Referring to our colleagues

As optometrists we aim to treat each patient to the best of our ability, offering compassionate, personalized and evidence-based care. Our patient’s trust, that as vision and ocular health professionals, we can solve any problem pertaining to the eye and visual system. Heck, sometimes we believe that with all of the knowledge gained and skills mastered over the years, we should be able to diagnose, manage and treat everything within our scope of practice on our very own. But, what happens when we come across a scenario in which we do not have the expertise, the setting, the technology or the materials to manage effectively?

Sadly, the overwhelming trend has been to punt the patient to our friendly, “more qualified” specialist, our trusted ophthalmologist who has eagerly accepted our referrals on so many occasions. In optometry, more so than any other healthcare profession, we shy away from referring to our colleagues, other ODs with specialized skill sets. Whether it is ingrained in us to refer to ophthalmology (and there are definitely appropriate times to do so), or we feel ashamed that we will be judged by our own community, or it may be for the thought that our patients will not be returned to us – we have not learned to support each other professionally, and trust each other’s expertise to establish solid co-management practices with our peers.

Forget your pride, the patient comes first

You are an amazing doctor of optometry, you are a phenomenal problem solver, and sometimes you try to be a superhero to all – it is unrealistic and impossible. Be able to recognize when the needs of your patient surpass your superpowers. Keep the best interest of the patient in mind, and partner with someone who can step in, and along with your expertise, offer the best visual and ocular health outcomes for your patient, when fitting specialty contact lenses, managing diseases or simply talking through a case. Get to know other ODs in your area.

Get to know your local ODs, take the time to meet them and learn about their scope of practice, area of expertise and technologies that are available their office. Ask to set up a time to tour their practice and even follow them for a few hours to get acquainted with their style of patient care. Recognize that you can co-manage by referring the patient solely for testing – specify exactly what you want to be performed, utilize their instruments! You may then choose to continue the care of your patient in your practice.

Stay involved

Express your desire for co-management in writing. If you are referring to another OD for specialty contact lens fitting, indicate that you may want to be involved in the follow-up care and where along the process you feel comfortable jumping in. If you are managing a patient with anterior segment diseases who may require further vision care, feel free to refer for testing and request the data/report to take over the contact lens-associated services. Feel free to custom tailor the experience to stay as involved as you want, keeping patient care as your primary focus. In states which allow ODs to perform lasers and minor surgical procedures, indicate whether you want to be involved in the pre and post-op care.

Establish yourself as a source for referrals

Find your niche. If you have an area of expertise, or a special skill set, or even technology in your office that others within your vicinity may benefit from, make it known. Let other ODs in your area know your interest in working together and exactly how the partnership can be mutually beneficial in the care of patients. Write reports! Stay in touch – share your findings and plan of action. Keep the referring OD up to date, this is a great way to establish and cultivate trust.

Be proud of what you bring to our profession

Optometry is such a unique profession, with so many opportunities to focus on specialties, evolve subspecialties, be creative and practice in areas we truly feel passionate about. Continue to develop your specialized skill set, because a team of specialists is always stronger than a standalone. Believe in each other, trust each other, promote each other and most importantly respect each other.

Potential Conditions for Optometric Referrals, to name a few…


Advance/Specialty Contact lens management

  • Scleral lenses
  • Prosthetic lenses
  • Custom soft lenses
  • Complex GPs
  • Corneal refractive therapy (CRT)

Keratoconus, Pellucid Marginal Degeneration

  • Detection
  • Pediatric screening (early detection)
  • Diagnosis and management

Ocular surface diseases

  • Meibomian Glad Disease
    • Imaging, in-office treatment
  • Dry eye
    • Advance diagnostics, in-office treatment, therapeutic contact lens management
  • Traumatic and post-traumatic corneal conditions
    • Anti-inflammatory treatment, amniotic membrane

Myopia management

  • CRT
  • Soft multifocal contact lenses
  • Atropine

Vision Therapy

  • Amblyopia management
  • Post-TBI management
  • Binocular vision development

Refractive Surgery Evaluation

  • Advance diagnostic testing and anterior segment imaging

Ocular surface emergency

  • Toxic, traumatic, post-surgical management