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How I Created a Comprehensive Ocular Wellness Exam And Reduced Remakes to Less Than 1 Percent

By Rasa Tamulavichus, OD

There is an emphasis in health care today on preventive medicine and wellness. When patients come to my practice, they have the expectation that I will not only check their vision and evaluate the current state of their eye health but will screen for problems on the horizon. I have added highly advanced technologies to my practice that allow me to do this, while enhancing practice efficiency and profitability. These technologies are Luneau Technology’s integrated Visionix® solutions, which I have implemented in seven of my practice’s 13 locations.

Today, I can provide a more accurate refraction than ever before while also screening for underlying eye disease. Patients leave my office assured that they have both the best in visual acuity and comfort and the best in medical eyecare screening and treatment.


The VX650

Any new technology we add to our offices must be able to keep up with our high volume of patient care. Integrated technologies allow me to do more without compromising data quality. Our newest investment, the Visionix® VX650 enables a comprehensive ocular health assessment—anterior and posterior segment analysis in one device. Because VX650 is integrated with the Visionix® Eye Refract and our wavefront lens analyzer, I have everything I need to know about my patient’s eye health even before I meet with them in the exam room.

Eye Refract makes a scalable workflow possible across multiple locations because data collection is now performed by my technicians, and it has become an easy and seamless part of pretesting. That efficiency is tremendously important in my practice, as our seven doctors, including myself, see 50 to 80 patients per weekday and 100 patients on a weekend. In addition to the ease of implementing this technology into our practice’s workflow, it is accurate and efficient and offers repeatable results. We know it provides information that we can rely on to make diagnoses and create treatment plans that will help preserve our patients’ eye health and vision.


Eye Refract provides refraction data accuracy by eliminating accommodation. Physiological Refraction enables me to quickly find the balance between clear and comfortable vision, and facilitates the fast identification of the patient’s visual comfort zone. From my patients’ perspective, it reduces the pressure to provide the right answer to “Which is better, one or two?”

I can also provide comparisons for daytime and nighttime vision for the patient, which opens up conversations with them about aberrations and vision adjustments. The technology even includes keratometry to fit contact lenses. All the refraction data is automatically imported into my EHR for easy review.

The great functionality of this technology is made even more valuable to my practice because the data collection process can be delegated to a moderately trained user. I can step back as doctor and focus on interpreting the data and providing a diagnosis and treatment plan.


Anterior and posterior segment analysis using the Visionix VX650 offers multi-modal clinical applications to assess everything from the lids and lashes to the retina. This empowers me to quickly and accurately screen for cataracts, glaucoma, retinal and corneal pathologies. With one device, I can perform a comprehensive assessment. I am able to keep early-stage medical eyecare conditions in-house for treatment, rather than having to refer immediately to outside specialists. This allows me to monitor threats to eye health and vision. I can provide an in-depth consultation to determine the next best steps in the treatment plan for my patients.


Multi-function technology like VX650 does more than safeguard my patients’ eyes. That alone would make it a worthwhile investment. But more than that, it allows me to educate patients about my exam findings and why I am prescribing specific treatment plans. The technology allows me to show patients exactly where I have pinpointed a potential problem, or evidence of eye disease. I can then tie that explanation to how we will work to monitor, improve, or at least slow the progression, of the problem.

This elevated level of care and patient education is now possible at every location of my practice where  Visionix technology has been added. It means that regardless of which of those practice locations my patient visits, they will receive the same impressive level of care.

My role, and that of the other seven doctors in my practice, is transformed to the role of a preventive eye health expert and patient educator, with an emphasis on interpreting data from advanced technology to provide the best, most cutting-edge care. I am able to take patients past the idea of the optometrist as the expert on only refraction, glasses and contact lenses. Patients who visit my practice find optometrists who are medical eye care experts with the best technology on the market to support our work.


The combination of VX650 and Eye Refract system is ideal for cold-start practices, making it easier for the owner to diversify revenue, while driving profitability by keeping more care within the practice. The small footprint means you can add it to your practice without substantially increasing your overhead costs.

My eyeglasses remake rate is down to less than 1 percent, thanks to the accuracy of the technology, and my practice has never been more efficient. We are able to perform screening and refraction with the technology, capturing essential data is under 10 minutes.

I can offer a high level of advanced care. That assurance helps me feel more secure as I expand my practice, even in changing times. Because of the ease of use and scalability of our integrated Visionix technologies, we successfully launched multiple cold-start locations. I know that with the benefit of Visionix, patients will have the best refraction and eye health screening possible in whichever of my offices they happen to visit where we have implemented this technology. That consistency of superior care creates a practice that patients are eager to return to and refer friends and family to experience.

Rasa Tamulavichus, OD, is the owner of Big City Optical, a 13-location practice in the greater Chicago area.

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