Revolutionizing Anterior Segment Care with the Maestro2 OCT: A Veteran Optometrist’s Perspective
Dr. Susan Resnick’s journey into optometry is one of both inspiration and personal experience. It all began when she became a patient at a contact lens specialty practice in New York, which piqued her interest in the field. Impressed by the care and dedication of the practice, Dr. Resnick decided to pursue a career in optometry. After completing her education, she returned to the very practice where her journey started and has been part of it ever since.
A Legacy of Excellence in Contact Lens Fitting

The practice, Drs. Farkas Kassalow Resnick & Associates, founded in 1958, has been known for its dedication to contact lenses since its inception. At a time when optometrists primarily served as refractionists with few privileges, the original owners, Drs. Paul Farkas and Ted Kassalow, created a unique niche focusing entirely on contact lenses. Over the years, as the profession evolved and optometrists gained expanded privileges, the practice diversified, offering additional services such as comprehensive primary eye care and ocular surface disease management. However, contact lens fitting, especially medically necessary lenses, remains the cornerstone of the practice.
“We’re still known for contact lenses, and a lot of what we do is specialty fitting—scleral lenses, keratoconus, high astigmatism, and multifocal lenses,” Dr. Resnick explains. Her practice has developed a reputation for taking on challenging cases, often helping patients who have been told elsewhere that they cannot wear contact lenses or that there are no suitable options for them.
“Our goal is to achieve success with these difficult cases—patients who’ve been around the block a thousand times and have been unhappy with previous attempts,” she says. “A lot of the time, these cases are actually not that difficult if you have the right knowledge and the right equipment.”
A Focus on Advanced Technology: Enter the Maestro2
One of the key tools in Dr. Resnick’s arsenal is the Topcon Maestro2 Optical Coherence Tomography (OCT) system. While OCT is typically associated with retinal imaging for conditions like macular degeneration and glaucoma, Dr. Resnick has discovered that the Maestro2’s full potential extends far beyond the retina. Although she originally purchased the Maestro2 for retinal imaging, she quickly realized how useful it is in evaluating the anterior segment of the eye with precision and the immense value it brings to optimizing her contact lens fittings, particularly scleral lenses.
“The Maestro has transformed how we do anterior segment assessments and has really opened my eyes to how versatile OCT can be,” Dr. Resnick shares. “We use it to measure tear film meniscus height, especially when monitoring dry eye, and it’s a great tool for scleral lens fitting. At first, we didn’t think we needed it. We already had retinal imaging, and we were confident that we were catching everything we needed in our assessments. But when we got the Maestro, it was like the lights turned on.”
Precision in Scleral Lens Fitting
Dr. Resnick notes that one of the primary uses of the Maestro2 in her practice is measuring scleral lens clearance. Previously, she would estimate the lens-to-cornea subjective clearance with her naked eye and by looking at fluorescein patterns during fitting. While this method proved effective, the Maestro2 offers a more objective, higher level of precision. “With the OCT, I can measure the clearance down to just a micron,” she explains. “For instance, when I fit a scleral lens, I aim for a clearance between 200 and 300 microns initially. Then, at the patient’s one or two-week follow-up, I check the clearance again. I want to make sure that at least 100 to 150 microns remain to ensure the lens is safe throughout the day.”
In addition to evaluating clearance, Dr. Resnick uses the Maestro2 to examine lens edges, ensuring there is no impingement or poor landing. Although she still uses a slit lamp to visually inspect these aspects, the OCT allows her to qualify her findings and feel confident in her assessments.
Expanding Applications: Beyond Scleral Lenses
While Dr. Resnick primarily uses the Maestro2 for scleral lens fitting, the instrument’s capabilities extend far beyond that. For example, the Maestro2 can help assess corneal thickness and identify early signs of corneal thinning secondary to keratoconus. Early detection of keratoconus is essential in a practice focused on corneal and contact lens care, and the Maestro2’s ability to provide insights into corneal pachymetry allows for timely diagnosis and management.
