Technological advancements continue to transform the way we approach and address clinical research in optometry and ophthalmology. Our sight stands as one of humanity’s most vital senses. It serves as our window to the world, shaping our experiences, interactions, and understanding of our surroundings. Yet, despite its significance, billions of people globally live with some form of vision impairment, many of which could have been prevented or mitigated with timely care and attention to eye health.
The World Health Organization (WHO) estimates that nearly 2.2 billion individuals globally live with some form of vision impairment, in which 1 billion of cases could have been prevented or have yet to be addressed. According to the WHO reports, only 17% to 36% of patients with vision impairment due to refractive errors or cataracts have adequate access to appropriate eye care. Recognizing the significant burden of ophthalmology diseases, the World Council of Optometry (WCO) is on a mission to ensure eye care becomes a fundamental human right. Various stakeholders, from optometry and ophthalmology clinicians to eye research sponsors and contract research organizations (CROs), make valuable contributions to vision care and eye health around the world.
In recognition of these professionals and their work, the WCO invites patients and eye care providers to celebrate World Optometry Week and Day from March 17-23. In honor of the WCO’s theme for 2024, “Advancing Optometry’s Commitment to Global Eye Care,” this article will explore the top five technological advancements in optometry driving improvements in eye care.
1. Optical Coherence Tomography (OCT) in Ophthalmology
Optical coherence tomography (OCT), also known as optical retinal biopsy, has revolutionized optometry by becoming a crucial diagnostic tool for detecting and treating various eye diseases, including glaucoma, macular degeneration, and diabetic retinopathy. OCT is a convenient, non-invasive, and painless procedure for patients to undergo because it uses safe laser light to take highly detailed cross-sectional images of 18 zones of the retina. By mapping out the eye in this manner, optometrists can detect subtle changes in the retina to determine the severity and stage of disease, track disease progression, and compare images after examination with documented results. Therefore, the development of OCT has allowed eye conditions to be diagnosed much earlier than with traditional methods, enabling earlier intervention and improved patient outcomes.
2. Virtual Reality (VR) in Optometry
Although certainly not a new concept, the use of virtual reality (VR) in optometry and eye research has evolved significantly over recent decades. Today, VR technology is considerably more accessible and affordable, increasing its potential for applications within ophthalmology. For example, in the clinical space, inexpensive portable VR devices can be used for home-based monitoring of disease progression for conditions like glaucoma or amblyopia, similar to how Holter monitor wearables are used by cardiologists to track cardiac arrhythmias. Transmissions from these VR devices can inform the eye care team about necessary follow-up appointments or required changes to treatments. The real-time data collection enabled by portable VR technology not only enables earlier detection of disease progression but also presents opportunities in an ophthalmology sponsor’s or CRO’s clinical trials to aid in their eye research objectives. Furthermore, VR headsets can be used by ocular surgeons to enhance visualization during robotic surgeries by providing OCT-based interactive 3D images of eye anatomy. Although some challenges do exist, such as simulator sickness and privacy concerns with transmitted data, VR technology presents significant potential to transform all realms of eye care.
3. Tele-optometry: Telemedicine in Eye Care
The global health crisis caused by the COVID-19 pandemic created a unique opportunity for the advancement of telehealth across several medical fields and optometry is no exception. The widespread emergence of convenient remote communication software has led to a significant surge in the utilization of tele-optometry in the eye care sector. Prior to the pandemic, less than 25% of eye care patients were aware of telemedicine as an option; however, as the pandemic persisted, the frequency of virtual visits with optometry and ophthalmology professionals has increased by anywhere from 257% to 700%. Tele-optometry provides a feasible solution for triage, screening, consultation, and remote supervision, particularly for patients with diabetic retinopathy. The sustained growth of tele-optometry has continued even post-pandemic because it ensures continuity of care, especially for vulnerable populations such as the elderly, individuals with disabilities, and those living in medically underserved areas. Telehealth effectively reduces travel time and cost, breaking down accessibility barriers for at-risk patients requiring eye care services.
4. Automated Refraction Systems for Effective Vision Testing
Automated refraction systems are computerized devices that measure a person’s refractive error to determine the corrective lenses best suited to improve their vision. For nearly 200 years, the refractive error was assessed with a manual, time-consuming method that was subject to inaccuracies. Since their introduction nearly 30 years ago, these systems have taken the guesswork out of vision testing, offering a higher degree of precision compared to traditional manual methods, and leading to more accurate prescriptions. Today, autorefractors are widely used by ophthalmic clinicians and eye care practitioners globally to assess refractive error, accommodation, and prescription and dispense of spectacles. They offer a highly repeatable, reliable, and accurate alternative to retinoscopy and are particularly useful in assessing children and determining astigmatism. A key advantage of this technology is that it can be operated by clinical ophthalmic assistants or mid-level ophthalmic personnel, thus increasing the range of settings in which patients can be assessed without the immediate need for an optometrist. Lastly, considering the efficiency these devices introduce to eye exams, automated refraction systems reduce the in-clinic time required from patients, while increasing the number of individuals optometrists can evaluate in a day
5. Artificial Intelligence (AI) in Optometry
In the past decade alone, applications of artificial intelligence (AI) and deep learning (DL) in optometry have expanded considerably to assist with disease screening, management, and patient triage. AI systems like IDx-DR and EyeArt have already received approval from the United States Food and Drug Administration to be used in diabetic retinopathy screening. With their applications in complex retinal image analysis, AI algorithms present opportunities to streamline the detection and management of several eye diseases, including glaucoma, keratoconus, and cataracts. For example, optometry and ophthalmology professionals heavily rely on high-resolution images captured in patients with valuable anatomical and functional information to guide clinical decisions. However, interpreting this data can sometimes be challenging due to sheer volume; to address this, AI systems can be trained to extract and classify these datasets, thus reducing diagnostic errors and improving the treatment of ocular conditions. DL tools can also be applied in teleophthalmology consultations to detect, diagnose, and control visual impairment in patients within a primary care or community setting, particularly for vulnerable populations who commonly face accessibility issues when seeking eye care.
In conclusion, these five advancements in technology have had a transformative impact on optometry, enhancing the accuracy of eye examinations, revolutionizing treatment options, and making eye care more accessible. They have not only improved the quality of care but have also redefined the patient experience, making eye care and eye research processes more patient-centric. As technological innovation continues to evolve, the field of optometry can expect to see even more exciting developments that have the potential to promise better eye care outcomes for patients in the future.
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