion. If we
think of applying the Pareto efficiency
theory and relating it to the steep road
to success in Optometry, it would be
very difficult because of the constant
involvement of new technologies. The
Pareto efficiency is used in policy
making; in eye care it is almost
impossible to make any change
without affecting or making another
individual worse off.
For example, selling contact lenses
online has made a strong negative
impact on the regular schedules for
eye exam. Other diagnostics
procedures that optometrists perform
have a significant effect on
ophthalmologists and vice versa. In
this context it is very
…markets and
economies move
toward a sort of
Pareto efficiency
when all goods and
services are
tradeable in
competitive markets
with no transaction
costs.
Pareto Efficiency and Optometry
In economics, Pareto efficiency is
when all the resources and goods in
an economy are allocated to the
maximum level of efficiency, and in
such situation there is no room for
any change to be made and therefore
any change made would make
someone worse off. A pure Pareto
efficiency is theoretical and cannot
exist in practice. However, markets
and economies move toward a sort of
Pareto efficiency when all goods and
services are tradeable in competitive
markets with no transaction costs.
Moreover, a Pareto Improvement will
occur when changes in the allocation
of resources benefit at least one
individual without making any
other individual worse off.
In eye care and Optometry many
think that the steep road that leads to
success is the result of moving
toward Pareto efficiency. However,
the rational behind it is due to the lack
of entrepreneurship

28. difficult to think of a Pareto efficiency
or a Pareto improvement in eye care.
However, the third principle of
Gregory Mankiw’s principles of
economics that states “rational people
think at the margin” is applicable and
more appropriate than applying the
Pareto efficiency theory.
28
People rarely decide to perform a
service or produce a product if the
marginal benefit does not exceed the
marginal cost. This explains in part
why ophthalmologists abandon
procedures to optometrists and why
optometrists abandon procedures or
products to online sellers and other
disruptors.
IS OPTOMETRY AT PARETO
EFFICIENCY?
Yes
No
“Men follow their sentiments and their self-
interest, but it pleases them to imagine that
they follow reason. And so they look for, and
always find, some theory which, a posteriori,
makes their actions appear to be logical. If
that theory could be demolished scientifically,
the only result would be that another theory
would be substituted for the first one, and for
the same purpose.”
― Vilfredo Pareto

29. 2021 World
Orthoptic Day By Dr. Gilbert
Nacouzi
29
Historical timeline:
The history of Orthoptics and
Orthoptists supporting eye care dates
back to 1550 BC when humans’
interests were in the functioning of the
muscles responsible for eye
movements. They experimented with
treating strabismus using tortoise
brains mixed with honey, crocodile
dung, and lizard blood.
In 200 AD, Galen acknowledged that
there is an association between the
retinal cones and how binocular vision
works.
In 550 AD, Aeginaeta developed the
first recorded treatment of strabismus
which consisted of using a mask with
small perforations for the eye that
was meant to be straightened.
The year 1560 witnessed the first
recorded accurate description of the
extra-ocular muscles.
In 1743, Amblyopia treatment
became well-known.
2021 World Orthoptic Day
World Orthoptic Day is held every
year on the first Monday in June.
Today Orthoptists all over the world
celebrate and promote their
profession and their works as eye
care providers. It is a day to
showcase unity and solidarity among
the global Orthoptic community as
well as among eye care
professionals: Contact lens
specialists, Ophthalmic medical
technicians and Ophthalmic
dispensers also known as Opticians,
Optometrists, and Ophthalmologists.
Orthoptics is a career allied to the
eye care profession. Orthoptists are
the specialists who diagnose and
treat defects in eye movements and
problems with binocular vision.
Binocular problems can be caused by
issues with the muscles around the
eyes or defects in the nerves that
enable communication between the
brain and the eyes. Orthoptists are
responsible for the diagnosis and
non-surgical management of
strabismus a.k.a squint, amblyopia
a.k.a lazy eye, and eye movement
disorders.
Orthoptics is a
career allied to the
eye care profession.
The history of
Orthoptics and
Orthoptists supportin
g eye care dates
back to 1550 BC

