- Chocolate and Onions
- 5 Things You May Not Have Known (And Now You Do)
- Special Report: TFOS DEWS II
- Contact Lenses for a Young Athlete
- Scleral Lenses: From the Renaissance to the 21st Century
- Stage 3 Dry Eye Treatments: Amniotic Membrane Grafts
- CTX? Never Heard of It
- Orthokeratology for Myopia Control: An Introduction
- Collaborative Care: A Win-Win
- Facilitating Coordinated Care for Diabetic Retinopathy
- A Team Approach to Premium IOLs
- Back-to-School Pearls
- Back to Campus
- Back-to-School Eye Care
- The Role of Aesthetics in an Optometric Practice
- Intro to Injectables
- Going From Gere to Gosling: The Male Side of Aesthetics
- Aesthetics by the Numbers
- Make Patients Aware of UV Risks
- NSAIDs: Where Are We in 2017?
- Get to Know Margie Recalde, OD
- Investing in Better Patient Care
Please share with us your background.
I was born and raised in Madera, California. I attended California State University, Fresno and received my Bachelor of Science degree and Doctor of Optometry degree at the University of California, Berkeley. After completing my residency at the Fresno Veterans Affairs Medical Center, I was hired to work full-time as the staff optometrist and was later promoted to Residency Program coordinator. I also served as a clinical instructor for senior year optometry externs rotating through several schools of optometry across the country. From 2003 to 2017, I was at Eye-Q Vision Care, a multispecialty MD/OD group practice in Fresno. Recently, I purchased a private practice: Lifetime Optometric.
What drew you to optometry and, specifically, to your field of interest?
Growing up, I aspired to be a doctor. I chose optometry because vision is our most precious sense and, as an optometrist, I felt that I could play an important role in helping to make patients’ lives better. I established my dry eye niche when the doctor who started the dry eye clinic at Eye-Q Vision Care asked me to take over her responsibilities because she was leaving the practice. My colleagues—we have 16 doctors on staff—began to refer their dry eye patients to me either to initiate treatment or see these patients for long-term, continued care. As a dry eye sufferer myself, I know what these patients are going through, and I am happy that I can help them get the relief they need.
Please describe your current position.
In addition to running our dry eye clinic, I provide primary eye care to patients, including comprehensive eye examinations and treatment and management of ocular disease such as glaucoma, macular degeneration, and diabetic retinopathy. I also speak at national and regional conferences, state association meetings, and promotional dinner programs for pharmaceutical companies, and author articles to advance the field of optometry. I am currently president of the Central California Optometric Society, which is comprised of over 50 optometrists in the Central California area.
Who are/were your mentors?
Gerald Melore, OD, who was then chief of optometry at the Fresno Veterans Affairs Medical Center, was an early influencer in my career. During my fourth year student rotations at the medical center, he asked me if I would consider a residency. I was intrigued by the idea because I loved what I was doing there, and the opportunity to get advanced clinical training appealed to me. Dr. Melore helped me develop my clinical skills and really instilled in me the value of a residency, something I encourage many optometry students to consider. After he retired, I became the chief of optometry because of his mentorship and guidance.
Ralph Handly, OD, who was the chief of optometry at Eye-Q Vision Care, brought me into the practice. I was used to doing everything myself at the Veterans Affairs Medical Center. He taught me how to work in a private practice setting, especially how to delegate and work closely with staff. I learned how to become a more efficient clinician because of what he taught me. He also encouraged me to advance my education and pursue my fellowship from the American Academy of Optometry. Prior to his retirement a few years ago, he mentored me to become the practice’s next chief of optometry. To this day, I still depend on him for advice and guidance.
What are some new technological advances that you have found particularly exciting? Which advances in the pipeline are you most enthusiastic or curious about?
I am excited about technology for evaluating meibomian gland dysfunction (LipiScan; TearScience). I am hoping our practice will be able to get this device, because it would help us better identify patients who might have meibomian gland dysfunction or who may have been misdiagnosed or undiagnosed in the past. This would not only be helpful for making a diagnosis but for framing treatment expectations in discussions with patients.
I am curious about Allergan’s TrueTear, which has been studied for temporarily increasing tear production in patients with dry eye disease due to decreased tear production.1,2 We are used to telling dry eye patients that they might have to wait weeks or months before noticing improvement in symptoms, but from what I have heard about this device, patients may begin to see improvements very quickly. If it is approved by the US Food & Drug Administration, it could be a game changer in treating chronic dry eye disease.
What advice do you have for your colleagues who want to build, grow their dry eye practice?
When building a dry eye practice, I believe having a good mentor is crucial. You need someone to help guide you along the way. No matter what stage your practice is in, having the right staff is important. It is a team approach so you need staff who is reliable, knowledgeable, and willing to learn new techniques and procedures to help you improve your practice.
What is a typical day in your life? What keeps you busy, fulfilled, and passionate?
A typical day starts with dropping off my twin sons at school. I am in the office from 8 a.m. to 5 p.m. When I get home, it is all about the kids—homework, dinner, and bedtime. After that, I have plenty to keep me busy—whether it is attending to my responsibilities as president of the Central California Optometric Society, preparing for speaking engagements, finishing patient charts for the day, or previewing charts for the next day. I am also a chart auditor for Eye-Med Vision Care. If I have all of my responsibilities done, I relax by playing the piano.
What advice can you offer to individuals who are just now choosing their career paths after finishing OD school?
I urge students to consider doing a residency. When I was in optometry school, residencies were not popular but that does appear to be changing. I think you can get 3 to 5 years’ worth of experience during a 1-year residency program. I also recommend considering job shadowing, which involves talking with different doctors at different practices. Graduates should also continue their American Optometric Association membership after graduation.
Any practice tips you would like to share with your colleagues?
In our practice, we prefer to prescribe branded medications, but we know that cost is often a concern for patients. While many pharmaceutical companies offer savings cards or coupons to reduce or eliminate the cost, we noticed that some pharmacies were unwilling or did not know how to process these cards to save money for our patients. We partnered with a local pharmacy that activates these cards for our patients and provides free delivery of the medication to them within 24 hours. My patients get the medication they need at the best price possible, and I get a compliant patient. It is a win-win situation.
1. Pondelis NJ, Dieckmann G, Kataguiri P, et al. Intranasal Neurostimulator induces morphological changes in meibomian glands in patients with dry eye disease. Presented at: ARVO; May 7-11, 2017; Baltimore, Maryland.
2. Woodward AM, Senchyna M, Franke M, et al. Effect of intranasal neurostimulation on tear protein content in patients with dry eye. Presented at: ARVO; May 7-11, 2017; Baltimore, Maryland.
Margie Recalde, OD, FAAO
• Lifetime Optometric in Fresno, California
• financial disclosure: consultant to Allergan, Bausch + Lomb, Biotissue, and Shire