It wasn’t too long ago that providing eye care was the near-exclusive province of optometry and ophthalmology. Aside from a few simple vision screening techniques used by pediatricians and other family practitioners, if you wanted your eyes checked out, you got in a car and drove to see an OD or an OMD. That model isn’t going away any time soon, and it remains the gold standard, but we’d all be remiss if we ignored the growth of alternative modes of eyecare delivery.

The pandemic accelerated some trends that were already in motion, notably the desire or need to provide some semblance of care virtually. Many observers see in the Millennial and Gen Z cohorts a generational shift toward viewing eye care as just one more product to purchase online. That’s an easy overgeneralization to make, but when you grow up conducting much of your day-to-day life online, you see it as the default experience, not an outlier.

Online refraction services get a lot of flak from optometrists—rightly so, they’re terrible—but they do at least show that a market is there for it. It stands to reason that these will evolve and eventually achieve a level of respectability such that ODs themselves might even employ them for limited uses, like doing a contact lens Rx refill on a pre-existing patient who does also periodically come in for an exam. 

Telehealth services, after being the only game in town during the 2020 lockdown, looks to maintain an ongoing presence too in optometry. In this month’s 45th annual Technology Report, Marta O’Grady, OD, weighs in on lessons learned and where the experience is heading. 

Most ODs think of telehealth as a half-a-loaf-is-better-than-none method of maintaining contact with their patients, and there’s something to be said for that view, but it can also expand optometry’s reach. “As optometry historically moves towards more systemic treatment and collaborative work with other medical subspecialties, virtual visits may accelerate this pursuit by allowing us to virtually consult in emergency departments without leaving our offices as well as collaborate with primary care practitioners, internists, nutritionists and neurologists,” writes Dr. O’Grady in her article

Artificial intelligence—covered this month by Lauren White, OD—is another way technology is disrupting the delivery of eye care. AI-powered cameras that screen for diabetic retinopathy in GP offices and drug stores may not yet be commonplace, but there’s every reason to expect that’s coming. These tools can also come in handy for optometrists, serving as sort of an instant consult with a digital retina specialist. As Dr. White writes, “Al can democratize fundus photo interpretation by leveling the playing field for providers with varying clinical expertise.”

These technology and market-driven changes were part of a wide-ranging discussion held last month at New England College of Optometry. For me, the take-home message was this: even if these trends and tools aren’t ready for prime time, it behooves us to reckon with them now so they can support optometry’s general ethos and commitment to patient care. Otherwise, we stand vulnerable to outside forces that see only profit and conquest in the disruptive power of new tech.