In this episode of The 20/20 Podcast, Dr. Harbir Sian sits down with Donna Mikulecky, Executive Director of Optometry Giving Sight, to discuss how the organization is helping build sustainable optometry services around the world. Donna explains that Optometry Giving Sight focuses on preventing vision impairment and blindness caused by uncorrected refractive error, with a mission that goes beyond short-term vision missions. Instead, the organization helps fund long-term infrastructure, including optometry schools, vision centres, and community-based programs that continue serving patients long after initial support is provided.

The conversation explores the real-world impact of access to eye care: children staying in school, adults being able to work, families becoming more independent, and local communities gaining employment opportunities through sustainable eye care systems. Donna also shares how optometrists, clinics, corporate partners, and patients can support Optometry Giving Sight through programs like the World Sight Day Challenge, Team OGS, patient rebate donations, and practice-based fundraising campaigns. The episode also addresses common questions around charitable giving, including where donations go, how grants are awarded, and how Optometry Giving Sight monitors the programs it funds.

3 Key Takeaways

1. Optometry Giving Sight focuses on sustainable eye care, not just temporary aid.

The organization supports long-term solutions such as optometry schools, vision centres, and local eye care programs that remain in communities and continue serving patients over time.

2. The impact of vision care extends far beyond glasses.

Access to eye care can help children succeed in school, allow adults to work, support family independence, and create career opportunities for local eye care providers.

3. Every optometry practice can participate in giving back.

Whether through the World Sight Day Challenge, Team OGS, donating a portion of frame sales, encouraging patient rebate donations, or sharing OGS content online, practices can make giving part of their culture in a simple and meaningful way.

Learn more and contribute to Optometry Giving Sight at givingsight.org

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In this episode of The 20/20 Podcast, Dr. Harbir Sian speaks with Dr. Peter Rozanec, a Waterloo-trained optometrist, longtime Mississauga practitioner, and founder of the Canadian Optometry Group, Canada’s largest online community for optometrists.

Dr. Rozanec reflects on his 36-year career, from buying his first practice before graduation to becoming an early adopter of technology in optometry. He shares stories about the early days of the internet, building websites, purchasing LASIK-related domain names, launching an optometry podcast in 2009, and later creating COG as a national forum for Canadian ODs.

The conversation also explores the role of AI in optometry. Dr. Rozanec takes a balanced view, describing AI as a useful tool and “intelligence amplifier,” but not a replacement for optometrists. He emphasizes that clinicians still need strong foundational knowledge, critical thinking, and good judgment when using new technology.

The episode closes with advice for students and new grads: be confident, stay curious, keep reading, and remain grounded in science. Dr. Rozanec reminds listeners that optometry has always faced disruption, but the profession continues to adapt because people will always need people.

3 Key Takeaways

1. AI will likely support optometrists, not replace them.

Dr. Rozanec believes AI will become a useful supplement in optometry, especially for tasks like documentation, transcription, and information processing. However, he cautions that AI still requires human judgment, clinical knowledge, and context.

2. Technology is most powerful when it improves human connection.

From early internet tools to future AI scribes, Dr. Rozanec’s view is that technology should free optometrists to spend more time with patients — not create more administrative burden. The ideal technology works quietly in the background.

3. Community matters, especially during times of uncertainty.

The Canadian Optometry Group has become a trusted space for Canadian ODs to exchange ideas, ask questions, and support each other. Dr. Rozanec highlights how professional communities become especially valuable during periods of disruption, such as COVID, political challenges, and industry change.

Join the Canadian Optometry Group:

canadianoptometrygroup.com

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In this episode of The 20/20 Podcast, host Dr. Harbir Sian sits down live at the BCDO Conference with the one and only Dr. Richard Maharaj, widely known in Canadian optometry as the “Dry Eye Jedi.”

Dr. Maharaj is the Managing Partner of Optometry Services at Prism Eye Institute and one of the most respected voices in dry eye disease, ocular surface disease, chronic eye pain, and optometric research. But this conversation goes far beyond tear breakup time, MMP-9, meibography, and treatment algorithms.

Instead, Harbir and Richard explore the human side of clinical care: how we speak to patients, how we handle chronic pain, why patients often carry anxiety into the exam chair, and why clinicians need to pause before delivering information that may unintentionally create fear.