30. In 1865, French Ophthalmologist
Louis Javal, who is now considered
the “Father of Orthoptics”, introduced
the employment of ocular exercises,
surgery, and stereoscope in the
treatment of strabismus.
In 1919 in England, Mary Maddox
pioneered the orthoptic
profession and was the first
documented orthoptist who practiced
as an allied health professional. She
was trained by her father, Ernest E.
Maddox, in response to increasing
patient demand and the time needed
to examine and treat patients.
Dr. Ernest Maddox was a well-known
ophthalmologist who also invented
various instruments for investigating
binocular vision.
Mary Maddox started her own
practice in London in the early 1920s
and her first hospital clinic opened at
the Royal Westminster Hospital in
1928. Mary Maddox’s work in the
orthoptic investigation and the
treatment of strabismus inspired
others to choose the profession too.
In the 1930’s, the study of orthoptics
spread from Great Britain to North
America and Australia.
In 1931, the first Australian hospital
clinic with orthoptists was established
at the Alfred Hospital in Melbourne.
In 1937, the first Canadian orthoptic
clinic was opened in Winnipeg.
In 1938 the American Orthoptic
Council was formed to represent the
interests of American orthoptists.
In the 1940s in Poland, Professor
Marian Wilczek (1903 – 1967)
initiative led to the construction of the
Eye Hospital in Witkowice near
Krakow, just after the end of World
War II.
30
Professor Wilczek was known for
running regular courses for orthoptists
working at clinics specializing in
strabismus and amblyopia.
In 1940 Vancouver opened the first
Canadian training school, and in 1967
The Canadian Orthoptic Society and
the Canadian Orthoptic Council were
founded.
References:
Vukicevic, M., Koklanis, K and
Giribaldi, M. Orthoptics: Evolving to
meet increasing demand for eye
service. In Insight news. March 2013:
Sydney, Australia.
More information on how to
participate at the 2021 World
Orthoptic Day can be found
at https://www.internationalor
thoptics.org/
Upcoming International
Events and Congresses for
Orthoptist
17. June.2021 – 19.
June.2021: 2021 EPOS
congress
Location: Copenhagen,
Denmark
Link: www.epos2020.dk
19.June.2021: WSPOS
Webinar – Virtual
Strabismus wet lab 2
Location: Online
Link: http://www.wspos.org/w
orld-wide-webinar/

31. What to do When
you Have Tons of
Ideas By Dr. Gilbert Nacouzi
31
called “The Decision Making Matrix”
and is detailed in his book “The $100
Startup”. This tool also helps in
making decisions not only for your
next project, your organization, or the
team you manage but also comes in
very handy for your life decision-
making.
You build the matrix by first listing all
ideas you have in mind. You will then
use “The decision-making matrix” to
quantify those ideas and get point
totals which will help you decide the
next task you should tackle.
You build a matrix where you list your
ideas one in each row in the first
column, and then you add five
columns. The first four columns
consist of the four different criteria
that you will run
…not all entrepreneurs
want to learn as MBA
students do and for
many, doing more with
less is the rule...
What to do When you Have Tons of
Ideas
The problem when you have one idea
is that you have no choice and you
don’t have enough ideas. But for most
entrepreneurs having more than one
idea is not a problem, because they
have a lot of ideas going on their
minds daily. However, their problem
is to be able to find an opportunity or
to be able to create time to pursue
those ideas that are worth pursuing.
Professor James Green provides in
detail what entrepreneurs should
learn and perform using “the
opportunity analysis canvas”.
However, not all entrepreneurs want
to learn as MBA students do and for
many, doing more with less is the
rule.
When you have so many ideas and
so many important decisions to make
I suggest you employ a fairly simple
tool that helps you decide which idea
you should pursue first. The tool has
been developed by Chris Guillebeau,
it is
IDEAS

