Healthy Aging

Bonus
Article
Page 26
Support us: Hy.page/opticalforum
September
is Healthy
Aging
Month
Optical Forum 7
September
2021
ISSUE
Blog Flipbook
Making an Impact
In this
Issue
Presbyopia Eye
Drops Approval
Emotional
Intelligence for Eye
Care
Passive Leadership
in Optometry

Optical Forum
Blog flipbook
Emotional Intelligence for Eye Care - Page 10
Presbyopia Eye Drops Approval - Page 6
Passive Leadership in Optometry - Page 13
2

News and editor’s perspective
his month we welcomed our first Optical Forum Editorial Board
wave of members. A lot of responsibilities await us in the future.
With the help of diverse, competent, and qualified board members we
are confident that a lot will also be accomplished.
September is healthy aging month. The risk of vision loss due to age-
related macular degeneration should not be underestimated. Eye care
professionals spend a significant amount of time consulting with
patients and presenting to the community about ways to reduce the
risk of eye diseases as we age. We repeatedly emphasize on regular
yearly eye exam, healthy diet, protection against Ultra Violet sunlight,
appropriate protection against light transmitted from electronic
devices, etc.
At Optical Forum and during September we continued to post new
original content on daily basis. This month’s topics revolved around
Eye Health, Technology, Practice Management, Motivation, emotional
intelligence, along with other topics of entrepreneurship, leadership,
marketing, etc…
As is the case in every issue, we thank and salute every scholar and
professional who volunteered to create and review the content of this
issue. We also invite every one to share his or her story with us. By
doing so you help advance the boundaries of knowledge. You are all
invited to accompany us in this journey so feel free to submit your
articles and comments to feedback@opticalforum.space or fill the form
at https://opticalforum.space/contribute/
A big “Thank you” for all our followers and colleagues who trust us,
believe that we can make an impact, and are supporting us by following
us at hy.page/opticalforum
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
T
GilbertNacouzi

• Lorem ipsum dolor sit
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 The Editor:
Dr. Gilbert Nacouzi
admin@opticalforum.space
Editorial Board:
Dr. Catherine M. Croke
Dr. Jeanne Andary
Dr. Rasha Faraj
Miss Maria Adra
Article Reviewers:
Samer Hanna
Asma Eid
7
September
2021
ISSUE

Contents
Passive Leadership in
Optometry
What to know?
Emotional
Intelligence For
Eye Care
6 What does the
future hide?
Presbyopia Eye Drops
Approval
10
13
5
Find Meaning in Your Optometric Work 28
Transitions in Optometry 30
Extending Your Services and
Representativeness 32
Old Man’s Eyes 33
PERMA In Optometry 35
Optometry Customer Experience 37
Team Weak Link 39
Counseling in Optometry 41
Ocular Histoplasmosis 43
Avocado Fruit Eyesight Benefits 8
Is Strategic Thinking Only for
Executives? 14
Strategic Agility in Optometry 16
Fixed Mindset vs Growth Mindset 17
Things Keeping You Under a Bad
Boss 19
Employees Burnout Early Signs 21
Ray-Ban Stories are More Than 30
Seconds 22
What if You are Demotivating
Your Team? 24
Time is Money! But
Time to Think is
Gold
26
The impact of the
employer on the
employee

Presbyopia Eye Drops
Approval
Answer & Insights
IMAGES ARE INVERTED
THROUGH A PINHOLE
True
False
True
False

Presbyopia Eye Drops Approval
For eye care professionals there are
various ways to treat presbyopia
without using eye drops. As people start
losing their near vision many try ready-
made reading glasses from malls, online
retailers, and pharmacies before
consulting their eye doctor. The
majority of people, however, prefer to
undergo a thorough and complete
comprehensive eye exam before
selecting one or more of the other
available solutions, which include
customized reading glasses,
progressives, and multifocal contact
lenses. Many get bored with all those
corrective tools and opt for a refractive
surgery where they can select between
monovision laser surgery, multifocal
laser surgery, and recently IntraCor
laser surgery.
The theory behind the accommodation
proposes that given the elasticity of the
lens, any relief in the zonular tension
caused by a contraction of the ciliary
muscle will lead the lens to round up
and increase its refractive power
allowing humans to focus and see near
objects. With age, the ability of the lens
to round up and increase in power
slowly disappears causing presbyopia.
7
…any relief in the
zonular tension caused by
a contraction of the
ciliary muscle will lead
the lens to round up and
increase its refractive
power …
The rectilinear theory of light is a
principle that explains the fact that
light travels in straight lines. In
cameras that use a pinhole system
instead of a lens, images are formed
inverted on the film and dimmer. The
same phenomena appear when the eyes
of humans are in bright light causing
pupil constriction to act as a pinhole
that selects light that travels through
the center of the lens.
Miotic eye drops partially treat
presbyopia not by correcting the cause
of presbyopia but rather by inducing
pupil constriction allowing a pinhole
effect and improving both near and far
vision in different light settings. Those
eye drops that leverage the pinhole
effect and increase visual acuity, are
expected to provide eye care providers
new opportunities to help patients who
previously relied solely on ready-made
and over-the-counter reading glasses.

Avocado Fruit Eyesight
Benefits
Avocado Fruit Eyesight Benefits
If you ask dieticians about the health
benefits of Avocados, they insist on
heart health improvement, promote
weight loss, supplies nutrients like
potassium and vitamin B. Avocado-
based products help reduce hair loss,
rejuvenate skin, and of course make
the famous Guacamole. Because of
nutritional fatty acids in avocados
that help moisturize dry skin, many
skin therapists recommend avocados
to help disappear dark circles under
the eyes caused by dehydrated skin.
It is believed that macular pigment
(MP) protects against age-related
maculopathy (ARM). MP is
composed of the only two dietary
carotenoids lutein (L) and zeaxanthin
(Z) as they cross the blood-retina
barrier. Studies suggest that dietary
L and Z help in maintaining cognitive
health as their concentration in brain
tissues correlate with macular levels.

9
Researchers have proved that in the absence of retinal pathology, “the
relative lack of MP seen in association with increasing age, tobacco use
and family history of ARM supports the hypothesis that the enhanced
risk that these variables represent for ARM may be attributable, at least
in part, to a parallel deficiency of macular carotenoids.” (Nolan et al.,
2007)
Avocado fruit is a rich source of Lutein. In addition to Avocado’s
benefits to improving cognitive health, it has been proved that avocado
consumption increases MP density. Its antioxidant function helps retard
cataracts. Eating avocados regularly helps in reducing the risk of ARM
and provides overall better eye health over the long run.
REGULAR AVOCADO CONSUMPTION
INCREASES MACULAR PIGMENT
True
False
True
False
The
Recommended
Daily Intake is
½ to one
Avocado
References:
Nolan, J. M., Stack, J., O'Donovan, O., Loane, E., & Beatty, S. (2007). Risk
factors for age-related maculopathy are associated with a relative lack of
macular pigment. Experimental eye research, 84(1), 61-74.
Scott, T. M., Rasmussen, H. M., Chen, O., & Johnson, E. J. (2017). Avocado
consumption increases macular pigment density in older adults: a randomized,
controlled trial. Nutrients, 9(9), 919.