The episode dives deep into the biopsychosocial model of pain, the difference between pain and visible clinical signs, how to approach patients with symptoms that do not match what we see on the ocular surface, and why mental health support can be an important part of the care pathway.

Dr. Maharaj also shares emerging insights into the role of vitamin B, vitamin D, nutrition, corneal nerve health, oxidative stress, and ocular surface disease, including how B vitamins may support patients with chronic ocular pain and neurosensory symptoms.

This is a reflective, clinically rich, and deeply human conversation about dry eye, pain, gratitude, patient communication, and the responsibility optometrists have as trusted healthcare providers.

3 Key Takeaways

1. Chronic eye pain must be understood beyond the ocular surface

Dr. Maharaj explains that pain is not simply a direct reflection of visible tissue damage. In many patients, especially those with chronic ocular pain, the experience of pain is shaped by the brain, psychology, anatomy, and social context. Optometrists need to recognize that “normal-looking eyes” do not mean the patient’s symptoms are not real.

2. Patient communication can either calm or catastrophize

Patients often come into the exam room after consuming online information about dry eye, gland loss, or chronic disease. Dr. Maharaj encourages clinicians to avoid fear-based messaging and instead focus on measurable improvement, realistic timelines, reassurance, and clarity. Most patients improve, but they need to understand that progress is not always linear.

3. Nutrition may play a growing role in ocular surface disease

Dr. Maharaj discusses emerging research around vitamin B, particularly B12, in corneal nerve health, oxidative stress, and chronic pain. While topical treatments and procedures remain important, nutrition and supplementation may become an increasingly relevant part of dry eye and ocular surface management.

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In this episode of The 20/20 Podcast, Dr. Harbir Sian sits down with internationally recognized dry eye expert and ophthalmologist Dr. Laura Periman from Seattle, Washington. Rather than focusing on rigid protocols or step-by-step treatment algorithms, the conversation zooms out to explore how clinicians should think about dry eye disease in an era of rapidly evolving science.

Dr. Periman explains why “dry eye” is an oversimplified label for an incredibly complex and multifactorial disease process involving inflammation, neurosensory dysfunction, pain pathways, microbiome disruption, blink mechanics, ocular surface disease, and more. She describes the field as a constantly expanding landscape where curiosity, innovation, and questioning old assumptions are essential.

The discussion dives into emerging innovations in dry eye care, including molecular therapies aimed at repairing corneal tissue, targeted approaches to recurrent corneal erosion, novel pain-signaling pathways, and therapies addressing neurosensory compromise. Dr. Periman shares insights from presenting recent dry eye innovations at the American Society of Cataract and Refractive Surgery, highlighting how advances in the field are reshaping our understanding of ocular surface disease.

The conversation also explores personalized medicine in dry eye management. Rather than applying generic treatments, Dr. Periman advocates identifying the specific mechanistic contributors in each patient—whether that’s Demodex, rosacea, incomplete blinking, inflammation, dysbiosis, blepharitis, or neurosensory dysfunction—and selecting targeted interventions accordingly.

Finally, the episode touches on the growing importance of ocular surface optimization before refractive and cataract surgery. Dr. Periman discusses evidence suggesting that preoperative management with immunomodulators may improve surgical outcomes, patient satisfaction, and visual quality. She also challenges long-held beliefs about how quickly these therapies work, emphasizing the importance of revisiting old dogma as new evidence emerges.

At its core, this episode is a reminder that the best clinicians remain curious, question assumptions, and continually evolve alongside the science.

Key Moments

1. “Dry eye isn’t just dry eye.”

Dr. Periman reframes dry eye as an enormous umbrella term covering multiple overlapping disease mechanisms, emphasizing the need for deeper thinking beyond traditional categories.

2. The future of treatment is molecular and personalized.

The conversation explores emerging therapies targeting recurrent corneal erosion, connexin signaling, pain pathways, and tissue repair—pointing toward increasingly precise, individualized care.

3. Better surgical outcomes may start weeks before surgery.

Dr. Periman discusses evidence supporting pre-treatment of ocular surface inflammation prior to refractive and cataract procedures, potentially improving outcomes and patient satisfaction.

Guest Contact Information

Dr. Laura Periman

https://dryeyemaster.com/

Instagram: @dryeyemaster

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Dr. Harbir Sian sits down with Dr. Julian Prosia and Dr. Kulvir Singh for a fiery conversation about dry eye care, industry relationships, specialty practice, and the ethical challenges facing modern optometry.

