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Part 4: What Would I do if I were a New Grad with a Fresh O.D. Degree?

By Thomas and Amee Lecoq

Remember the three most important things in Real Estate? It’s location, location, location.

Well, it’s a very important choice for my would-be practice. First, I’d want to locate in a city that I’d like to live in or nearby. An above-average income community, perhaps a college or university town is fertile ground for potential patients. A place with good schools for my children, and lots to do. I like community theater, so I’d like to find a place that has one. I also want one with a distinct media market with religious and talk radio, a local newspaper and perhaps a modest TV station. Having most, if not all of these would place the area on my list. I’d also research clubs, organizations, private schools, home schoolers and their suppliers, and public schools – potential hosts for community outreach presentations.

Because I understand and plan to do active marketing and community outreach, the visibility of the practice is only moderately important. I would avoid a commercial area because I’m not going to serve that market. But while setting things up, I might just find a commercial practice to work in on Fridays through Sundays. This would pay my bills, and banks are much more interested in loans to people who have income. I’d look first at small office complexes, preferably where there were other professionals. Above all, it must be a location where parents feel comfortable taking their children.

I’ve seen and helped set up a large number of VT offices, so I’d look for a minimum of 2000 square feet, and a five-year lease with first refusal on renewal. Sounds like a lot of space, but I’d want to have the following areas:

A long exam lane, with enough room for parents to sit comfortably during evaluations. This is a critical space, and while it would display my diplomas, memberships and awards, the connection with parents and patients is foremost, and the space must be welcoming and insular. If a computer is present, it’s not on during evaluations or case presentation.

A comfortable waiting room with a small, fenced space for kids to play on kid sized chairs and table. Parents will be bringing their younger children in and this will contain them. In one practice, the doctor had a glassed-in area, so children were visible, but not heard. A single or double French door with clear glass panels would separate the waiting room and therapy area. I want parents to see therapy underway when they come in for an evaluation. I also want them to see their children during therapy without being in the therapy room. In fact, I’d have French doors (opaque glass panels, with white paint) on the exam lane, vision therapy administrator’s and chief therapist’s office. They really open up the space.

Over time, the walls would display more and more success stories in frames. I might have videos showing, but only those relating to vision therapy. Some on YouTube, TED Talks, COVD and a few other videos as well. Continuous showing with captions and earphones for those who want to listen.

Staff Work Areas

A reception area, open to the therapy space and a counter opening to the waiting area. Some steel cabinets to store records (I’d use a notebook for each patient with all papers, records, test results, etc. inside.

As an alternative, I’d set the reception space in a narrow area with a back wall and behind that wall would be the therapist’s work area. I’d add a couple of high bar stools so they can sit at the counter. Shelves above the counter for storage. The areas would share an open archway into the large therapy space, perhaps with a swinging door to discourage patient intrusions.

A VTA office with a desk and a round table for parent conferences, a critical part of the Lecoq enrollment process. This would be a fairly large area, just a bit smaller than the lane. Warm and friendly decor. And over time, lined with success stories. It would have a monitor on the wall to show videos or a feed from the perceptual testing area so parents can see their child without influencing their performance.

Chief Therapist’s office and testing area. A desk and small table for testing. A mirror behind the table so the chief therapist can make and record those all-important observations. This is a relatively small, intimate space.

A break area, away from the workspaces with refrigerator, coffee maker, microwave, sink. No popcorn or distractingly aromatic food allowed in the microwave, and a ventilation fan should be present. Some separation from the therapy space is best, for staff privacy and to isolate any loud conversation or laughter from patients and parents.

The Therapy Space

A large, open space for therapy. With 2x4 tables set endwise against a wall, with electrical outlets at each. (You cannot have too many electrical outlets in a VT room. Consider installing some higher up, around table height for ease of use.) Initially I’d use closed steel cabinets to store bulky things in. I would also build this so the sink for the restroom or break area shared plumbing with a low sink in the therapy room for children to wash their hands before therapy began and whenever they wiped their nose. You will have far fewer sick days that way.

Some offices have a small area for a dark room for projecting stereo slides. If you’re developmental in orientation, this is a must. An alternative would be to install a movable, opaque curtain so you can darken a small area for this purpose. Last, not least, a really large chalk board, preferably not homemade, set low enough for children.

I like the idea of distinct workstations, so each table would be for a specific kind of activity. I’d want four tables. I’d use folding furniture at first, until I was certain how I wanted built ins to be arranged. If I had to push a table against a wall, I’d install a large mirror on the wall so the therapist can observe the movements and such. I like the idea of two tables with a therapist chair in the middle, patient chairs on the outside. This will allow fast conversion to group therapy as therapists gain skill.

At the end of each table I’d locate some plastic drawers on casters. You can find carts that break apart and can be restacked, mix and matched. Two large drawers, 6 inches deep, plus three or four smaller 3-inch-deep drawers. These are wonderful for storing small therapy devices, along with the instruction sheets for how to use them. I believe therapy patients should retrieve, use and then put away all their equipment. It helps them learn to organize things, and you’ll be surprised how often a parent will rave about how their usually messy child not puts his things away. It’s all part of vision therapy to me.

Equipment: I’d buy all the equipment used in whatever VT course(s) you take. No special list. We helped develop the Ideal Vision Institute Quick Start Curriculum, so that list would be my start.

I would also want a small trampoline, and some tumbling pads for floor work, and of course, a walking rail. I’m a woodworker, so I’d make my own out of beautiful hardwood.

I also like the idea of canvas walking mats, hand painted with “streets”, signs, houses and stores. Very helpful for directionality work. I’d roll them up on thick, wooden drapery rods. Part of early staff training would be painting parties to make new ones. Probably five in all, with a shop made tall box to store them. Artist canvas comes in 64-inch-wide rolls. Let’s see, a small town with railroad tracks, a neighborhood with a school, an alley and a movie theater. An airport with runway and taxiways as well as boarding terminals. Maybe a water course with all kinds of channels they “swim” through so you get body and limb movement. This is sometimes called Tank, but I’d like a more peaceful theme.

Notice there are no supporting walls, and no hallways. They are a waste of valuable and expensive space.

If you’ve been inspired to start or add VT to your professional life, remember that as part of our full consultation or as paid per hour consulting, we will review the to-scale floor plan your agent provides. We’re not architects, but we’ve visited hundreds of practices and helped design many for our clients.

Use the contact form at to find out more, and to discuss your plans for your own ideal VT practice.

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