Emotional Intelligence for Eye Care
Practitioners who have a strong
Emotional Intelligence exceed patient’s
expectations by providing them with
exceptional service and building long-
lasting and worthwhile relationships.
Emotional Intelligence helps eye care
providers deliver better service and
higher outcomes through rigorous
practice and a patient-centered
attitude.
Emotional Intelligence goes beyond
thinking with logic and employing the
knowledge of facts. It comprises of
incorporating logic and the knowledge
of facts with the capability that allows
us to identify, recognize, and
understand our emotions as
practitioners and the emotions of the
patients and their parents. It’s about
being able to differentiate between
different feelings and controlling
emotions in order to adapt to the
environmental changes.
Emotional Intelligence was popularized
by Daniel Goleman, an American
psychologist, who defined five key
elements that constitute emotional
intelligence: self-awareness, self-
regulation, motivation, empathy, and
social skills. A “perfect leader”
accordingly, is someone who -no matter
what the situation is- never let his
emotions or temper get out of control,
has the complete trust of his team
10
members, listens to every member, it is
always easy to communicate with, and
all his decisions are carefully made after
thorough research and review of all
available information.
Self-awareness helps you understand
how you feel and how you stand among
people around you and your
environment. It provides you with an
updated picture of your strengths and
weaknesses and reminds you why you
constantly need to be humble and have
the humility to progress and be able to
achieve your agenda. To improve self-
awareness leaders keep journals where
they write down their thoughts and
they slow down whenever they
experience anger or other emotions.
Emotional Intelligence
for Eye Care

EMOTIONAL INTELLIGENCE
Good
Bad
goes beyond the thinking of logic
and knowledge of facts
is thinking using only knowledge
of facts
Self-regulation pertains to leadership traits of resilience and versatility.
Self-regulated leaders understand their values, hold themselves
accountable, and constantly work to improve their skills and
capabilities to manage their anger.
Motivation pertains to constantly and continuously work to get to their
goals, achieve what they deserve, and be hopeful they will get the
rewards no matter what problems they face.
Empathy pertains to leaders who know how to put themselves into
somebody else’s shoes and feel their struggles and pains.
Social skills reflect the communication ability of the leader, their
capacity to resolve conflicts, praise others, and improve their
communication skills.

September is Healthy
Aging Month
“One in six Americans age
65 and older have a vision
impairment that cannot be
corrected with glasses or
contact lenses. The risk of
eye disease increases with
age, yet many older adults
neglect to see an
ophthalmologist for care.
To bring attention to
taking care of our eyes as
we age, the American
Academy of
Ophthalmology celebrates
Healthy Aging Month to
raise awareness of the signs
and symptoms of vision
loss - and steps to help
seniors take care of their
sight.”
https://www.aao.org/newsr
oom/observances
Read “Old
Man’s Eyes”
Page 33

Passive Leadership In
Optometry By Dr. Gilbert Nacouzi
In most types of
leadership, there is an
active impact from the
boss on the employees
…
Passive Leadership in Optometry
Leadership is necessary in Optometry as
it pertains to both practice management
and regulatory within the national
health system. The primary role of
leadership in such a complex
environment is to increase efficiency in
the service of eye care and make it
affordable, of better quality, and
effective.
The most common types of leadership
we find in Optometry and healthcare
include transformative, participative,
transactional, autocratic, laissez-faire,
etc. In most types of leadership, there is
an active impact from the boss on the
employees. Many employees
emphasized the role their boss played in
shaping and developing their skills.
However, this is less the case in laissez-
faire and passive leadership. Moreover,
scholars argue that passive leadership
can negatively affect both employees
and the organization.
Passive leadership consists of combining
both passive management by exception
and laissez-faire leadership. Passive
management by exception is when
leaders avoid action until problems and
missteps can no longer be ignored.
Laissez-faire is characterized by the
total absence of leadership. Studies
revealed that passive leaders avoid
engaging with their employees and
become less effective because they fail
to make decisions in the absence of
response and feedback from
subordinates. On the other hand,
employees under passive leadership
built a perception that their
organization undermines their well-
being and does not have the necessary
support and encouragement to succeed.
It is very important to provide team
members total autonomy, however, no
one should ignore the fact that team
members expect leaders to give them
directions, solve problems, proving
authority, and make decisions.
Optometrists and other healthcare
providers are sometimes so preoccupied
with their clinical responsibilities that
they become unaware how passive their
leadership grew into. Therefore, some
indicators should reflect this situation.
Those red flags include not receiving
feedback from team members, not being
able to identify poor performers on
daily basis and not having to step in to
help, no teams problems being reported,
and no conflict resolution and decisions.

14
According to you, what makes him/her
a strategic thinker? And the answers I
get vary around the qualities he
possesses and demonstrates.
Most qualities that people find in
strategic thinkers include wit,
intelligence, innovation, creativeness,
ability to connect and interact with
people and audience, being receptive to
feedback, always learning, have many
advisors, think of people around them,
are risk-takers, and constantly have a
lot of things going on. Harvard Business
Review author, Nina Bowman
emphasizes the need to develop
strategic thinking and being able to
validate what is acquired in strategic
thinking to advance in a career.
LEADERSHIP IN OPTOMETRY
PERTAINS TO BOTH
Practice management and Regulatory
within the national health system
Narcissism and Vanity
Is Strategic Thinking
Only for Executives?
Is Strategic Thinking Only for
Executives?
Strategic Thinking is often attributed to
executives. When we think of strategic
thinking as a required skill in hiring for
management positions we sometimes
forget that strategic thinking is needed
in every position, moreover, developing
it is beneficial for every job even for
students. Strategic thinking helps in
achieving tasks and responsibilities at a
higher level and a higher standard of
doing things. Strategic thinking is
becoming among the top required
skills to excel in the workplace and
recruiters look at it the most. When I
hear colleagues and friends talking about
a strategic thinker I often ask them:

