MEJO 121: Final Project Interviewing Dr. Elizabeth Gunst, OD

By Ben Murphy

Published: May 2025

CHAPEL HILL, NC -- Dr. Elizabeth Gunst, OD is an optometrist based out of Cary, North Carolina, working for Triangle Visions Optometry. After growing up in eastern North Carolinia, Dr. Gunst attended college at the University of North Carolina Wilmington (UNCW), and optometry school at Pennsylvania College of Optometry. 

Dr. Gunst is not only very knowledgeable about ocular anatomy and vision care, but also very friendly, personable, and genuinely interested in bettering the lives of her patients and encouraging future optometrists. To learn more about Dr. Gunst and optometry, watch or read the Q & A-style interview.

(Edited YouTube version is linked above and full Q & A transcript is listed below)

Note: Transcript has been slightly edited for grammar and clarity

Q: Can you tell us a bit about yourself and where you practice optometry?

A: My name is Dr. Elizabeth Gunst. I grew up in eastern North Carolina and I went to the University of North Carolina Wilimington (UNCW) for undergrad and optometry school at Pennsylvania College of Optometry. I'm almost scared to tell you how long ago I graduated, but I graduated in 2008 and have been practicing optometry since then. I currently work for Triangle Visions Optometry in our Cary location, and I have been with Triangle Visions for almost four years now.

Q: Why did you choose optometry as a career?

A: When you think about how in the world you want to spend the next 30 years of your life, or maybe more - depending on how long you want to work - you want to pick something that you love. I always knew growing up that I loved the sciences. Biology was always my jam, so I enjoyed that part of school. The chemistry not as much. The math definitely not as much. But I knew I wanted to be in the medical field somewhere, and I've had terrible eyes my whole life. I started wearing glasses at two and the optometrist was the only doctor that never gave me shots, so I was always interested in optometry early on. As I got into high school, I realized that optometry is the kind of field where you can genuinely help people every single day. You can help people see, and if people can see then they're more independent and they can do the things they really love. So, it just adds value to their life... and I love people and I love to talk. I could talk to that wall behind you, so I think it's just a good mix for my personality. I love people, I love science, and I'm passionate about the eyes because mine are so bad as it is. And if I can help somebody else see it's a gift, so that's why I picked optometry.

Q: What was your path in applying and choosing an optometry school like?

A: Yeah, so like any graduate-level coursework, whatever it is that you're looking at, you kind of already have those schools in your head like, "Oh, these are the good ones. These are the best ones." You want to get into those. So, I did my four-year (undergraduate) degree in biology in Wilmington (UNCW) and I only applied to three optometry schools - Pennsylvania College of Optometry, Southern College of Optometry, and Boston (New England College of Optometry) - there are two schools in Boston now, but at the time there was only one. So, I got into all three, toured all three, and chose Philadelphia (Pennsylvania College of Optometry) for a couple of reasons. Philadelphia and Memphis (Southern College of Optometry) have really similar class and clinical experiences. So, for backgraound, all optometry schools are four-year degrees, and for most, you do three years of class and clinicals and just one year of externships. But, Philadelphia and Memphis, at least at the time, you did one-year-and-a-half of externships. So they crammed three years of coursework into two-and-a-half, which was terrible because you would take something like 32.0 credit hours a semester, which was bananas!! But (because of that) I got so much more face-to-face and practical time with patients, so having more time in patient care was a big deal. So, that's how I ended up picking Philly, plus it was 8 hours away from home versus 16 hours.

Q: Was there anything that surprised you or was unexpected about your experience in optometry school?

A: It was pretty close to what I was expecting. I knew it was going to be pretty hardcore. I knew it was going to be a lot of studying. Studying has not ever really come super easy, so I definitely had to study and I was always jealous of those people that could never come to class and still make As on their tests. So, I think the realization that you knew you were going to have to study a lot, but then you actually have to study was even more. But I think the other piece too is the clinical aspect. I loved it even more than I thought I would. I knew I would like it, but once you get into the hands-on like clinical labs and you're learning how to use the equipment, how it all connects, I enjoyed that more than I realized I was going to, which usually means you picked the right profession.

Q: What does your average workday look like?

A: People get us (optometrists) confused with opticians and ophthalmologists all the time. As an optometrist, you're a primary care practitioner, so I do everything from eye exams on five-year-olds to treating glaucoma and macular degeneration, that kind of thing. But it does differ based on the state that you're in, so legislation does make a difference in what you're allowed to do. Sometimes, it's even what you're allowed to prescribe. There are some states that are even limited in what medications optometrists can prescribe. But, in North Carolina, we've got a really wide scope of practice, which is great and part of what you're taught (in school) to do. This morning alone, I saw a patient who's on high-risk medication, so we're doing speciality testing for that, I had a gentleman who had a stroke recently and he's had some vision loss, so we're managing that, and I had a couple of really healthy patients who just need glasses and contacts. So, it can be a wide range. But I love that the vast majority of your patients you can build relationships with, even if you just see them once a year or once every eighteen months. Then you get those patients that you see all the time for different disease processes, so they're the ones that you really get to build those (strong) relationships with. So, that's kind of what an average day looks like.

Q: What is your favorite part about being an optometrist?

A: To get "that patient." Usually, they're children that just don't know that they can't see. So, usually, it's a kid in like second or third grade, they're having trouble at school, and then they get their first glasses or they've got the phoropter - which is how we check the prescription for their eyes - in front of them and I show them with and without vision correction. Sometimes, their eyes just light up and they're like, "Oh my gosh. I didn't know I couldn't see!" And you get that (reaction) a little bit with adults occasionally, but I think there's just this really amazing lightbulb moment where sometimes you have these (children) where you're like, "I just totally made a difference for that child," who maybe has been in school and struggling a little bit, so they're being evaluated for learning disabilities or all these other things. And it's not that they're not smart or that they can't do the material - they just can't see and they just don't know that they can't see. That's probably my favorite.