32. your ideas through and the fifth
column is the total scores column
where all quantified scores for the
four criteria of every idea are added
up.
The four criteria are scored between
1 and 5 and consist of:
Impact: defined as how much of an
impact will this idea of a project make
on your business and customers. “1”
is the score for the least impact.
Effort: is defined as how much time
and work will it take to create this
project. “1” is the score for the idea
that requires the most effort.
32
Profitability: defined as how much
money will the project generate
compared to other ideas. “1” is the
score for the least profitable idea.
Vision: defined as how close does
this idea or project fit the
organization’s overall vision and
mission. “1” is the score for the least
ideas mission in terms of alignment
with the organization’s overall
mission.
Once you add all scores you can
select the idea with the highest score
and start with.
WHAT TO DO WHEN YOU HAVE TONS
OF IDEAS
Determine Which Idea to Tackle
First
Determine Which Employee is
most Suitable for the project
Legal Entities in
Optometry
type of legal entity, as well as some
other details like liabilities, expenses,
and taxes.
The types of legal entities in
Optometry include: the sole
proprietorship, the general
partnership, the corporation,
Legal Entities in Optometry
In the following series of posts (only
accessible on Patreon) we will write
about the different types of legal
entities that self-employed
optometrists can choose for their
practice, the advantages and
disadvantages of each

33. the subchapter S corporation, and the
limited liability company. In this post
we will detail the sole proprietorship
type of legal entity.
The sole proprietorship is defined as
a natural person. The optometrist is
the only person who owns 100% of
the practice and is responsible for all
the liabilities of the business. In the
United States, a small percentage of
private practice owners are sole
proprietors. The sole proprietor can
employ other optometrists or staff and
he can include independent
practitioners as independent
contractors. There are two ways that
sole proprietorship is possible either
by starting a new practice or
purchasing an existing one.
The advantages of a sole
proprietorship include full control of all
the strategic, planning, and
operational decisions as well as for
deciding on opening hours, products
and services, and activities practiced.
Moreover, the sole proprietor decides
on who to hire who to fire, with full
ownership of the practice income as
well as assets.
33
The disadvantages of a sole
proprietorship include no replacement
available in case of illness, vacation,
or absence for conferences and
exhibitions. The sole proprietor will
have to fully support all the practices’
financials. He should accept a low
income at the beginning that may
sometimes continue for a prolonged
time in the case of a cold starting. He
should also develop a good
knowledge and education in law,
finance, marketing, and strategy to be
able to create a competitive
advantage.
The duration or the lifetime of a sole
proprietorship could be extended to
as long as the optometrist is living or
wants to stay in business and the
practice can later be sold to another
practitioner. In the case of a sole
proprietorship, the owner is
responsible for reporting business
taxation and individual taxation. Even
though he can write off some
business expenses, other business
legal types come with better tax
advantages that we will write about
in coming posts*. So stay tuned…
*Only Accessible Through Patreon
AMONG ALL LEGAL ENTITIES, THE
SOLE PROPRIETORSHIP
Has the least establishment fees.
Pays no tax.

34. Marketing Research
for Optometrists
34
business by fulfilling the customers’
needs and wants. Therefore,
marketers know that they need
information about the target market to
determine the needs and wants of
customers to build the right marketing
strategy. Moreover, marketers need
to constantly monitor and collect
updated information about
competition and markets to be aware
of environmental changes. When
companies conduct wrong marketing
research it leads to wrong decisions.
We employ marketing research in a
practice when we want to:
1- Identify market opportunities and
problems; that could be accomplished
by environmental analysis studies,
SWOT analysis, market segment
To demonstrate
effective marketing
for an optometry
practice, its
products, and
services, managers
are on a mission to
understand the
marketing concept
and be able to put a
marketing strategy
Marketing Research for
Optometrists
Marketing research is an integral part
of marketing. To demonstrate
effective marketing for an optometry
practice, its products, and services,
managers are on a mission to
understand the marketing concept
and be able to put a marketing
strategy. To accomplish this mission,
they need the information to carry out
the marketing concept and come up
with the right strategy. Even the most
successful companies have at a
certain point in time failed to bring to
the market the right product due to
lack of marketing research; and that
costed them fortunes. Marketing
research enables designing,
gathering, analyzing, and reporting
information that will be
used to solve a specific marketing
problem.
Marketing managers are required to
make countless decisions while
applying the marketing concept and
developing a marketing strategy. The
marketing concept is based on the
belief that a marketer can help build a
successful

