‘Changing the face of how we practice’

How will technology change the profession for future doctors of optometry?  

Tareq Nabhan, O.D., an assistant clinical professor at the University of Missouri-St. Louis (UMSL) School of Optometry, is determined to help students prepare for the nature of that future. He is lead attending physician in the optometry department at Affinia Healthcare, where optometry students receive hands-on learning as they rotate through every eight weeks.  

Among those lessons? How emergent technology, including AI, will impact their practice of optometry. In addition to teaching at UMSL, Dr. Nabhan conducts research focused on developing hardware-software solutions to democratize eye care. AI, Dr. Nabhan says, can improve access to care for patients, including those with the greatest need. 

“I think there is significant value in knowing as much as we can about something that can change the face of how we practice,” says Dr. Nabhan, who spoke to AOA Focus about this moment in technology. 

At UMSL, how is technology integrated into the curriculum? 

We have the bread and butter any optometry school needs to deliver a quality clinical education: OCTs, fundus cameras, liquid lens visual fields, corneal topographers. In our “Intro to Optometry” course, I go into some emergent technology and briefly discuss AI, enough to let them know there is something there. There are tools leveraging artificial intelligence and they’re only getting better, becoming more portable and are being developed to detect multiple diseases.  

It’s what we do with our community partners that makes us a little different. We are developing teleretinal services (in partnership with Affinia Healthcare) at a federally qualified health center—and that would be UMSL’s first-ever teleretinal service. Affinia Healthcare has 15 locations, providing around 200,000 service encounters for approximately 48,000 unique patients a year. We provide on-site optometric services at one of their sites and have three fourth-year students who rotate through every eight weeks. We are on-site five days a week. Unfortunately, we see more advanced diseases, but, fortunately, we get to be part of the process to improve conditions. Our teleretinal service will connect us with patients in primary care settings at other Affinia sites. 

You also lecture on AI. What’s your message? 

I have a couple of lectures that include AI. One of them is about AI in general. I provide a foundational understanding of what it is, what is machine learning, what is image processing and computer vision; what’s happening between AI and health care, AI and automation, AI and gameplay.  

We want them to know it’s integrated into a lot of things we enjoy today. We then move into AI in eye care and evaluate the research and the actors in the space. I think it’s critical that we graduate students capable of navigating a new landscape. We need to prepare them to thoughtfully influence decisions exploring AI solutions in optometric care. 

Why is learning about this technology so significant for optometry students? 

I don’t know exactly how a transmission works. But I have a basic idea that allows me to know what a vehicle can and can’t do. If AI is driving my car, I need to know how effective it is and what it can’t do. I want to know a lot about it because my existence and that of my family and patients is in its hands. We’re at that moment in health care. Optometry is being very proactive about getting the people who know a little about AI—or maybe a lot about it—into the space to help figure out what this looks like in eye care. 

Your own story, in a sense, is a testimony to how technology or innovation can transform lives. How did being fitted with contact lenses as a teenager translate into a future career as an optometrist? 

I was always a patient of optometry. As a young person, my success rested significantly on the ability of my optometrist to help me see better. It allowed me to engage in things better.  

And when contact lenses were more of an option for me, it took my ability to engage in athletics (basketball, football, track and tennis) to levels that I couldn’t reach before because I was always getting my glasses broken. I got glasses in second grade and contact lenses in high school. 

How did that technology have a profound impact on you? 

Growing up, I always seemed to need a stronger prescription when I saw the optometrist and thought that, at some point, they wouldn’t be able to improve my vision and that I would go blind. It was my neighbor (an optometrist) in high school who read my demeanor. He said, ‘You know you’re not going blind, right? You just need stronger glasses, and it’s going to slow down and you’re going to see well.’  

The value provided by that moment, by a health care professional giving appropriate perspective, gave me the reassurance and confidence I needed to excel. Little things can mean a great deal when you’re growing up, trying to live to your full potential. I needed to give back to a profession that gave me so much. 

Read how Dr. Nabhan gave his students a glimpse of what it takes to participate in the profession by providing feedback on the AOA’s Policy Statement on Telemedicine in Optometry. You can still make a contribution to the update of the AOA’s groundbreaking and industry-leading Policy Statement on Telemedicine in Optometry. 

The deadline to submit comments for proposed changes to the statement has been extended to Nov. 1. Read the current statement and submit feedback online here.