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The 20/20 Podcast
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The 20/20 Podcast

Author: Harbir Sian, OD

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Dr. Harbir Sian is an award-winning optometrist based in Vancouver, Canada. In The 20/20, Dr. Sian interviews guests from various backgrounds and industries to share their struggles and successes. Guests include business owners, entrepreneurs, world-class athletes, media personalities, medical professionals, and more.

Through conversations with these guests, Canada's number 1 optometry podcast brings clarity to business, entrepreneurship, and eyecare. Dr. Sian also shares his personal experiences through his shorter Eye2Eye segment. In these short episodes, Dr. Sian opens up and provides a vulnerable look into the challenges he has faced (and overcome) in his personal and professional life.

The 20/20 Podcast gives you a look through different lenses and helps you focus on your growth.

223 Episodes
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Increasing optical sales doesn’t have to mean becoming more “salesy.” In fact, Andrew Bruce argues that the best optical practices grow by doing the opposite: slowing down, asking better questions, understanding the patient’s lifestyle, and confidently recommending eyewear solutions that genuinely improve how they see and function throughout their day.In this episode of The 20/20 Podcast, Dr. Harbir Sian sits down with licensed dispensing optician, educator, consultant, and longtime industry veteran Andrew Bruce to explore practical ways optometrists, opticians, and optical teams can increase eyewear sales while delivering a better patient experience. Andrew shares why one pair of glasses rarely meets every visual need, how a strong doctor-to-optician “transfer of authority” can dramatically strengthen the optical conversation, and why clinicians shouldn’t be afraid to recommend multiple eyewear solutions when they are truly in the patient’s best interest.The conversation also dives into the details that can separate an average optical from a great one: frame inventory, merchandising, premium product, pricing strategy, optical measurements, fabrication, dispensing, and knowing your patient demographic. Andrew explains why empty frame boards can unintentionally communicate neglect, why he prefers broader style selection over stocking multiple colours of the same frame, and why starting with premium options can sometimes lead to better outcomes than beginning with the least expensive product.Whether you’re an optometrist looking to improve optical capture rate, an optician trying to strengthen patient conversations, or a practice owner looking for practical ways to increase optical profitability, this episode is packed with strategies that can be implemented immediately.Key Takeaways1. Prescribe eyewear solutions — don’t simply sell glasses. Ask patients about their work, hobbies, driving, screen use and lifestyle. Every unmet visual demand may represent an opportunity to recommend a more appropriate eyewear solution, whether that means occupational lenses, prescription sunglasses, a second pair or another specialized option.2. The doctor-to-optician handoff matters. A strong “transfer of authority” helps reinforce the treatment plan and positions the optician as the expert who will carry out the doctor’s recommendations. Repeating those recommendations during the handoff can increase patient confidence and create a smoother path into the optical conversation.3. Optical profitability is built on the entire experience. Great product matters, but so do precise measurements, fitting, fabrication, merchandising, inventory turn, frame selection and presentation. Andrew’s message is simple: quality and attention to detail create value — and patients are more likely to invest when they understand that value.About Andrew BruceAndrew Bruce is a licensed dispensing optician with more than 25 years of experience in private practice and optical management. He holds a master’s degree in ophthalmic optical and contact lens technology and is a Fellow of the Contact Lens Society of America. After retiring from private practice, Andrew became a full-time educator and industry consultant through ASB Opticianry Education Services, where he provides optical training, practice management education, and ABO and NCLE preparation. He is also a prolific writer and speaker within the optical industry.Learn more about Andrew and ASB Opticianry Education Services at asbopticianry.com.Love the show? Subscribe, rate, review & share! http://www.aboutmyeyes.com/podcast/
Myopia management has quickly become one of the most important areas in modern optometry. But knowing why it matters is very different from knowing how to actually build it into a successful practice. In this episode of The 20/20 Podcast, Dr. Harbir Sian sits down with Dr. Fallon Patel, multi-practice owner, speaker, and myopia management leader, to break down what it takes to move from simply believing in myopia management to consistently delivering it in everyday clinical practice.Dr. Patel shares the systems that helped her scale myopia management across multiple clinics and a large team. From starting with just one or two treatment options, to developing a "myopia champion," training the entire staff, mapping the patient journey, and creating repeatable protocols that make it easier for every doctor and team member to participate. The conversation also dives into the importance of tracking simple KPIs. As Dr. Patel explains, clinicians may genuinely believe they are recommending myopia management consistently, only to discover that the numbers tell a very different story. Tracking creates visibility, accountability, and an opportunity to improve both patient care and practice performance.Dr. Patel explains why