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    Optometry in 2035. Does it exist?

    In 20 years, will optometry as we know it still exist?

    Eye health aside, any optometrist honest with herself will concede the primary purpose of an optometrist is to refract. Refraction, although definitely a skill, is at risk of extinction due to advances in technology. Although technology is a threat to many aspects of modern eyecare, and while one can argue about the timing/immediacy of such events (i.e. are we on the cusp of wholesale change now, or is the landscape going to largely be the same 10 years from now?), I consider refraction particularly susceptible to obsolescence in the continuum of facets of eyecare (which includes things like eye health assessments, appliances for seeing, and surgery).

    I consider visual/seeing appliances to eventually be at the mercy of technology as well, but I believe that era remains farther off. But when we have the world's most wealthiest corporations such as Google blurring the line between technology and every-day consumerism/physiology (e.g. Google Glass), and predicting that the human brain will be embedded with data chips by 2030 (while actively pursuing that goal), it's hard to see how human-performed refraction will continue to be a paid-for service in the future. Kiosks already exist for refraction today in the U.S., not to mention an iPhone app.

    How long do optometrists have? For those who will not be "retired" in 20 years, how much longer will the practice of optometry be able to sustain an optometrist's career? Will those early in their careers today have to eventually re-educate themselves and re-enter the workforce in another capacity?

    #2
    2035???

    I think it will evolve to be radically different by 2025. Your post is very interesting.
    Last edited by RIMLESS; 08-11-2015, 07:46 PM.
    90% of everything is crap...except for crap, because crap is 100% crap

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      #3
      What "radically different" changes are you predicting? What do you believe an optometrist will be doing in 2025?

      I chose a time horizon of 20 years over 10 years, because in 10 years, I believe refractive error will still be corrected by glasses. If refracting robots do eventually replace optometrists, this will take time and money. Time, for laws to catch up to modern technology, and money to put these robots into each refraction lane in the country, as they will not be free. In fact, this "robot-scenario" may never really happen, and if it does, may only be temporary. Thus, I don't think it's guaranteed we'll see such changes in 10 years, but 20 years is anyone's guess as there will be new non-3-O players involved. "Optical lenses" may very well not be the primary means for correcting refractive error by 2035 either, as corporate behemoths such as Google and Apple will probably be involved at that point, and they are all about providing technology to the masses (unlike ophthalmology, whose refractive interventions are prohibitively expensive for most, and will thus not be the primary reason why glasses become obsolete at any time in the foreseeable future).

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        #4
        I've heard this for 25+ years. Yes it will but it may not be exactly what it is today.
        Did anyone think ODs would be using OCTs or VFs in the late 80s?
        Careers evolve as do most things in life.

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          #5

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            #6
            From the site:

            What changes will we see in the next 20 years? Here is what I believe optometry care will encompass by the year 2035:
            1. Optometrists will largely separate into medical and refractive specialists.
            2. Optometry residencies focused on ocular disease will continue to further incorporate co-management with ophthalmology.
            3. 75% of all states will have certain laser (SLT, PI’s, yag etc) and injectable privileges.
            4. 5% of all states will have posterior segment laser privileges and intravitreal injections.
            5. A “medical school track” will be established to allow optometry graduates an opportunity to complete an ophthalmology residency without having to complete formal medical school training.
            6. Optometry and Ophthalmology will get along (for the most part). Ophthalmologists will still petition against all of the procedures listed above, but the two professions will work harmoniously to provide the best care for the patient.

            My predictions might be completely wrong, but I don’t think so. States with large rural populations will slowly jump on the bandwagon to reform optometry laws. The greatest resistance will come from states with large metropolitan areas where patients have easier access to ophthalmologists.


            Nothing in this author's opinion considers the role technology will play in vision. In fact, we could have his exact 2035 scenario TODAY through legislation alone.
            Last edited by optio; 08-12-2015, 09:05 AM.

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              #7
              Originally posted by David_Garza View Post
              Careers evolve as do most things in life.
              You're right, "careers" do "evolve" although mouthing platitudes doesn't mean optometry necessarily will. Some careers evolve better than others. Some careers don't evolve at all. Professional typewriter repairmen probably aren't doing too well today. That's the point of my OP.

              Apple and its iPhone has effectively put an end to all traditional low vision reading gadgetry, that just a few years ago, cost literally thousands of dollars more. I hardly believe those Sherlock-Holmes-magnifying-lens-makers have evolved into Apple Inc. technicians.

              You're right about OCTs and VFs but you're also wrong. Most ODs aren't using them as their patients can't afford them.

              Some ODs will be able to survive in a human-performed-refraction-free world, but will everyone?
              Last edited by optio; 08-12-2015, 09:38 AM.

