As more states expand scope of care, a growing number of ophthalmologists are moving procedures out of hospitals and into fully equipped surgical suites inside the office—a shift that’s reshaping how, and where, patients get vision-saving care. The office-based surgery (OBS) model is gaining traction as ophthalmologists turn to performing surgery in an accredited, in-office suite rather than a hospital or ambulatory surgery center (ASC).
On June 30, LensCrafters, part of EssilorLuxottica, announced the launch of the first LensCrafters Vision & Eye Health Center in Exton, Pa., a premium comprehensive eyecare and surgical offering in a modern, patient-centric environment. LensCrafters called the opening of this center the first step within its North American growth strategy, with a longer-term goal of “shaping the future of eye health and empowering people to reach their full potential through a holistic suite of vision care and surgical solutions made available under one roof.”
This is a two-part series. Look for the second part of this story in the July 25 edition of VMAIL Weekend.
Following this announcement, Alfonso Cerullo, president of LensCrafters and For Eyes, spoke with VMAIL at EssilorLuxottica’s New York City showroom, where he discussed this development and the company’s future growth plans. “At the center of this vision are the patient and customer. What we want to do is to elevate the care in the communities that we serve.”
Alfonso Cerullo.
Cerullo, elaborating on the rise of the office-based surgery model, told VMAIL Weekend that LensCrafters is focused on making vision care more connected, accessible and patient-oriented, noting the retailer’s investment in advanced technologies, including the Heidelberg Spectralis OCT integrated with Retina AI technology, and the Heidelberg Anterion and Opera Microscope. He said the company is also building highly trained teams and fostering strong clinical partnerships.
“This allows us to build a more connected ecosystem of care. That’s the vision behind the LensCrafters Vision & Eye Health Center, creating a scalable model that combines innovation with comprehensive and coordinated, patient-centered care—empowering humans to achieve their best possible vision and quality of life,” he said.
Traditionally, patients are required to navigate multiple providers and locations during and after surgery, but Cerullo believes by bringing advanced diagnostics and surgical services through independent providers and comprehensive eyecare into one holistic ecosystem, the company is creating a simpler, more seamless experience.
“Patients benefit from a more personalized experience with greater convenience, shorter and more coordinated care journeys and the confidence that comes from having their care managed within a trusted and familiar environment. Our goal is to remove friction from the patient experience so people can focus on achieving better vision, not navigating the healthcare system,” he said.
Cerullo said trust is built over time, and the relationship between patients and their eyecare providers is incredibly important. The LensCrafters Vision & Eye Health Center model is designed to strengthen that relationship by keeping patients connected to the providers they trust and who know them best throughout their vision care journey, from prevention and diagnosis to advanced treatment and lifelong care. Rather than feeling like they are being handed off from one location to another, under the OBS model, patients experience coordinated care where everyone involved is aligned around the same goal, allowing ECPs to deliver the best possible vision care outcomes that empower patients to reach their full potential.
“That continuity builds confidence, improves the overall experience and reinforces the long-term relationships that are central to exceptional vision care,” Cerullo said.
Image courtesy of iOR Partners, a healthcare company that specializes in building and managing office-based surgery (OBS) suites for ophthalmologists
The Role of Optometrists
Optometrists play a critical role in helping patients understand their eye health and guiding them toward the most appropriate treatment options, said Dr. Clark Chang, senior director, medical and surgical operations, EssilorLuxottica North America. He noted when surgical care is integrated into a coordinated interdisciplinary model, communication between the referring doctor and surgical team becomes more seamless, allowing patients to remain connected to the doctor they trust, both before and after their procedure.
Dr. Clark Chang
Dr. Chang said, “That collaborative approach creates a better patient experience because every provider has a clear understanding of the patient’s history, goals and ongoing care plan. It reinforces continuity while ensuring patients receive access to the right care at the right time.” He believes the first priority should always be patient safety and quality of care. Practices also need to carefully evaluate patient selection criteria, establish standardized clinical protocols, invest in appropriate diagnostic and surgical technology, and ensure compliance with all applicable state regulations and accreditation requirements.