In addition, the Maestro2 helps Dr. Resnick assess the corneal profile, visualize the limbal angle, and determine whether additional toricity is needed in the scleral lens. The precision of these measurements, combined with her experience in interpreting fluorescein patterns, enhances her ability to make informed decisions and fine-tune her fittings. “It’s like having a safety net,” Dr. Resnick admits. “I’m very confident in my ability to eyeball these things, but having the Maestro there to double-check my assumptions has been incredibly valuable. It’s not just about getting it right; it’s about getting it right with confidence.”
Surprising Benefits of the Maestro2: Speed, Ease of Use, and Robotics
One of the standout features that Dr. Resnick highlights about the Maestro2 is its ease of use. Known for its robotic automation, the Maestro2 has made imaging faster and more intuitive, which is especially beneficial in a busy practice environment.
“When I first used the Maestro, I was surprised by how simple it was,” Dr. Resnick says with enthusiasm. “It’s so automated that even I—someone who normally delegates all tech-related tasks—could use it effectively. It’s even fun to use, which is not something I thought I’d ever say about optical equipment!” This ease of use and speed has made it relatively painless for Dr. Resnick’s staff to be trained quickly on the system, further streamlining the workflow in the practice. “I trained my staff on it in a matter of minutes, and they were just as impressed with how intuitive it is,” she adds.
Advice for New ODs: Invest in the Right Equipment
Dr. Resnick’s experience and expertise in scleral lens fitting, combined with her adoption of the latest technology, make her a valuable resource for new optometrists. She is very passionate about mentoring young optometrists and guiding them through the challenges of starting or transitioning into private practice.
Her advice for those just starting out in the field? Focus on investing in equipment from companies that engineer quality and modern solutions that enable you to become both efficient and precise.
“The tools you choose to invest in will determine the type of care you can provide, and ultimately, how successful your practice will be,” she says. “With OCT technology, I’m able to offer more comprehensive care and grow my practice in a way that benefits both my patients and my bottom line.”
“The Maestro has been a game-changer for us. It’s allowed us to take our scleral lens fittings to the next level and make sure that we’re doing things as accurately as possible.”
“If you’re going to focus on contact lenses—especially specialty lenses—having the right tools is essential,” she advises. “The Maestro has been a game-changer for us. It’s allowed us to take our scleral lens fittings to the next level and make sure that we’re doing things as accurately as possible. You, of course, have to work within your budget, but the right instruments will offer a return on investment through the specialty services you can provide. An OCT is no longer a luxury—it’s an essential requirement for any optometric practice,” she summarizes.
Looking Ahead
As Dr. Resnick continues to innovate and expand her practice, she remains committed to offering the best possible care for her patients—especially those with complex contact lens needs. While the practice is known for its specialty fitting of scleral lenses, Dr. Resnick is also working to expand the demographic of her patient base, including focusing on myopia management for children.
“We’re trying to bring in younger patients and diversify a bit,” she shares. “The practice, like me, is getting older. It’s important to make sure that we’re meeting the needs of all patients, from the complex to the more routine.”
Conclusion
Dr. Resnick’s journey in optometry, coupled with her expertise in contact lens fitting and her embrace of advanced technologies like the Maestro2 OCT, underscores the importance of continuous learning and adaptation in an evolving field. Her investment in the Maestro2 OCT system has not only improved her scleral lens fitting process but has also opened up new possibilities for anterior segment evaluation, dry eye management, and early disease detection. For new optometrists just starting out, her advice is clear: invest in equipment that will enhance your practice, stay focused on your specialty, and never stop learning. Whether you’re fitting scleral lenses or tackling other complex cases, the right tools can make all the difference in providing exceptional care.
Susan Resnick, OD, FAAO, is president and managing partner of Drs. Farkas Kassalow Resnick & Associates in New York City and Long Island. A Diplomate in the Cornea and Contact Lens Section of the American Academy of Optometry and Fellow of the Scleral Lens Society, she focuses clinically on specialty contact lens fitting. Dr. Resnick can be reached at [email protected]
This article was sponsored by Topcon Healthcare, Inc.