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                #8
                Everything changes, I suppose, but I do not agree about a few things you said about refraction. In my mind, refraction is not just determining the best sphere, cylinder and axis. True, most people can be taught to do that, and even a dumb-phone can be programmed to do it.

                PRESCRIBING, on the other hand, is another matter. Certainly for a large majority of patients, simple myopes,... a quickie refraction might suffice, but there are many patients with anisometropia, latent hyperopia, muscle imbalances, medical issues affecting best acuity, that are quite problematic. Medical decision making skills are needed here.

                I think the State Boards of our professions will be fighting an uphill battle to stop these online refractions...just look at what is happening with online glasses and contacts. It seems we live in an age where the "rights" of the consumer outweigh public licensing laws and the concept of public protection.

                I don't see Optometry today as primarily a refracting profession. I have so many technological aids that help me to determine refractive information...it is more a matter of making the right decision as to what to prescribe based on all factors including the habitual Rx and symptomatology.

                Medical care is a BIG part of optometry today. Ophthalmological residencies are down across the country, those who do become OMDs tend to have more surgical practices. Optometrist numbers are increasing.

                So, will the delivery of refractive services and materials change over the next 20 years?...probably. Will the need for optometrists decrease?...not likely.

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                  #9
                  I think your perspective is still within the "refraction" box. I'm an optometrist so you don't have to tell me about the skill of refraction. I'm talking about changes that don't involve the current three-Os. For instance, everything about "prescribing" you describe above can be applied to selecting low vision reading aids. But all that training goes to the wayside, when you use an iPhone with a real-time magnifying glass app. So no, in terms of low vision reading aids, prescribing skill doesn't save the prescriber from advances in technology.

                  I'll mention there are already modern or contemporary challenges today that didn't exist before. Internet dispensing is one, but what about over-supply? There's more graduates coming out these days than 10 years ago, so supply/demand alone makes it harder for ODs to get by now, than before. Evolution is one thing, but supply and demand is another. If there's too much supply, salaries go down. Are we to blame new grads for their under-employment that they haven't been adept at evolving?

                  What I was referring to, however, to larger outside-the-scope changes. Google has been developing driverless technology to make roads safer. An Alberta mine is using this technology to drive its mine trucks.

                  Last week, Suncor signed an agreement to buy 175 driverless trucks for its Alberta operations - with plans to replace its entire fleet of heavy haulers by the end of the decade. Local union members fear major job losses. But industry expert Barrie Kirk says the trucks are here to stay.


                  Are those now-unemployed drivers supposed to evolve into public-transit drivers? There are already public transit drivers. Those people will simply be out of work. What was supposed to be an innocuous means of helping reduce traffic deaths will now bankrupt several hundreds of families.

                  At some point, Google will invent a contact lens that you put in your eye that will allow you to get a real-time Iron Man virtual-reality interface, that is independent of optometric refraction. I think that's in play for 20 years from now. Things like that are the game changers I'm talking about that will make optometric refraction obsolete.

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                    #10
                    I'm going to mention that the point of this thread isn't to try to prognosticate WHAT will replace glasses/optometrists, but that my position is human-performed refraction will end within a generation. Current IT specialists estimate by 2050, artificial intelligence will have reached a point that we will be able to have relationships and marry robots. I believe if a robot is capable of fornication, it will be capable of refraction. That's 35 years from now. I didn't want to discuss 2050 because that's probably going to be mostly irrelevant to most of us. I didn't want to discuss 10 years from now either, cause the point wasn't to get into whether humans can or should be replaced by autorefractors. Although I guess I can address that now briefly.

                    Non-human (auto) refraction already exists. In the US, some OD is marketing a system that is an auto-refraction signed off by an OMD, and it's apparently already legal in some 20+ states.



                    If we expand the scope to outside North America, optometry in fact doesn't even exist in many countries. Glasses are prescribed by autorefractors or eyeglass-peddlers (refractionists?), so the non-optometrist paradigm already exists in the world today. Legislation is responsible for the existence of optometry in North America.

                    At some point, people won't pay $95 to have a human do a refraction on them because they'll be able to get a reliable refraction done somewhere else for less. Go to some other countries (Japan, France) where refraction is treated like the measuring of feet to size shoes, and hell-no they won't pay for a refraction (so optometrists in France are "unemployed" in that they don't even exist there). Any advances in 3-O technology will inevitably protect ophthalmologists more than optometrists. As an aside, it's not as though medicine is completely immune to tech either. If my understanding is correct, there is now not enough work to go around for cardiac surgeons because of the advances in stent technology. "Non-surgical" heart-docs who do get their training through internal medicine channels - these folks are called cardiologists (as opposed to surgeons), are able to apply stents very uninvasively. So gone are the days where every blocked artery required a cardiac surgeon to open a guy's chest to do a bypass. Again, I'm not a heart guy, so pardon any inaccuracies.

