By: Paul M. Karpecki, OD, FAAO Clinical Director – PECAA

The medical eye care trend is definitely a friend to optometry as it may be ours to own and, to some extent, we are doing so. Online refraction however is a trend that is not our friend. What are our opportunities as PECAA doctors?

Let’s begin with online refraction. First we have to understand that this trend is firmly in place and I was told there are almost 200 companies out there that provide online or remote optical sales ranging from frames and spectacles to refraction.  So like whack-a-mole, it would be tough to knock one down without another popping up. So what is our best course of action?

First we have to always continue to look at what is best for patients. I don’t believe that an online refraction or remote refraction is in the best interest of patients. Too many patients may perceive this as a full eye exam because they completed the refraction step.  But this is just one step of many that could not only save a patient’s eyes, but their lives.  I have seen countless cases of a malignant choroidal melanoma in patients with 20/20 vision that would be missed with a remote refraction. It would be the same as going to a drug store, using the blood pressure device there and assuming you completed your cardiac health examination. We must educate patients about the hundreds of systemic diseases that we can determine through a patients eyes ranging from brain tumors to diabetes and hypercholesteremia. We cannot let the public lose vision or worse, lose their life because they thought they could do something online or remotely that failed to assess ocular and/or systemic health. Next we must be wary of companies that say they are working with optometry and at the same time are setting up remote refraction systems to compete with optometry. Finally, this trend may not be our friend but we need to understand patient needs, the lack of time people have and the desire for advanced technology. So there are companies that have found ways to enhance the refraction experience and efficiency in an optometry office including incredibly novel automated refraction systems like VMax, Visionix or Reichert. Vmax appears to have the most impressive technology with studies showing equal accuracy to a doctors refraction using voice automated technology, but the company is still focusing on optometry first. When advanced technology can enhance our efficiency, the patient experience and deliver what patients want today, we have to consider how best to participate.

At the same time, we need to be looking to areas where there is not 200 competing companies – the blue ocean so to speak – and this appears to be medical eye care. The trend is strong for the following areas of ocular disease; dry eye, AMD, glaucoma, management of diabetic retinopathy and cataract surgery comanagement. Each of these will double or more in the next decade. At the same time, the shortage of surgeons has left medical eye care open for the taking.  Here’s a trend that is definitely our friend.

So the saying of the trend is your friend, isn’t always true and we have to educate patients about risks to our patients eyes and lives and work to ensure they are protected. In cases where the trend is our friend, then those who embrace it will typically do better and enjoy the ride along the way.

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