Q: What is the hardest thing about being an optometrist?

A: Oh, 100% the bad news days. It's just really hard to tell somebody, "I can't help you" or "there's this disease process that's taking place and I can't do anything about it," whether it's too far gone, there's no treatment available, or that kind of thing. So, walking patients through that kind of bad news. And, sometimes, they already know that they have a disease but they're coming to me thinking that I can help them see better with just glasses - glasses don't fix everything. I think that's the hardest. Ugh, I hate bad news days.

Q: After becoming an optometrist, has there been anything that has surprised you about the profession?

A: I think some of the ways that we practice. In optometry, when I first started practicing, as far as just a whole, we tended to have more of what I call, "Mom and Pop" offices, where it was just single practices, that kind of thing. And now there's chains, so it's just a bigger organization. So I think the hardest part is still kind of owning your own treatment style - like in the exam room doing what you think is best for the patient - without somebody in corporate trying to tell you how to do your job. So I think that's kind of the trickiest piece to find the balance of, "Yes. It's a business," like any other medical practice you have to be able to keep your doors open, but at the same time, doing what's best for the patient, which is not always the most financially rewarding. And that's the tricky part.

Q: How has the work-life balance of optometry been for you?

A: "It's been good and it's challenging. So, before I had kids, I would work six days a week. I would do Monday-Friday, and add in a Saturday trying to pay off all those student loans because, good gracious, there was a lot of that. But, as I've had more years of experience, I was able to go part time when my kids were young, which was a super gift. Now, working full time for me looks like four-and-a-half days, which is kind of the sweet spot. I work to 8am-5pm, and I usually tease my staff, "I'm like, listen if I'm here after 5pm something is wrong... that's not really how I like to do it." But it tends to be really good. I always knew I wanted to be a mom, and so for me having a profession where I can do what I love, take care of people's eyes, help them see, and all the things, and then also be able to make it to soccer practice on time, church on Wednesday nights, or whatever else, that was always really important. And you can't do that in all the medical fields, so for me, it's been a really good balance. And I would say this as advice too: luckily, in North Carolina, optometrists are needed. There's definitely not a surplus of us, we're underserved in a lot of areas, and so I think knowing your value too can help with (work-life balance).

Q: Without saying any names for HIPAA purposes, what is your most memorable patient exam?

A: I don't know if I have one that's just super memorable. Well, you sometimes remember the bad ones too, so I don't necessarily want to talk about those ones, but let me think... Well, I will say, it's another kids story, but there's a young boy (patient of mine) and he's an athlete and he's been wearing glasses for a long, long time. He's just really farsighted with a ton of astigmatism, so he just has a hard time seeing anything without his glasses and he was having a hard time playing soccer, he does soccer, he does swim, and all these things. And at like eight-years-old his parents, because I know his parents, were like, "can we put him in contacts?" I was like, "100% we're gonna put this eight-year-old in contacts." And I think it's been really cool just because I know him personally to watch his self-esteem just go up because he can now see and play sports. And for him, academically, it also made a difference because he would run out the door (before school) and forget his glasses, so I think that would probably be a good example for me." 

Q: What's one piece of advice you would give to "pre-optometry" students?

A: I would say definitely shadow to give you a pretty good idea of "Do I actually wanna do this?" Because I remember going to optometry school and there were people in my class that didn't even realize that we treated disease. They just thought that it was glasses and contacts. So I think shadowing would be really important just to get a feel for patient interaction, the types of things you see, and how often you see certain things. And just to make sure that you really like the eye. I know that sounds real silly, but teeth creep me out. I know I would never be a good dentist because I don't want any part to do with the teeth. And then I think about people like my sister, who's a labor and delivery nurse, and the eye creeps her out, but labor doesn't. So, I think part of it is just making sure that you feel comfortable with the type of treatment that you're going to be giving patients and that it seems interesting. Because if you shadow and are like, "this is so boring," it's probably not the field (for you). 

Q: If you could do it all over again, would you still become an optometrist?

A: Yes. And it's funny, because my roommate from optometry school would say just as fast "No." because it's just a different experience altogether. But I genuinely love what I do. I really do. And, so yes, I would do it 100% all over again. Even all that school work - it's not fun but it's like a means to an end. 

Q: What's your best fun fact about the eye?

A: Every now and then, when you do a slit lamp exam - where you're using the microscope to evaluate health on the front part of the eye and then eventually the inside of the eye - some people go "Oh, what's that?" and they're literally seeing what looks like a cracked riverbed or tree branches. So, I'll tell them that's your "Purkinje image," which why I remember that from school I have no idea, but that's where the fun fact comes in. Because what they're actually seeing is the shadow that the (slit lamp) light is casting on their arteries and things in the back of the eye. So, then you get to tie in the anatomy of the eye and what they're actually seeing, which is kind of cool. That's probably my number #1 fun fact. The other thing I think is really cool, and I learned this in optometry school too, is that carrots are actually not the best vegetable for your eyes, which seems really crazy because we've always been taught that carrots are, but it's actually a myth from World War II. The Allied Forces let it leak to the Germans that the reason that their pilots had such great vision was because they ate carrots all the time. And it's not because they ate carrots all the time, it's because we had radar before they did. So we had air superiority because we had radar but they made it into the whole carrots thing, and that's where the myth came from. Spinach is actually the best, those leafy greens. So Popeye (the sailor) kind of had it all figured out, but carrots are good for your eyes - the beta-keratin, all the other things - they're not the best thing for your eyes. So, if you're gonna eat one thing, stick with Popeye and not Bugs Bunny is kind of what I tell people.