You know the story; it might even be your story. Graduate optometry school with a lot of enthusiasm—and a lot of debt. Pick up all the extra days you can just to stay afloat financially. Now you’re in the high-volume, low-reward daily grind of refraction, primary eye care and the same old conversations with patients about what astigmatism is. Hello, burnout.

What to do? For Ada Noh, OD, the answer was to commit to a specialty concentration in dry eye, forgoing the trappings of routine eye care—bye-bye, phoropter!—for the intellectual stimulation of advanced care and the risks and rewards of self-employment.

Dr. Noh describes her journey to specialty practice with great anecdotes about how she came to face her fears about starting cold, in an unfamiliar new city to boot. Job one was building a referral base and that meant emb ...