The episode explores the growing trend toward specialization in optometry, with both guests sharing how they’ve built careers heavily focused on dry eye treatment. Julian discusses balancing clinical practice with running Ophthalogix Canada, while Kulvir explains why focusing exclusively on dry eye care has improved both efficiency and patient outcomes.

The conversation quickly shifts into a deeper discussion around expensive clinical technology, KOL culture, and the pressure some practitioners feel after investing heavily in equipment. Harbir delivers a passionate warning about blindly trusting sales-driven recommendations, while Julian and Kulvir emphasize the importance of evidence-based medicine, transparency, and always prioritizing what is truly best for the patient.

A major theme throughout the episode is collaboration over competition. The group discusses the importance of OD-to-OD referrals, leaning on trusted colleagues, and recognizing that no single practitioner can master every niche within optometry. Their message is clear: when optometrists work together and put patients first, everyone wins.

Key Takeaways

• Patient care must come before profitability. Expensive equipment and industry relationships should never dictate clinical decision-making.
• OD-to-OD referrals are a strength, not a weakness. Collaboration between colleagues ultimately creates better patient outcomes and stronger trust within the profession.
• Not all industry partnerships are created equal. Evidence-based medicine, transparency, and unbiased advice matter more than hype or financial incentives.

Guest Contact Info

Dr. Julian Prosia

• Founder: Ophthalogix Canada
• Instagram: @doctorprosia

Dr. Kulvir Singh

• Dry eye-focused optometrist based in the Greater Toronto Area
• Instagram: @the.tieclip.eyedoc

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In this Eye2Eye episode, I wanted to do something more personal and reflective. I’m sharing a poem that I’ve come back to time and time again throughout my life: “If—” by Rudyard Kipling.

It’s one of those pieces that seems to hit differently depending on where I’m at. I’ve turned to it during tough moments when I’ve needed a reset, but also during the highs as a reminder to stay grounded and keep my ego in check. For me, it’s not just a poem... it’s a blueprint for how to navigate life with a bit more clarity and intention.

In this episode I want to take a few minutes to reflect on some of the lines that resonate most with me. Lines about staying calm when everything around you feels chaotic, trusting your instincts even when others doubt you, and learning to treat both success and failure as temporary states rather than defining moments.

There are also lessons about being willing to take big swings, knowing that sometimes you might have to start over—and the importance of pushing forward even when you feel like you’ve got nothing left in the tank.

At the end of the day, this episode is really just a reminder (to myself as much as to anyone listening) that growth doesn’t come from comfort. It comes from staying steady, doing the work, and continuing to show up, no matter where you are in your journey.

Key Takeaway

1. Leadership starts with composure

When things feel chaotic, your ability to stay calm and steady is what sets the tone for everyone around you.

2. Success and failure are both temporary

Treating triumph and disaster as “imposters” helps you stay grounded and focused on the long game.

3. Progress requires courage and persistence

Taking risks, starting over when needed, and pushing forward—especially when it’s hard—is what ultimately drives growth.

If this episode gave you something to think about, shoot me a DM, take a screenshot, share it on Instagram or LinkedIn, and send it to someone who might need this reminder today!

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In this episode of The 20/20 Podcast, I sit down with Dr. Meenal Agarwal, a multi-practice owner, speaker, podcast host, and now author of the upcoming book Stuck in a Flat World. But more than her resume, this conversation is about perspective.

We go deep into something many of us have noticed in clinic but haven’t fully connected the dots on… why patients (especially kids) are changing. Less eye contact. More anxiety. Avoidance of driving. Difficulty engaging socially. We’ve blamed screens for years… but Meenal takes it further.

She introduces the concept of Spatial Awareness Processing Disorder (SAPD), a framework connecting excessive screen use to changes in how the brain processes space, fear, and human interaction. It’s a powerful lens that links optometry to broader neurological and mental health conversations.

But this episode isn’t just clinical… it’s personal.

Meenal opens up about:

• The drive (and trap) of constantly chasing growth
• Burnout and the search for fulfillment beyond business
• Rejection early in her speaking and podcast journey
• Being told she “wasn’t the right fit”—and pushing forward anyway
• A recent experience with online criticism and how the profession rallied behind her

This is a conversation about identity, resilience, and what it really means to show up—not just as an optometrist, but as a human being.