Leaders in companies need to know
what employees know. Therefore by
demonstrating strategic thinking
employees show how suitable they are
to certain positions. Bowman
emphasizes four ways to improve and
demonstrate strategic thinking, know
by observing and seeking trends, think
by asking the tough questions, speak to
sound strategic, and act by making time
for thinking and embrace conflict.
The skills that everyone needs to
develop to become a better strategic
thinker include:
Reading, learning, and constantly
acquiring new knowledge. This can be
achieved by creating enough time to
work on developing ourselves. Creating
enough time requires developing and
improving the skill of time
management.
Be ready to accept critics and feedback.
This can be accomplished by inviting
critics and surrounding ourselves with
15
friends and people who care for our
development and constantly advice us
on small and large issues.
Become a good listener. This can be
achieved by developing observation and
questioning.
Become a good concluder. This can be
achieved by following up after
questioning with hypothesizing,
information gathering, and analysis.
Added to all these skills is being able to
lay down all possible consequences and
end results. This allows us to close,
promise, or schedule future encounters.
The skills needed for better strategic
thinking are endless the more you
master the more you discover that there
is much more to be acquired. As you
improve your strategic thinking you
constantly find new ways to solve
problems in the organization and new
ideas to be tested and implemented to
ensure future growth and profit.
IS STRATEGIC THINKING ONLY
VALUABLE FOR EXECUTIVES? CAN
EVERYONE BENEFIT FROM IT?
True
False

Strategic Agility in
Optometry By Dr. Gilbert Nacouzi
16
There is a great distinction between
Strategic Agility and Operational
Agility. Operational Agility pertains to
making better products and services. In
terms of providing people with lighting,
if operational agility was to make a
better candle strategic agility drove
Edison to create the electric light
bulb. In times of crisis, Strategic agility
leads organizations not just to survive
but thrive. Research showed that
Airbnb successfully navigated the
pandemic identified when to shift from
its strategic plan and embraces the
changing environment dictated by
COVID-19. Airbnb followed three
distinct ways, the first one was being
agile to avoid the worst effect of the
crisis, the second way was being strong
Organizational leaders
who develop strategic
agility will almost always
be ready to recognize
shifts in the markets
…
• Strategic Agility in Optometry
• An organization that moves faster
than its environment demonstrates
working strategic agility. The world is
constantly changing, the markets
have never been so unpredictable and
shifting as in the past year due to the
pandemic. While most organizations
are focusing on how to survive the
effect of the pandemic, many
organizations are thinking of long-
term strategy focusing on the post-
pandemic and innovatively imagining
and executing plans that will succeed
thanks to their strategic agility.
• Strategic Agility is the propensity of
the organization to freely and
independently shift inside its business
and outside its business environment
to fit crisis circumstances. Strategic
Agility consists of holding a
competitive edge by identifying
opportunities in every circumstance
and capitalizing on those
opportunities.
Organizational leaders who develop
strategic agility will almost always be
ready to recognize shifts in the markets
and be prepared to quickly implement
change providing innovation and
profitable solutions.

enough to absorb the effect of the
pandemic when it struck them, and the
third way is being resilient enough
to accelerate forward quicker and
stronger than other competitors. These
three capabilities are referred to as the
Triple “A”s of strategic agility.
If you haven’t thought about strategic
17
agility yet, think about those three
capabilities and how you can identify
them in your Optometry practice: avoid,
absorb, accelerate. Are you focusing on
surviving the pandemic or thriving?
what opportunities have you identified?
how did you shift your strategy in
response to the pandemic?
can be a potential growth enabler. It
becomes a kind of an obsession that
good opportunities for growth are scarce
and irreplaceable that only few people
with a programmed mind to identify
and grab unique opportunities are those
who can seize the opportunity and
succeed in ensuring ever growth.
Stanford University Psychologist,
Doctor Carol Dweck and her colleagues
researched thousands of students and
their attitudes about failure three
decades ago.
THE TRIPLE “A”s OF STRATEGIC
AGILITY REFER TO
Align, Aspire, Accelerate
Avoid, Absorb, Accelerate
Fixed Mindset vs
Growth Mindset
Fixed Mindset vs Growth Mindset
Motivation is a hot topic that has been
the subject of many posts at Optical
Forum. Both intrinsic and extrinsic
motivations are principle drivers for
achievement and success for eye care
employees and Optometrists as practice
owners and businessmen. A growth
Mindset is used to describe a state of
mind that entrepreneurs and
businessmen constantly live to ensure
they don’t miss on any opportunity that

It was Doctor Dweck who coined both
terms fixed mindset and growth mindset.
With the latter that we frequently use
without mentioning the first. Dr.
Dweck and colleagues were able to
contribute significant explanations
about learning and intelligence. When
students believe they can get smarter,
they realize that their efforts make
them stronger, learning becomes their
goal, and by spending more time
learning and working harder they can
achieve higher results and accomplish
more.
For example, how do we motivate
optometry staff, employees, and
ourselves to believe that people can
become smarter and more resilient by
working harder and putting more effort
to become high achievers? Distributing
easy tasks or even giving rewards to
18
easy jobs will encourage a fixed mindset
in employees. Whereas rewarding hard
tasks and constantly distributing
challenging tasks that need effort,
creativity, and bringing new
experiences that develop new skills and
capabilities to solve problems,
cultivates a growth mindset. So next
time you think of distributing tasks,
what motivates employees, and the
mindset you want to cultivate in them,
think about Dr. Dweck’s theory we all
have different beliefs about what we
can do and what we cannot do, so unless
we cultivate a growth mindset that
asserts that intelligence and abilities
can be cultivated through hard work,
our fixed mindset will lead us to give up
on challenges, avoid hard tasks, and
accept failure.
BOTH INTRINSIC & EXTRINSIC
MOTIVATIONS ARE PRINCIPLE
DRIVERS FOR ACHIEVEMENT
True
False
Fixed Mindset “Failure is the limit of my
abilities”
Growth Mindset “Failure is just an opportunity to
grow”