                    But the point is, refraction at it's most basic form, is an algorithm. A computer can be taught to apply an algorithm. And even if there's still some residual "human-experience" component, it's not as though it is infallible either. We all know of a local optometrist who gets paid to routinely prescribe less-than stellar Rxs for his patients. In that case, a smart computer may in fact be able to do the job better, and soon enough, for less. So no, human refraction isn't necessarily always going to be better than a robot.

                    The current paradigm has companies like Luxottica and Zeiss as king. If it remains that way, then perhaps optometry very well may be able to sustain itself going forward. However, this will not last forever. Google and Apple combined have what, 10,000X the market capitalization of Luxottica? If they get involved, things will change fast. They not only have the wealth, but the talent to to change the game. Is ANYONE at Luxottica even intelligent enough to be hired to work at Google? Chances are, no. And they are working on the visual experience. There's already Google Glass. Even if it isn't Google, or Apple, this isn't the point. There will be a game changer within our lifetimes that makes human performed refraction obsolete, whether due to robots, or a new refractive "solution", and it will come from outside the 3-Os. At that point, optometrists won't necessarily go obsolete, but there will be a much reduced need for them.

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                      #11
                      Originally posted by David_Garza View Post
                      I've heard this for 25+ years.
                      I'll mention that this is impossible as Google was founded in 1998. If you think there'll be optometrists toting around phoroptors in 2035, then we'll just agree to disagree.

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                        #12
                        I guess you'll just have to carry on a discussion with yourself.....

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                          #13
                          Originally posted by fjpod View Post
                          I guess you'll just have to carry on a discussion with yourself.....
                          Actually I was done until you replied. Your point?

                          Also 700 views in just a couple days. It seems there's a lot of folks interested in reading what I have to say. Including yourself. Thanks for perusing this thread.
                          Last edited by optio; 08-14-2015, 08:30 AM.

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                            #14
                            Essilor and Luxottica who now definitely have entered the direct to consumer market.

                            I am always wondering that new developments in any field are given only interest on what is happening on this continent instead of looking at a world wide situation.

                            The North American continent has become the play and testing ground for the 2 biggest players world wide in the optical manufacturing field, namely Essilor and Luxottica who now definitely have entered the direct to consumer market.

                            Eye care training develops livelihoods in rural India -
                            "Thanks to a new public private partnership agreement recently signed in Rajasthan, 4,000 youths are expected to be trained over the next three years in that state alone. “Since the beginning of the year we have equipped 70,000 new wearers, with EMO responsible for putting glasses on the faces of over a third of those wearers,” explained Saugata Banjeree, Head of 2.5 NVG India, “We have now partnered with several local skills and livelihood development agencies to roll out the training of EMO.”

                            - See more at: http://www.essilorseechange.com/deve....7370ZEaf.dpuf

                            Knowledge share is a two way street in India
                            In January, Essilor organised its first Eye Mitra annual convention for local entrepreneurs. Weeks later, the Group’s Advanced Management Program brought in 33 senior staff from 12 countries to learn about developing markets on the ground at Indian rural eye clinics.


                            “There is no age limit for learning new things. I successfully completed my training and am now doing well and conducting vision screening camps regularly,” said Mr Nand Kishore, a previously unemployed 57 year-old at the Eye Mitra (“Friend of the Eyes” in Hindi) Convention.
                            One of the first wave of Essilor trainees, he has acquired the skills and knowledge to become a “friend of the eyes” in his local community, and given a starter-kit to help set up his new business. He was one of around 100 individuals at the convention near Delhi. Many had travelled long distances to swap ideas with their fellow Eye Mitras and interact with Essilor managers.


                            - See more at: http://www.essilorseechange.com/know....MFiTAxLa.dpuf



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                              #15
                              Originally posted by fjpod View Post
                              I guess you'll just have to carry on a discussion with yourself.....

                              I just noticed that you are the same person who replied above. It didn't occur to me when I replied to your post (my last post above). My apologies. I thought you were some outside observer posting a "troll" post with nothing better to say. Given you had already replied with your opinions above, that totally changes the context.

                              I think everything you have posted here is reasonable, even your last remark.

                              Anyhoos - 25 years ago, we weren't in the digital age yet. 25 years from now, we'll almost be 50 years into the digital age. EVERYONE in this thread has referred to inevitable changes/evolution of our profession. If so, why is there resistance to the idea that some of these changes may be bad for practicing optometrists? I won't post again unless prompted.

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