Equally important is building a multidisciplinary care team—successful office-based surgical programs rely on close collaboration between optometrists, ophthalmologists, technicians, surgical staff and administrative teams. “Clear communication, defined workflows and a shared commitment to quality are essential to delivering consistent outcomes,” he noted.
To avoid workflow interruptions, Dr. Chang recommends that integration begins with careful planning. Practices should develop standardized policies and patient pathways that clearly define each step of the care delivery process, from diagnosis and consultation through surgery and post-operative care.
Clearly established roles for every member of the care team help ensure efficiency while maintaining high clinical standards and accountability. Additionally, training staff, implementing shared communication systems and introducing new services in phases can also minimize disruption. “The goal isn’t to replace existing workflows; it’s to thoughtfully enhance them while preserving the quality and continuity of patient care,” he said.
Onboarding patients also requires strong communication skills and clarity—doctors should take time to explain the recommended treatment, discuss the benefits and potential risks, answer questions and tailor conversations to each patient’s individual needs. He said by employing educational materials, visual aids and clear communication can help patients feel informed, prepared and confident throughout their care journey.
“Patients gain additional reassurance when they understand they’re being cared for by a coordinated team using advanced technologies and established clinical protocols. Combining clinical expertise with personalized communication builds trust, empowers patients to make informed decisions and supports a seamless, high-quality care experience,” Dr. Chang concluded.
Building a Collaborative Surgical Program
Smaller- to medium-sized practices are also playing a part in the expansion and adoption of the office-based surgery model. For Ryan Witt, OD, of Illinois-based Chittick Eye Care, OBS is a natural extension of the role optometry is already playing. “Optometrists provide the majority of primary eyecare in this country. They diagnose disease, identify when surgery is needed, educate patients, and manage much of their postoperative care,” he said. “One of the benefits of office-based surgery is providing optometric practices with the opportunity to build a collaborative surgical program where ophthalmologists can provide surgical care alongside the patient’s existing eyecare team.”
Ryan Witt, OD.
Dr. Witt believes that the new model strengthens the relationship between optometry and ophthalmology while allowing patients to stay connected to the practice and doctors they already know and trust, noting there isn’t one blueprint for making the model work. Instead, he said, some optometric practices may develop their own office-based surgery program while others may partner with neighboring practices or collaborate with surgeons who already operate in an OBS setting.
“At the end of the day, the goal is better access to surgical care, better coordination between providers, and ultimately a better experience for patients,” he said.
Chittick Eye Care launched its own ophthalmology program in 2023, and today, the practice, which provides more than 35,000 eye exams a year, continues to see increased demand for cataract surgery and more premium options. Initially Dr. Witt said, the surgeon saw patients in the company’s optometry clinics and then performed surgery two days a week at a local hospital/ASC.
“We have always strived to deliver an exceptional patient experience from the moment a patient walks through our doors, and it was evident that that experience did not carry over to the hospital/ASC,” he said. This motivated his team to explore other options, including office-based surgery.
To hear from iOR Partners founder and CEO Tony Burns, see the sidebar below.
“As we learned more about the model and were introduced to iOR Partners, [a leader in building and managing OBS suites for ophthalmologists] we saw an opportunity to create a system we could be really proud of. Today, the patients have their consults in the same building as their surgery; they get to know the team pre-op, during the surgery day, and post-op. Nearly a year into the program, the feedback has been overwhelmingly positive,” he said, adding patients appreciate the convenience, familiarity and continuity of receiving their care from one integrated team. And the surgical team is also pleased with the operating environment. “We believe it has elevated both the patient experience and the quality of care.”
Dr. Witt believes one of the greatest benefits of the model has been the convenience it offers and the improved continuity of care—patients remain within the same practice where they already know the doctors and staff and, in many cases, have developed years of trust.
“Communication between the optometrist and surgeon is immediate. We are on the same team, so the surgeon and optometrist understand what IOL options will be discussed, what the patient’s goals are, and what outcomes can be expected,” he said. The setup allows the optometrist to have a meaningful conversation at the time of referral and better prepare the patient for their surgical consult.