Things Keeping You
Under a Bad Boss By Dr. Gilbert Nacouzi
19
explains multiple reasons why quitting
is hard.
Employees, overtaken by their daily
tasks and responsibilities hardly find
the energy to look for a new company
and a new job;
Being surrounded by good colleagues or
having a perfect job and a great
commute often makes them try to
forget their bad bosses;
Being dependent of the salary and not
affording a pay cut;
No better job offerings are being open.
Again this is a personal perspective of
the value of the offering available;
Not wanting to lose the benefits, even
though many employees end up losing
We may think that bad
leadership is pushing
employees to leave the
company but in many
cases, it is because of bad
leadership that employees
are staying.
Things Keeping you Under a Bad Boss
No university leadership program can
make a good boss if he is not willing to
learn and develop good leadership. In
a previous post, we emphasized how to
deal with poor leadership before finally
deciding to quit or leave to another
company. Many employees leave their
jobs because of poor leadership in the
organization that affects their
performance and has a direct effect on
their daily work. However, despite all
the negative consequences that bad
bosses impose on their employees, many
employees stay at their job, under the
same bad boss, and never change or try
to search for a better job. We may think
that bad leadership is pushing
employees to leave the
company but in many cases, it is
because of bad leadership that
employees are staying.
Organizational consultant, Mary
Abajay, while describing what is like to
be working with bad bosses, she
Bad

benefits because of bad bosses as the
relationship deteriorates over time;
Having invested too much and worked
hard to establish himself in this current
organization;
Being well compensated and not finding
a better or similar salary;
Not having the skills for contemporary
20
job offerings and not having enough
time and opportunities for continuing
development or for learning new skills
and upgrading existing ones;
Hoping that things might get better
with their boss. Who knows, maybe
their boss might be the one getting a
better job elsewhere.
ONE OF THE REASONS WHY
QUITTING IS HARD IS BEING
DEPENDENT OF THE SALARY AND
NOT AFFORDING A PAY CUT
True
False
“
A bad leader can take a good staff and destroy it
causing the best employees to flee and the remainder
to lose all motivation”
“Bad leaders care about who is right. Good leaders
care about what is right”
~ Simon Sinek ~

Employees Burnout
Early Signs By Dr. Gilbert Nacouzi
21
In practice, Optometrists can spot
employee’s signs of burnout by
underperforming, increases in illness,
failing to meet deadlines, a negative
attitude, fatigue, anxiety, reduced
amount of friendship, etc. In remote
settings, an Optometrist should be able
to spot signs of burnout when he
realizes that employees start sending
reports and emails outside of work
hours or during weekends. With other
obligations like childcare or
homeschooling, it is very easy that
employees get overworked and
consumed to show their employer that
they are committed. Therefore, the
most important thing is to set realistic
workload but also boundaries for remote
work and making those boundaries clear
that employees don’t surpass.
Employees Burnout Early Signs
Sometimes it is hard to admit that the
Optometrist is at the center of the
practice. What the practice manager
cannot do, the Optometrist can solve
and set the path for future organization.
He can be the CEO, the leader, the
manager, and people’s person at the
same time. The Optometrist as a people
person is one of the most important
roles because he gets his hands on the
most valuable asset in the practice and
the second most important asset to the
Optometrist after his academic degree.
Being a people person implies being able
to hire the best talents, keep the best
employees, and most importantly work
everything possible to make and keep
employees and staff happy. Making
employees' health and well-being a top
priority is the most essential part of
keeping them happy.
The pandemic is one of the most
challenging moments that pushed
employees to the edge of burnout due to
increased workload and having to adapt
to new work guidelines like remote work
and the adoption of new technology. In
this changing world, Optometrists
should not ignore or undermine the risks
that negatively affect the practice’s
most valuable asset. There are many
warning signs and failing to recognize
them early on can go beyond slowing
the performance of the practice but it
can lead to weakening staff, destroying
the shared commitment of teams, and
demotivating employees right at the
time they are most needed.
Spotting employees burnout in a remote
setting can be more difficult than in
practice.

Another way to prevent employee
burnout is to offer a flexible work
schedule to help them cope with other
home family obligations. To continue
developing the practice culture of well-
being in remote settings, Optometrists
can encourage open and one-to-one
discussions to understand the team’s
needs and individually follow each
employee’s circumstances as well.
22
The most important thing to keep in
mind in those circumstances to help
support employees prevent burnout is
to constantly remind them of their real
clear and unique role in the organization
reducing the friction and avoiding
distracting them with many goals and
exhausting them in trying to find what
they should do.
RECOGNIZING EMPLOYEES BURNOUT
IN REMOTE SETTINGS
is possible
is not possible
Ray-Ban Stories are
More Than 30 Seconds
everyday reality. The first thing about
its reality is its price and where it’s sold.
You can buy Ray-Ban Stories starting
at 299usd online and anywhere the Ray-
Ban brand is sold. they are now being
sold online and in stores in the United
States, Canada, United Kingdom, Italy,
Ireland, and Australia. Unlike other
smart glasses, the frame is very realistic,
they feature the iconic Wayfarer,
Round, and Meteor styles and they are
slightly heavier than the original ones.
Ray-Ban Stories are More than 30
Seconds
For the past 24 hours, everyone was
talking about the first Facebook smart
glasses. This is not the first time
Facebook gets into hardware. In 2014
Facebook acquired Oculus and
throughout these years it introduced
significant progress in virtual reality.
But now with Ray-Ban Stories, the
story is completely different. It is not
about virtual reality but it’s about

This realistic form and weight make
them the most comfortable smart
glasses in the market. That is not to
mention the high quality of material
and finishing that Luxottica is known
for. Even though they don’t have any
HUD features, however, the lenses
available include various tints,
polarized, and transitions leaving the
consumer with choices of frame style
and lens tint combination of twenty
with the option of prescription lenses.
The two front cameras may not capture
as high resolution as the new generation
of smartphones cameras but instead,
they are made to be used when both
hands are occupied. Moreover, the voice
command makes the process even more
comfortable and versatile. Photos
captured are stored on the companion
mobile phone View app. Even though
videos are limited to thirty seconds, the
device has the capacity to store more
than 36 videos or 500 photos in memory
before transmitting them into the
mobile phone View app. Its audio
capabilities allow you to take phone
calls, listen to music, and podcasts. Its
batteries take about an hour to fully
23
charge and can last up to six hours with
intermittent use.
Along with a microfiber bag, the
carrying case that comes with the Ray-
Ban Stories looks very techy and has a
built-in charger that can refill the
battery three times. To recharge the
case they added a USB-C cable in the
box.
True
False
Ray-Ban STORIES HAVE TWO FRONT
CAMERAS THAT RESPOND TO VOICE
COMMAND
While Ray-Ban Stories are in their first
version, they are the first step in the
multiyear partnership between
Facebook and the European eyewear
conglomerate Essilor Luxottica. They
both are promising future products that
can dive more into augmented reality
glasses.
@
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a
d
e
r
e
v
i
e
w

What if You are
Demotivating Your Team?
By Dr. Gilbert Nacouzi
24
Management guru and best thinker
Peter Drucker used to say “culture eats
strategy for breakfast, operational
excellence for lunch and everything else
for dinner”. Perhaps it may be easy to
understand the team’s culture if it is a
small team. However, as the
organization begins to grow and many
large teams become involved, the role of
culture in understanding the employees’
values becomes more important and
indispensable.
Understanding Culture in an
organization does not mean ordering
breakfast, dining, or outing together. It
is about what needs and wants every
employee is trying to achieve working
at your practice.
Micromanaging is not
the only way a leader
ought to demotivate
his team
...
What if You are Demotivating your
Team?
On every occasion to write a post on
team’s leadership we emphasize
motivation and the ability to push
employees and team members to deliver
more than they can. Very few times do
we mention demotivation or explain
why some behaviors or actions we take
can demotivate our staff.
Micromanaging, for example, is one way
most leaders admit they do their best
not to employ it. We prefer to employ
the word motivation and talk about
what motivates employees rather than
the word demotivation because it gives
a negative sense of the process.
Micromanaging is not the only way a
leader ought to demotivate his team.
Not understanding the practice’s
culture and betting everything on
strategy is another important way to
demotivate the team.