young patients can be excellent contact lens candidates and introduces her "3 Cs" of pediatric contact lenses - convenience, confidence, and compliance. She and Dr. Sian explore why clinicians should be cautious about deciding what a child can handle - or what a family can afford - before the conversation has even taken place. The episode also looks at MySight and MyDay MySight, patient compliance, staff delegation, and why giving families a complete picture of their options may be just as important as the treatment itself.Ultimately, this is a conversation about turning good intentions into action. Whether you are just starting a myopia management program or trying to scale one across multiple doctors and locations, the message is simple: start the conversation, build the system, measure what you are doing, and stop making decisions on behalf of the patient before they have had the opportunity to make them for themselves.3 Key Takeaways·      Keep myopia management simple at the beginning. You do not need every technology or treatment modality before starting. Dr. Patel recommends beginning with a manageable number of options, building confidence, and expanding from there.·      Your entire team has to understand the patient journey. Front desk staff, technicians, doctors, and team members responsible for insertion and removal training all influence whether a myopia management recommendation actually turns into treatment. A clear system makes the process easier for both patients and providers.·      Track what you actually do - not what you think you do. Simple metrics such as the number of eligible children seen and the number of treatments initiated can reveal the gap between clinical intention and clinical behaviour. Tracking creates the visibility needed to improve patient care and practice performance.**Correction: MiSight is supported by a 7- year study. During the conversation, Dr. Sian and Dr. Patel stated it was 8 years.About Dr. Fallon PatelDr. Fallon Patel is a multi-practice owner in the Greater Toronto Area with more than 15 years of clinical experience. She is a recognized speaker and key opinion leader in myopia management and contact lenses, with a particular focus on building practical systems that help optometry teams deliver consistent, scalable myopia care.A special thank you to CooperVision Canada for supporting this episode of The 20/20 Podcast and for their ongoing commitment to advancing myopia management education, technology, and resources for eye care professionals across Canada.Love the show? Subscribe, rate, review & share! http://www.aboutmyeyes.com/podcast/
Dry eye care has changed dramatically over the past decade—but with more diagnostics, pharmaceuticals, in-office treatments, and technology than ever before, it can also feel increasingly complicated. In this episode of The 20/20 Podcast, Dr. Harbir Sian sits down with Dr. Etty Bitton, Professor at the Université de Montréal, Head of its Dry Eye Clinic, and a Canadian ambassador for the Tear Film & Ocular Surface Society (TFOS), to discuss how optometrists can simplify their approach while staying aligned with the latest evidence in dry eye disease.Dr. Bitton explains why clinicians should start with diagnosis before investing in treatment technology, including the importance of standardized symptom assessment with the OSDI-6 and a systematic approach to evaluating tear-film stability, osmolarity, ocular-surface staining, eyelid disease, inflammation, and other anatomical contributors. She also discusses how the evolving TFOS DEWS III framework moves beyond simply categorizing dry eye as evaporative versus aqueous deficient and instead encourages clinicians to identify the specific structures and mechanisms involved.The conversation also explores several issues increasingly relevant to everyday optometric practice: screen time, incomplete blinking and meibomian gland dysfunction in younger patients; Demodex and its connection with dermatological conditions; cosmetics, retinoids and products used around the ocular surface; and the value of building referral relationships with other optometrists, dermatologists, rheumatologists and specialists. Dr. Bitton's message is ultimately a practical one: before building an advanced dry eye clinic around expensive equipment, make sure you understand the disease, use evidence-based diagnostic tools, and speak the same diagnostic language as your colleagues.3 Key Takeaways1. Get the diagnosis right before worrying about the technology. Dry eye management can become overwhelming when clinicians start with IPL, RF, meibography, pharmaceuticals or other treatments. Dr. Bitton argues that the first priority should be a consistent, evidence-based diagnostic process—including standardized symptom assessment such as the OSDI-6.2. Screen time may be affecting the ocular surface much earlier than we think. Screen use is associated with more frequent partial blinking, which can interfere with normal meibomian gland function. Dr. Bitton discusses seeing significant gland changes even among optometry students in their early twenties and emphasizes the opportunity for earlier patient and parent education.3. Dry eye history-taking needs to extend beyond the eyes. Cosmetics, skin-care products, retinoids, dermatological conditions and systemic disease can all provide important clues. Asking patients about what they put around their eyes—and developing collaborative relationships with other healthcare professionals—can become an important part of comprehensive dry eye care.Love the show? Subscribe, rate, review & share! http://www.aboutmyeyes.com/podcast/
