Does a longer exam actually find more?

It creates room for the tests that get skipped under time pressure, particularly binocular vision assessment and careful peripheral retinal examination. Whether it finds something depends on whether there is something to find.

Are you more expensive?

For basic eyewear, generally yes. For specialty work, often not, because a fitting that succeeds first time is cheaper than one that does not.

How far ahead do I need to book?

Usually a few days to a week for a routine exam. We hold same-day slots for eye emergencies.

Two Patients an Hour | How It Changes Your Eye Exam

By Dr. Mark Page · August 10, 2026 · 3 min read

Every practice says it cares about patients, so the claim carries no information. What carries information is a decision that costs money.

Ours is the schedule. Two patients an hour, since 1994. I want to explain specifically what that changes, because the difference is not warmth or attentiveness in the abstract. It is which tests actually get done.

The arithmetic, plainly

An exam room generates revenue per patient. Running two patients an hour instead of six means roughly a third of the revenue from the same room, the same equipment and the same doctor's time.

That is not a marketing position. It is a permanent, daily cost that this practice absorbs, and it is why high-volume models exist. They are not run by worse people. They are run to a different arithmetic.

What disappears when the schedule is full

When an exam has to fit into eight or ten minutes, certain things go first, and they go in a predictable order.

The history. A proper conversation about your work, screen use, medications, family history and what you have actually noticed becomes three quick questions.
Binocular vision testing. How your eyes work together as a pair is not tested by a chart, and it is the most commonly skipped part of an exam.
Careful retinal examination. Looking at a retina thoroughly takes minutes, not seconds, particularly at the periphery where detachments begin.
The explanation. This is the one patients notice. Being handed a prescription is not the same as understanding what was found and why it matters.

What the time actually buys

The most common feedback we get is some version of finally understanding what is going on with my eyes. I do not think that is because our doctors are unusually gifted communicators. It is because they had twenty-five minutes rather than eight.

Concretely, it means we take a history that surfaces the cause before any instrument is used, which happens more often than people expect. It means binocular testing that catches convergence problems making a child's reading difficult. It means a retinal look that finds a peripheral change nobody was looking for.

And it means showing you your own retina on screen and going through it, which changes how patients engage with their own health in a way no leaflet does.

A side effect worth mentioning

We run close to schedule. That is not a virtue, it is arithmetic again: a book that is not overloaded does not cascade into delay.

If you have ever sat for forty minutes past your appointment time, that is what overbooking looks like from the waiting room.

Where this makes us more expensive

I would rather be direct. For a basic pair of glasses, a retail optical chain will beat us on price and we are not going to match it. Our exam takes longer and our fitting is more thorough, and that costs more to deliver.

For specialty contact lens work the comparison usually runs the other way, because the alternative is often a fitting that does not succeed.

And if you live a long way away and want a routine annual exam, we will tell you to find someone good and closer. We say that to patients regularly, and it is a reasonable thing to expect a practice to tell you.

The short version

We schedule two patients an hour. High-volume optical chains typically schedule four to six.
That costs this practice roughly two thirds of the potential revenue per exam room, every day.
What it buys is the parts of an exam that disappear first under time pressure: the history, binocular vision testing, careful retinal examination, and the explanation.
A side effect is that we run close to schedule, because a book that is not overloaded does not cascade into delay.
For basic eyewear, a retail chain will beat us on price and we do not pretend otherwise.
If you live far away and want a routine annual exam, we will tell you to find someone good and closer.
The most common feedback we get is that patients finally understand what is going on with their eyes, which is a function of time rather than talent.
Two patients an hour is a business decision that costs money daily, and it is the one thing on this site that cannot be copied cheaply.

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This article is general educational information, not medical advice or a diagnosis, and it is not a substitute for an examination. If you are experiencing sudden vision loss, eye pain or an eye injury, contact us immediately or go to an emergency room.

Why Two Patients an Hour Changes Your Eye Exam