From this emerges another great way to
demotivate employees that is by
praising employees for important none
important things. Some leaders rely on
drive-by praise methods to praise
employees for great achievements. They
often don’t make a formal recognition
for the employee’s effort because they
are too busy. On the other hand, many
leaders praise every little thing even
silly obvious things employees do,
thinking that brings positive energy.
However, many employees look for the
honest and serious opinion that helps
them develop their skills and grow their
25
personality. Therefore they look for real
challenges and need appropriate
guidance from reliable leaders.
One last way you may demotivate
employees is the way you solve conflict
among team members and if you
privilege some employees and not the
others. Remember that the goal of
effective team leadership is to motivate,
and a way to do this during conflict
among teammates is to come up with
creative solutions that foster a
collaborative environment and promote
motivation to increase productivity.
IN THE WAY YOU SOLVE CONFLICT
BETWEEN TEAM MEMBERS; IF YOU
PRIVILEDGE SOME EMPLOYEES AND
NOT THE OTHERS, WOULD THAT LEAD
TO DEMOTIVATING YOUR TEAM?
True
False
“If everyone is moving forward together, then success
takes care of itself.”
~ Henry Ford ~

Time is Money! But Time
to Think is Gold By Dr. Gilbert Nacouzi
26
The consequences that develop from
such a result include isolating ourselves
from the changes in the outside world,
assuming infallibility, and completely
undermine and eliminate the time
allocated to thinking.
There is a saying “A desk is a dangerous
place from which to view the world”.
That is of course before the time of the
internet. However, the idea is that
when you isolate yourself behind a desk
you immediately become a decision-
maker without choices that reflect the
outside world. If thinking relates to
understanding the world around us,
decision-making consists of making a
single choice or choosing one scenario
among a given number of scenarios.
Your decision leads to one course of
action among different scenarios.
Overtime decision
making becomes
routine and we forget
the factor of thinking.
Time is Money but Time to think is Gold
The time we take to make our decision
is valued in money. However if this
time is a time to think it spares us
money. Thinking allows us to make
sense of the world around us, it helps us
build a perspective of what is
happening, and allow us to build a
model to interpret things. We are
constantly faced with time constraints,
deadlines, and end points. We are
expected to make decisions on daily
basis and on the smallest things in our
lives. As Optometrists we decide on the
eye health of our patients, as
entrepreneurs we decide on strategies,
planning, marketing, investing, and
purchasing.
As household owners we decide on every
little piece of furniture, clothes, food,
and consumables.
Overtime decision making becomes
routine and we forget the factor of
thinking.
Time is Money!

A different decision leads to a different
course of action, a different opinion,
choice, or output. Isolating yourself
from the outside world reduces your
sources of information and changes your
process of thinking, therefore affects the
choices you have from which you select
a possible scenario.
Assuming infallibility will make prompt
immediate decision-making. Confidence
is a very important trait, but as a
decision-maker confidence should only
be supported by data and facts. As
Optometrists, we obtain our confidence
in the decisions we make based on the
27
facts, numbers, and answers provided
from the patient questionnaire,
symptoms, and diagnostics. There is the
time involved in retrieving all the
information to make a decision.
Assuming infallibility leads to
eliminating the processing time and
leads to quick decisions that are subject
to errors.
When a bad decision leads to bad
consequences look at correcting one of
those three: isolating yourself, assuming
infallibility, and not taking time to
think.
“It’s better to get wisdom than Gold. Gold is another’s,
wisdom is our own; gold is for the body and time,
wisdom for the soul and eternity.”
~Mathew Henri~
Time to think is Gold

Find Meaning in your
Optometric Work
28
With such information, we can better
understand who are the most people
interested in our service and who are
the ones valuing our services and willing
to pay the highest value for our
services.
This applies to both employees and
employers. Employers may look at their
markets as people interested in their
products and services whereas
employees may look at their bosses and
company as people interested in their
products and services.
A good way to remember those two
elements is to let one of your best
colleagues at work remind you why you
work and what your market is. This
way you build your purpose as a result
of alteration in those two elements.
Find Meaning in You Optometric Work
We always emphasize finding our
purpose early in life. It helps us live a
happier life than getting well
compensated or owning a lot of assets
but feeling empty. As we grow we
realize that purpose is rather built not
found. At work two very important
elements to remember that help us
maintain a deliberate way and
thoughtfulness in practice are to
constantly remind ourselves of why we
work and to constantly identify our
market and who our customers are to
serve them the best. Those two
reminders are a sufficient reason we
keep working on improving ourselves by
developing new skills that are to date
with our constantly changing
environment.
Knowing why we work helps us
understand what we like the most in our
jobs but also how we would like to be
compensated. We may want to work for
the fun of the job like meeting new
people every day, to gain experience
from the good team we’re working with,
or to earn money to live a certain
lifestyle or support our family or
Organizations in the community.
Identifying our market and knowing
who our customers are, helps us
understand to whom our service is being
administered and how it is impacting
and changing their lives.
Knowing why we work
helps us understand what
we like the most in our
jobs but also how we
would like to be
compensated
…

Transitions in Optometry
30
Acuff lists four career transitions that
every person encounters during life and
the corresponding resources required to
survive those transitions.
The first transition is when you have
been fired. It has been said, “it is not
what you know but who you know”. If
you have been fired and you have
enough connections you will transition
to a new job in no time. Each time
Acuff has been fired he found someone
he knows in less than 72 hours who
hired him.
The second transition is if you get to a
dead-end job. You hit a ceiling that
does not seem to break and further
advancement becomes impossible.
Perhaps the best book I
read about career change
by New York best-selling
author Jon Acuff, is Do
Over: Rescue Monday,
Reinvent Your Work, and
Never Get Stuck.
Transitions in Optometry
Everyone goes through many
transitions in life. It could be a
transition to college, to Optometry
school, to residency program, to
internship, to employment, to practice
associateship, to practice ownership, to
career change, or retirement. Perhaps
the best book I read about career
change by New York best-selling author
Jon Acuff, is Do Over: Rescue Monday,
Reinvent Your Work, and Never Get
Stuck. In this book, Acuff shows what it
takes to make big career changes
whether by choice or necessity to escape
the terrible mistake and trap of being
stuck in the wrong job.
He brings out why people spend more
than eighteen years studying and
preparing to get into college, but later
spend little to no time thinking of what
their career could be of the change
between college and retirement.

