The new year is always an incredible opportunity to make a new start; to dream of the potential you want to achieve and then make it happen. The journey and learning is as much of the experience as achieving the end goal. There are five key trends in eye care worth diving into and making your goals this year: virtual reality (VR), artificial intelligence (AI), myopia management, digital device use and efficiency.
Let’s face it, digital device use is increasing and plays a role in MGD, blepharitis, DED and, likely, progressive myopia. Positioning your practice to address any of these conditions could be valuable.
New FDA approvals—for evaporative dry eye in Miebo (perfluorohexyloctane ophthalmic, Bausch + Lomb) and Demodex blepharitis in Xdemvy (lotilaner ophthalmic solution, 0.25%)—are showing impressive and quick results.
Myopia management is also a major opportunity, and even Apple is addressing this with auto shutdown if children under the age of 13 don’t hold the device an appropriate distance away from their eyes. The key may be having multiple options for myopia management, and an FDA-approved prescription possibly to become available this year would set the stage for a potential explosion in awareness.
While this area includes big tech companies from Meta to Apple and Google/Alphabet, the optometry field is not without their own innovative technologies. One VR headset, Smart System (M&S Technologies), has bridged the gap from a screening device to a glaucoma management tool. Whatever technology you’re looking at, be sure it has active eye tracking with automated pause, otherwise you’ll have patients moving their eyes within the device.
Neurolens moved from a stand-alone desktop to VR headset, allowing for rapid testing of misalignment/phorias in about three minutes, while educating patients how contoured prism may help alleviate headaches, dizziness, dry eye sensation and/or photophobia.
Dark adaptation for age-related macular degeneration (AMD) diagnosis uses VR headsets, making it easier for patients and doctors by not requiring a separate dark room. VR devices that look like normal glasses are showing significant improvement in vision and functionality for patients with advanced AMD (Eyedaptic).
This fast-growing technology is already used in practical eyecare applications. One example mentioned earlier is Neurolens; the instrument has collected over 10 million data points and has transformed the information through AI to provide the exact phoria correction required with countered prism within minutes of measurement.
While VR headsets for VF testing mentioned above also incorporate AI, deep learning is going to be a common place for how primary eyecare doctors decide who to treat and who to refer in conditions ranging from glaucoma, diabetic macular edema, geographic atrophy, AMD and even dry eye. EHR systems and retinal imaging systems (e.g., AI optics) will use this information to spot high-risk diabetic retinopathy, glaucoma and AMD patients, so appropriate referrals can be made. Low-risk patients will continue to be monitored by their optometrist, and specialists will only receive those who need advanced treatments. This is also a model for efficiency (more on that below).
This will also be the year when efficiency is essential, as we come off of COVID-19 and experience staffing turnover like never before. I don’t just write these things; I live them. I see over 50 patients a day in my OSD clinic, thanks to an incredible staff and efficiency in every aspect of what we do. Examples include moving pre-testing to automated, higher resolution widefield imaging (Eidon), VR headsets for VF screening, rebound tonometers (iCare, Reichert), osmolarity in dry eye (TruKera Medical), streamline testing protocols and even EHR systems with significantly less clicks (Barti).
Patient education takes a significant portion of our time, but can be minimized with tools (Rendia) and/or slit lamp imaging (TelScreen). Technology itself solely serves to increase efficiency.
A new year is a wonderful time to begin implementing one or more of these ideas as these trends are not short-lived. Set your plans, get the team onboard and start making things happen.
Dr. Karpecki is medical director for Keplr Vision and the Dry Eye Institutes of Kentucky and Indiana. He is the Chief Clinical Editor for Review of Optometry and chair of the New Technologies & Treatments conferences. A fixture in optometric clinical education, he consults for a wide array of ophthalmic clients, including ones discussed in this article. Dr. Karpecki's full list of disclosures can be found here.