35. identification, or market demand
determination.
2- Generate, refine, and evaluate
potential marketing actions; that could
be accomplished by marketing-mix
evaluation testing, new-product
prototype testing, pricing tests,
advertising pretesting, etc
3- Monitor marketing performance;
that could be accomplished by
studying practices that already have a
marketing
35
mix to evaluate how well this nix is
performing. Examples include image
analysis, customer satisfaction
studies, employee satisfaction
studies, website evaluation studies,
etc.
4- Improve marketing as a process
rather than solving a specific problem;
that could be accomplished by
studying ROI improvement studies,
new product innovation studies, new
media studies, new marketing
processes studies, etc.
MARKETING RESEARCH IS PART OF
THE MARKETING PROCESS THAT
Consists of collecting and
analyzing Information
Consists of solving a specific
problem using gathered data.
“Marketing is not the art of finding clever ways to
dispose of what you make. It is the art of
creating genuine customer value.”
― Philip Kotler
Become a Patron of Optical
Forum and unleash
exclusive content

36. Alcon Total30
By Dr. Gilbert Nacouzi
36
comfort and vision,” said Cheryl
Donnelly, International Head of
Professional Affairs at Alcon. Adding
“Whilst we will miss the in-person
interaction, the virtual BCLA event will
enable us to share promising clinical
evidence with even more eye care
professionals so they can make
informed decisions about patient
care.”
During the two-days virtual event,
Alcon will be presenting 18 abstracts
as well as studies related to Total30
evaluating the integrity of the contact
lens material after on-eye wear,
durability after daily wear, and daily
cleaning for a period of one month.
Moreover, they will present
information related to disinfecting and
storing the
“the first-and-only
monthly replacement
water gradient
contact lens”.
Alcon Total30 “A lens to start in
and stay in”
As the 2021 BCLA’s virtual Clinical
Conference and Exhibition prepare to
start off in a live-streamed setting this
Sunday 13th of June, Alcon prepares
to showcase Vision Care Innovation,
including Clinical Data for its
forthcoming reusable monthly contact
lens Total30. Alcon describes Total30
as “the first-and-only monthly
replacement water gradient contact
lens”. Alcon has had great success
with Dailies Total1®, and Total30 will
be the first-and-only monthly
replacement water gradient contact
lens featuring an innovative water
gradient material with biomimetic
Celligent™ technology.
“We are delighted to partner with the
BCLA to present our robust scientific
data on several of our products,
notably on TOTAL30, which is
designed to address two of the key
factors to maximize contact lens
wearer retention:

37. lenses, surface softness, and
comparison to other contact lens
materials (samfilcon A, comfilcon A,
senofilcon C, senofilcon A, or
fanfilcon A) wettability after on-eye
wear for one month, and structure
properties. Those studies reveal
Total30 has exceptional
37
lubricity, outstanding surface
softness, and high durability.
Total30 is expected to be launched
during 2021 in the U.S. and select
markets in Europe, while a worldwide
introduction will be during 2022.
Motivating
Employees
Motivating Employees
Every employee is motivated by
something. Some employees are
motivated by things that are external
in nature like money and status, while
others are motivated by things that
are intrinsic in nature such as a desire
to do a good job or the desire to go a
level up in the hierarchy.
We often argue that the type of
leadership in Optometry as in
healthcare is often the type of
transformational leadership. One of
the justice theories in the workplace is
the equity theory as it focuses on
determining whether resources are
distributed in a fair way to both
relational partners. Employees are
driven by the rewards they get in
exchange for their efforts. They seek
to maintain an equity relation between
the “inputs” they contribute to a job
and the “outcomes” that they receive
from it against the perceived “inputs”
and “outcomes” others are receiving
(Adams, 1965). In the equity theory,
motivation is based on the concept of
the tension created when an
employee
feels that his input/outcome ratio is
higher than others ratio, which means
that the rewards for the efforts he is
contributing are less than others
rewards for the same efforts or equal
to other rewards for fewer efforts.
Motivation occurs assuming that the
employee has a clear thought of what
fair amount of reward to be
exchanged for his efforts, compares
this exchange, and believes that this
exchange is not equitable with what
others are receiving.
Through equity theory, Adams tends
to demonstrate that salaries and
conditions alone do not produce
motivation. “We arrive to our measure
of fairness-Equity – by comparing our
balance of effort and reward and
other factors of give and take – the
ratio of input and output- with the
balance or ratio enjoyed by other
people, whom we deem to be
relevant reference points or example”
In organizations, understanding
equity theory makes a good tool for
motivating employees and
snowballing effectiveness through
increased

