Eye care and optical construction in Dallas–Fort Worth

What is different about building an eye care office

Most eye care offices are two businesses under one roof. The front is a retail store that sells frames and has to look good in daylight. The back is a clinic where rooms are measured against the equipment, the lights have to dim almost to dark, and every instrument needs power and a data connection. The two halves want opposite things from the lighting and the storefront.

Our clients across North Texas include optometrists, ophthalmologists, and eye surgeons. S&I has built and renovated optometry and ophthalmology clinics, optical retail and dispensary spaces, laser vision correction centers, and diagnostic and imaging rooms.

On this page:

• Optometry, ophthalmology, and retina offices
• Exam lane sizing and refraction distance
• Lighting control and dimming
• Pre-test and special testing rooms
• Optical retail, dispensing layout, and frame display
• The optical lab
• Laser and minor procedure rooms
• Finish-outs in retail centers
• Equipment vendors
• Permits, price, and schedule
• Questions eye doctors ask

Optometry, ophthalmology, and retina offices

The kind of practice changes the building more than the size does.

• Optometry. Retail at the front, a pre-test area, a small number of exam lanes, a contact lens area, and sometimes a finishing lab. Most are finish-outs in retail centers. Some are freestanding buildings, such as Colleyville Vision Associates, which we built from the ground up.
• Ophthalmology. Little or no retail, more lanes for each doctor, technician work-up rooms, a larger diagnostic testing area, a laser or minor procedure room, and offices for surgery scheduling. Patient volume is higher, so waiting space, parking, and restrooms matter more.
• Retina and other subspecialties. Heavy on imaging, with rooms for injections and minor procedures that need cleanable surfaces and a sink, and waiting areas sized for patients who are dilated and stay longer. Retina Center of Texas in Southlake and Advanced Eyelid Surgery Center in Colleyville are two of ours.

Exam lane sizing and refraction distance

An exam lane is sized from the inside out. The starting point is how you measure acuity. A lane that tests directly needs the full test distance from the patient's eyes to the chart, plus room behind the chair. A shorter room works with a mirror, or with a digital chart that is calibrated to the actual distance in that room. Either way, the chart system and the chair and stand should be chosen before the walls are drawn, and the dimension that matters is the finished one, after drywall and casework.

Lanes also have a hand. The instrument stand sits on one side of the chair and the doctor works from a set side, so a row of mirror-image rooms, the cheapest way to share plumbing walls, makes every other room backward. Decide early whether all lanes must be identical or whether mirrored rooms are acceptable.

The same early decisions fix the rough-in. The chair and stand need power at an exact spot in the floor or wall. A wall-mounted chart display needs power, data, and solid backing behind the drywall. Most lanes have a sink, and the door has to leave a clear path for a patient in a wheelchair to reach the chair. A lane that is a few inches short is found on the day the equipment arrives, when it is expensive to correct.

Where we judge that a job needs it, we lay out each exam lane on the slab from the equipment supplier's drawings and walk it with the doctor before framing.

Lighting control and dimming in exam rooms

Exam and testing rooms need two kinds of light: bright, even light for cleaning and conversation, and a low, steady level for refraction and for examining the eye. LED fixtures that flicker, step, or shut off before they reach a low level are a common complaint in exam rooms, and the usual cause is a fixture, driver, and dimmer that were never matched to each other.

Four things prevent it:

• Matched parts. The fixture, its driver, and the dimmer are specified together, and one room is installed and tested before the rest.
• Controls at the chair. The doctor should be able to reach the dimmer from the stool, not only from the door.
• Sensors that fit the room. The energy code requires lights in most rooms to turn off automatically. The sensor has to be the type, and in the position, that will not switch the lights on or off in the middle of an exam.
• Darkness. A dim room stays dim only if light from the corridor does not come under the door, through a sidelight, or around a window shade.

Glare matters as much as level. A fixture directly over the chair shines into the eyes of a reclined patient, so fixture locations are set from the equipment layout, not from the ceiling grid.

Pre-test and special testing rooms

Pre-test areas and special testing rooms hold the diagnostic instruments: autorefractors, retinal cameras, optical coherence tomography (OCT), corneal topography, and visual field analyzers. Each sits on its own table, and each needs power and a network connection at that table. Practices add instruments over time, so it is worth installing more outlets and data drops than the first equipment list calls for.

Visual field testing has its own needs. The patient has to concentrate in a dim, quiet room for several minutes, so the room should be away from the front desk and the lab, with walls and a door that hold back sound. Pre-test lanes need enough width to move a patient, including a patient in a wheelchair, from one instrument to the next.