At this point you best transition into
building new skills and awaking new
capabilities that prospective employers
would value.
The third transition is if you have
decided to leap or jump. At this point,
you voluntarily jump to a new career.
Jeff Bezos leaving his job at Wall Street
to sell books online founding Amazon is
a good example for leaping. This effort
needs resilience, risk-taking, and a bold
entrepreneurial spirit in decision-
making.
The fourth transition is when you are
faced with an unplanned opportunity.
This transition Acuff calls “the
opportunity” where he also refers to
certain types of people like
entrepreneurs who hustle and know
how to deal with opportunities enabling
them to be successful where others
cannot.
31
HBR author Avivah Wittenberg-Cox
guides how to make better transitions.
She emphasizes the role of planning,
knowing in advance when it is time to
end, having self-knowledge on how to
use your judgment on those around you,
and knowing what others think about
you and appreciate in you before you
make your destined leap.
Network Capital founder Utkarsh
Amitabh, before leaving Microsoft to
found one of the world’s largest career
intelligence communities that serves as
a partner to Government of India’s Atal
Innovation Mission, asked himself three
questions: why do you want to change?
What do you want to do? and when will
the change happen? In addition to those
three simple questions that helped him
in his transitions, he always set realistic
expectations and had a backup plan.
UNPLANNED CAREER TRANSITION
OPPORTUNITIES ALSO CALLED “THE
OPPORTUNITY” ARE THE TYPE OF
TRANSITIONS THAT ARE SUITABLE FOR
Employees with entrepreneurial
spirit
Literally all employees

Extending Your services
and Representativeness
32
You may think that your existing
customers will buy this new service and
that you will acquire new customers,
however, the reality might be
completely different. While extending
to new services can increase growth the
strategy sometimes may take an
undesirable effect to what was intended.
Every opportunity should be carefully
studied and analyzed. Poor analysis of
the opportunity may lead to failure.
There may be space in your market for
brands and designer eyewear however
this does not mean the customer wants
to buy them from his contact lens
provider. This may be true in some
regions but it does not mean that this
strategy will work in your market.
employees can come up
with ideas to solve a
problem or relief from a
constraint that the
business is having and
that is preventing it from
profiting and growing
…
Extending your brand and
Representativeness
Every practice owner who has been
practicing for a significant time at the
same location develops a deep sense of
knowledge about the competition in his
region and about the competitive
advantage of every eye care business
around him. Even though all practices
provide comprehensive eye exams,
contact lenses services, optical and
sunglasses showrooms, glasses repair,
etc there is one specific area that each
practice is a reference in.
When you think about it for a second it
immediately comes to your mind which
practice is the most extensive in brands
and designer eyeglasses and sunglasses.
You know this just like you know what
your practice is the best at. At this
point, every practice eager to grow
starts thinking of areas it can extend in.
Extending services becomes a major
part of the practice’s growth strategy.
The assumption that if your practice
success has been associated with
providing the best contact lenses service
in the region means that it will provide
the best brand and designer eyewear
services too could be sometimes biased.

Your analysis should be built on
understanding the job the patient is
trying to fulfill when he chooses to buy
contact lenses from you. If he hires you
for this job he might not hire you for
the job of getting his eyeglasses or
sunglasses.
In this context, we realize that
representativeness is frequently
employed as a rule of thumb. An
example of bias in employing
representatives as a rule of thumb could
33
be:
If you got the most popular Instagram
account in your town you will certainly
become the most popular optometrist
and your optometry practice will have
space for all eye products and will be
the best at providing all services. When
it comes to extending services, you need
to assess when a detailed analysis is
needed and at what level of
generalization you can commit to
representativeness as a rule of thumb.
Old Man’s Eyes
Old Man’s Eyes
Old man’s eyes are not blurry but see
the whole truth. The beauty of aging is
it comes unexpected but rejoices the
mind with old beautiful memories. Old
people are not the only ones to associate
old memories with present truth and
blurry vision.
Recent research findings revealed the
association of age-related macular
degeneration (AMD), cataract, and
diabetes-related eye disease -but not
glaucoma- to the increased risk of
dementia (Shang et al., 2021). The risk
of dementia is even higher for
individuals with both ophthalmic and
systemic conditions
WHEN EXTENDING SERVICES,
REPRESENTATIVENESS
is the rule of thumb
can not be used as a rule of thumb

than for those with an ophthalmic or
systemic condition only. A previous
study revealed that eye care
professionals employing Optical
coherence tomography (OCT) can
detect very early functional and
morphologic changes in the retina of
carriers of familial Alzheimer’s disease.
This study suggests that OCT and
retinal vascular parameters help in
diagnosing Alzheimer’s disease prior to
the onset of cognitive decline.
A regular visit to the eye doctor can
help detect potential dementia and
Alzheimer’s disease and for the old man,
it will help the beauty of the past to
rejoice in his mind. But we all know
that that’s not all since we all know this
old man; because there are millions like
him and we can make him change his
mind by offering him not necessary
more but less. A comprehensive eye
exam for aging people helps detect
common age-related eye problems
including presbyopia, glaucoma, dry
eyes, age-related macular degeneration,
cataracts, etc.
34
We simply want to make him come to
the annual appointment and we are
ready to follow up with him. We know
he sees the whole truth but we want to
make him see 20/20 for years to come.
We want him to be able to use his
smartphone, capture beautiful photos,
send text messages, and make new
memories. We want to wish him a
happy and “healthy aging month”.
“One in six Americans age 65 and older
have a vision impairment that cannot
be corrected with glasses or contact
lenses. The risk of eye disease increases
with age, yet many older adults neglect
to see an ophthalmologist for care. To
bring attention to taking care of our
eyes as we age, the American Academy
of Ophthalmology celebrates Healthy
Aging Month to raise awareness of the
signs and symptoms of vision loss – and
steps to help seniors take care of their
sight.” American Academy of
Ophthalmology
Reference:
Shang, X., Zhu, Z., Huang, Y., Zhang, X.,
Wang, W., Shi, D., ... & He, M. (2021).
Associations of ophthalmic and systemic
conditions with incident dementia in the UK
Biobank. British Journal of Ophthalmology.
ARE OPHTHALMIC CONDITIONS
ASSOCIATED WITH DEMENTIA RISK
True
False