If you’ve ever questioned your direction, your value, or your voice in this profession… this one’s for you.

Key Moments

• Introducing SAPD – Connecting screen use, spatial awareness, and rising anxiety in patients
• Why behavior is changing – Kids avoiding driving, social interaction, and eye contact
• The “Costco effect” – Understanding sensory overload and spatial processing challenges
• From growth to burnout – Building multiple practices and realizing it wasn’t fulfilling
• Pushing through rejection – Starting a podcast and speaking career despite being told “no”

Memorable Quotes

“You can blame everybody else, but you need to believe in yourself.”

“If we feel our profession isn’t worthy, what are others going to think of us?”

“Don’t focus on the people who weren’t there. Be grateful for the ones who were.”

bout Dr. Meenal Agarwal

Dr. Meenal Agarwal is a Toronto-based optometrist, entrepreneur, and thought leader in modern eye care. She owns three practices, hosts the Uncover Your Eyes podcast, and is the author of the upcoming book Stuck in a Flat World, exploring the connection between screen use, brain function, and spatial awareness.

She is passionate about expanding the role of optometry within healthcare and advocating for a more holistic understanding of vision.

What You’ll Learn

• A new framework for understanding behavioral changes in patients
• The neurological link between vision, space, and anxiety
• Practical ways to support kids struggling with spatial processing
• How to push through rejection and build something meaningful
• Why communication and vulnerability matter in our profession

Connect with Dr. Meenal Agarwal

• Instagram: @drmeenalagarwal
• Podcast: Uncover Your Eyes
• Newsletter: Available via Instagram link in bio
• Book Waitlist: https://www.drmeenal.com/book-waitlist-entry

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What if the biggest growth opportunity in your clinic isn’t new technology, better marketing, or more patients—but the person standing right beside you?

In this episode of The 20/20 Podcast, Dr. Harbir Sian sits down with Dr. Romie Dhaliwal and optician-entrepreneur Arshdeep Manghera to unpack a topic that quietly shapes every eyecare practice: the relationship between optometrists and opticians.

Too often, that relationship sits somewhere between neutral and strained—defined by silos, hierarchy, and missed opportunities. But Romie and Arsh have built something different.

From a pivotal moment during pregnancy to a bold decision to co-own a practice, Romie shares how she stepped away from comfort and into uncertainty. Arsh brings a story rooted in persistence—building a relationship with a clinic owner over seven years before finally acquiring the opportunity to take over. Together, they transformed a 30-year-old optical into a modern, thriving practice that blends clinical care, retail excellence, and community connection.

But what makes their story truly compelling isn’t just the business success—it’s how they’ve achieved it.

By breaking down the traditional “front vs back” divide, they’ve created a seamless patient experience where clinical knowledge and optical expertise work hand-in-hand. Their collaboration allows for better patient education, stronger trust, and more effective treatment adoption—especially in areas like dry eye.

Beyond the clinic walls, they’ve reimagined what an optometry practice can be. From hosting comedy shows and wellness events to partnering with local businesses and community organizations, they’ve turned their space into a hub for connection. It’s not just about attracting patients—it’s about becoming part of the fabric of the neighborhood.

This conversation also explores the realities of ownership—structuring partnerships, navigating legal complexities, and building systems that support growth. And as they look ahead, Romie and Arsh are investing in branding, social media, and influencer collaborations to take their practice to the next level.

At its core, this episode is a reminder that growth doesn’t always come from doing more—it often comes from working better together.

Key Takeaways

• Collaboration between ODs and opticians can dramatically elevate both patient care and business growth
• Breaking down traditional roles leads to better communication, trust, and outcomes
• Community engagement is a powerful (and underused) marketing strategy
• Old-school networking still creates massive opportunities
• Growth starts when you step outside your comfort zone

Memorable Quotes

“If we’re not collaborating with each other, how can we collaborate with anyone else?”

“Working together has taken our patient care from neutral to above and beyond.”

“You either win or you learn—the worst they can say is no.”

“When you get too comfortable, you don’t grow.”

Connect with the Guests

eyesonacademy@gmail.com

@academyoptical

@drromiedhaliwal

@thetailoredoptician

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