Build It and They Will See
Opening an optometry practice “cold” (starting from scratch rather than buying into an existing practice) is one of the most challenging paths in the profession. For Ohio State Optometry graduates Keyana Kelley (OD’19) and Cara Lai (OD/MS’03), building their practices from the ground up has proven to be one of the most rewarding choices of their careers.
Dr. Keyana Kelley
Eye Expressions, Columbus, Ohio
Dr. Kelley grew up seeing her mother work in healthcare. While medical school and dentistry didn’t resonate with her, a conversation with her own optometrist sparked her curiosity. After shadowing local optometrists, she realized there was much more to the profession than she expected.
She always envisioned herself as a private practice owner. “Growing up, I only ever went to private optometry offices, so that’s what I associated the profession with from the very beginning,” she says. “To me, being an optometrist naturally included building personal connections with patients and creating an environment that felt welcoming and individualized.”
Dr. Kelley explored buying established practices, but none aligned with her vision. So, she chose to start from scratch. “I had a clear idea of the kind of experience I wanted patients to have, from the atmosphere to the technology to the way they’re treated the moment they walk in,” she explains. “Starting Eye Expressions cold gave me the freedom to build everything from the ground up.”
To fund her vision, Dr. Kelley secured a small business loan through Wells Fargo’s new practice program.
The early days brought both excitement and obstacles. Dr. Kelley remembers the learning curve being steep, though the freedom to care for patients exactly as she envisioned made it worthwhile. “That’s actually one of the biggest benefits of opening cold. I had the time to figure things out, make adjustments, and learn how to handle challenges on my own,” she says.
Dr. Kelley prioritized accessibility when choosing a location and selected a shopping strip mall for its convenience and parking. As a Vision Source member, she had access to demographic reports that helped evaluate potential locations.
Once the location was set, Dr. Kelley was intentional about creating an interior that reflected her values. She says she envisioned “a space that feels more like visiting a friend’s home than a traditional doctor’s office.” She curated every detail, from furniture to scent and music. “We greet everyone as soon as they walk in, always offer coffee, tea, or water, and even include a little piece of chocolate with every glasses dispense.”
The relationships formed with early patients have become defining features of Dr. Kelley’s practice. She notes that many first patients have referred their families and friends. “Those early patients still stop by just to say hello when they’re in the area.”
Eye Expressions has grown from Dr. Kelley and one team member to expanded staff and services. “One of the biggest additions has been our dry eye program, which has allowed us to offer more specialized care.”
Her definition of success has evolved. She explains, “In the beginning, success meant getting the doors open. Now, I define success by the quality of care we provide, the relationships we build, and the positive reputation we’ve earned in the community.”
Balancing patient care with business demands requires intentional choices. Dr. Kelley sets aside one day weekly for business logistics, dedicating the rest to patient care. “I’ve learned the importance of delegating tasks to my team and outsourcing certain responsibilities.”
For optometrists considering opening cold today, Dr. Kelley emphasizes careful planning. “Ask questions often, and don’t be afraid to lean on your resources and professional networks. There will always be challenges but stay focused on your vision and remember why you started.”
She wants prospective owners to understand the reality behind success. “A lot of people see the finished product—the beautiful space, the patients, the success—but not the years of planning, late nights, and problem-solving it takes to get there.”
Dr. Cara Lai
Dublin Vision Development, Dublin, Ohio
Dr. Lai’s inspiration to become an optometrist came in a single “a-ha” moment. “The day I shadowed the optometrist, he sat in the exam chair, handed me the ophthalmoscope and said, ‘Do you want to look in my eye?’ I saw the red reflex, it took my breath away, and I was hooked,” she recalls. “Maybe that is why I see kids—an excuse to be mesmerized by that wonder on retinoscopy every day.”
Her journey to private practice was somewhat circuitous. After her pediatric residency, she joined the late Robert “Bob” Sorrell (OD’78) at his practice. “Dr. Sorrell saw something in me that I didn’t see in myself,” she reflects. After buying into his practice and learning the business for 11 years, she took a two-year sabbatical to focus on her family and to earn a Diplomate in the American Academy of Optometry. Then she was ready to build something of her own. She was fortunate to have capital from selling her shares in her previous practice, allowing her to self-fund Dublin Vision Development.
When it came time to choose a location, the decision was deeply personal. “I wanted to practice in the community where I lived. Now I can bike to work,” she says.
Dr. Lai also wanted autonomy and specialization. “I already grew the pediatric/vision therapy aspect within a primary care optometry practice, and I wanted to build my new practice differently,” she says. Her vision for Dublin Vision Development was clear: To ensure that vision does not hinder patients’ ability to see, learn, play, and achieve their ultimate potential.
Dr. Lai took a structured approach to business preparation. “I knew how to run a practice, but I didn’t know how to start a business,” she admits. “I took ALL the classes offered at the Columbus Small Business Development Center.” Those classes, mostly free or low-cost, proved invaluable. “I met motivated entrepreneurs launching food trucks, event services, and retail businesses. The coaches worked us through everything from registering with the Secretary of State, to writing a business plan, to marketing.”
She designed her space from an unfinished shell with whimsical touches for young patients. “My logo or mascot is a shamrock with glasses. His name is Lucky. Every year I purchase a fairy door at the Dublin Irish Festival. The doors are hung around the office. I tell the little patients that Lucky uses the doors to move around.”
Dr. Lai’s opening in late October 2019 was followed by the COVID-19 pandemic. “I wanted to be up and running in 2020, ‘The year of vision and optometry,’” she recalls. “The shutdown occurred when my office was about five months old. With such a new office and limited payroll history, I was not well positioned for PPP Loans. I could not have kept the office going if I hadn’t been self-funded.”
Insurance credentialing complexities were another obstacle to navigate. Specialization created a host of challenges. “As a practice focused on pediatric care and in an area with many optometry practices, I have been unable to join many vision and medical insurance panels,” she notes.
Dublin Vision Development recently celebrated its sixth anniversary. Dr. Lai notes that “although slower than I envisioned, the practice is coming along. My schedule is consistently full. I have many local optometrists who trust me to share in the care of their patients. I hope to bring on an associate soon.”
Dr. Lai created a “work-life teeter-totter”. “I see patients Tuesday through Thursday and do administrative tasks during the day on Monday and Friday. This allows me to really focus on the office and my patients. Then Thursday night through Monday, I can be more present at home. This arrangement functions due to my husband’s, Nicky Lai (OD/MS ’03), ability to manage the home front and tolerance of my overachieving ways."
Dr. Lai offers specific guidance for part-time schedules: “If someone is considering a cold start practice and does not want to work five or six days per week, I would encourage them to open with a partner who has similar goals and a complementary practice focus.”
Would they do it again? Despite the challenges, Dr. Kelley and Dr. Lai find deep satisfaction in what they’ve built. Patients at Eye Expressions frequently tell Dr. Kelley they’ve never had such a thorough eye exam. For Dr. Lai, the wonder that first drew her to optometry continues to fuel her work, helping patients discover new confidence through optometric vision therapy.
These Ohio State Optometry alumni exemplify the entrepreneurial spirit and dedication that characterize the best of optometry. Their cold start journeys have allowed them to create practices that reflect their values, serve their communities, and provide personalized care. As Dr. Kelley sums it up, “If you’re passionate about patient care and willing to put in the work, it’s absolutely worth it.”