What if one of the most overlooked opportunities for growing an optometry practice is already sitting in the contact lens room? In this episode of The 20/20 Podcast, Dr. Harbir Sian sits down with Dr. Harmin Chima, VP of Professional Services at West Point Optical Group, to explore the business case for private label contact lenses and why optometrists may be underestimating the value of contact lens patients. The conversation examines how private label contact lenses can create stronger margins, improve patient retention, increase in-office purchasing and help differentiate an optometry practice from online contact lens retailers.Harbir and Dr. Chima also challenge a common mindset in optometry: that contact lens sales simply aren't an important source of practice revenue. They discuss the long-term value of contact lens patients, the importance of proactively introducing contact lenses as a vision correction option, and why doctors shouldn't wait for patients to ask. Harbir shares his own approach of discussing contact lenses with patients across virtually every age group — including offering simple in-office trials to patients who may never have considered themselves contact lens candidates.Beyond the numbers, this episode is ultimately about delivering better patient care while building a healthier optometry business. From selecting lenses based on lifestyle and clinical needs to allowing the product to “do the talking,” the discussion offers practical ideas ODs can immediately bring into the exam room. If you're an optometrist, practice owner, corporate or sublease OD, or anyone looking to improve contact lens profitability, patient loyalty and practice growth, this conversation may change the way you think about private label contact lenses and the role contact lenses can play in your business.3 Key TakeawaysPrivate label contact lenses can strengthen both margins and retention. By creating a product patients associate directly with the practice, private label can help keep more contact lens purchases in-house while improving the economics of each sale.Optometrists may be underestimating the lifetime value of contact lens patients. Contact lens wearers tend to return more frequently and can create additional professional-service and optical opportunities over time.Don't wait for patients to ask about contact lenses. Proactively presenting contact lenses as a vision correction option — and reducing friction with simple in-office trials — can uncover demand that patients may never express on their own.A special thank you to CooperVision for supporting this episode.Love the show? Subscribe, rate, review & share! http://www.aboutmyeyes.com/podcast/
Optometrists see the opportunity in building a dry eye clinic but often get stuck on how to get started. In this episode of The 20/20 Podcast, Dr. Harbir Sian sits down once again with Dr. Trevor Miranda to explore the business of building a successful dry eye clinic, from creating treatment protocols and developing your team to improving patient conversion and generating a meaningful new revenue stream.Dr. Miranda shares how dry eye has grown to the point where his practices now generate more revenue from dry eye products and services than from contact lenses. He breaks down his LION approach — Lids, Inflammation, Obstruction and Nutrition — and explains why having a structured clinical philosophy makes it easier to develop treatment plans, train staff and create consistency across a practice. Just as importantly, Trevor explains why doctors should not be doing everything themselves. By developing highly trained ocular hygienists, his clinics are able to run dry eye treatments alongside primary eye care, creating greater efficiency while giving patients more education and support.The conversation also dives into the systems behind a thriving dry eye business: creating a dedicated dry eye assessment pathway, clearly recommending the optimal treatment rather than simply the cheapest option, training team members to confidently discuss treatment, establishing a dry eye champion, setting revenue targets and tracking KPIs. Trevor explains why implementation — not simply acquiring knowledge — is what separates practices that dabble in dry eye from those that truly build a successful specialty service.Finally, Harbir and Trevor discuss the Dry Eye Summit, which brings together doctors, staff, industry partners and dry eye leaders for focused education, hands-on exposure to new technology and practical business strategies. The Summit also offers dedicated training for ocular hygienists and an advanced procedures lab, making it an opportunity to elevate not only the doctor’s knowledge but the capabilities of the entire dry eye team. And because the Dry Eye Summit is now held only once every two years, this year's meeting represents a valuable opportunity for practices looking to take their dry eye services to the next level.Key TakeawaysBuild systems, not just a collection of technology. Successful dry eye clinics need structured treatment protocols, patient pathways and clearly defined roles for the doctor and team.Empower an ocular hygienist or dry eye champion. Properly trained team members can educate patients, coordinate treatment, perform delegated services and help the dry eye clinic operate alongside primary eye care.Treat dry eye like a real business unit. Set revenue goals, track referrals and KPIs, hold regular team meetings and continue investing in education and training.About Dr. Trevor MirandaDr. Trevor Miranda is the owner of Cowichan Eyecare in British Columbia, operating five clinics with a team of 12 doctors. He has built two dedicated dry eye centres and a team of ocular hygienists, and is one of the founders of the Dry Eye Summit alongside Dr. Richard Maharaj and Dr. Jeff Goodhew.Dry Eye SummitThe Dry Eye Summit takes place November 21–22, 2026, with an Advanced Procedures Lab on November 20. The ocular hygienist course takes place November 21.Learn more at mydryeye.ca.Love the show? Subscribe, rate, review & share! http://www.aboutmyeyes.com/podcast/
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