PERMA In Optometry
35
The positive approach helps Optometry
staff to look forward to positive
outcomes and better results as they
struggle to make ends meets.
Engagement from both the
Optometrist/staff and the patient is
crucial for success. Reminding patients
about their next eye test appointment
or their next contact lenses replacement
date is an example of effective
engagement.
Relationships in the Optometry
practice are very important.
Relationships benefit the practice from
the patient’s loyalty, and benefit the
patient from allowing the practitioner
While Maslow’s needs
theory focused on “what”
motivates people Taylor’s
scientific management
focused on “how” people
are motivated
PERMA in Optometry
For those who don’t know what
PERMA is: it is an evidence-based
model for the active ingredients of well-
being that has been developed by
Professor Martin Seligman who has
pioneered Positive Psychology during
the past couple of decades at the
University of Pennsylvania. PERMA
stands for Positive emotions,
Engagement, Relationships, Meanings,
and Accomplishment. Adding PERMA
to the Optometry workplace can be for
the betterment of everyone. As a model,
it has its importance for caring for
patients and for helping employees too.
In the workplace, PERMA can
strengthen the relationship and helps
employees perform better while
inspiring them to become more creative.
For patients, the Positive Emotions
approach of the Optometrist gives
internal satisfaction as it benefits the
patient in overcoming his vision
problems.

to understand the patient’s visual needs
and be able to apply his extensive
Optometry knowledge to improve the
quality of care.
Meanings reflect why Optometrist
dedicate their lives to learning the latest
solutions for eye problems and helping
people see better. Meanings help build
confidence in the patient that an
Optometrist is a person he can count on.
Achievement can be a simple as
providing several comprehensive eye
exams per day or building a highly
valued practice.
36
Getting the patient to understand his
eye problems and how to cope with
them is a great achievement. It brings a
sense of self-accomplishment and self-
esteem in every patient and makes the
optometrist feel he has done a great
achievement by improving the patient’s
condition.
Aiming to develop well-being in the
optometry workplace for both staff and
patients happily provides better eye
care and reduces the risks of staff
burnout.
“PERMA” STANDS FOR POSITIVE
EMOTIONS, ENGAGEMENT,
RELATIONSHIPS, MEANINGS, AND
ACCOMPLISHMENT
True
False
“The meaning of Life is to find your
gift, the purpose of life is to give it
away”
~Pablo Picasso~

Optometry Customer
Experience By Dr. Gilbert Nacouzi
37
Often eye care providers emphasize that
they provide exceptional customer
service by delivering a one-hour eye
exam including dispensing eyeglasses.
Another way of good service is to be able
to provide ample time for each patient
and having the doctor interact in person
with the patient. Moreover, allowing the
patient to reach out to the eye doctor
through Facebook or Instagram as if he
is interacting with friends.
Customer experience, on the other hand,
is putting ourselves in the patient’s shoes
and trying to experience how the patient
feels towards all those services altogether
and if he feels something missing.
…as soon as other
optometrists and staff
begin to join the
practice they all will
be filtered in a way
that goes with the
founder’s culture...
Optometry Customer Experience
People often use the terms customer
experience and customer service
interchangeably as if they mean the
same thing. However, those who know
the difference, know that customer
service makes a significant part of the
customer experience, and those who
understand how to create an effective
customer experience, know how to
provide good customer service. Being
able to provide great customer service
strengthens the customer’s belief in the
products you deliver, creates loyalty,
and fulfills his expectations.
Good customer service in Optometry
includes speed in dealing with
customers’ requests, treating
customers with respect and in a
friendly way, and being available in
their usual social media environment
whenever they want them.

The customer experience starts at the
first encounter with the practice – like
marketing, advertising, or reading a
post on social media, etc.- till the
moment he becomes a loyal customer
for life and starts referring other
patients.
We live in an era where customer data is
available more than any other time
before, especially in healthcare and
Optometry. A good customer experience
starts with knowing the patient’s needs.
Many think that online shopping
experiences have dictated the
experience Optometry practices should
provide to the patient. We know those
experiences that online retail platforms
are delivering to patients work in selling
households, clothing, fashion
accessories, etc. However, no one said
that this would be the ultimate solution
to providing eye care. In a patient and
customer-centric environment copying
successful processes is the worst thing
you can do. However, if you can figure
out why those processes are successful
you can build a successful process to
any problem. Customer experience is
about people and the processes they
go through to get their products and
38
services. The best way to create a
patient-centric process is to first try the
experience yourself and then invite the
patient to engage in building the process
by providing suggestions and
expectations about a seamless end-to-end
experience. The more personalized the
experience gets the better the patient’s
engagement and the more the data
collection and analysis plays an
important role.
For example, the effect of the pandemic
on the customer experience dictates that
every optometry practice should create a
seamless online experience of telehealth,
telemedicine, and online shopping. The
experience patients are expecting is
completely different than the experience
they got in the past. Once again it is very
important to put ourselves in the
patient’s shoes and see what experience
is required. In addition, the second
crucial step is to engage patients in
providing their perspective and engaging
in creating the experience. We may want
to set up a special telecommunication
system while most patients are more
comfortable using Zoom or Whatsapp.
Collecting data about each patient’s
preferred method of communication
helps provide a better experience.
are the same concept, and can be used
interchangeably
are not the same concept and cannot
be used interchangeably
CUSTOMER SERVICES AND CUSTOMER
EXPERIENCES

Team Weak Link
39
The optometrist in each of the cases
provides the team with either the
practice performance expectation,
challenges, and results or leaving to the
team enough flexibility to develop a
shared commitment to a specific
purpose, set goals, and develop its work
approach to build upon the opportunity
being discovered. No doubt the worth of
a group is the sum of individual
contributions by groupmates, however,
the worth of a team is higher than the
amount of a teammate’s contribution
and it accounts for the individual
contribution of teammates and the
collective enormous capability.
Teams with predetermined roles for
each member distributed by the
optometrist may lack shared
commitment.
Optometrists are making
practice management and
business adjustments that
mainly focus on
transitioning to remote
work…
Team Weak Link
The role of an optometrist is very
important in shaping the purpose of the
team early on in the practice. Managers
in eye care can differentiate teams into
teams that recommend things, teams
that make things, teams that run
things. Obviously, for teams that make
things, they are given a degree of
freedom that allows them to apply an
intrapreneurial behavior whereas for
teams that run things their roles are
predetermined by the Optometrist
based on a set of rules that can be
determined and distributed
accompanied by a set of guidelines and
expected outcomes.
For intrapreneurial teams, things might
be quite different, since most successful
intrapreneurial teams form their
purposes when they are confronted with
an opportunity by their higher
management.