38. employee retention and increased
commitment. Employees who
increase their effort when they
understand the importance of the
ratio comparison will get better
rewards. For example, when
38
part-time workers know that full-time
workers have higher rewards when
comparing to their inputs/outcomes
ratio they will push to contribute more
in time.
IN THE EQUITY THEORY,
MOTIVATION IS BASED ON THE CONCEPT
OF THE TENSION CREATED WHEN AN
EMPLOYEE FEELS HIS INPUT/OUTCOME
RATIO IS HIGHER THAN OTHERS RATIO
True
False
“Justice consists not in being neutral
between right and wrong, but in finding out
the right and upholding it, wherever found,
against the wrong.”
― Theodore Roosevelt

39. Fireworks Eye Safety
By Dr. Gilbert Nacouzi
39
bystanders passing by by accident.
Children should never play with
fireworks. Burns and injuries may
occur from sparklers. Protective
eyewear should be used and in case
of any eye injury people should not
rinse, rub their eyes or try to remove
foreign particles instead they should
seek immediate medical attention.
Precautions should include
wearing protective eyeglasses,
staying far from the fireworks, and it
is always recommended to go to the
professional displaying events rather
than playing and lighting fireworks
himself.
Pyrotechnicians are
the only persons to
know how to safely
handle and
manipulate
fireworks.
Fireworks Eye Safety
The American Academy of
Ophthalmology (AAO) has declared
June is Fireworks Eye Safety and
Cataract Awareness Month. Summer
is always the right time for fireworks.
With the COVID-19 coming to its end
and the advancing in the numbers of
vaccinated population, the time has
come for people to start playing with
fireworks. As lovely and fun to watch
fireworks can be extremely
dangerous therefore good safety
measures should be considered. Eye
injuries represent a significant
percentage of reported injuries from
fireworks.
Commercial fireworks are extremely
dangerous. Pyrotechnicians are the
only persons to know how to safely
handle and manipulate fireworks.
Injuries frequently happen to fingers,
hands, faces, laps and mostly
constitute burns-related injuries.
Injuries can happen to

40. Level 5 Leadership:
Is your Company Charting your Career
Path? By Dr. Gilbert Nacouzi
40
available like getting good people on
the bus and bad people off the bus as
well as creating a culture of discipline.
Moreover, the four levels under Level
5 include “highly capable individual” in
Level 1, “Contributing Team Member”
in Level 2, “Competent Manager” in
Level 3, and “Effective Leader” in
Level 4. Those notes are very
important for Optometrists because
during their career as they transition
from technical to managerial positions
the lack of managerial and leadership
knowledge may negatively affect their
performance.
Level 5 Leaders
propel a company
from merely good to
truly great...
Level 5 Leadership: Is your
Company Charting your Career
Path?
In a previous post, we
emphasized Level 5 Leaders propel a
company from merely good to truly
great. According to Jim Collins
research “the most powerfully
transformative executives possess a
paradoxical mixture of personal
humility and professional will. They
are timid and ferocious. Shy and
fearless. They are rare-and
unstoppable.”
Collins research returned that in a
hierarchy of executive capabilities,
Level 5 is the highest level. In the four
levels beneath Level 5, leaders can
generate high levels of success but
not enough to transform a company
from average to sustained excellence.
It is also very important to note that
Level 5 leadership is not the only
requirement to transforming a
company from good to great, but
other factors need to be

41. Peter Drucker emphasized that the
time when people relied on their
companies to chart their career paths
has gone. Times have drastically
changed, today’s managers must
learn to manage themselves and their
own careers by learning to develop
themselves. That is by putting
themselves in the place where they
can contribute the most to their
company and overall community: a
place where they can make a real
and tangible impact. This can be
achieved by staying mentally alert
and aware when to change the work
they do in order to deliver results and
sustained success by doing what they
are good at and through ways that fit
their ability. For this reason and in
order to be able to take advantage of
their fundamental strengths
Optometrists who are transitioning
from technical to managerial positions
need to be able to
41
answer five questions that Drucker
employed to challenge new managers
to focus on improving the skills they
have and accepting responsibilities
that fit their individual way of doing
things. Those questions are, What
are my strengths? How do I
perform? What are my values?
Where do I belong? What should
my contribution be?
Today more than ever, success
comes to those who understand their
strength and themselves. Successful
managers are those who answer
those questions and understand that
their careers are not planned out in
advance. However, their careers
develop when they become prepared
for opportunities because they have
answered those questions and have
carefully and thoroughly determined
their unique qualities and constantly
worked on developing them.
YOU MUST DETERMINE YOUR
CAREER PATH BASED ON
Qualities and Characteristics that
you developed overtime
What Career Path your Company
has planned out.

