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Focal Point Episode 4: Dr. Ondhia on Surgical Co-Management

 

Elevating Patient Care and Practice Growth Through Surgical Collaboration

In the rapidly evolving landscape of ophthalmic surgery, the bridge between primary care optometry and surgical intervention has never been more critical. Dr. Anu Ondhia, a subspecialized optometrist at Prism Eye Institute, shares her insights on modernizing co-management workflows to enhance clinical outcomes and drive practice sustainability.

Surgical co-management is often viewed through the lens of administrative tasks and post-operative checks. However, at its core, it is a clinical partnership designed to optimize the patient journey. 

As the field moves toward more advanced refractive cataract surgery and interventional glaucoma treatments, the role of the primary care optometrist (OD) is transforming from a referral source to a perioperative specialist.

The Missing Link: Intentional Communication

When asked about the most common "missing link" in communication between primary care ODs and surgeons, Dr. Ondhia points to the richness of the patient's history. While clinical data (topography, IOP, and VA) is essential, it doesn't tell the whole story.

Co-management isn't just about the "what" of the clinical data, but the "who" of the patient’s daily life.

Driving Practice Growth and Financial Health

Beyond clinical excellence, a robust co-management program is a powerful engine for the financial health of an independent practice. It is not just about the co-management fees; it is about longevity and loyalty.

Including or building a surgical co-management program can be wonderful from a business standpoint. When patients see that their primary care OD is an integral part of their surgical journey, from the initial diagnosis to the final post-op check, they don't just see an optometrist; their OD as their primary eye care advocate for life.

The Horizon: Trends for the Canadian Community

Looking globally, Dr. Ondhia sees a significant trend on the horizon that Canadian optometrists should prepare for: Interventional Glaucoma (IG). The shift away from "drops first" toward early-stage surgical interventions (like MIGS) means primary care providers must be adept at identifying candidates early and managing these patients long-term. This proactive approach mirrors the evolution we saw in refractive cataract surgery over the last decade.

Implementing Change on Monday Morning

If attendees take only one lesson from Dr. Ondhia’s session at the National Training Event, she hopes it is a shift in workflow strategy. To make the administrative lift of co-management feel seamless, she recommends standardizing the referral protocol. By creating clear, templated communication pathways that include both clinical metrics and lifestyle descriptors, staff can handle the logistics while doctors focus on the clinical relationship.

About Dr. Anu Ondhia

Dr. Anu Ondhia is a subspecialized optometrist practicing at Prism Eye Institute in the Greater Toronto Area with an acute focus in ocular pathology, clinical research, and surgical co-management. After completing her optometric degree at Aston University (UK), she pursued residency training under world-renowned ophthalmic subspecialists at Queen’s Medical Centre (Nottingham, UK). She completed the International Optometric Bridging Program at the University of Waterloo and has continued to practice full-scope optometry in the GTA.