Dilated patients need somewhere to wait that is not the bright retail floor. A small secondary waiting area near the lanes, with lower light, is worth planning.

Optical retail, dispensing layout, and frame display

The dispensing floor is the part of the project most like a store build-out, and its layout decides how well it sells.

Start with the path. A patient leaving an exam lane should arrive in the optical without crossing the waiting room, and someone who walks in only to shop or pick up glasses should not have to pass through the clinic. Dispensing tables need room for the patient, a companion, and the optician, with a mirror and good light at each one. A pickup and adjustment bench near the front keeps short visits short. Check-out works better apart from check-in, so the front desk does not back up. Contact lens training needs a counter, a sink, and a mirror somewhere quieter than the sales floor.

Frames and faces need light that shows color accurately. That means fixtures with good color rendering and a consistent color temperature across the room, so a frame looks the same at the display, at the mirror, and at the dispensing table. Lit shelves and frame boards need power routed inside the casework, and the drivers that feed them need to be somewhere a technician can reach without taking the display apart.

Frame displays are either custom millwork or a manufactured display system, and the choice affects the schedule and the walls. Custom casework is built from shop drawings that you approve. A display system arrives from a vendor and hangs on backing that has to be in the wall before drywall. Security belongs in the same conversation: locking displays, camera locations, and how much of the frame inventory can be seen and reached from the storefront.

Newberry Vision Center in McKinney has separate clinic and optical entrances. Eagle Ranch Vision Source in Fort Worth and Simply Eyes in Colleyville show lit frame displays on an open showroom floor.

The optical lab and edging room

If the practice finishes lenses in the office, the lab is a small workshop. Edging equipment may need dedicated circuits, and depending on the machine, water, a drain, or dust and odor control. The room is noisy, so it belongs away from exam lanes and visual field testing, with sound insulation in its walls. The lab is designed from the cut sheets of the machines you are actually buying.

In-office laser and minor procedure rooms

Many practices add a laser or minor procedure room. The requirements depend on the equipment. Lasers used in the exam setting need little more than the right power, a room that can be darkened, and laser safety measures at the door. Refractive surgery lasers are more demanding: their manufacturers publish site requirements for power, room size, floor loading, and the temperature and humidity the room has to hold, and the air conditioning for that room is usually designed separately from the rest of the office. ANSI Z136.3 is the standard for the safe use of lasers in healthcare, and it governs items such as warning signs, door and window treatment, and eye protection. Clearview Eyecare and Laser Center in Southlake is one of our projects with a laser procedure room.

The decision to settle before design starts is what kind of facility the room is. A facility licensed as an ambulatory surgical center is a different project from a procedure room inside a practice, with state licensing rules for the building. Which you need depends on the procedures, the anesthesia, and how you plan to bill, and it is a decision for you and your advisors, not the contractor. If the answer is a licensed center, see our surgery center construction page.

Optometry finish-outs in retail centers

Most optometry offices are finish-outs in retail centers, and the shell decides more than the floor plan does. Before you sign a lease, look at:

• The dimensions. The width and depth of the bay decide how many lanes fit and how long they can be.
• The floor. Some retail shells are delivered without a finished slab, which makes plumbing easy. In a previously occupied space, new sinks and restrooms mean cutting the existing slab.
• The systems. The electrical service, the rooftop units, and the water and sewer lines were sized for a store. A clinic with many small rooms needs air delivered and controlled room by room.
• The landlord's terms. The work letter and allowance, the sign criteria for the storefront, and the rules for construction hours and deliveries all affect the budget and the schedule.
• The use. Confirm with the city that medical office use is allowed in the center and that the parking supports it.

We help with site selection, tenant finish-outs and renovations, and new buildings. PersonalEyes Vision Care in Flower Mound is an optometry office finished out in a lease suite. We also build freestanding eye care buildings from the ground up, including Colleyville Vision Associates and Advantage Eye Care in North Richland Hills. Budget for sound control as well: exam room walls that stop at the ceiling grid let conversation carry into the next room.

Coordinating with your equipment vendors

We go over the power, clearances, lighting, and infrastructure that ophthalmic equipment needs with each vendor early, while a change still means a revised drawing instead of torn-out drywall. An eye care project can have separate vendors for lane equipment, diagnostic instruments, lab equipment, frame displays, and a laser, each with its own drawings and delivery dates. Where those drawings disagree with the architect's, the conflict has to be found on paper, before it becomes a change order.

Some equipment is fastened to the building. A surgical microscope or a ceiling-mounted instrument needs structural support and conduit in place before the ceiling is closed.