42. New Test to Assess
Keratoconus RiskBy Dr. Gilbert Nacouzi
42
AvaGen, by Avelino Lab USA is a
genetic test that is aimed to assess
and quantify patients risk of
keratoconus and corneal
dystrophies. The test enables
managing and treating patients
with these conditions with more
confidence. Moreover, it allows
patients to benefit from the FDA
crosslinking procedure at an early
stage thus getting the chance to
preserve their vision.
The results that this test provides
also improve the quality of
decision-making when it comes to
opting for refractive surgery.
Elizabeth Yeu, MD, of Virginia Eye
Consultants, an
Today’s diagnostic
imaging tools that
optometrists and
ophthalmologists
employ don’t allow
early detection of
corneal dystrophies
as well as the early
diagnosis of
keratoconus
New Test to Assess Keratoconus
Risk
At its very early stages, Keratoconus
is often confused with myopia and
astigmatism. Today’s diagnostic
imaging tools that optometrists and
ophthalmologists employ don’t allow
early detection of corneal dystrophies
as well as the early diagnosis of
keratoconus. Keratoconus is being
diagnosed only after a significant
deterioration of vision. With the
availability of a new genetic test, the
risk of keratoconus can now be
quantified at an early stage.
It’s not even a decade yet that
corneal crosslinking has been
FDA approved in the U.S. to stabilize
Keratoconus progression using
GLaukos riboflavins
and UV illumination device. Despite
the trials and attempts by scholars to
find new ways to stabilize the
progression of keratoconus, they now -
with the introduction of Avelino new
clinical tool- need to identify
candidates right away for them to
consider crosslinking at the earliest
possible.

43. advisor to Avellino emphasized the
role of the test in helping her to know
early about the patient’s genetic
predisposition and enables her to
make treatment and management
decisions with confidence. She notes
“Assessing keratoconus is multi-
factorial. Until now, genetic data has
been missing from the equation. I
order AvaGen when I have any red
flag concerns in my refractive surgical
evaluations, such as high astigmatism
or steep corneal curvature, against-
the-rule or irregular astigmatism in
younger patients, a thin cornea, or in
family members of a known
keratoconus patient”.
The test was made available in late
2019
43
when the lab shifted its efforts to
developing COVID-19 test. Avellino
CEO and President Jim Mazzo
notes “While we made AvaGen
available in late 2019, we quickly
pivoted our resources to do our
part to address the COVID-19
pandemic over the last year with
the development of our widely-
used SARS-CoV-2/COVID-19 test,
which received Emergency Use
Authorization (EUA) from the FDA.
Thanks to widespread testing and
adoption of the COVID-19
vaccines, we are now able to offer
AvaGen nationally.”
KERATOCONUS RISK FACTORS ARE
NOW ASSESSED BY A TEST
True
False
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44. The Power of
Leading With
Questioning
By Dr. Gilbert Nacouzi
44
practice.
Why good questioning is related to
good Leadership in Optometry?
Good questioning leads to the truth
that is based on facts and not
leadership charisma:
Good questions that prosecutors ask
never end with a simple yes or no
answer. Prosecutors never let go until
every little detail is understood, every
“what” but most importantly every
“why”. Prosecutors master the art of
hypothesis testing. Thus, questioning
is used to gain understanding: the way
Socrates did it. Socrates’ method is
based on cooperative argumentative
debates that promote critical thinking
through asking and answering
questions that
Imagine you are a
prosecutor who is
supposed to ask and
investigate in order
to come with a
solution and not an
optometrist who is
supposed to know
the answers to all the
questions related to
the practice…
The Power of Leading With
Questioning
In this post, we will try to demonstrate
that good questions are at the basis
of good leadership in Optometry.
Once you have the right people in
your practice, good practice
management relies on asking the
right questions. The right questions
turn even an informal meeting into a
debate. You don’t want your practice
to be governed by the culture of
lecturer-attendants type of meeting
where staff listen to the practice
manager or the optometrist and then
resume their work or continue diner.
Don’t expect your staff to be the ones
asking you questions. Be proactive
and engage them in questions that
push
the whole ambiance to creatively
find solutions. Imagine you are a
prosecutor who is supposed to ask
and investigate in order to come
with a solution and not an
optometrist who is supposed to
know the answers to all the
questions related to the

