Five-year-old Shaman Mallery noticed it first, bringing the entire shopping entourage of his mother, his 2-year-old sister and two of his mother's friends to a screeching halt in front of what appeared to be just another store at Fair Oaks Mall.
It must be the Discovery Channel, Shaman's mother, Christina, thought as they all stared, open-mouthed, at a 33-inch television screen on which was displayed a huge eyeball, with steel, spider-like clasps holding the eyelid open.
Venturing closer, they peered through a 30-foot-wide window into an operating room where an actual surgeon stood hunched over an actual patient stretched out in a special chair.
"What are they doing?" Christina Mallery, 26, asked in wonder. A squeamishly close image of the surgeon placing a suction ring over the patient's eye flashed on the three large TV monitors.
"Oh, wow! Oh, wow! I can't believe this!" said her friend Aimee Villars, 25.
"Jeez, they're peeling his eyes off!" exclaimed Keith Barry, 46, as he joined the cluster of shoppers quickly collecting at the window.
Behind that panoramic glass partition was the latest in medical marketing, a mesmerizing surgical sales pitch topped off with a twinge of voyeurism: Now you can have laser eye surgery done at the mall.
Yes, somewhere between getting your tires rotated and your hair coiffed, it is now possible in Fairfax County to get your eyes fixed at the mall. What's more, the entire 15-minute procedure can be performed in front of gawking spectators, though only if you allow them that thrill. Patients preferring privacy can pull the blinds closed.
The brainstorm of a Leesburg ophthalmologist, the Visual Freedom Center is the nation's first laser surgery center to be located in a shopping mall. And it won't be the last. A similar center opened last month in Minneapolis, and others are in the pipeline. A second Visual Freedom Center will open this September in suburban Maryland.
"It's not as crazy as it sounds," said Myles Weiner, chief executive of the Fair Oaks site, which opened last February in the same wing of the mall as LensCrafters. "It's a simple concept. We're trying to appeal to a mass market."
However unusual, sociologists and economists who study culture and shopping malls say it makes good sense.
"The shopping mall is becoming more of a public spectacle," said Tyler Cowen, a George Mason University professor who studies commercial culture, including malls. "People want to watch other people, and they want to do more than just shop."
Kurt Barnard, an economist and publisher of Barnard's Retail Trend Report in Montclair, N.J., said shopping malls are undergoing a transformation and are trying to attract unusual businesses.
"Lots of shopping center operators are getting worried about the Internet, and they'll do whatever they can to bring in people, not just to buy shoes but also to be entertained," he said. "Although I question the entertainment value of laser eye surgery, it's a novelty that is likely to bring a lot of people to the mall."
Fair Oaks Mall's marketing director, Judith Lewis Morris, said management was initially hesitant to lease mall space for a surgical center because "it was so out of the norm." But once they decided to give it a try, she said, the business has boomed, generating more traffic than most shops at the mall. "They continue to amaze us with their success," Morris said.
The center performs the LASIK (Laser in-situ Keratomileusis) procedure, an increasingly popular form of laser surgery used to correct nearsightedness, farsightedness and astigmatism. An estimated 950,000 people nationwide will undergo the LASIK procedure this year, more than double last year's 450,000, according to Spectrum Consultants, a laser research firm.
With a bottom line of about $5,000 for both eyes, laser surgery is an expensive elective procedure that most insurance plans don't cover. Even so, more than 1,000 patients have had their vision corrected at the Fair Oaks site thus far, with an average of 15 a day lately, according to center records.
A second Visual Freedom Center will open this September at The Mall in Columbia next to the Nordstrom store. Company officials are considering other sites outside the Washington area, with inquiries coming from as far away as California and Florida.
Robert M. Johnston, the Leesburg ophthalmologist who started the company, said patients are asked beforehand whether they want the window blinds open or closed to the public during their surgery; about 70 percent say to leave them open, he said. Patients also can have the 15- to 18-minute procedure videotaped.
Johnston, one of three eye doctors who operate at the Fair Oaks site, said he got the idea while talking with his teenage daughter, herself a frequenter of malls. He realized that performing eye surgery in such a venue would not only expose the procedure to many potential patients but also would help eliminate fear and ignorance that exists about laser surgery.
By having people watch, "we felt that the relative simplicity and brevity of the procedure would greatly diminish the fear factor," Johnston said. And because the center accepts walk-ins, there is no need to pay other doctors for referrals -- a savings Johnston said he passes along to his patients, about 60 percent of whom are walk-ins. The savings are 10 to 20 percent, Johnston said.
Adding to the throng of shoppers who stand outside the center when the camera is running, patients' family members and friends sometimes show up, armed with their own video cameras. The result is an event that feels half-MTV party and half-medical school.
Fairfax County police officer Tom Black invited his patrol partner, Mike Shamblin, his girlfriend, Helleh Sadeghi, and his sister, Tammy, to witness his recent procedure.
"I think it'll be fun," Shamblin said at the outset. "I have a bit of morbid curiosity anyway."
Soon, Black appeared in the operating room behind the window, dressed in a blue surgical gown. He smiled and waved, then sat in the operating chair.
As the camera zoomed in for a close-up of ophthalmologist John Essepian placing a clamp over Black's eye to hold it open, Sadeghi started to squirm.
"Oh god, I can't watch," she said, putting her hands over her mouth.
When Essepian began to peel back the outer layer of Black's eye, Sadeghi had seen enough. "I just can't watch this," she said, turning away. "Is it done yet?" she asked several times.
Ten minutes later, Black, blinking a bit more than usual, emerged from the operating theater to a round of applause from his friends and several strangers.
"It's neat, not bad at all," the 39-year-old officer said as he put on the dark sunglasses he would have to wear for a few days. "It's a little foggy, but other than that, it's fine. I think it's a lot worse watching it than having it done."
Some were not convinced. Others wondered whether the days of a casual stroll through the mall are now gone forever.
"This is not exactly what I expected at the mall," said Susan McDonald, 26, visiting from Richmond. She shook her head and grimaced as the surgeon cut away. "What will be next? Open-heart surgery?"
CAPTION: Lucas Pollard, 4, watches laser eye surgery being preformed on his father, Steve, at the Visual Freedom Center at Fair Oaks Mall.
CAPTION: Bill Taylor has eye surgery by ophthalmologist Robert M. Johnston, flanked by technicians Brian Haskell and Karen Thompson. The operation was in view of a window on the mall.