Go Little or Go Home: Building Your Practice Through Pediatric Care

With over 26.2 million children in the U.S., having an optometric practice that serves the pediatric population can not only grow and differentiate your practice, but it can also be incredibly rewarding, motivating, and fill an unmet need.

This month, I interviewed leaders in the pediatric optometry field — Erin McCleary, OD (Clear Horizon Eye Care, Plainville, Connecticut), Katherine Schuetz, OD (Little Eyes, Carmel, Indiana), and Jennifer Zolman, OD, FCOVD (Draisin Vision Group, Charleston, South Carolina) — to learn how independent eye care practitioners can find success in this specialty. The group discusses their training in pediatrics, how they market their services, how they set up their offices, and the value in working with children.

What Kind of Training Do You Need? 
While many of us understand the importance of providing clear, crisp vision to patients of all ages, it can often be intimidating to see young children. We may feel we don’t have the training if we have not done a pediatric residency, or we may think we don’t have the right tools or space in our practices.

Dr. Erin McCleary of Clear Horizon Eyecare in Central Connecticut finds that while she didn’t do a pediatric residency, the combination of Pacific University College of Optometry’s strong binocular and Optometric Extension Program Foundation curriculum, and her training as an InfantSEE provider early on in her career, gave her the skill set she needed. “When my staff realized I wasn’t afraid of babies, I started getting all the kids,” she said.  Her experience continued to grow from the number of patient encounters she has had over the past 16 years. 

Her comments echoed those of Dr. Jennifer Zolman. In addition to being the owner and CEO of Draisin Vision Group in Charleston, South Carolina, Dr. Zolman is the Chair of the American Optometric Association’s InfantSEE and Children’s Vision Committee. She also did not do a pediatric residency, but she earned her Fellowship in COVD and has read every book and article and taken every course on pediatrics available. As a parent of four kids, ages 1-9, she often draws upon her own experiences as well.  

Dr. Katherine Schuetz practices at a pediatric-only practice, Little Eyes, in Carmel, Indiana, and pediatrics came to her later in her career. Once she learned how to effectively communicate with kids and put them at ease, she realized her unique skills could fill an unmet need in the community.

Setting Up Your Office Space
For those looking to add pediatrics, there isn’t a one-size fits all approach to private practice. Dr. Zolman’s practice is over 6,000 square feet, with around 2,000 square feet dedicated to vision therapy and pediatrics — and it has its own entrance. They also have a dedicated team member who is focused on the scheduling and administrative tasks for pediatric patients. 

Little Eyes, where Dr. Schuetz practices, is a completely separate location, focused only on pediatric care. “We were originally seeing kids through adults under one roof, but when the owner found a smaller office to buy, we knew a primary care pediatric office was the right move,” said Dr Schuetz. Her office is “fun, but professional; whimsical, but we get things done.” 

Dr. McCleary takes a family approach to her care. “We really like having a family-centric practice.” She finds that it is “great when we get familiar with the entire family, rather than piecemealing their care in different locations.” She added, “The older, established population of patients isn’t always used to the extra ‘excitement’ that a waiting room of kids can provide,” and she hopes to one day have a large enough space to have a pediatric-only waiting room.

Getting the Word Out About Pediatrics
Marketing a pediatric specialty can be similar to other niches in eye care. Dr. Schuetz finds her best sources of new patients come from word of mouth and mom groups/blogs. 

Dr. Zolman has integrated her practice both in the community and in the health care team of patients. She seeks referrals from fellow ODs, neurologists, occupational therapists, concussion/sports medicine doctors, ENTs, pediatricians, and educational sources. However, her best marketing comes from the success stories of her own patients. “Don’t be afraid to ask your happy patients for referrals of their friends or anyone who they may know that can benefit from your services,” she said. 

Dr. McCleary tries to “overflow the fax machines of primary care practitioners and pediatricians after every consultation so they associate the best, most thorough, and caring pediatric eye care with her practice.” She also finds the InfantSEE program to be a great practice builder. 

The Power of Pediatric Eye Care
Changing the lives of children through eye care can be a powerful experience – for the patients and providers. Dr. Zolman has realized over the years “how underserved this population is, mostly due to lack of education in how important comprehensive eye care is to our littlest patients.” She added, “We should be leading the way in infant and children’s vision.”  

Dr. McCleary echoed that sentiment. “Being able to see the tangible ways that I have made an immediate impact on their vision, and often academic lives, is so entirely rewarding. It’s a dopamine hit every day.” 

For Dr. Schuetz, giving her pediatric patients the “best platform for academic success also leads to confidence, and helps them excel in sports and other non-academic pursuits.” She added, “We know we are setting them up for success, which is incredibly rewarding.”

Treating Younger Eyes
Unlike many specialties, pediatric care can be added with time, patience, and creativity – and not necessarily expensive equipment. Dr. Schuetz relies heavily on retinoscopy and loose lenses, and she takes retinal photos on 95% of her patients.  She also uses a Spot Screener for tough retinoscopy cases, and keratometry and autorefraction as well (although she relies less on this). 

Dr. McCleary finds retinoscopy to be her superpower, but she also relies on prism bars, grating paddles, and fun fixation targets. She uses a SPOT autorefractor for squirmy kids, and her ophthalmoscope for Hirschberg and Bruckner reflexes. 

Dr. Zolman’s practice uses fun targets, special reading charts, Keystone Visual Skills Testing, and the latest vision therapy equipment, including virtual reality.

Learning to Work with Kids
Being able to change gears is especially important with younger patients. Dr. Schuetz “has to be incredibly flexible when seeing the younger population.” Her staff is great at adjusting their communication style to the specific age/development stage of the patient, and she mirrors that. 

Dr. McCleary agreed on being flexible – both mentally and physically – and being a great multitasker. She finds “children can be unreliable and unpredictable,” and she must be efficient in gathering information and distilling it down. 

Dr. Zolman added that she incorporates time for consultation with parents and caregivers, in addition to testing for accommodative and visual skills for learning.  

Pediatric Care is Not Without its Challenges
Dr. McCleary noted that continuity of care can be difficult, in addition to home environment support, and insurance reimbursement. Dr.Zolman agreed, and said that “if you are going to start a vision therapy-only practice, you do not accept insurance.” For. Dr Schuetz, adding a subspecialty of myopia management helped both the patients and the practice to expand their scope in a profitable way.

The Benefits of Pediatric Eye Care
While adding a specialty to an already successful private practice can be challenging, providing care to younger patients is a great way to differentiate and grow your practice. 

“Talking to kids on their level makes them like you, which should make the parents approve too,” Dr. Schuetz said. 

Similarly, Dr. Zolman has learned to think like a kid. “Once you are comfortable seeing kids, you’ll get the parents and other family members as patients too,” she said. Watching her vision therapy patients graduate and thrive in school, sports, and life is “so, so rewarding. Crying tears of joy with parents as their children’s self-esteem rockets is priceless!” 

Dr. McCleary’s best advice: “Don’t be afraid of being perfect. There is definitely an art to pediatric care.” Also: “Have fun! Sing songs, be goofy, make silly faces, and be genuinely interested in what the kids are telling you.” Lastly: “Don’t underestimate a child. They will almost always surpass your expectations.”