Pure Passion

One low vision-centric O.D. unpacks her best, hard-earned advice on the patient’s path to care

Northwest Hills Eye Care
Austin, TX

Laura Miller, O.D., has been practicing low vision since she opened Northwest Hills Eye Care in Austin, TX, 18 years ago. “I love people, and low vision is my passion,” she says.

Today, Dr. Miller’s practice boasts four optometrists and 11 staff members, including an ophthalmic tech—plus a busy low vision specialty. It has a wall of low vision devices on display, to boot.

Here, she shares her best advice for a thriving low vision practice.


“The psychology of low vision is very interesting. Patients are experiencing loss. Some of my appointments end up being more like counseling sessions.“


“Sometimes they’re not accepting yet. They may still be in anger or denial. If they’re not ready for help yet, I sometimes suggest they just look at devices to see what’s available. A lot of them will come back when they are ready.”


“I tell them I know it’s frustrating and explain that they’ll have to do things another way and with different tools. Sometimes I’ll suggest an inexpensive device to start so they at least get the idea. I also say this is like a prosthetic that we’re fitting you for, similar to if you had diminished use of an arm.”


“Once we’ve decided on a few things, they will see the OT—either later or in a separate appointment. She can go through their daily activities and actually go to their homes and help set things up. Unlike devices, that is all covered by Medicare.

“Having her on board has changed my practice. And it allows me to see more low vision patients and not do as many follow-ups.”


“We book 60-minute slots for the initial exam. Generally, if they follow up with me, it’s a separate 40-minute slot. The initial evaluation with my OT is 60 to 90 minutes.”


“As part of my optical, I have a low vision store with things like large-print calendars, tactile dots, task-specific lighting, etc. Patients usually end up with two or three devices. Glasses is a big part, of course, and they’ll usually get a hand magnifier, and, after that, it depends on which tasks are most important to them.”

The product wall at Northwest Hills Eye Care boasts everything from magnifiers to large-print watches.


“Devices and device evaluation are private pay, so there’s profit in that...often more than on glasses. Also, because I don’t do just low vision, I get asked by family if they can come see me, too. Low vision is definitely profitable.”