Those teams are more like working
groups that perform as individuals.
Members in those groups don’t take
responsibilities other than their own.
Weak links in such teams are regarded
as the root for bad team performance.
Weak links put stress on other strong
team members forcing them to leave
their positions to come to the help or
just complain to their manager. Team
managers tend to try to improve weak
links performance as a first step, then
they try to reassign them other tasks,
but if the weak link proves not to be
progressing he ought to be replaced. In
this case, a chain is no stronger than its
weakest link, and a team that wants to
increase its performance needs not just
to have strong links but also to
completely eliminate weak links.
40
The importance of a team is shared
commitment that turns a team into a
powerful unit of collective performance.
The capabilities of each team member
no matter how strong or weak they are,
are developed through training,
education, and mentoring. Weak links
are not the team’s performance limiters
where team members have a shared
commitment toward a common
purpose, a set of performance goals, and
an approach for which they hold
themselves mutually accountable.
Moreover, the team aspires to
something greater than its members
could achieve individually, and in this
case, a chain is stronger than its
weakest link.
TEAMS WITH SHARED COMMITMENT
TOWARD A COMMON PURPOSE
overcome Team Weak Link
don’t overcome Team Weak Link
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Counseling in Optometry
41
When we talk about Counseling in
Optometry, the first thing that comes
to mind is that counseling is a
fundamental competency for family
physicians who employ it for counseling
patients on lifestyle and unhealthy
behavior change and medical adherence
difficulties. However, effectiveness in
providing eye care increases with the
adoption and application of some
structured counseling strategies that
physicians use that don’t take more
than few minutes to perform.
Counseling could be important to help
patient stop smoking, reduce alcohol
consumption, or adopt contact lenses
care methods.
Effective optometrists
have a systematic
perception of what needs
to be understood by
listening to each patient
and by knowing how to
communicate effectively
to convey the right
message and get the
patient to comply
Counseling in Optometry
No matter how objective Optometry
tests become and no matter how
technologically advanced diagnostics
evolve in Optometry, the most effective
eye care is that the patient and the
optometrist work together to help the
patient get the best treatment and see
better. The most effective optometrists
know that to help the patient, the
patient needs to help us by providing
the right information and feedback.
Those optometrists are skilled in allying
with the widest range of patients’
personalities and characteristics and get
the patient to collaborate in the process.
Effective optometrists have a
systematic perception of what needs to
be understood by listening to each
patient and by knowing how to
communicate effectively to convey the
right message and get the patient to
comply. They know how to follow up
with patients’ visual needs and know
how to handle problems every step of
the way.

According to the patient’s motivation
for change, a practitioner would select
the optimal counseling approach.
Patients who are aware and responsive
to awareness about the eye problems
that can occur with unhealthy behavior
are approached with structured
sequential strategies like the five A’s
and FRAMES. Patients less aware of
unhealthy behavior effects or care less
about the consequences, motivational
interviewing is employed to help initiate
behavioral change.
The five A’s technique has been
associated with reducing alcohol and
smoking and consists of ask, advise,
assess, assist, arrange. The five A’s
technique pertains of a stepwise
protocol to efficiently assess and counsel
the patient asking about the behavior
as if the practitioner don’t know about
it, advise on how this behavior is
42
currently affecting his health, assess his
behavior with general metrics and
norms, assist him in achieving a change,
and finally arrange a plan of action or
when to see him again for follow up.
The FRAMES technique has been
associated with reducing alcohol-related
risks and cannabis use and consists
of feedback about personal risk,
responsibility of patient, advice to change,
menu of options, empathy, self-efficacy
enhancement.
The employment of motivational
interviewing has been associated with
weight loss, blood pressure, and alcohol
use. It consists of establishing rapport
and eliciting patient values based on
asking open-ended questions,
affirmation of information, reflection on
the situation outcomes, and
summarization.
COUNSELING PROVIDES BETTER EYE
CARE OUTCOMES
True
False
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Ocular Histoplasmosis
43
Symptoms occur due to choroidal
neovascularization and loss of outer
retinal layers and the retinal pigment
epithelium. Ophthalmologists treat
POHS the same way they treat Age-
Related Macular Degeneration by
applying laser photocoagulation. New
treatments include injecting anti-
vascular endothelial growth factors.
During the past few years many poultry
keepers started re-adopting the Deep
Litter Method to manage their coop
litter during winter. This method has
been popularized due to YouTube
Ocular Histoplasmosis
“Chicken is the pet that poops
breakfast”, however, we should not
forget that chicken and other birds
droppings in the soil of the chicken run
and the floor of the coop increase the
risk of making the environment a
favored habitat for fungal spores known
as Histoplasma capsulatum.
Histoplasmosis is an infection that
affects the respiratory system and is
caused by those spores once they are
inhaled and get into the lungs. Those
spores are so light they can quickly go
airborne the moment the soil is
disturbed or when cleaning or sweeping
the floor of the coop.
People may attract Histoplasmosis
asymptotically or sometimes symptoms
can be similar to a flu. Ocular
symptoms occur at later stage,
sometimes many decades later.
Depending on their immunity, many
people who attract histoplasmosis may
never have Ocular manifestations.
However, for those who develop a
Presumed Ocular Histoplasmisis
Syndrome (POHS) consequences on
visual acuity can be severe specially if it
affects the macula.

videos by old-timer farmers as a dual
method to low maintenance of the coop
during winter as well as to generate
natural organic compost enriching the
garden soil when spring comes. As
winter approaches, people who own
chicken start by cleaning their coops to
prepare for the deep litter with wood
shavings. This action requires a lot of
attention and emphasis from eye care
professionals to help create awareness to
protect and prevent any risk of inhaling
fungal spores while cleaning the coop or
plowing the field. Prevention against
inhaling fungal spores begins by
wearing appropriate face masks and
44
shields as well as spraying, rising, and
soaking the floor and soil with
surfactants and disinfectants before any
disturbance to prevent aerosolized dust
formation. It is also recommended to
engage specialized people who know
how to handle special disinfectants
effective in decontaminating the soil
that contains fungal spores.
Histoplasmosis are more frequent in
specific parts of the world. A map by
the CDC provides information of regions
that are more susceptible to higher risk
of fungal spores contamination.
CAN BACKYARD POULTRY LEAD TO
BLINDENESS?
Yes, due to risks of Ocular Histoplasmosis
No
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