45. draw out ideas underlined in
presuppositions and presumptions.
This method is employed to bring
out definitions implicit in the
interlocutor’s belief and help
advance understanding the truth by
eliminating contradicting
hypotheses. Constantly rejecting
hypotheses lead to finding a steady
hypothesis. By following this
method you motivate your staff to
search for commonly held truth that
makes beliefs and tests them to
determine their consistency with
other beliefs.
45
Collectively you formulate a series of
questions as logic tests and fact tests
that are aimed at revealing the team’s
beliefs about any topic and any
circumstance.
Leading as an Optometrist or a
practice manager does not rely on
coming up with all the answers and
then trying to motivate or convince
your staff to follow your vision. Instead,
it relies on being able to reveal the fact
and the truth that is not enough
understood to have a general answer
and then come up with the right
questions that lead to the best possible
outcomes in any situation.
LEADING WITH QUESTIONING
Requires finding the right way to
getting the right answers
Requires delivering answers to
show your right point of view.
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46. What Does it Take to
Become a Great
Leader By Dr. Gilbert Nacouzi
46
They demonstrate unwavering
resolve to resist everything that
potentially keeps them from doing
what must be done to bring the best
long-term results against all
difficulties and obstacles;
They set the standard that separates
a great company from a good
company and they never accept less
than great;
Level 5 leaders
create superb results
that are at the core of
transitioning a
company from good
to great…
What does it take to become a
Great Leader?
I got a call from a colleague today, he
was telling me that he has been
appointed for a new international
leadership position in eye care. After I
congratulated him we began to recall
some events from the past. He truly
was a leader right from the beginning.
Anyone, who met him would expect
that he will be a good optometrist.
However, as we talked and talked it
quickly came to my mind to reflect on
how he transitioned from being a
good Optometrist and a good leader
to a great leader. I remembered the
Level 5 leadership that Jim Collins
wrote about in his best-selling book
“Good to Great”.
My colleague truly has the traits of
Level 5 Leadership. In his book, Jim
Collins emphasized Level 5 Leaders
who are required to turn a good
company into a great one. According
to Jim, by attempting to compare this
type of leader with high-profile
leaders with big personalities leaders
who make headlines and become
celebrities, Level 5 Leaders seem to
have come from Mars. They have a
mix of personal humility and
professional will.
Level 5 leader Professional Will:
Level 5 leaders create superb results
that are at the core of transitioning a
company from good to great;

47. They never blame other people,
never blame external factors, they
take responsibility for their
wrongdoing and always look in the
mirror and not outside the window;
Level 5 leader personal humility:
They always demonstrate a
compelling modesty, and never show
excessive pride and self-satisfaction
in one’s achievements, possessions,
or abilities;
They act discreetly with calm
determination, and rely on inspired
standards and not compelling
attractiveness or charm or charisma
to inspire devotion in others;
They promote and channel ambition
into the company rather than into
themselves. They inspire and help
successors for greater success and
achievements than he was able to
achieve;
47
Credit success and achievement to
peers and other people whom he
sees as indispensable assets for the
success of the company.
“The great irony is that the animus
and personal ambition that often drive
people to positions of power stand at
odds with the humility required for
Level 5 leadership. When you
combine that irony with the fact the
boards of directors frequently operate
under the false belief that they need
to hire a larger-than-life, egocentric
leader to make an organization great,
you can quickly see why Level 5
leaders rarely appear at the top of our
institutions.” Jim Collins
LEVEL 5 LEADERS HAVE A MIX OF
Personal Humility and
Professional Will
Excessive Pride and Follow
Imposed Standards

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