For Dr. Witt’s practice, OBS also allows his office to be more accommodating to patients’ health needs and schedules.
“If a patient has an important event or vacation coming up and wants to improve their vision beforehand, we’re often able to make that happen. With surgeons on our team and full control over the surgical suite, we can adjust schedules much more easily than if we were relying on hospital or ASC operating room availability,” he said.
Dr. Witt believes the OBS surgery suite stands to improve access to care across the country, where issues such as the anesthesiology provider shortage and general staffing shortages affect surgeons’ ability to get OR time. OBS also reduces the financial burden on patients who may have to travel long distances to have their surgeries completed.With appropriate patient selection, a range of office-based surgeries can be integrated into a practice, including cataract surgery, he noted.
He pointed out that these operating rooms are not just another room in a clinic but are designed to meet rigorous standards and can undergo accreditation by The Joint Commission, which includes an extensive on-site survey of the facility, policies, procedures and quality programs.
“Patient safety and quality outcomes are a result of standardized protocols, ongoing training, emergency preparedness, infection prevention, and continuous quality monitoring. When all of this is executed, you can achieve the ultimate combination of a patient-centered experience that is safe and efficient,” Dr. Witt.
He emphasized that OBS isn’t about expanding who performs surgery or broadening scope authorization, as surgeries are performed by ophthalmologists. Instead, it’s about expanding access to high-quality surgical care by moving appropriate procedures from the hospital or ambulatory surgery center into accredited office-based surgical suites.
“I believe the ability to expand the number of office-based surgery suites will continue to strengthen collaborative care. As demand for ophthalmic services grows with an aging population, integrated practices that combine optometry and ophthalmology can deliver care more efficiently while maintaining excellent outcomes,” he explained.
iOR Partners, Making it Easier for Optometric Practices to Partner With Physicians
iOR Partners, a healthcare company that specializes in building and managing office-based surgery (OBS) suites for ophthalmologists, has developed 250 OBSs in four countries, and conducts 180,000 procedures annually. Tony Burns, founder and CEO of iOR Partners, said his company’s approach makes it easier for an optometric office to partner with a physician to offer patients a wider range of services.
Tony Burns.
“There’s four models that we offer, but in most cases the OD owns the OBS, and then they are bringing the ophthalmologist into the OBS under contract services,” he said, adding that conceptually, the optometrist is keeping the patients in their practice and putting the OBS inside their practice in a contract scenario. As a result, no referral is required. “Because you’re not referring a patient out of your practice, it is considered an internal revenue split,” he said.
After several years of observation, Burns said the vast majority of cases he sees in optometric OBSs are either premium cataracts or the cash refractive market and this is due in part to the patient demographic in optometric practices skewing younger than it does in MD practices. This is also influenced by the fact that, historically, optometric practices have marketed these kinds of services in the past. As a result, he expects there to be a shift in the market going forward.
“We believe that is going to be the business model that will carry forward, and it will deliver a much more cohesive patient care model,” he said.
The biggest barrier to adoption Burns sees has been perception rather than legal challenges. The optical industry was initially leery of potential compliance issues or that an office would have to bring a surgical suite in-house. This is not the case, he said, noting the legal definition of office-based surgery is anywhere that a surgeon performs a procedure outside another licensed facility, which is usually an ASC or hospital.
“So the OBS can actually be in a separate location from the practice. It just becomes an extension of the practice wherever you are, as long as it’s not in another licensed facility,” he said.
Doctors considering adding an OBS to their practice should look at the numbers and determine whether it makes financial and practical sense. For example, he noted practices that see 100 patients a week will have five converts to a surgery scenario. In addition, the model keeps patients in the practice so an optometrist can continue to be a partner in long-term care. He advised optometrists not to feel intimidated by the concept and should instead view it as a growth opportunity.
“I think my best advice for anybody who’s considering this is to just step in. It’s more turnkey than they suspect, and the patients are much more responsive and open to the conversations than optometrists think they are. It’s a paradigm shift for optometry to think this way, because we’ve had such a rigid structure for so many years,” Burns concluded.
